The carbon emission trading policy is a key policy for China to achieve its dual carbon goals.This paper aims to examine the emission-reduction effects,transmission mechanisms,and carbon-market efficiency of China’s ...The carbon emission trading policy is a key policy for China to achieve its dual carbon goals.This paper aims to examine the emission-reduction effects,transmission mechanisms,and carbon-market efficiency of China’s carbon-emission trading policy from 2012 to 2023.We adopt the difference-in-differences(DID)model to analyze the effects of policy on emissions,and the empirical results from the DID model confirm that the pilot carbon emission trading policy has significantly reduced carbon emission intensity in pilot areas.Then we use the mediation model to study the transmission mechanism of the pilot carbon emission trading policy,and the mediation analysis demonstrates that the pilot carbon emission trading policy achieves emission abatement through four parallel transmission channels:scientific innovation,energy conservation,clean energy substitution,and industrial structure upgrading.Data envelopment analysis evaluates the carbon market efficiency of China.The result shows that the average carbon market efficiency of pilot areas has improved steadily,particularly from 2012 to 2023,especially in Beijing,Hubei,and Guangdong.Moreover,the efficiency of the national carbon market has shown an upward trend since its 2021 launch;it remains lower than the pilot average,constrained primarily by limited sectoral coverage,which impacts scale efficiency.展开更多
BACKGROUND Gastric cancer is a major global health issue,and the perioperative period critic-ally influences patient outcomes.The different effects of sevoflurane inhalation anesthesia and propofol total intravenous a...BACKGROUND Gastric cancer is a major global health issue,and the perioperative period critic-ally influences patient outcomes.The different effects of sevoflurane inhalation anesthesia and propofol total intravenous anesthesia on intraoperative stability,postoperative complications,and long-term oncologic outcomes in patients with gastric cancer undergoing radical gastrectomy remain unclear.AIM To compare the effects of sevoflurane inhalation anesthesia and propofol total in-travenous anesthesia on clinical outcomes,including intraoperative indicators,postoperative complications,adverse effects,pain scores,and survival.METHODS This single-center retrospective cohort study included 204 patients who underw-ent radical gastrectomy for gastric cancer from February 2019 to December 2022.Patients were assigned to either the sevoflurane group(n=103)or the propofol group(n=101)based on intraoperative anesthetic regimen.Standardized protoc-ols for anesthesia management,intraoperative monitoring,and postoperative analgesia were applied.Baseline characteristics;intraoperative metrics;adverse events;complications;Visual Analog Scale(VAS)scores at 2,4,6,24,and 48 hours;and survival outcomes were retrospectively collected.Group comparisons were performed usingχ2 for categorical variables,t test for continuous variables,RESULTS Baseline demographic and clinical characteristics were similar between groups.No significant differences were observed in intraoperative indicators or most 30-day postoperative outcomes,including length of stay,emergency department visits,and readmission rates.The propofol group showed elevated mean VAS pain score at 24 hours postoperatively,but no differences were found at other time points.The propofol group also had significantly higher postoperative nausea incidence and transiently higher systolic/diastolic blood pressure and heart rate at the time of incision than the sevoflurane group.No significant differences were seen in overall rates or severity of postoperative complications,intraoperative adverse events,or in overall survival and progression-free survival.CONCLUSION In patients undergoing radical gastrectomy for gastric cancer,sevoflurane and propofol anesthesia demonstrated similar profiles regarding intraoperative safety,postoperative complications,adverse events,postoperative pain,and long-term survival.The selection of anesthesia can be personalized without significantly affecting periop-erative or oncologic outcomes.展开更多
National essential medicine policy （NEMP） is an important part of new health care reform and core content of national drug policy. We chose Hebei province as a case to study, utilized standard methods from WHO/HAl a...National essential medicine policy （NEMP） is an important part of new health care reform and core content of national drug policy. We chose Hebei province as a case to study, utilized standard methods from WHO/HAl and built interrupted time series （ITS） model to qualitatively and quantitatively evaluate the effects of NEMP in Hebei province from the utilization of essential medicines. Shortly after implementing EMP, the purchasing and utilization rate of essential medicines significantly increased, but no further continuous effects. In order to perfect the essential medicine policy, training of rational drug utilization should be strengthened, hierarchical essential medicine list and dynamic monitoring on the effect of NEMP are necessary.展开更多
The addition of municipal solid wastes （MSW） is considered as a possible strategy for soil rehabilitation in southeast Spain. The objective of this study was to evaluate the long-term （17 years） effect of five dos...The addition of municipal solid wastes （MSW） is considered as a possible strategy for soil rehabilitation in southeast Spain. The objective of this study was to evaluate the long-term （17 years） effect of five doses of MSW addition on the microbiological, biochemical, and physical properties of semiarid soil. Increased values of several parameters that serve as indicators of general microbiological activity, such as, basal respiration, adenosine triphosphate （ATP） or dehydrogenase activity; microbial population size （microbial biomass C）, and extracellular hydrolase activity related to macronutrient cycles, such as, urease, 3-glucosidase, and N-a-benzoyl-L-argininamide protease, were observed in the amended soils. The highest MSW doses showed the highest values in these hydrolase activities. The incorporation of municipal waste resulted in a more dense development of the plant cover, 50% greater in higher doses than in the control treatment, which generated a substantial increase in several C fractions. Total organic carbon reached 12 g kg^-1 soil with the highest MSW doses, compared to 4.30 g kg^-1 soil in the control treatment. The physical properties of the soil were also improved, showing greater percentage of stable aggregates and water holding capacity. Positive correlation coefficients between C fractions and parameters related to microbial activity and aggregate stability were observed. Although these improvements were greater in the soils receiving the highest doses of organic amendment, the increases were not proportional to the amount added, demonstrating the existence of a threshold, above which an increase in the amount of organic matter added is not reflected in an increase in the soil＇s physical, biochemical, and microbiological properties. However, the addition of municipal solid wastes proved its suitability for improving soil quality, thereby indicating the potential of such an amendment, to prevent desertification in Mediterranean areas such as those studied.展开更多
AIM:To evaluate the long-term effect of foldable capsular vitreous body(FCVB)in the treatment of severe ocular rupture to provide a practical basis for clinical selection.METHODS:A total of 26 patients(26 eyes),23 men...AIM:To evaluate the long-term effect of foldable capsular vitreous body(FCVB)in the treatment of severe ocular rupture to provide a practical basis for clinical selection.METHODS:A total of 26 patients(26 eyes),23 men and 3 women,with severe ocular rupture who underwent FCVB implantation between March 2018 and September 2018 were retrospectively analysed.All open ocular wounds located in zone III,with preoperative visual acuity grade IV and above(Snellen less than 4/200).The best corrected visual acuity(BCVA),intraocular pressure(IOP),cornea,anterior chamber,iris,lens,choroid,and retina were evaluated before and after the surgery.The subjective feeling and the location of FCVB were also assessed.RESULTS:The average age of the 26 patients was 36y(20-60y).Postoperative follow-up was from 10 to 14mo.At the end of follow up,BCVA was light perception(LP)in 10 cases,no light perception(NLP)in 13 cases,hand motions(HM)in 3 cases.IOP was 11±5 mm Hg.Corneal degeneration was in 3 cases and corneal endothelial dystrophy was in 7 cases.Shallow anterior chamber was in 8 cases and hyphema was in 8 cases.Organized membrane in the pupil was in 14 cases.Epiphora occurred in 3 cases.FCVB drainage tube exposed in 3 cases.All FCVBs were in their normal location and no rejection occurred.CONCLUSION:FCVB implantation is a long-term effective treatment and may provide a practical selection for severe ocular rupture.展开更多
Agents response equilibrium (ARE) model has been taken advantage of to build a multi-agent system for analyzing fiscal policy effect. Through establishing various types of economic entities and endowing them with abil...Agents response equilibrium (ARE) model has been taken advantage of to build a multi-agent system for analyzing fiscal policy effect. Through establishing various types of economic entities and endowing them with abilities to react and make decision, the whole system will evolve to new conditions in response to policy change. Compared with different scenarios, it can be concluded that when raising taxation ratio, sectoral scale will shrink to some extent. But supported by government expenditure, certain sectors could be kept in comparatively larger production scale.展开更多
Measuring bullwhip effect is useful for making better controls on production planning and enhancing the supply chain operating efficiency.First,this article establishes the comparative analysis model of bullwhip effec...Measuring bullwhip effect is useful for making better controls on production planning and enhancing the supply chain operating efficiency.First,this article establishes the comparative analysis model of bullwhip effect between(s,S)and Periodic Review(PR)inventory policy based on the quantitative bullwhip effect model under different inventories.Then,the impacts of lead time,inventory review time,autocorrelation coefficient,and the number of samples on the gap of bullwhip effect under(s,S)and PR IP are analyzed.The results show that bullwhip effect in PR is more intense than(s,S)inventory policy.Contractors should pay more attention to control bullwhip effect when adopting PR inventory policy to enhance the total operating efficiency of the engineering project supply chains.展开更多
Insufficient assessment of emission reduction effects still exists in the carbon emission rights trading system,a major environmental regulation measure in China.Based on the data from the carbon trading pilot coverin...Insufficient assessment of emission reduction effects still exists in the carbon emission rights trading system,a major environmental regulation measure in China.Based on the data from the carbon trading pilot covering the years from 2007 to 2017,this study combined the synthetic control method with dynamic spatial Durbin model to comprehensively evaluate the spatial emission reduction effects of carbon trading policies.The results showed that:①The carbon trading policies promoted carbon emission reductions in the pilot regions,among which Tianjin and Hubei responded significantly,and also helped to suppress carbon emissions in the neighboring areas.②Long-term emission reduction effect from carbon emissions trading became gradually significant,while the indirect emission reduction effect was relatively weaker.③In term of reducing carbon emissions,the economic development channel played a key role,but it had a threat to the promotion of carbon emissions in the surrounding areas.Energy consumption was the main obstacle to the growth of carbon emissions.④In the long run,technological progress tended to become the key to the effective implementation of potential emission reduction effects of carbon trading policies.Based on the above findings,we suggest that the construction of a national carbon trading market should be promoted,the balanced development and orderly advancement of regional carbon trading markets should be paid attention to,the coordinated development of green economy as well as knowledge and technology exchange and cooperation among regions should be strengthened to form a low carbon development model among regions.展开更多
Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can...Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can predispose to a number of pathological changes and clinical diseases,including diabetes;hypertension;atherosclerosis;coronary artery disease and stroke;obstructive sleep apnea;depression;weight-related arthropathies and endometrial and breast cancer.A body weight 20%above ideal for age,gender and height is a severe health risk.Bariatric surgery is a set of surgical methods to treat morbid obesity when other treatments such as diet,increased physical activity,behavioral changes and drugs have failed.The two most common procedures currently used are sleeve gastrectomy and gastric bypass.This procedure has gained popularity recently and is generally considered safe and effective.Although current data show that perioperative mortality is low and better control of comorbidities and short-term complications is achieved,more randomized trials are needed to evaluate the long-term outcomes of bariatric procedures.This review aims to synthesize and summarize the growing evidence on the long-term effectiveness,outcomes and complications of bariatric surgery.展开更多
Introduction: The incidence and severity of Clostridium difficile infection (CDI) has been increasing and long-term care facility (LTCF) residents are at high risk given their age, co-morbidities, and high antibiotic ...Introduction: The incidence and severity of Clostridium difficile infection (CDI) has been increasing and long-term care facility (LTCF) residents are at high risk given their age, co-morbidities, and high antibiotic exposure. Infection control policies are crucial for controlling CDI, but there are currently no regulatory guidelines in the United States. Therefore, we evaluated infection control policies in local LTCFs to define the CDI-specific policies and the administrative and staff understanding of CDI, so as to identify perceived barriers for compliance. Methods: IRB approval was sought and exemption granted, all 8 local LTCFs were asked to participate. Each facility was visited by study personnel who interviewed the administrative Infection Control Practitioner (ICP) and 3-4 Licensed Practical Nurses (LPNs) with distinct survey format. Infection control policies were then compared to the SHEA recommendations for CDI in LTCFs. Results: Of the eligible facilities, 75% (n = 6) participated. ICP (n = 6) and LPNs (n = 21) were interviewed. All facilities accept residents with active CDI and 2 had written CDI-specific infection control policies. All facilities had hand hygiene or glove use policies and 2 had policies for the use of sporicidal environmental cleaning. No facility restricted antibiotic use. Each facility has a policy to instruct their staff through in-services, either annually or upon new hire, but 33% (n = 7) LPNs reported no facility-based CDI training. While 80% (n = 17) of LPNs felt comfortable with the facility CDI policies, only 11 accurately restated it. ICPs felt the most relevant barrier to staff compliance was time constraints (n = 4, 67%), however, LPNs felt it was limited knowledge (n = 10, 48%) and poor communication (n = 2, 10%). Discussion and Conclusions: With the increasing incidence and severity of CDI in LCTF, few of the facilities surveyed had CDI-specific policies. Despite CDI-specific training, there is a perceived knowledge and communication gap for staff caring for residents with CDI.展开更多
Empirical research has shown that there were international spillover effects from the U.S. monetary policy to output level, net exports and price levels of each country, and the impact on prices in each country was of...Empirical research has shown that there were international spillover effects from the U.S. monetary policy to output level, net exports and price levels of each country, and the impact on prices in each country was of synchronous effect. The structural impulse response analysis showed that U.S. monetary policy could improve U.S. income and payment without damaging U.S. economic growth, but the shocks negatively affected the economic growth in the rest of the world. Hence, it's important to pay close attention to the moral risks of U.S. monetary policy to evade the global shocks caused by the "benefit-itself-at-the-expense-of-others" polices of the American government. Besides these findings, U.S. monetary policy shocks strongly affect China's trade surplus fluctuations. Based on this, we propose that the approaches of balancing China's current account could be explored efficiently from the perspective of monetary policy.展开更多
Background： Allergic rhinitis（AR） is defined as an immunoglobulin led atopic disorder that affects the nasal mucosa. Moxibustion on herbs, a common complementary and alternative medicine approach, is frequently use...Background： Allergic rhinitis（AR） is defined as an immunoglobulin led atopic disorder that affects the nasal mucosa. Moxibustion on herbs, a common complementary and alternative medicine approach, is frequently used for treating AR in clinical practice. Western medicine is good at quick symptomatic relief,while offer little or no sustainable and steady long-term effect. Little established evidence is available to support the long-term effectiveness of moxibustion on herbs for AR.Objective： This study is a randomized controlled trial to assess the long-term effectiveness of moxibustion on herbs in moderate-severe persistent AR population.Methods： The study sample size is 56 patients. Eligible patients with moderate-severe persistent AR will be randomized into a moxibustion on herbs combined with conventional treatment group（MOHCT group） and a conventional treatment group（CT group） in a 1：1 ratio. Patients in the MOHCT group will receive a 30-min moxibustion on herbs treatment on Zhiyang（至阳 GV 9）, Dàzhuī（大椎 GV 14） and bilateral Shenshu（肾俞 BL 23）, Fèishū（肺俞 BL 13） for a total of 12 times on the basis of conventional treatment, while those in the CT group will receive conventional treatment alone. The primary outcome measure is VAS score for total nasal symptoms, which will be obtained via a self-recorded AR diary. The secondary outcome measures include the average occurrence of symptoms per week, use of medication and Rhinoconjunctivitis Quality of Life Questionnaire（RQLQ）.Discussion： The objectives of this study include（1） to evaluate the long-term effectiveness and safety of moxibustion on herbs for treating AR;（2） to evaluate whether moxibustion on herbs can reduce the frequency of AR symptoms in patients with moderate-severe persistent allergic rhinitis. The finding of this study will provide evidence on the long-term effectiveness of moxibustion on herbs for moderatesevere persistent AR.展开更多
Objective: To observe the long-term effect of homoharringtonine (HHT) on chronic granulocytic leukemia (CGL) and its pharmacological mechanism. Methods: 76 patients with newly diagnosed early chronic phase CGL receive...Objective: To observe the long-term effect of homoharringtonine (HHT) on chronic granulocytic leukemia (CGL) and its pharmacological mechanism. Methods: 76 patients with newly diagnosed early chronic phase CGL received treatment of merely 1.5 mg/m2 daily HHT for induction remission and long-term maintenance treatment. The apoptosis rate of bone marrow CD34+ cells induced by HHT was assayed with flow cytometer. Results: 86.8% patients achieved CHR, 13.2% patients PHR and 31.8% patients got cytogenetic response in HHT treatment group, which was longer than 31 (8-54) months in hydroxyurea (HU) group (P<0.05). The effect of apoptosis induction HHT was stronger on CGL-CP patients bone marrow CD34+ cells than on normal person bone marrow CD34+ cells. Conclusion: HHT is a very effective drug for remission induction and long-term maintenance treatment in early chronic phase CGL patients.展开更多
Paraquat is a broad-spectrum herbicide known to produce lung injury via oxidative stress-mediated mechanisms. Different pharmacological strategies have been explored to reduce the formation of these reactive oxygen sp...Paraquat is a broad-spectrum herbicide known to produce lung injury via oxidative stress-mediated mechanisms. Different pharmacological strategies have been explored to reduce the formation of these reactive oxygen species and/or prevent their toxic effects in the treatment of paraquat poisoning. The present study was carried out to investigate whether the antioxidant (L-tocopherol, incorporated into liposomes and delivered directly to the lungs of rats, could protect the organ against the long-term toxic effects of paraquat.Plain liposomes (composed of dipalmitoylphosphatidylcholine, DPPC) or α-tocopherol liposomes (8 mg α-tocopherol/kg body weight) were administered intratracheally to animals 24 h prior to an intraperitoneal injection of paraquat dichloride (20 mg/kg) and rats wefe killed 0, 1, 4, 6, 8, 10, 12, 16, 19 or 24 days after paraquat treatment. Results of this study showed that lungs of animals treated with paraquat were extensively damaged,as evidenced by significant increases in lung weight and decreases in lung angiotensin converting enzyme (ACE) and alkaline phosphatase enzyme (AKP) activities. Moreover,paraquat treatme; resulted in a significant reduction in the number of neutrophils in the blood of rats with a concurrent increase in the pulmonary myeloperoxidase activity,suggestive of neutrophil infiltration in the lungs of treated animals. Pretreatment of rats with liposomes alone did not significantly alter the paraquat-induced changes of all parameters examined. On the other hand, pretreatment of rats with (t-tocopherol liposomes,24 h prior to paraquat challenge, attenuated paraquat-induced changes in ACE, AKP and myeloperoxidase activities but failed to prevent increases in lung weight. Thus, pretreatment of rats with liposome-associated α-tocopherol appears to protect the lung against some of the toxic effects of paraquat展开更多
We examine momentum and contrarian effects in China＇s stock market during 1994-2004 and find that no medium momentum effects exist. Meanwhile, contrarian strategy works effectively over the horizon of 18-36 months. 1...We examine momentum and contrarian effects in China＇s stock market during 1994-2004 and find that no medium momentum effects exist. Meanwhile, contrarian strategy works effectively over the horizon of 18-36 months. 1-month gap for avoiding bid-ask bounce and lead-lag effect make no considerable change to our empirical results. Transaction costs seem to have no significant impact on contrarian strategies＇ profit.展开更多
The market development and policy matching of existing building energy-saving retrofits determine the effectiveness of policies in promoting the operation of existing building energy-saving retrofit market.Based on th...The market development and policy matching of existing building energy-saving retrofits determine the effectiveness of policies in promoting the operation of existing building energy-saving retrofit market.Based on the perspective of market development to evaluate the effectiveness of existing building energy-saving transformation policy,it is necessary to clarify the basic connotation of the effectiveness of existing building energy-saving transformation policy,systematically analyze the evaluation content,construct a multi-level evaluation index system,and select scientific and effective quantitative evaluation methods to implement a strict evaluation process.展开更多
The government audit authority has the necessity and feasibility to carry out the audit of the implementation effect of economic policies.The evaluating index system for the audit of the implementation effect of econo...The government audit authority has the necessity and feasibility to carry out the audit of the implementation effect of economic policies.The evaluating index system for the audit of the implementation effect of economic policies includes the legality,scientificity,rationality,applicability,operability and performance of the economic policy.Since at present this kind of audit is still a new area,we shall quicken the steps of theoretical researches for the audit of the implementation effect of economic policies,innovate the auditing procedures and methods,improve the construction of the related system of laws and regulations and the teams of auditing professionals,and give full play to the"immune system"function of the government audit.展开更多
Background： The rapid growth of type 2 diabetes mellitus （T2DM） remains a big challenge for clinicians worldwide.Traditional Chinese medicine may bring a new approach for solving this problem. The Tianqi Capsule Di...Background： The rapid growth of type 2 diabetes mellitus （T2DM） remains a big challenge for clinicians worldwide.Traditional Chinese medicine may bring a new approach for solving this problem. The Tianqi Capsule DiabetesPrevention Study （REDUCES Study） reported that 1 years of therapy with Tianqi capsule reduced the risk of diabetes by32.1% compared with the placebo. Here we aimed to assess the long-term effect of Tianqi capsule on prevention ofT2DM in people with impaired glucose tolerance after discontinuation of active intervention. Methods/design： 420subjects will be followed-up for 8 years to assess the long-term effect of Tianqi capsule intervention. The causes of deathand the status of living subjects will be investigated. Follow-up data for living subjects will be collected by personalinterview and clinical examination and medical record review to determine diabetes status. Questionnaires will be givento all the subjects to investigate the factors that probably affect the diabetes status during the 8-year of discontinuation ofintervention. The primary outcome is the incidence of T2DM, and the secondary outcomes are body mass index, bloodglucose, blood lipids and blood pressure. The Cox proportional hazards model will be used to estimate the hazard ratiofor diabetes incidence. Analyses will be done with SAS 8.2 software package. Discussion： Results from this study mayprovide evidence for the long-term efficacy of Tianqi capsule in patients with prediabetes. The findings will provide abasis for further confirmatory studies. Ethics： The protocol has been approved by the Medical Ethics Committee ofGuang’anmen Hospital of China Academy of Chinese Medical Sciences （approval number 2016-046-KY-01）. Studyregistration number： ClinicalTrials.gov; NCT02848053.展开更多
This paper aims at improving the employmentpromoting effects of employment service policies(ESP) to enhance family development. Based on process evaluation methods of public policy, there are three positive effects of...This paper aims at improving the employmentpromoting effects of employment service policies(ESP) to enhance family development. Based on process evaluation methods of public policy, there are three positive effects of ESP, but despite these effects we cannot overrate the performance of ESP. The problem is the double segmentation between urban and rural areas as well as among different regions, the poor basic fund, and the deviation of positioned policy support objects. Hence, China should regulate ESP as soon as possible to benefit family development.展开更多
基金supported by the National Social Science Fund of China under Grant 25CJL064.
文摘The carbon emission trading policy is a key policy for China to achieve its dual carbon goals.This paper aims to examine the emission-reduction effects,transmission mechanisms,and carbon-market efficiency of China’s carbon-emission trading policy from 2012 to 2023.We adopt the difference-in-differences(DID)model to analyze the effects of policy on emissions,and the empirical results from the DID model confirm that the pilot carbon emission trading policy has significantly reduced carbon emission intensity in pilot areas.Then we use the mediation model to study the transmission mechanism of the pilot carbon emission trading policy,and the mediation analysis demonstrates that the pilot carbon emission trading policy achieves emission abatement through four parallel transmission channels:scientific innovation,energy conservation,clean energy substitution,and industrial structure upgrading.Data envelopment analysis evaluates the carbon market efficiency of China.The result shows that the average carbon market efficiency of pilot areas has improved steadily,particularly from 2012 to 2023,especially in Beijing,Hubei,and Guangdong.Moreover,the efficiency of the national carbon market has shown an upward trend since its 2021 launch;it remains lower than the pilot average,constrained primarily by limited sectoral coverage,which impacts scale efficiency.
文摘BACKGROUND Gastric cancer is a major global health issue,and the perioperative period critic-ally influences patient outcomes.The different effects of sevoflurane inhalation anesthesia and propofol total intravenous anesthesia on intraoperative stability,postoperative complications,and long-term oncologic outcomes in patients with gastric cancer undergoing radical gastrectomy remain unclear.AIM To compare the effects of sevoflurane inhalation anesthesia and propofol total in-travenous anesthesia on clinical outcomes,including intraoperative indicators,postoperative complications,adverse effects,pain scores,and survival.METHODS This single-center retrospective cohort study included 204 patients who underw-ent radical gastrectomy for gastric cancer from February 2019 to December 2022.Patients were assigned to either the sevoflurane group(n=103)or the propofol group(n=101)based on intraoperative anesthetic regimen.Standardized protoc-ols for anesthesia management,intraoperative monitoring,and postoperative analgesia were applied.Baseline characteristics;intraoperative metrics;adverse events;complications;Visual Analog Scale(VAS)scores at 2,4,6,24,and 48 hours;and survival outcomes were retrospectively collected.Group comparisons were performed usingχ2 for categorical variables,t test for continuous variables,RESULTS Baseline demographic and clinical characteristics were similar between groups.No significant differences were observed in intraoperative indicators or most 30-day postoperative outcomes,including length of stay,emergency department visits,and readmission rates.The propofol group showed elevated mean VAS pain score at 24 hours postoperatively,but no differences were found at other time points.The propofol group also had significantly higher postoperative nausea incidence and transiently higher systolic/diastolic blood pressure and heart rate at the time of incision than the sevoflurane group.No significant differences were seen in overall rates or severity of postoperative complications,intraoperative adverse events,or in overall survival and progression-free survival.CONCLUSION In patients undergoing radical gastrectomy for gastric cancer,sevoflurane and propofol anesthesia demonstrated similar profiles regarding intraoperative safety,postoperative complications,adverse events,postoperative pain,and long-term survival.The selection of anesthesia can be personalized without significantly affecting periop-erative or oncologic outcomes.
文摘National essential medicine policy （NEMP） is an important part of new health care reform and core content of national drug policy. We chose Hebei province as a case to study, utilized standard methods from WHO/HAl and built interrupted time series （ITS） model to qualitatively and quantitatively evaluate the effects of NEMP in Hebei province from the utilization of essential medicines. Shortly after implementing EMP, the purchasing and utilization rate of essential medicines significantly increased, but no further continuous effects. In order to perfect the essential medicine policy, training of rational drug utilization should be strengthened, hierarchical essential medicine list and dynamic monitoring on the effect of NEMP are necessary.
基金Project supported by the EU and the Spanish Ministry of Science and Technology.
文摘The addition of municipal solid wastes （MSW） is considered as a possible strategy for soil rehabilitation in southeast Spain. The objective of this study was to evaluate the long-term （17 years） effect of five doses of MSW addition on the microbiological, biochemical, and physical properties of semiarid soil. Increased values of several parameters that serve as indicators of general microbiological activity, such as, basal respiration, adenosine triphosphate （ATP） or dehydrogenase activity; microbial population size （microbial biomass C）, and extracellular hydrolase activity related to macronutrient cycles, such as, urease, 3-glucosidase, and N-a-benzoyl-L-argininamide protease, were observed in the amended soils. The highest MSW doses showed the highest values in these hydrolase activities. The incorporation of municipal waste resulted in a more dense development of the plant cover, 50% greater in higher doses than in the control treatment, which generated a substantial increase in several C fractions. Total organic carbon reached 12 g kg^-1 soil with the highest MSW doses, compared to 4.30 g kg^-1 soil in the control treatment. The physical properties of the soil were also improved, showing greater percentage of stable aggregates and water holding capacity. Positive correlation coefficients between C fractions and parameters related to microbial activity and aggregate stability were observed. Although these improvements were greater in the soils receiving the highest doses of organic amendment, the increases were not proportional to the amount added, demonstrating the existence of a threshold, above which an increase in the amount of organic matter added is not reflected in an increase in the soil＇s physical, biochemical, and microbiological properties. However, the addition of municipal solid wastes proved its suitability for improving soil quality, thereby indicating the potential of such an amendment, to prevent desertification in Mediterranean areas such as those studied.
基金2020 Shaanxi Provincial Natural Science Basic Research Program(No.2020JM-683)2020 Scientific Research Incubation Fund of Xi’an People’s Hospital(Xi’an Fourth Hospital)(No.FZ-63).
文摘AIM:To evaluate the long-term effect of foldable capsular vitreous body(FCVB)in the treatment of severe ocular rupture to provide a practical basis for clinical selection.METHODS:A total of 26 patients(26 eyes),23 men and 3 women,with severe ocular rupture who underwent FCVB implantation between March 2018 and September 2018 were retrospectively analysed.All open ocular wounds located in zone III,with preoperative visual acuity grade IV and above(Snellen less than 4/200).The best corrected visual acuity(BCVA),intraocular pressure(IOP),cornea,anterior chamber,iris,lens,choroid,and retina were evaluated before and after the surgery.The subjective feeling and the location of FCVB were also assessed.RESULTS:The average age of the 26 patients was 36y(20-60y).Postoperative follow-up was from 10 to 14mo.At the end of follow up,BCVA was light perception(LP)in 10 cases,no light perception(NLP)in 13 cases,hand motions(HM)in 3 cases.IOP was 11±5 mm Hg.Corneal degeneration was in 3 cases and corneal endothelial dystrophy was in 7 cases.Shallow anterior chamber was in 8 cases and hyphema was in 8 cases.Organized membrane in the pupil was in 14 cases.Epiphora occurred in 3 cases.FCVB drainage tube exposed in 3 cases.All FCVBs were in their normal location and no rejection occurred.CONCLUSION:FCVB implantation is a long-term effective treatment and may provide a practical selection for severe ocular rupture.
文摘Agents response equilibrium (ARE) model has been taken advantage of to build a multi-agent system for analyzing fiscal policy effect. Through establishing various types of economic entities and endowing them with abilities to react and make decision, the whole system will evolve to new conditions in response to policy change. Compared with different scenarios, it can be concluded that when raising taxation ratio, sectoral scale will shrink to some extent. But supported by government expenditure, certain sectors could be kept in comparatively larger production scale.
文摘Measuring bullwhip effect is useful for making better controls on production planning and enhancing the supply chain operating efficiency.First,this article establishes the comparative analysis model of bullwhip effect between(s,S)and Periodic Review(PR)inventory policy based on the quantitative bullwhip effect model under different inventories.Then,the impacts of lead time,inventory review time,autocorrelation coefficient,and the number of samples on the gap of bullwhip effect under(s,S)and PR IP are analyzed.The results show that bullwhip effect in PR is more intense than(s,S)inventory policy.Contractors should pay more attention to control bullwhip effect when adopting PR inventory policy to enhance the total operating efficiency of the engineering project supply chains.
文摘Insufficient assessment of emission reduction effects still exists in the carbon emission rights trading system,a major environmental regulation measure in China.Based on the data from the carbon trading pilot covering the years from 2007 to 2017,this study combined the synthetic control method with dynamic spatial Durbin model to comprehensively evaluate the spatial emission reduction effects of carbon trading policies.The results showed that:①The carbon trading policies promoted carbon emission reductions in the pilot regions,among which Tianjin and Hubei responded significantly,and also helped to suppress carbon emissions in the neighboring areas.②Long-term emission reduction effect from carbon emissions trading became gradually significant,while the indirect emission reduction effect was relatively weaker.③In term of reducing carbon emissions,the economic development channel played a key role,but it had a threat to the promotion of carbon emissions in the surrounding areas.Energy consumption was the main obstacle to the growth of carbon emissions.④In the long run,technological progress tended to become the key to the effective implementation of potential emission reduction effects of carbon trading policies.Based on the above findings,we suggest that the construction of a national carbon trading market should be promoted,the balanced development and orderly advancement of regional carbon trading markets should be paid attention to,the coordinated development of green economy as well as knowledge and technology exchange and cooperation among regions should be strengthened to form a low carbon development model among regions.
基金Supported by the European Union-NextGenerationEU,through the National Recovery and Resilience Plan of the Republic of Bulgaria,No. BG-RRP-2.004-0008-C01。
文摘Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can predispose to a number of pathological changes and clinical diseases,including diabetes;hypertension;atherosclerosis;coronary artery disease and stroke;obstructive sleep apnea;depression;weight-related arthropathies and endometrial and breast cancer.A body weight 20%above ideal for age,gender and height is a severe health risk.Bariatric surgery is a set of surgical methods to treat morbid obesity when other treatments such as diet,increased physical activity,behavioral changes and drugs have failed.The two most common procedures currently used are sleeve gastrectomy and gastric bypass.This procedure has gained popularity recently and is generally considered safe and effective.Although current data show that perioperative mortality is low and better control of comorbidities and short-term complications is achieved,more randomized trials are needed to evaluate the long-term outcomes of bariatric procedures.This review aims to synthesize and summarize the growing evidence on the long-term effectiveness,outcomes and complications of bariatric surgery.
文摘Introduction: The incidence and severity of Clostridium difficile infection (CDI) has been increasing and long-term care facility (LTCF) residents are at high risk given their age, co-morbidities, and high antibiotic exposure. Infection control policies are crucial for controlling CDI, but there are currently no regulatory guidelines in the United States. Therefore, we evaluated infection control policies in local LTCFs to define the CDI-specific policies and the administrative and staff understanding of CDI, so as to identify perceived barriers for compliance. Methods: IRB approval was sought and exemption granted, all 8 local LTCFs were asked to participate. Each facility was visited by study personnel who interviewed the administrative Infection Control Practitioner (ICP) and 3-4 Licensed Practical Nurses (LPNs) with distinct survey format. Infection control policies were then compared to the SHEA recommendations for CDI in LTCFs. Results: Of the eligible facilities, 75% (n = 6) participated. ICP (n = 6) and LPNs (n = 21) were interviewed. All facilities accept residents with active CDI and 2 had written CDI-specific infection control policies. All facilities had hand hygiene or glove use policies and 2 had policies for the use of sporicidal environmental cleaning. No facility restricted antibiotic use. Each facility has a policy to instruct their staff through in-services, either annually or upon new hire, but 33% (n = 7) LPNs reported no facility-based CDI training. While 80% (n = 17) of LPNs felt comfortable with the facility CDI policies, only 11 accurately restated it. ICPs felt the most relevant barrier to staff compliance was time constraints (n = 4, 67%), however, LPNs felt it was limited knowledge (n = 10, 48%) and poor communication (n = 2, 10%). Discussion and Conclusions: With the increasing incidence and severity of CDI in LCTF, few of the facilities surveyed had CDI-specific policies. Despite CDI-specific training, there is a perceived knowledge and communication gap for staff caring for residents with CDI.
文摘Empirical research has shown that there were international spillover effects from the U.S. monetary policy to output level, net exports and price levels of each country, and the impact on prices in each country was of synchronous effect. The structural impulse response analysis showed that U.S. monetary policy could improve U.S. income and payment without damaging U.S. economic growth, but the shocks negatively affected the economic growth in the rest of the world. Hence, it's important to pay close attention to the moral risks of U.S. monetary policy to evade the global shocks caused by the "benefit-itself-at-the-expense-of-others" polices of the American government. Besides these findings, U.S. monetary policy shocks strongly affect China's trade surplus fluctuations. Based on this, we propose that the approaches of balancing China's current account could be explored efficiently from the perspective of monetary policy.
基金Supported by the Natural Science Foundation of Beijing Municipality,China:No.7164272the Project of Development of Science and Technology of TCM of Beijing:No.JJ2015-62~~
文摘Background： Allergic rhinitis（AR） is defined as an immunoglobulin led atopic disorder that affects the nasal mucosa. Moxibustion on herbs, a common complementary and alternative medicine approach, is frequently used for treating AR in clinical practice. Western medicine is good at quick symptomatic relief,while offer little or no sustainable and steady long-term effect. Little established evidence is available to support the long-term effectiveness of moxibustion on herbs for AR.Objective： This study is a randomized controlled trial to assess the long-term effectiveness of moxibustion on herbs in moderate-severe persistent AR population.Methods： The study sample size is 56 patients. Eligible patients with moderate-severe persistent AR will be randomized into a moxibustion on herbs combined with conventional treatment group（MOHCT group） and a conventional treatment group（CT group） in a 1：1 ratio. Patients in the MOHCT group will receive a 30-min moxibustion on herbs treatment on Zhiyang（至阳 GV 9）, Dàzhuī（大椎 GV 14） and bilateral Shenshu（肾俞 BL 23）, Fèishū（肺俞 BL 13） for a total of 12 times on the basis of conventional treatment, while those in the CT group will receive conventional treatment alone. The primary outcome measure is VAS score for total nasal symptoms, which will be obtained via a self-recorded AR diary. The secondary outcome measures include the average occurrence of symptoms per week, use of medication and Rhinoconjunctivitis Quality of Life Questionnaire（RQLQ）.Discussion： The objectives of this study include（1） to evaluate the long-term effectiveness and safety of moxibustion on herbs for treating AR;（2） to evaluate whether moxibustion on herbs can reduce the frequency of AR symptoms in patients with moderate-severe persistent allergic rhinitis. The finding of this study will provide evidence on the long-term effectiveness of moxibustion on herbs for moderatesevere persistent AR.
文摘Objective: To observe the long-term effect of homoharringtonine (HHT) on chronic granulocytic leukemia (CGL) and its pharmacological mechanism. Methods: 76 patients with newly diagnosed early chronic phase CGL received treatment of merely 1.5 mg/m2 daily HHT for induction remission and long-term maintenance treatment. The apoptosis rate of bone marrow CD34+ cells induced by HHT was assayed with flow cytometer. Results: 86.8% patients achieved CHR, 13.2% patients PHR and 31.8% patients got cytogenetic response in HHT treatment group, which was longer than 31 (8-54) months in hydroxyurea (HU) group (P<0.05). The effect of apoptosis induction HHT was stronger on CGL-CP patients bone marrow CD34+ cells than on normal person bone marrow CD34+ cells. Conclusion: HHT is a very effective drug for remission induction and long-term maintenance treatment in early chronic phase CGL patients.
文摘Paraquat is a broad-spectrum herbicide known to produce lung injury via oxidative stress-mediated mechanisms. Different pharmacological strategies have been explored to reduce the formation of these reactive oxygen species and/or prevent their toxic effects in the treatment of paraquat poisoning. The present study was carried out to investigate whether the antioxidant (L-tocopherol, incorporated into liposomes and delivered directly to the lungs of rats, could protect the organ against the long-term toxic effects of paraquat.Plain liposomes (composed of dipalmitoylphosphatidylcholine, DPPC) or α-tocopherol liposomes (8 mg α-tocopherol/kg body weight) were administered intratracheally to animals 24 h prior to an intraperitoneal injection of paraquat dichloride (20 mg/kg) and rats wefe killed 0, 1, 4, 6, 8, 10, 12, 16, 19 or 24 days after paraquat treatment. Results of this study showed that lungs of animals treated with paraquat were extensively damaged,as evidenced by significant increases in lung weight and decreases in lung angiotensin converting enzyme (ACE) and alkaline phosphatase enzyme (AKP) activities. Moreover,paraquat treatme; resulted in a significant reduction in the number of neutrophils in the blood of rats with a concurrent increase in the pulmonary myeloperoxidase activity,suggestive of neutrophil infiltration in the lungs of treated animals. Pretreatment of rats with liposomes alone did not significantly alter the paraquat-induced changes of all parameters examined. On the other hand, pretreatment of rats with (t-tocopherol liposomes,24 h prior to paraquat challenge, attenuated paraquat-induced changes in ACE, AKP and myeloperoxidase activities but failed to prevent increases in lung weight. Thus, pretreatment of rats with liposome-associated α-tocopherol appears to protect the lung against some of the toxic effects of paraquat
基金This paper is supported by the National Natural Science Foundation of China （NSFC, No.70302012）, the New Century Excellent Talents （NCET-04-0596） and the Fok Ying Tung Education Foundation （No.101087）.
文摘We examine momentum and contrarian effects in China＇s stock market during 1994-2004 and find that no medium momentum effects exist. Meanwhile, contrarian strategy works effectively over the horizon of 18-36 months. 1-month gap for avoiding bid-ask bounce and lead-lag effect make no considerable change to our empirical results. Transaction costs seem to have no significant impact on contrarian strategies＇ profit.
基金supported by the National Natural Fund of China(Grant No.71872122)Later Stage Support Project of Philosophy and Social Sciences Research of the Ministry of Education of China(Grant No.16JHQ031)+1 种基金Later Stage Support Project of Tianjin Social Science Planning(Grant No.TJGLHQ1403)Higher Education Innovation Team of Tianjin(Grant No.TD13-5006)。
文摘The market development and policy matching of existing building energy-saving retrofits determine the effectiveness of policies in promoting the operation of existing building energy-saving retrofit market.Based on the perspective of market development to evaluate the effectiveness of existing building energy-saving transformation policy,it is necessary to clarify the basic connotation of the effectiveness of existing building energy-saving transformation policy,systematically analyze the evaluation content,construct a multi-level evaluation index system,and select scientific and effective quantitative evaluation methods to implement a strict evaluation process.
文摘The government audit authority has the necessity and feasibility to carry out the audit of the implementation effect of economic policies.The evaluating index system for the audit of the implementation effect of economic policies includes the legality,scientificity,rationality,applicability,operability and performance of the economic policy.Since at present this kind of audit is still a new area,we shall quicken the steps of theoretical researches for the audit of the implementation effect of economic policies,innovate the auditing procedures and methods,improve the construction of the related system of laws and regulations and the teams of auditing professionals,and give full play to the"immune system"function of the government audit.
文摘Background： The rapid growth of type 2 diabetes mellitus （T2DM） remains a big challenge for clinicians worldwide.Traditional Chinese medicine may bring a new approach for solving this problem. The Tianqi Capsule DiabetesPrevention Study （REDUCES Study） reported that 1 years of therapy with Tianqi capsule reduced the risk of diabetes by32.1% compared with the placebo. Here we aimed to assess the long-term effect of Tianqi capsule on prevention ofT2DM in people with impaired glucose tolerance after discontinuation of active intervention. Methods/design： 420subjects will be followed-up for 8 years to assess the long-term effect of Tianqi capsule intervention. The causes of deathand the status of living subjects will be investigated. Follow-up data for living subjects will be collected by personalinterview and clinical examination and medical record review to determine diabetes status. Questionnaires will be givento all the subjects to investigate the factors that probably affect the diabetes status during the 8-year of discontinuation ofintervention. The primary outcome is the incidence of T2DM, and the secondary outcomes are body mass index, bloodglucose, blood lipids and blood pressure. The Cox proportional hazards model will be used to estimate the hazard ratiofor diabetes incidence. Analyses will be done with SAS 8.2 software package. Discussion： Results from this study mayprovide evidence for the long-term efficacy of Tianqi capsule in patients with prediabetes. The findings will provide abasis for further confirmatory studies. Ethics： The protocol has been approved by the Medical Ethics Committee ofGuang’anmen Hospital of China Academy of Chinese Medical Sciences （approval number 2016-046-KY-01）. Studyregistration number： ClinicalTrials.gov; NCT02848053.
基金the partial result of the Research on the Employment Quality of Beijing and the Improvement of Employment Policy"(15JGB132)which is a Beijing Social Science Fund Project
文摘This paper aims at improving the employmentpromoting effects of employment service policies(ESP) to enhance family development. Based on process evaluation methods of public policy, there are three positive effects of ESP, but despite these effects we cannot overrate the performance of ESP. The problem is the double segmentation between urban and rural areas as well as among different regions, the poor basic fund, and the deviation of positioned policy support objects. Hence, China should regulate ESP as soon as possible to benefit family development.
