Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipien...Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipients at high risk of PNF and EAF were urgently needed. Recently, the Model for Early Allograft Function(MEAF), PNF score by King's College(King-PNF) and Balance-and-Risk-Lactate(BAR-Lac) score were developed to assess the risks of PNF and EAF. This study aimed to externally validate and compare the prognostic performance of these three scores for predicting PNF and EAF. Methods: A retrospective study included 720 patients with primary LT between January 2015 and December 2020. MEAF, King-PNF and BAR-Lac scores were compared using receiver operating characteristic(ROC) and the net reclassification improvement(NRI) and integrated discrimination improvement(IDI) analyses. Results: Of all 720 patients, 28(3.9%) developed PNF and 67(9.3%) developed EAF in 3 months. The overall early allograft dysfunction(EAD) rate was 39.0%. The 3-month patient mortality was 8.6% while 1-year graft-failure-free survival was 89.2%. The median MEAF, King-PNF and BAR-Lac scores were 5.0(3.5–6.3),-2.1(-2.6 to-1.2), and 5.0(2.0–11.0), respectively. For predicting PNF, MEAF and King-PNF scores had excellent area under curves(AUCs) of 0.872 and 0.891, superior to BAR-Lac(AUC = 0.830). The NRI and IDI analyses confirmed that King-PNF score had the best performance in predicting PNF while MEAF served as a better predictor of EAD. The EAF risk curve and 1-year graft-failure-free survival curve showed that King-PNF was superior to MEAF and BAR-Lac scores for stratifying the risk of EAF. Conclusions: MEAF, King-PNF and BAR-Lac were validated as practical and effective risk assessment tools of PNF. King-PNF score outperformed MEAF and BAR-Lac in predicting PNF and EAF within 6 months. BAR-Lac score had a huge advantage in the prediction for PNF without post-transplant variables. Proper use of these scores will help early identify PNF, standardize grading of EAF and reasonably select clinical endpoints in relative studies.展开更多
OBJECTIVE The current retrospective study aims to evaluate the management of non-functioning the assessment of experience on pituitary macroadenoma through clinical, biochemical, radiological features, and treatment o...OBJECTIVE The current retrospective study aims to evaluate the management of non-functioning the assessment of experience on pituitary macroadenoma through clinical, biochemical, radiological features, and treatment outcome of patients, and to identify prognostic factors affecting progression-free survival （PFS）. METHODS Data of 55 patients macroadenoma presented to the with non-functioning pituitary Clinical Oncology and Nuclear Medicine department between 1998 and 2009 were investigated. RESULTS The most common symptom was visual disturbance （38.2%） followed by headache （27.3%）. The presence of male predominance was observed （1.4：1）. Ten patients received radio-therapy （RT） only. Extrasellar extension was the more common treatment. The overall response rate was 72.8% with completed response at 16.4%. Memory and intellectual sequelae were the most common late complications of treatment （14%）. The ten-year PFS was at 84.6%. PFS was found to be significantly better with higher dose of RT （up to 54 Gy）, treatment by both surgery and RT, absence of visual field defect, and tumor localized to sella, whereas it was not significantly affected by age and sex. CONCLUSION The data confirmed that the prevalence of mass effect and hypopituitarism in patients with non-functioning pituitary macroadenoma is elevated. Conventional external RT up to 54 Gy is safe and effective in controlling non-functioning pituitary macro- adenoma with tolerable and acceptable morbidity.展开更多
Introduction: Despite the fact that non-functioning pituitary adenomas do not overproduce hormones, many will stain positive for a particular pituitary hormone, which can be used to differentiate these adenomas into s...Introduction: Despite the fact that non-functioning pituitary adenomas do not overproduce hormones, many will stain positive for a particular pituitary hormone, which can be used to differentiate these adenomas into subgroups. If these different sub-groups behave differently in terms of post surgical progression of disease (PSPD) rates or other clinical variables, then better treatment and prognosis could be predicted. Methods: This was a retrospective cohort study. Patients who have undergone surgery for removal of a non-functioning pituitary adenoma at Emory University Hospital served as the source for all data used in this study (n = 184). Data were collected from a database of electronic medical records (EMRs) for these patients in 2010 documenting clinical and demographic variables including treatment and PSPD. Results: Risk for PSPD did not differ by adenoma subtypes: follicle-stimulating hormone (FSH+), luteinizing hormone (LH+), or those that do not stain positive for any hormone (non-functioning, or NF?) (p = 0.971). There were two clinical characteristics statistically related to adenoma subtype: altered mental status and the anterior-posterior (AP) dimension of pre-operative adenomas. PSPD was related to several clinical characteristics, including gender, previous adenoma, post-operative residual, and follow-up time.展开更多
NFMAs are benign tumors that do not produce any biologically active hormones and exceed 10 mm (0.39 in) in size. Although NFMAs are benign in origin, mass effects may lead to serious clinical symptoms such as visual i...NFMAs are benign tumors that do not produce any biologically active hormones and exceed 10 mm (0.39 in) in size. Although NFMAs are benign in origin, mass effects may lead to serious clinical symptoms such as visual impairments, chronic headache, and pituitary insufficiency. The authors describe a 51-year-old woman who had a NFMA (35 × 24 × 25 mm). The vision was reduced to 7/10 in the both eyes. A transnasal transsphenoidal surgery was performed and the tumor was successfully resected. Postoperatively, the patient had visual (9/10) and headache improvement. This case highlights a rare presentation of non-functioning pituitary macroadenoma.展开更多
Requirements elicitation step is of paramount importance in the requirements engineering process. In the distributed environment of so-called inter-company cooperative information system, this step is a thorny issue. ...Requirements elicitation step is of paramount importance in the requirements engineering process. In the distributed environment of so-called inter-company cooperative information system, this step is a thorny issue. To elicit require-ments for an inter-company cooperative information system, we early proposed a methodology called MAMIE (from MAcro to MIcro level requirements Elicitation) with an accompanied tool. In MAMIE methodology, requirements are the result of composing functional and non-functional concerns. Before non-functional concerns composition, it’s primary to identify relationships between them. According to the most existing approaches, a non-functional concern may have a negative, positive or null contribution on the other non-functional concerns. In this paper, we argue that using only these three contributions types is not sufficient to express relationships which may exist between non-functional concerns. Thus, we propose a process which aims to identify non-functional concerns’ relationships and model them using a fuzzy cognitive map. The resulting model is composed of non-functional concerns, relationships between them and the weight of these relationships expressed with linguistics fuzzy values. Using fuzzy cognitive maps to model non-functional concerns relationships allows moving from the conventional modelling toward developing a computer based model. An example from the textile industry is used to illustrate the applicability of our process.展开更多
In the process of oxidative phosphorylation, protons are pumped into the intermembrane space to establish the mitochondrial membrane potential (MMP). Relying on the electrochemical gradient, protons can return to the ...In the process of oxidative phosphorylation, protons are pumped into the intermembrane space to establish the mitochondrial membrane potential (MMP). Relying on the electrochemical gradient, protons can return to the matrix through the ATP synthase complex with ATP generation. MitoQ, a lipophilic cation drug, can be bsorbed to the inner mitochondrial membrane with the cationic moiety staying at the intermembrane space[1].展开更多
In clinical practice,pancreatic neuroendocrine neoplasms(pNENs)with a diameter smaller than 2 cm are commonly referred to as small pNENs.Due to their generally favorable biological characteristics,the diagnosis and tr...In clinical practice,pancreatic neuroendocrine neoplasms(pNENs)with a diameter smaller than 2 cm are commonly referred to as small pNENs.Due to their generally favorable biological characteristics,the diagnosis and treatment of small pNENs differ from other pNENs and are somewhat controversial.In response to this,the Chinese Pancreatic Surgery Association,Chinese Society of Surgery,Chinese Medical Association have developed a consensus on the diagnosis and treatment of small pNENs,which is based on evidence-based medicine and expert opinions.This consensus covers various topics,including concepts,disease assessment,treatment selection,follow-up,and other relevant aspects.展开更多
目的探讨奥拉西坦联合银杏叶提取物治疗非痴呆型血管性认知障碍(vascular cognitive im pairment non-dementia,VCIND)的疗效及对神经电生理指标的影响。方法采用前瞻性研究方法,按照随机数字表法将于秦皇岛市第一医院2023年1月至2024...目的探讨奥拉西坦联合银杏叶提取物治疗非痴呆型血管性认知障碍(vascular cognitive im pairment non-dementia,VCIND)的疗效及对神经电生理指标的影响。方法采用前瞻性研究方法,按照随机数字表法将于秦皇岛市第一医院2023年1月至2024年12月就诊的152例VCIND患者分为奥拉西坦组(76例)和联合组(76例)。奥拉西坦组接受奥拉西坦治疗,联合组接受奥拉西坦联合银杏叶提取物治疗,观察并比较奥拉西坦组和联合组的认知量表评分、神经电生理指标、血流动力学指标、血清学指标及安全性。结果治疗后,联合组蒙特利尔认知评估量表、简易精神状态检查表、改良Barthel指数评分[分别为(24.52±1.73)、(23.48±1.69)、(79.04±4.74)分]均高于奥拉西坦组[分别为(21.06±1.62)、(20.06±1.63)、(74.58±4.33)分](t=12.727、12.698、6.056,均P<0.05)。治疗后,联合组诱发电位P300潜伏期和θ/α功率比值[分别为(291.54±18.62)ms、(1.27±0.36)]均低于奥拉西坦组[分别为(328.63±19.54)ms、(1.54±0.43)](t=11.980、4.197,均P<0.05),电位波幅和α波相对功率[分别为(8.11±1.85)μV、(35.26±5.18)%]均高于奥拉西坦组[分别为(6.36±1.48)μV、(30.17±4.82)%](t=6.439、6.271,均P<0.05)。治疗后,联合组平均血流速度为(66.74±6.48)cm/s高于奥拉西坦组(62.83±6.52)cm/s(t=3.708,P<0.05),搏动指数和阻力指数[分别为(1.03±0.12)、(0.64±0.14)]均低于奥拉西坦组[分别为(1.17±0.18)、(0.73±0.16)](t=5.642、3.690,均P<0.05)。治疗后,联合组白细胞介素6、神经元特异性烯醇化酶及同型半胱氨酸[分别为(7.74±5.48)μg/L、(14.03±3.12)ng/mL、(11.64±3.14)μmol/L]均低于奥拉西坦组[分别为(10.83±5.52)μg/L、(16.17±3.18)ng/mL、(15.73±3.16)μmol/L](t=3.463、4.188、8.004,均P<0.05)。奥拉西坦组和联合组不良反应发生率差异无统计学意义[5.26%(4/76)vs 7.89%(6/76)](χ^(2)=0.428,P>0.05)。结论奥拉西坦联合银杏叶提取物治疗VCIND的疗效较好,能有效改善患者认知功能、日常生活能力、脑血流动力学及神经电生理指标,并具有神经保护及抑制炎症等多重机制,且安全性良好。展开更多
针对预热压力容器罐出料口堵塞、颗粒预热不足等性能缺陷,提出融合TRIZ(theory of inventive problem solving)创新理论与数值模拟的系统解决方案。通过构建技术系统功能模型、专创融合解题流程及性能提升框架,结合ARIZ算法生成多方案...针对预热压力容器罐出料口堵塞、颗粒预热不足等性能缺陷,提出融合TRIZ(theory of inventive problem solving)创新理论与数值模拟的系统解决方案。通过构建技术系统功能模型、专创融合解题流程及性能提升框架,结合ARIZ算法生成多方案并优选“设置分流锥”方案。基于颗粒预热数学模型与气固耦合模型,采用ANSYS CFX对60°、90°、120°顶角分流锥的流道工况进行数值模拟,对比分析流速、湍流涡耗散、湍流动能等流场特征,并通过Q-criterion准则解析旋涡结构演化规律。结果表明:上部锥形顶角60°分流锥方案最优,可显著提升流动与预热性能,降低功能退化量;有限单元法验证显示其结构可靠性满足设计要求。可见,提出的方案可谓探索预热压力罐优化设计提供新思路。展开更多
基金supported by grants from the National Nat-ural Science Foundation of China (81570587 and 81700557)the Guangdong Provincial Key Laboratory Construction Projection on Organ Donation and Transplant Immunology (2013A061401007 and 2017B030314018)+3 种基金Guangdong Provincial Natural Science Funds for Major Basic Science Culture Project (2015A030308010)Science and Technology Program of Guangzhou (201704020150)the Natural Science Foundations of Guangdong province (2016A030310141 and 2020A1515010091)Young Teachers Training Project of Sun Yat-sen University (K0401068) and the Guangdong Science and Technology Innovation Strategy (pdjh2022b0010 and pdjh2023a0002)。
文摘Background: Primary non-function(PNF) and early allograft failure(EAF) after liver transplantation(LT) seriously affect patient outcomes. In clinical practice, effective prognostic tools for early identifying recipients at high risk of PNF and EAF were urgently needed. Recently, the Model for Early Allograft Function(MEAF), PNF score by King's College(King-PNF) and Balance-and-Risk-Lactate(BAR-Lac) score were developed to assess the risks of PNF and EAF. This study aimed to externally validate and compare the prognostic performance of these three scores for predicting PNF and EAF. Methods: A retrospective study included 720 patients with primary LT between January 2015 and December 2020. MEAF, King-PNF and BAR-Lac scores were compared using receiver operating characteristic(ROC) and the net reclassification improvement(NRI) and integrated discrimination improvement(IDI) analyses. Results: Of all 720 patients, 28(3.9%) developed PNF and 67(9.3%) developed EAF in 3 months. The overall early allograft dysfunction(EAD) rate was 39.0%. The 3-month patient mortality was 8.6% while 1-year graft-failure-free survival was 89.2%. The median MEAF, King-PNF and BAR-Lac scores were 5.0(3.5–6.3),-2.1(-2.6 to-1.2), and 5.0(2.0–11.0), respectively. For predicting PNF, MEAF and King-PNF scores had excellent area under curves(AUCs) of 0.872 and 0.891, superior to BAR-Lac(AUC = 0.830). The NRI and IDI analyses confirmed that King-PNF score had the best performance in predicting PNF while MEAF served as a better predictor of EAD. The EAF risk curve and 1-year graft-failure-free survival curve showed that King-PNF was superior to MEAF and BAR-Lac scores for stratifying the risk of EAF. Conclusions: MEAF, King-PNF and BAR-Lac were validated as practical and effective risk assessment tools of PNF. King-PNF score outperformed MEAF and BAR-Lac in predicting PNF and EAF within 6 months. BAR-Lac score had a huge advantage in the prediction for PNF without post-transplant variables. Proper use of these scores will help early identify PNF, standardize grading of EAF and reasonably select clinical endpoints in relative studies.
文摘OBJECTIVE The current retrospective study aims to evaluate the management of non-functioning the assessment of experience on pituitary macroadenoma through clinical, biochemical, radiological features, and treatment outcome of patients, and to identify prognostic factors affecting progression-free survival （PFS）. METHODS Data of 55 patients macroadenoma presented to the with non-functioning pituitary Clinical Oncology and Nuclear Medicine department between 1998 and 2009 were investigated. RESULTS The most common symptom was visual disturbance （38.2%） followed by headache （27.3%）. The presence of male predominance was observed （1.4：1）. Ten patients received radio-therapy （RT） only. Extrasellar extension was the more common treatment. The overall response rate was 72.8% with completed response at 16.4%. Memory and intellectual sequelae were the most common late complications of treatment （14%）. The ten-year PFS was at 84.6%. PFS was found to be significantly better with higher dose of RT （up to 54 Gy）, treatment by both surgery and RT, absence of visual field defect, and tumor localized to sella, whereas it was not significantly affected by age and sex. CONCLUSION The data confirmed that the prevalence of mass effect and hypopituitarism in patients with non-functioning pituitary macroadenoma is elevated. Conventional external RT up to 54 Gy is safe and effective in controlling non-functioning pituitary macro- adenoma with tolerable and acceptable morbidity.
文摘Introduction: Despite the fact that non-functioning pituitary adenomas do not overproduce hormones, many will stain positive for a particular pituitary hormone, which can be used to differentiate these adenomas into subgroups. If these different sub-groups behave differently in terms of post surgical progression of disease (PSPD) rates or other clinical variables, then better treatment and prognosis could be predicted. Methods: This was a retrospective cohort study. Patients who have undergone surgery for removal of a non-functioning pituitary adenoma at Emory University Hospital served as the source for all data used in this study (n = 184). Data were collected from a database of electronic medical records (EMRs) for these patients in 2010 documenting clinical and demographic variables including treatment and PSPD. Results: Risk for PSPD did not differ by adenoma subtypes: follicle-stimulating hormone (FSH+), luteinizing hormone (LH+), or those that do not stain positive for any hormone (non-functioning, or NF?) (p = 0.971). There were two clinical characteristics statistically related to adenoma subtype: altered mental status and the anterior-posterior (AP) dimension of pre-operative adenomas. PSPD was related to several clinical characteristics, including gender, previous adenoma, post-operative residual, and follow-up time.
文摘NFMAs are benign tumors that do not produce any biologically active hormones and exceed 10 mm (0.39 in) in size. Although NFMAs are benign in origin, mass effects may lead to serious clinical symptoms such as visual impairments, chronic headache, and pituitary insufficiency. The authors describe a 51-year-old woman who had a NFMA (35 × 24 × 25 mm). The vision was reduced to 7/10 in the both eyes. A transnasal transsphenoidal surgery was performed and the tumor was successfully resected. Postoperatively, the patient had visual (9/10) and headache improvement. This case highlights a rare presentation of non-functioning pituitary macroadenoma.
文摘Requirements elicitation step is of paramount importance in the requirements engineering process. In the distributed environment of so-called inter-company cooperative information system, this step is a thorny issue. To elicit require-ments for an inter-company cooperative information system, we early proposed a methodology called MAMIE (from MAcro to MIcro level requirements Elicitation) with an accompanied tool. In MAMIE methodology, requirements are the result of composing functional and non-functional concerns. Before non-functional concerns composition, it’s primary to identify relationships between them. According to the most existing approaches, a non-functional concern may have a negative, positive or null contribution on the other non-functional concerns. In this paper, we argue that using only these three contributions types is not sufficient to express relationships which may exist between non-functional concerns. Thus, we propose a process which aims to identify non-functional concerns’ relationships and model them using a fuzzy cognitive map. The resulting model is composed of non-functional concerns, relationships between them and the weight of these relationships expressed with linguistics fuzzy values. Using fuzzy cognitive maps to model non-functional concerns relationships allows moving from the conventional modelling toward developing a computer based model. An example from the textile industry is used to illustrate the applicability of our process.
基金Key Program of National Natural Science Foundation of China (U1432248), National Natural Science Foundation of China (11505245), Western Talent Program of Chinese Academy of Sciences (Y460040XB0)
文摘In the process of oxidative phosphorylation, protons are pumped into the intermembrane space to establish the mitochondrial membrane potential (MMP). Relying on the electrochemical gradient, protons can return to the matrix through the ATP synthase complex with ATP generation. MitoQ, a lipophilic cation drug, can be bsorbed to the inner mitochondrial membrane with the cationic moiety staying at the intermembrane space[1].
基金supported by the Chinese Academy of Medical Sciences(CAMS)Innovation Fund for Medical Sciences(CIFMS)2021-I2M-1-002.
文摘In clinical practice,pancreatic neuroendocrine neoplasms(pNENs)with a diameter smaller than 2 cm are commonly referred to as small pNENs.Due to their generally favorable biological characteristics,the diagnosis and treatment of small pNENs differ from other pNENs and are somewhat controversial.In response to this,the Chinese Pancreatic Surgery Association,Chinese Society of Surgery,Chinese Medical Association have developed a consensus on the diagnosis and treatment of small pNENs,which is based on evidence-based medicine and expert opinions.This consensus covers various topics,including concepts,disease assessment,treatment selection,follow-up,and other relevant aspects.
文摘针对预热压力容器罐出料口堵塞、颗粒预热不足等性能缺陷,提出融合TRIZ(theory of inventive problem solving)创新理论与数值模拟的系统解决方案。通过构建技术系统功能模型、专创融合解题流程及性能提升框架,结合ARIZ算法生成多方案并优选“设置分流锥”方案。基于颗粒预热数学模型与气固耦合模型,采用ANSYS CFX对60°、90°、120°顶角分流锥的流道工况进行数值模拟,对比分析流速、湍流涡耗散、湍流动能等流场特征,并通过Q-criterion准则解析旋涡结构演化规律。结果表明:上部锥形顶角60°分流锥方案最优,可显著提升流动与预热性能,降低功能退化量;有限单元法验证显示其结构可靠性满足设计要求。可见,提出的方案可谓探索预热压力罐优化设计提供新思路。
文摘风力发电机叶片的故障噪声信号通常呈现非平稳、低信噪比的特性,其故障特征难以提取。为此,将自相关函数与主成分分析的优势结合,提出一种自相关增强的时频和主成分分析的解调方法(Autocorrelation Enhanced Time-frequency Analysis and Principal Component Analysis Demodulation,AETFA-PCAD)。使用AETFA-PCAD方法和小波包对仿真信号分析,证实所提方法对非平稳、低信噪比信号频率特征提取的可行性;利用AETFA-PCAD方法提取风力机叶片故障特征,并与小波包变换和Hilbert-Huang变换方法的特征提取效果对比。结果显示,提出的自相关增强的时频和主成分分析的解调方法能够利用非平稳、低信噪比声信号有效提取风力机叶片的故障特征,为风力涡轮机叶片故障诊断奠定坚实的理论基础。
