According to the Japanese Ministry of Health,Labour,and Welfare,14.2%of people were aged>75 years in Japan in 2018,and this number continues to rise.With population aging,the incidence of congestive heart failure(C...According to the Japanese Ministry of Health,Labour,and Welfare,14.2%of people were aged>75 years in Japan in 2018,and this number continues to rise.With population aging,the incidence of congestive heart failure(CHF)is also increasing.[1–3]Reports have shown that the presence of cognitive impairment(CI)in patients with CHF is associated with poor prognosis,[4–6]and the degree of CI is related to CHF severity.展开更多
Dear Editor,Lung cancer is a major global health concern,with 2.2 million patients diagnosed in 2020.Non-small cell lung cancer(NSCLC)accounts for 80%of these cases,primarily comprising two subtypes:lung adenocarcinom...Dear Editor,Lung cancer is a major global health concern,with 2.2 million patients diagnosed in 2020.Non-small cell lung cancer(NSCLC)accounts for 80%of these cases,primarily comprising two subtypes:lung adenocarcinoma(LUAD)and squamous cell carcinoma(LUSC)[1].Researchers use immunohisto-chemistry,next-generation sequencing,and single-cell RNA sequencing to study genetic alterations,tumor heterogeneity,and tumor microenvironments,aiming to identify potential therapeutic options for specific NSCLC subtypes[2].展开更多
BACKGROUND Thyroid malignancies,while accounting for a small proportion of cancer diagnoses globally,have demonstrated a consistent upward trend in occurrence across diverse populations,with gender-specific analyses r...BACKGROUND Thyroid malignancies,while accounting for a small proportion of cancer diagnoses globally,have demonstrated a consistent upward trend in occurrence across diverse populations,with gender-specific analyses revealing a disproportionate burden among women.Despite the characteristically indolent nature of most thyroid carcinomas and their associated high survival rates,emerging evidence points to significant unmet needs regarding psychosocial adaptation and neuropsychiatric sequelae in this growing survivor population.The spectrum of mental health conditions,ranging from affective and anxiety disorders to cognitive impairments,presents substantial barriers to functional recovery and may potentially influence disease trajectories through complex psychoneuroimmunological pathways.Clinical observations consistently report elevated rates of mood disturbances and executive function deficits persisting throughout the cancer continuum,from active treatment into extended follow-up periods.These findings highlight a critical knowledge gap in understanding the dynamic interplay between thyroid cancer biology,its therapeutic interventions,and the development of treatment-resistant psychiatric manifestations that complicate long-term patient care.AIM To analyse the factors influencing the poor prognosis of patients surviving longterm differentiated thyroid cancer with psychiatric disorders and to construct a prediction model.METHODS Forty-eight patients with mental disorders combined with differentiated thyroid cancer who were treated in our hospital during the period of March 2018 to March 2023 were retrospectively selected as the study subjects(thyroid cancer group),and 30 cases each of patients with mental disorders combined with benign thyroid nodules(benign nodules group)and patients with mental disorders alone(mental disorders group),who were treated during the same time period,were selected as controls.The patients with differentiated thyroid cancer were further divided into a poor prognosis group(10 cases)and a good prognosis group(38 cases).The study outcome was poor prognosis as shown by whole body bone imaging within 2 years after thyroid cancer surgery.Factors influencing poor prognosis in survivors of differentiated thyroid cancer were analyzed by univariate and multivariate logistic regression analyses,receiver operating characteristic(ROC)curve analysis was used to assess the predictive efficacy of these factors for poor prognosis,and the DeLong test was used to determine whether there was a statistically significant difference in the area under the curve(AUC)of the model.RESULTS One-way logistic regression analysis showed that tumour diameter[odds ratio(OR)=19.190,P=0.002],T-stage(OR=7.692,P=0.018),extra-glandular infiltration(OR=37.000,P=0.003),degree of differentiation(OR=24.667,P=0.008),serum free T3(OR=22.348,P=0.025),serum free T4(FT4)(OR=1.158,P=0.002),total bilirubin(TBil)(OR=1.792,P=0.004),albumin(OR=0.675,P=0.003),cortisol(OR=1.180,P=0.003),norepinephrine(OR=1.047,P=0.002),angiotensin II(OR=1.975,P=0.002),and superoxide dismutase(OR=0.515,P=0.005)all increased the risk of poor prognosis in patients with psychiatric disorders and long-term differentiated thyroid cancer.Multifactorial logistic regression analysis showed that tumour diameter(OR=16.570,P=0.021),extraglandular infiltration(OR=53.145,P=0.010),FT4(OR=1.186,P=0.007),and TBil(OR=2.823,P=0.048)were independent risk factors for poor prognosis of patients with psychiatric disorders with long-term differentiated thyroid cancer,and the regression equation was:Y=2.808×tumour diameter+3.973×extra-glandular infiltration+0.171×FT4+1.038×TBil-88.138.ROC analysis showed that the predictive power of the overall model(AUC=0.992,P=0.000)was significantly higher than that of independent risk factors(DeLong test P<0.05).CONCLUSION Tumour diameter,extra-glandular infiltration,FT4,and TBil are independent risk factors for poor prognosis in patients with psychiatric disorders with long-term differentiated thyroid cancer,and the combination of these factors is of higher value in predicting the prognosis of patients.These risk factors can be used as a basis to develop a reasonable prognostic management plan in clinical practice for patients with long-term differentiated thyroid cancer with mental disorders,so as to improve the prognosis and quality of life of patients.展开更多
BACKGROUND The prognosis of patients with poorly differentiated gastric neuroendocrine neoplasms(PDGNENs)is dismal and related research is limited.AIM To investigate the prognostic factors,and validate a novel prognos...BACKGROUND The prognosis of patients with poorly differentiated gastric neuroendocrine neoplasms(PDGNENs)is dismal and related research is limited.AIM To investigate the prognostic factors,and validate a novel prognostic nomogram for PDGNEN patients.METHODS We conducted a retrospective study using clinical and pathological data from PDGNEN patients treated at the First Medical Center of the Chinese PLA General Hospital from January 2000 to June 2023.Overall survival(OS)differences were assessed with the Log-rank test and Kaplan-Meier survival curves.Cox regression analysis identified independent risk factors for prognosis.Model performance was evaluated using Harrell’s concordance index,receiver operating characteristic analysis,area under the curve,calibration curves,and decision curve analysis(UDC),including the area under the UDC.RESULTS The study included 336 patients(227 with neuroendocrine carcinoma and 109 with mixed adenoneuroendocrine carcinoma).The average age was 62.7 years.The cohort comprised 80(24.7%)patients in stage I,146(42.9%)in stage II,62(18.1%)in stage III,and 48(14.3%)in stage IV.Significant differences in OS were observed across tumor-node-metastasis stages(P<0.001).Multivariate analysis showed age,Ki-67 index,invasion depth,lymph node metastasis,distant metastasis,and platelet-to-lymphocyte ratio as independent risk factors.We developed a nomogram with a concordance index of 0.779(95%confidence interval:0.743-0.858).Receiver operating characteristic analysis showed area under the curves for 1-year,3-year,and 5-year OS predictions of 0.865,0.850,and 0.890,respectively.The calibration curve demonstrated good agreement with actual outcomes.The area under the UDC for the nomogram vs the 8th American Joint Committee on Cancer tumor-node-metastasis staging system were 0.047 vs 0.027,0.291 vs 0.179,and 0.376 vs 0.216 for 1-year,3-year,and 5-year OS,respectively.CONCLUSION PDGNENs are predominantly found in older men,often in advanced stages at diagnosis,resulting in poor prognosis.The established nomogram demonstrates strong predictive capability and clinical utility.展开更多
AIM:To assess the visual electrophysiological outcomes in children with functional amblyopia who exhibited poor response to conventional treatment.METHODS:Twenty-one children with functional amblyopia,aged 5.7±2....AIM:To assess the visual electrophysiological outcomes in children with functional amblyopia who exhibited poor response to conventional treatment.METHODS:Twenty-one children with functional amblyopia,aged 5.7±2.1y(range:4-10y),underwent comprehensive ophthalmic and refractive evaluations.Spectral domain-optical coherence tomography(SD-OCT)and multifocal electroretinography(mfERG)were conducted to analyze the macular retinal thickness and the first-order response P1 ring of the mfERG in the amblyopic eye(AE)compared to the fellow good eye(GE).RESULTS:Initially,visual acuity in the AE ranged from 20/800 to 20/40,while the GE exhibited a range of 20/25 to 20/20(P<0.01).After 6mo of treatment,17 patients demonstrated improved visual acuity in the AE to 20/50 or better,while 4 children showed no improvement.SD-OCT revealed comparable macular and optic disc structures between the AE and GE.Prior to treatment,the mfERG P1 ring amplitude was significantly reduced in the AE compared to GE(P<0.05).The AE/GE ratio of P1 ring amplitude showed significant improvement post-treatment.However,a smaller AE/GE ratio before treatment was associated with poorer improvement post-treatment.CONCLUSION:In the management of functional amblyopia,a thorough assessment of amblyopic eye examinations is crucial.Approximately 20%of amblyopic eyes may not achieve significant improvement in visual acuity,despite the absence of detectable organic retinal abnormalities.mfERG may reveal underlying abnormalities.Integrating mfERG into initial assessments or treatment follow-ups can aid in identifying potential hidden retinal defects and predicting the prognosis of the amblyopic eye.展开更多
Ending extreme poverty and achieving sustainable development by 2030 poses a significant challenge for de veloping countries.In the past decade,China has pioneered the Targeted Poverty Alleviation(TPA)strategy and imp...Ending extreme poverty and achieving sustainable development by 2030 poses a significant challenge for de veloping countries.In the past decade,China has pioneered the Targeted Poverty Alleviation(TPA)strategy and implemented a range of anti-poverty programs,aiming to reconcile poverty reduction with environmental restoration.However,the effectiveness of the TPA strategy in facilitating sustainable development in the poor areas of China(PAC)remains unclear.Drawing on a perspective of systems,this study compiles a panel dataset of 832 nationally designated poverty-stricken counties in China from 2013 to 2020 and employ the coupling coordination degree model to examine the coupling and coordination relationships among economic,social,and environmental systems in the PAC.We find that during the TPA period,the socioeconomic level developed rapidly,while the environmental quality was slightly improved in the PAC.The TPA strategy promotes the co ordinated development of social,economic,and ecological systems in the PAC,shifting the relationship between human and environment from imbalance to coordination.Our findings underscore the necessity for the Chinese government to persist in its environmental restoration efforts in the PAC to guarantee a sustained development progress.展开更多
BACKGROUND Poorly differentiated thyroid carcinoma(PDTC)is a rare and aggressive form of thyroid cancer.Distant metastasis occurs frequently in PDTC.AIM To determine factors associated with distant metastasis and the ...BACKGROUND Poorly differentiated thyroid carcinoma(PDTC)is a rare and aggressive form of thyroid cancer.Distant metastasis occurs frequently in PDTC.AIM To determine factors associated with distant metastasis and the effects of metastasis,either diagnosed on initial presentation or developing during follow-up,on mortality in PDTC patients.METHODS Patients with PDTC diagnosed between January 1,1985 and July 31,2022 were identified using a thyroid cancer database at a medical center in Taiwan.Factors associated with distant metastasis and cancer-specific survival(CSS)were analyzed using binary logistic analysis and Cox regression,respectively.Survival analysis was conducted using the Kaplan–Meier method.RESULTS The study cohort included 39 patients with PDTC,including 16 with distant metastasis on initial presentation,5 with metastasis during the follow-up period,and 18 with no evidence of metastasis.Older age(≥45 years)was significantly associated with a higher risk of distant metastasis(odds ratio:5.31;95%confi-dence interval:1.27–22.2;P=0.018),while sex,tumor size,T stage,and N stage were not associated with distant metastasis.Patients with metastatic PDTC,either diagnosed at presentation or developing during follow-up,had poorer 5-year CSS rates(55.0%and 40.0%,respectively)than those without metastasis(5-year CSS,93.8%)(P=0.001 for both comparisons).CONCLUSION Older patients with PDTC have an increased risk of distant metastasis.Patients with metastatic PDTC,both diagnosed at presentation and developing during follow-up,have a dismal prognosis.展开更多
BACKGROUND In recent years,confocal laser endomicroscopy(CLE)has become a new endoscopic imaging technology at the microscopic level,which is extensively performed for real-time in vivo histological examination.CLE ca...BACKGROUND In recent years,confocal laser endomicroscopy(CLE)has become a new endoscopic imaging technology at the microscopic level,which is extensively performed for real-time in vivo histological examination.CLE can be performed to distinguish benign from malignant lesions.In this study,we diagnosed using CLE an asymptomatic patient with poorly differentiated gastric adenocarcinoma.CASE SUMMARY A 63-year-old woman was diagnosed with gastric mucosal lesions,which may be gastric cancer,in the small curvature of the stomach by gastroscopy.She consented to undergo CLE for morphological observation of the gastric mucosa.Through the combination of CLE diagnosis and postoperative pathology,the intraoperative CLE diagnosis was considered to be reliable.According to our experience,CLE can be performed as the first choice for the diagnosis of gastric cancer.CONCLUSION CLE has several advantages over pathological diagnosis.We believe that CLE has great potential in the diagnosis of benign and malignant gastric lesions.展开更多
While spray-drying has been widely utilized to improve the bioavailability of poorly water-soluble drugs,the outcomes often exhibit suboptimal particle size distribution and large particle sizes,limiting their effecti...While spray-drying has been widely utilized to improve the bioavailability of poorly water-soluble drugs,the outcomes often exhibit suboptimal particle size distribution and large particle sizes,limiting their effectiveness.In this study,we introduce electrostatic spraying as an advanced technology tailored for poorly water-soluble drugs,enabling the fabrication of nanoparticles with fine and uniform particle size distribution.Regorafenib(1 g),as a model drug,copovidone(5 g),and sodium dodecyl sulfate(0.1 g)were dissolved in 200 ml ethanol and subjected to conventional-spray-dryer and electrostatic spray dryer.The electrostatic spray-dried nanoparticles(ESDN)showed smaller particle sizes with better uniformity compared to conventional spray-dried nanoparticles(CSDN).ESDN demonstrated significantly enhanced solubility and rapid release in water.In vitro studies revealed that ESDN induced apoptosis in HCT-116 cells to a greater extent,exhibiting superior cytotoxicity compared to CSDN.Furthermore,ESDN substantially improved oral bioavailability and antitumor efficacy compared to CSDN.These findings suggest that ESD shows potential in developing enhanced drug delivery systems for poorly water-soluble drugs,effectively addressing the limitations associated with CSD methods.展开更多
BACKGROUND Carcinosarcoma of the gallbladder is a rare malignant tumor with a very poor prognosis.To date,only approximately 100 patients have been reported in the English literature.The prognosis of this tumor type i...BACKGROUND Carcinosarcoma of the gallbladder is a rare malignant tumor with a very poor prognosis.To date,only approximately 100 patients have been reported in the English literature.The prognosis of this tumor type is poor,the preoperative diagnosis is difficult,and there is a possibility of a misdiagnosis.We present an unsuccessful case of carcinosarcoma of the gallbladder with a preoperative misdiagnosis and rapid early postoperative recurrence.Therefore,we have a deeper understanding of the poor prognosis of gallbladder carcinosarcoma(GBC)patients.CASE SUMMARY The patient is a 65-year-old male.He was admitted to the hospital because of right upper abdomen distending pain and discomfort for half a month.Abdominal magnetic resonance imaging revealed a polycystic mass in the right lobe of the liver and the fossa of the gallbladder.After admission,the patient was diagnosed with a liver abscess,which was treated by abscess puncture drainage.Obviously,this treatment was unsuccessful.Hepatectomy and cholecystectomy were performed one month after the puncture.Postoperative pathologic examination revealed carcinosarcoma of the gallbladder,and the resected specimen contained two tumor components.One month after surgery,the patient's tumor recurred in situ and started to compress the duodenum,resulting in duodenal obstruction and bleeding.The treatment was not effective.The patient died of gastrointestinal hemorrhage and hypovolemic shock.CONCLUSION Carcinosarcoma of the gallbladder is a rare malignant tumor that is easily misdiagnosed preoperatively and has a poor prognosis.展开更多
Introduction: Hypertension is a real public health issue and its control is very difficult. We aim to determine the frequency of uncontrolled hypertension in hypertensive patients followed up as an outpatient at the c...Introduction: Hypertension is a real public health issue and its control is very difficult. We aim to determine the frequency of uncontrolled hypertension in hypertensive patients followed up as an outpatient at the campus university hospital of Lome (Togo) and to search for the associated factors. Methodology: The study was cross-sectional, descriptive and analytical, carried out from February (2022) to August 2022 in 260 hypertensive patients aged 22 years old, followed up (on an) as an outpatient for at least 3 months at the Lome University Hospital campus. A univariate then multivariate analysis were conducted in order to highlight the most common factors significantly linked to uncontrolled. Results: The mean age of hypertensives was 56.4 ± 12.7 years, the sex ratio (M/F) was 0.59. Prevalence of uncontrolled blood pressure was 42%. Associated Factors to poor blood pressure control in our study were age > 60 years (OR = 1.6 CI [1.17 - 2.50]), low socio-economic level (OR = 2.2 CI [1.96 - 4.33]), high cardiovascular risk level (OR = 3.1 CI [2.18 - 4.52]), non-adherence to regular blood pressure monitoring (OR = 3.3 CI [2.21 - 5.55]), low compliance to treatment (OR = 4.1 CI [2.33 - 6.76]) and a chronic renal failure (OR = 2.1 CI [1.21 - 3.10]). Conclusion: Nearly half of the hypertensives in our study had poorly controlled blood pressure by antihypertensive treatment medication. The factors of this poor control were age > 60 years, low socio-economic level, high or very high level of cardiovascular risk, low compliance to treatment, and renal failure.展开更多
Introduction: Autosomal dominant polycystic kidney disease (ADPKD) is a common, multisystemic, and progressive hereditary disease. It accounts for 6 to 8% of incident cases of end-stage chronic renal disease (ESRD) in...Introduction: Autosomal dominant polycystic kidney disease (ADPKD) is a common, multisystemic, and progressive hereditary disease. It accounts for 6 to 8% of incident cases of end-stage chronic renal disease (ESRD) in developed countries. The aim of this study is to describe the predictive factors for the development of end-stage chronic kidney disease (CKD) in the course of this disease. Material and Methods: This is a retrospective, descriptive, and analytical study including 300 cases of ADPKD collected at the Nephrology Department of Ibn-Sina Hospital in Rabat over a period of 30 years (1993 to 2023). Included in the study are all patients with ADPKD meeting the ultrasound diagnostic criteria. The analysis focused on demographic, clinical, paraclinical, evolutionary data, as well as prognostic factors associated with renal function deterioration. Results: The mean age of patients at diagnosis is 51.53 +/− 17 years [16 - 93] with a male predominance. The median serum creatinine at diagnosis is 15.5 mg/l [10 - 34]. 21% of patients had ESRD (eGFR 300 mg/24h (21%). The most common cystic complication is hemorrhage (12.3%). 21.3% of patients had hepatorenal polycystic disease. In adjusted analysis, the predictive risk factors for the occurrence of ESRD were smoking (p = 0.019), anemia (p Conclusion: ADPKD can progress insidiously to ESRD. Identification and early treatment of predictive factors for poor renal prognosis could contribute to a better outcome for this disease.展开更多
At present,ideological and political education is significant for poor college students.The focus of funding for poor students has gradually transformed from providing economic support for them to ideological and spir...At present,ideological and political education is significant for poor college students.The focus of funding for poor students has gradually transformed from providing economic support for them to ideological and spiritual help,which puts forward higher requirements on how to carry out ideological and political work.It also requires us to advance the work of ideological and moral education and put it in the most important position in the ideological and educational work for poor college students.Combined with the reality of poor college students,we will adhere to the idea of being student-oriented and endeavor to enhance the effectiveness,pertinence,and relevance of the work of ideological and political education.This paper analyzes the significance and problems of ideological and political education for poor college students and puts forward effective ways to solve the problems from the levels of ideology,cognition,and teaching staff.展开更多
The year of 2013 is a typical rainy and poor sunshine year, and the monthly sunshine hours from May to October were all lower than the average, which from July to September was only 69.3%,71.1% and 56.2% of average, r...The year of 2013 is a typical rainy and poor sunshine year, and the monthly sunshine hours from May to October were all lower than the average, which from July to September was only 69.3%,71.1% and 56.2% of average, respectively. In cotton-wheat system 10 cotton varieties （lines） were planted to select the most suitable varieties for cotton-wheat system in rainy and poor sunshine years through investigating cotton growing traits in 2013. The results showed that in cotton-wheat system the vegetative growth of cotton was mainly from late June to middle July especially in rainy and poor sunshine years. And with the increase of the cotton growth period the peak of vegetative growth delayed, the ratio of the autumn bolls increased, and the ratio of pre-frost yield decreased. In all the varieties unginned cottonyield of Zhongmiansuo 50 with shorter growth period, higher rate of summer bolls and better fiber quality, seed yield reached 3 814.1 kg/hm2, higher than that of other varieties （lines） significantly, and the rate of pre-frost yield reached 83.4%, which was the most suitable variety for cotton-wheat system in rainy and poor sunshine years.展开更多
Sense of economic gain of e-commerce participation is an important aspect for evaluating the inclusiveness of e-commerce development.Based on the data of 6,242 rural households collected from the 2017 summer surveys c...Sense of economic gain of e-commerce participation is an important aspect for evaluating the inclusiveness of e-commerce development.Based on the data of 6,242 rural households collected from the 2017 summer surveys conducted by the China Institute for Rural Studies(CIRS),Tsinghua University,this paper evaluates the effects of e-commerce participation on rural households’sense of economic gain with the propensity score matching(PSM)method,and carries out grouped comparisons between poor and non-poor households.Speci fically,the“Self-evaluated income level relative to fellow villagers”measures respondents’sense of economic gain in the relative sense,and“Percentage of expected household income growth(reduction)in 2018 over 2017”measures future income growth expectation.Findings suggest that e-commerce participation signi ficantly increased sample households’sense of economic gain relative to their fellow villagers and their future income growth expectation.Yet grouped comparisons offer different conclusions:E-commerce participation increased poor households’sense of economic gain compared with fellow villagers more than it did for non-poor households.E-commerce participation did little to increase poor households’future income growth expectation.Like many other poverty reduction programs,pro-poor e-commerce helps poor households with policy preferences but have yet to help them foster skills to prosper in the long run.The sustainability and quality of perceived relative economic gain for poor households are yet to be further observed and examined.All poverty reduction initiatives including pro-poor e-commerce must help poor households develop endogenous growth momentum to prosper beyond the effects of short-term pro-poor policies.展开更多
Trace elements, isotopic modeling and U-Th-Pb SHRIMP zircon age constraints are used to reconstruct the eruption history and magmatic processes of the Piedra Parada Caldera. In the early Eocene, the crystal-poor Barda...Trace elements, isotopic modeling and U-Th-Pb SHRIMP zircon age constraints are used to reconstruct the eruption history and magmatic processes of the Piedra Parada Caldera. In the early Eocene, the crystal-poor Barda Colorada ignimbrite(BCI), having >>15% micro-porphyritic crystals with respect to magmatic components, erupted a volume estimated in more than 300 km^3. The Piedra Parada caldera is located in the Patagonian Andes foreland, at the southern end of the calderas field of the Pilcaniyeu Volcanic Belt(PVB). This belt is related to an extensional tectonic setting as a result of the collision of the Farallon-Aluk ridge with South America, which enabled the development of a transform ocean/continental plate margin followed by the detachment of the Aluk plate and the opening of a slab window. The BCI extra-caldera Plateau is a >100 m thick deposit, having a lower unit with high silica(Si O_2> 76 wt.%),potassium poor rhyolitic composition(trondhjemitic like magma), and an upper unit with normal to high potassium rhyolitic composition(granitic like magma). A trace elements modeling of the BCI units shows that the BCI lower and upper units did not evolve from fractionation or immiscibility in the shallow magma reservoir. The BCI also have a primitive isotopic signature(initial87 Sr/86 Sr =0.7031-0.7049 and ε_(Nd)= +3.4 to +3.65). Thus, tectonic, compositional and isotopic constraints suggest the fast ascent of high silica magmas to a shallow reservoir, and point to an upper mantle origin for these rhyolitic magmas in a transitional(Orogenic-Anorogenic) tectono-magmatic setting. U-Th-Pb SHRIMP zircon crystallization ages of the Syn-caldera stage BCI units(56 -51.5 Ma) show a protracted life of 5 Ma for this caldera reservoir. The age of 52.9 ± 0.3 Ma is considered the best fit for the possible maximum age for the caldera collapse. The Late-caldera magmatism has trachyandesitic and rhyolitic compositions.The trace element modeling suggests that these rhyolites evolve from the trachyandesites and do not evolve from the BCI residual magma. The trachyandesites have U-Th-Pb SHRIMP zircon crystallization ages of 52 ± 1 Ma, suggesting that the caldera eruption was triggered by the arrival of the trachyandesitic magma.展开更多
My parents used to take us to all of the local weddings.Man,we got better at picking up the ricethan the birds did.We thought that running water was when you ran back to the house with a bucket of water from theneighb...My parents used to take us to all of the local weddings.Man,we got better at picking up the ricethan the birds did.We thought that running water was when you ran back to the house with a bucket of water from theneighbors hour.展开更多
BACKGROUND Pancreatic cancer is a major cause of cancer-related death,with a 5-year overall survival rate being below 5%.The main causes of poor prognosis in pancreatic cancer include easy metastasis,high recurrence r...BACKGROUND Pancreatic cancer is a major cause of cancer-related death,with a 5-year overall survival rate being below 5%.The main causes of poor prognosis in pancreatic cancer include easy metastasis,high recurrence rate,and robust drug resistance.Gemcitabine is a first-line drug for patients with unresectable pancreatic cancer.However,due to drug resistance,the clinical effect is not satisfactory.ADAM28 is reported as a tumor promoter in some cancers,but its role in pancreatic cancer and gemcitabine chemoresistance in pancreatic cancer has not been elucidated.AIM To identify if ADAM28 can act as an important target to reverse the gemcitabine drug resistance in pancreatic cancer.METHODS RNA-sequence analysis was applied to explore the potential targets involved in the gemcitabine of pancreatic cancer.SW1990 pancreatic cancer cells were treated with an increased dose of gemcitabine,and the mRNA levels of ADAM28 were evaluated by RT-PCR.The protein and mRNA levels of ADAM28 were confirmed in the gemcitabine resistant and parallel SW1990 cells.The ADAM28 expression was also assessed in TCGA and GEO databases,and the results were confirmed in the collected tumor and adjacent normal tissues.The overall survival(OS)rate and relapse-free survival(RFS)rate of pancreatic cancer patients with high ADAM28 level and low ADAM28 level in TCGA were evaluated with Kaplan-Meier Plotter.Furthermore,the OS rate was calculated in pancreatic cancer patients with high tumor mutation burden(TMB)and low TMB.CCK-8 assay was used to examine the effect of ADAM28 on the viability of SW1990 cells.The ADAM28 and its co-expressed genes were analyzed in the cBioPortal for cancer genomics and subjected to GSEA pathway analysis.The correlations of ADAM28 with GSTP1,ABCC1,GSTM4,and BCL2 were analyzed based on TCGA data on pancreatic cancer.RESULTS RNA-sequence analysis identified that ADAM28 was overexpressed in gemcitabine-resistant cells,and gemcitabine treatment could induce the expression of ADAM28.The mRNA and protein levels of ADAM28 were elevated in gemcitabine-resistant SW1990 cells compared with parallel cells.Also,the expression of ADAM28 was upregulated in pancreatic tumor tissues against normal pancreatic tissues.Notably,ADAM28 was highly expressed in the classical type than in the basal tumor type.Furthermore,the high expression of ADAM28 was associated with low OS and RFS rates.Interestingly,the high levels of ADAM28 was associated with a significantly lower OS rate in the high TMB patients,but not in the low TMB patients.Moreover,overexpression of ADAM28 could reduce the cell viability inhibition by gemcitabine,and knockdown of ADAM28 could enhance the proliferation inhibition by gemcitabine.The GSEA analysis showed that ADAM28 was related to the regulation of drug metabolism,and ADAM28 was significantly positively correlated with GSTP1,ABCC1,GSTM4,and BCL2.CONCLUSION This study demonstrates that ADAM28 is overexpressed in pancreatic cancer,and closely involved in the regulation of gemcitabine resistance.Overexpression of ADAM28 is a novel prognostic biomarker in pancreatic cancer.展开更多
BACKGROUND: In the early period of orthotopic liver transplantation (OLT), initial poor graft function (IPGF) is one of the complications which leads to primary graft non-function (PGNF) in serious cases. This study s...BACKGROUND: In the early period of orthotopic liver transplantation (OLT), initial poor graft function (IPGF) is one of the complications which leads to primary graft non-function (PGNF) in serious cases. This study set out to establish the clinical risk factors resulting in IPGF after OLT. METHODS: Eighty cases of OLT were analyzed. The IPGF group consisted of patients with alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) above 1500 IU/L within 72 hours after OLT, while those in the non-IPGF group had values below 1500 IU/L. Recipient-associated factors before OLT analyzed were age, sex, primary liver disease and Child-Pugh classification; factors analyzed within the peri-operative period were non-heart beating time (NHBT), cold ischemia time (CIT), rewarming ischemic time (RWIT), liver biopsy at the end of cold ischemia; and factors analyzed within 72 hours after OLT were ALT and/or AST values. A logistic regression model was applied to filter the possible factors resulting in IPGF. RESULTS: Donor NHBT, CIT and RWIT were significantly longer in the IPGF group than in the non-IPGF group; in the logistic regression model, NHBT was the risk factor leading to IPGF (P < 0.05), while CIT and RWIT were possible risk factors. In one case in the IPGF group, PGNF appeared with moderate hepatic steatosis. CONCLUSIONS: Longer NHBT is an important risk factor leading to IPGF, while serious steatosis in the donor liver, CIT and RWIT are potential risk factors.展开更多
AIM: To determine the prognostic risk factors of gastrointestinal bleeding in emergency department cases.METHODS: The trial was a retrospective single-center study involving 600 patients over 18-years-old and carried ...AIM: To determine the prognostic risk factors of gastrointestinal bleeding in emergency department cases.METHODS: The trial was a retrospective single-center study involving 600 patients over 18-years-old and carried out with approval by the Institutional Ethics Committee. Patient data included demographic characteristics, symptoms at admission, past medical history, vital signs, laboratory results, endoscopy and colonoscopy results, length of hospital stay, need of intensive care unit(ICU) admission, and mortality. Mortality rate was the principal endpoint of the study, while duration of hospital stay, required interventional treatment, and admission to the ICU were secondary endpoints.RESULTS: The mean age of patients was 61.92-yearsold. Among the 600 total patients, 363(60.5%) underwent upper gastrointestinal endoscopy and the most frequent diagnoses were duodenal ulcer(19.2%) and gastric ulcer(12.8%). One-hundred-and-fifteen(19.2%) patients required endoscopic treatment, 20(3.3%) required surgical treatment, and 5(0.8%) required angiographic embolization. The mean length of hospital stay was 5.21 ± 5.85 d. The mortality rate was 6.3%. The ICU admission rate was 5.3%. Patients with syncope, higher blood glucose levels, and coronary artery disease had significantly higher ICU admission rates(P = 0.029, P = 0.043, and P = 0.002, respectively). Patients with low thrombocyte levels, high creatinine, high international normalized ratio, and high serum transaminase levels had significantly longer hospital stay(P = 0.02, P = 0.001, P = 0.019, and P = 0.005, respectively). Patients who died had significantly higher serum blood urea nitrogen and creatinine levels(P = 0.016 and P = 0.038), and significantly lower mean blood pressure and oxygen saturation(P = 0.004 and P = 0.049). Malignancy and low Glasgow coma scale(GCS) were independent predictive factors of mortality.CONCLUSION: Prognostic factors for gastrointestinal bleeding in emergency room cases are malignancy, hypotension on admission, low GCS, and impaired kidney function.展开更多
文摘According to the Japanese Ministry of Health,Labour,and Welfare,14.2%of people were aged>75 years in Japan in 2018,and this number continues to rise.With population aging,the incidence of congestive heart failure(CHF)is also increasing.[1–3]Reports have shown that the presence of cognitive impairment(CI)in patients with CHF is associated with poor prognosis,[4–6]and the degree of CI is related to CHF severity.
基金support through Manipal University Jaipur for the Enhanced Seed Grant under the Endowment Fund(Grant No.E3/2023-24/QE-04-05).
文摘Dear Editor,Lung cancer is a major global health concern,with 2.2 million patients diagnosed in 2020.Non-small cell lung cancer(NSCLC)accounts for 80%of these cases,primarily comprising two subtypes:lung adenocarcinoma(LUAD)and squamous cell carcinoma(LUSC)[1].Researchers use immunohisto-chemistry,next-generation sequencing,and single-cell RNA sequencing to study genetic alterations,tumor heterogeneity,and tumor microenvironments,aiming to identify potential therapeutic options for specific NSCLC subtypes[2].
文摘BACKGROUND Thyroid malignancies,while accounting for a small proportion of cancer diagnoses globally,have demonstrated a consistent upward trend in occurrence across diverse populations,with gender-specific analyses revealing a disproportionate burden among women.Despite the characteristically indolent nature of most thyroid carcinomas and their associated high survival rates,emerging evidence points to significant unmet needs regarding psychosocial adaptation and neuropsychiatric sequelae in this growing survivor population.The spectrum of mental health conditions,ranging from affective and anxiety disorders to cognitive impairments,presents substantial barriers to functional recovery and may potentially influence disease trajectories through complex psychoneuroimmunological pathways.Clinical observations consistently report elevated rates of mood disturbances and executive function deficits persisting throughout the cancer continuum,from active treatment into extended follow-up periods.These findings highlight a critical knowledge gap in understanding the dynamic interplay between thyroid cancer biology,its therapeutic interventions,and the development of treatment-resistant psychiatric manifestations that complicate long-term patient care.AIM To analyse the factors influencing the poor prognosis of patients surviving longterm differentiated thyroid cancer with psychiatric disorders and to construct a prediction model.METHODS Forty-eight patients with mental disorders combined with differentiated thyroid cancer who were treated in our hospital during the period of March 2018 to March 2023 were retrospectively selected as the study subjects(thyroid cancer group),and 30 cases each of patients with mental disorders combined with benign thyroid nodules(benign nodules group)and patients with mental disorders alone(mental disorders group),who were treated during the same time period,were selected as controls.The patients with differentiated thyroid cancer were further divided into a poor prognosis group(10 cases)and a good prognosis group(38 cases).The study outcome was poor prognosis as shown by whole body bone imaging within 2 years after thyroid cancer surgery.Factors influencing poor prognosis in survivors of differentiated thyroid cancer were analyzed by univariate and multivariate logistic regression analyses,receiver operating characteristic(ROC)curve analysis was used to assess the predictive efficacy of these factors for poor prognosis,and the DeLong test was used to determine whether there was a statistically significant difference in the area under the curve(AUC)of the model.RESULTS One-way logistic regression analysis showed that tumour diameter[odds ratio(OR)=19.190,P=0.002],T-stage(OR=7.692,P=0.018),extra-glandular infiltration(OR=37.000,P=0.003),degree of differentiation(OR=24.667,P=0.008),serum free T3(OR=22.348,P=0.025),serum free T4(FT4)(OR=1.158,P=0.002),total bilirubin(TBil)(OR=1.792,P=0.004),albumin(OR=0.675,P=0.003),cortisol(OR=1.180,P=0.003),norepinephrine(OR=1.047,P=0.002),angiotensin II(OR=1.975,P=0.002),and superoxide dismutase(OR=0.515,P=0.005)all increased the risk of poor prognosis in patients with psychiatric disorders and long-term differentiated thyroid cancer.Multifactorial logistic regression analysis showed that tumour diameter(OR=16.570,P=0.021),extraglandular infiltration(OR=53.145,P=0.010),FT4(OR=1.186,P=0.007),and TBil(OR=2.823,P=0.048)were independent risk factors for poor prognosis of patients with psychiatric disorders with long-term differentiated thyroid cancer,and the regression equation was:Y=2.808×tumour diameter+3.973×extra-glandular infiltration+0.171×FT4+1.038×TBil-88.138.ROC analysis showed that the predictive power of the overall model(AUC=0.992,P=0.000)was significantly higher than that of independent risk factors(DeLong test P<0.05).CONCLUSION Tumour diameter,extra-glandular infiltration,FT4,and TBil are independent risk factors for poor prognosis in patients with psychiatric disorders with long-term differentiated thyroid cancer,and the combination of these factors is of higher value in predicting the prognosis of patients.These risk factors can be used as a basis to develop a reasonable prognostic management plan in clinical practice for patients with long-term differentiated thyroid cancer with mental disorders,so as to improve the prognosis and quality of life of patients.
文摘BACKGROUND The prognosis of patients with poorly differentiated gastric neuroendocrine neoplasms(PDGNENs)is dismal and related research is limited.AIM To investigate the prognostic factors,and validate a novel prognostic nomogram for PDGNEN patients.METHODS We conducted a retrospective study using clinical and pathological data from PDGNEN patients treated at the First Medical Center of the Chinese PLA General Hospital from January 2000 to June 2023.Overall survival(OS)differences were assessed with the Log-rank test and Kaplan-Meier survival curves.Cox regression analysis identified independent risk factors for prognosis.Model performance was evaluated using Harrell’s concordance index,receiver operating characteristic analysis,area under the curve,calibration curves,and decision curve analysis(UDC),including the area under the UDC.RESULTS The study included 336 patients(227 with neuroendocrine carcinoma and 109 with mixed adenoneuroendocrine carcinoma).The average age was 62.7 years.The cohort comprised 80(24.7%)patients in stage I,146(42.9%)in stage II,62(18.1%)in stage III,and 48(14.3%)in stage IV.Significant differences in OS were observed across tumor-node-metastasis stages(P<0.001).Multivariate analysis showed age,Ki-67 index,invasion depth,lymph node metastasis,distant metastasis,and platelet-to-lymphocyte ratio as independent risk factors.We developed a nomogram with a concordance index of 0.779(95%confidence interval:0.743-0.858).Receiver operating characteristic analysis showed area under the curves for 1-year,3-year,and 5-year OS predictions of 0.865,0.850,and 0.890,respectively.The calibration curve demonstrated good agreement with actual outcomes.The area under the UDC for the nomogram vs the 8th American Joint Committee on Cancer tumor-node-metastasis staging system were 0.047 vs 0.027,0.291 vs 0.179,and 0.376 vs 0.216 for 1-year,3-year,and 5-year OS,respectively.CONCLUSION PDGNENs are predominantly found in older men,often in advanced stages at diagnosis,resulting in poor prognosis.The established nomogram demonstrates strong predictive capability and clinical utility.
基金Supported by the National Natural Science Foundation of China(No.82271100)the Jiangsu Science and Technology Support Program(No.BE2022805)the Clinical Skills Enhancement Program of Jiangsu Province Hospital(No.JSPH-MC-2022-24).
文摘AIM:To assess the visual electrophysiological outcomes in children with functional amblyopia who exhibited poor response to conventional treatment.METHODS:Twenty-one children with functional amblyopia,aged 5.7±2.1y(range:4-10y),underwent comprehensive ophthalmic and refractive evaluations.Spectral domain-optical coherence tomography(SD-OCT)and multifocal electroretinography(mfERG)were conducted to analyze the macular retinal thickness and the first-order response P1 ring of the mfERG in the amblyopic eye(AE)compared to the fellow good eye(GE).RESULTS:Initially,visual acuity in the AE ranged from 20/800 to 20/40,while the GE exhibited a range of 20/25 to 20/20(P<0.01).After 6mo of treatment,17 patients demonstrated improved visual acuity in the AE to 20/50 or better,while 4 children showed no improvement.SD-OCT revealed comparable macular and optic disc structures between the AE and GE.Prior to treatment,the mfERG P1 ring amplitude was significantly reduced in the AE compared to GE(P<0.05).The AE/GE ratio of P1 ring amplitude showed significant improvement post-treatment.However,a smaller AE/GE ratio before treatment was associated with poorer improvement post-treatment.CONCLUSION:In the management of functional amblyopia,a thorough assessment of amblyopic eye examinations is crucial.Approximately 20%of amblyopic eyes may not achieve significant improvement in visual acuity,despite the absence of detectable organic retinal abnormalities.mfERG may reveal underlying abnormalities.Integrating mfERG into initial assessments or treatment follow-ups can aid in identifying potential hidden retinal defects and predicting the prognosis of the amblyopic eye.
基金supported by the National Natural Science Founda-tion of China(Grants No.72373153 and 41871183).
文摘Ending extreme poverty and achieving sustainable development by 2030 poses a significant challenge for de veloping countries.In the past decade,China has pioneered the Targeted Poverty Alleviation(TPA)strategy and implemented a range of anti-poverty programs,aiming to reconcile poverty reduction with environmental restoration.However,the effectiveness of the TPA strategy in facilitating sustainable development in the poor areas of China(PAC)remains unclear.Drawing on a perspective of systems,this study compiles a panel dataset of 832 nationally designated poverty-stricken counties in China from 2013 to 2020 and employ the coupling coordination degree model to examine the coupling and coordination relationships among economic,social,and environmental systems in the PAC.We find that during the TPA period,the socioeconomic level developed rapidly,while the environmental quality was slightly improved in the PAC.The TPA strategy promotes the co ordinated development of social,economic,and ecological systems in the PAC,shifting the relationship between human and environment from imbalance to coordination.Our findings underscore the necessity for the Chinese government to persist in its environmental restoration efforts in the PAC to guarantee a sustained development progress.
基金Supported by New Taipei Municipal TuCheng Hospital(Built and Operated by Chang Gung Medical Foundation),New Taipei City,Taiwan,No.CORPVVP0031the National Science and Technology Council of Taiwan,No.NSTC 112-2314-B-182A-111-MY3.
文摘BACKGROUND Poorly differentiated thyroid carcinoma(PDTC)is a rare and aggressive form of thyroid cancer.Distant metastasis occurs frequently in PDTC.AIM To determine factors associated with distant metastasis and the effects of metastasis,either diagnosed on initial presentation or developing during follow-up,on mortality in PDTC patients.METHODS Patients with PDTC diagnosed between January 1,1985 and July 31,2022 were identified using a thyroid cancer database at a medical center in Taiwan.Factors associated with distant metastasis and cancer-specific survival(CSS)were analyzed using binary logistic analysis and Cox regression,respectively.Survival analysis was conducted using the Kaplan–Meier method.RESULTS The study cohort included 39 patients with PDTC,including 16 with distant metastasis on initial presentation,5 with metastasis during the follow-up period,and 18 with no evidence of metastasis.Older age(≥45 years)was significantly associated with a higher risk of distant metastasis(odds ratio:5.31;95%confi-dence interval:1.27–22.2;P=0.018),while sex,tumor size,T stage,and N stage were not associated with distant metastasis.Patients with metastatic PDTC,either diagnosed at presentation or developing during follow-up,had poorer 5-year CSS rates(55.0%and 40.0%,respectively)than those without metastasis(5-year CSS,93.8%)(P=0.001 for both comparisons).CONCLUSION Older patients with PDTC have an increased risk of distant metastasis.Patients with metastatic PDTC,both diagnosed at presentation and developing during follow-up,have a dismal prognosis.
基金The Health Science and Technology Foundation of Inner Mongolia,No.202201436Science and Technology Innovation Foundation of Inner Mongolia,No.CXYD2022BT01.
文摘BACKGROUND In recent years,confocal laser endomicroscopy(CLE)has become a new endoscopic imaging technology at the microscopic level,which is extensively performed for real-time in vivo histological examination.CLE can be performed to distinguish benign from malignant lesions.In this study,we diagnosed using CLE an asymptomatic patient with poorly differentiated gastric adenocarcinoma.CASE SUMMARY A 63-year-old woman was diagnosed with gastric mucosal lesions,which may be gastric cancer,in the small curvature of the stomach by gastroscopy.She consented to undergo CLE for morphological observation of the gastric mucosa.Through the combination of CLE diagnosis and postoperative pathology,the intraoperative CLE diagnosis was considered to be reliable.According to our experience,CLE can be performed as the first choice for the diagnosis of gastric cancer.CONCLUSION CLE has several advantages over pathological diagnosis.We believe that CLE has great potential in the diagnosis of benign and malignant gastric lesions.
基金This work was supported by the National Research Foundation of South Korea(NRF)grants funded by the South Korean government(MEST)(No.2022R1A2C2004197,RS-2024-00407053 and RS-2023-00208448).
文摘While spray-drying has been widely utilized to improve the bioavailability of poorly water-soluble drugs,the outcomes often exhibit suboptimal particle size distribution and large particle sizes,limiting their effectiveness.In this study,we introduce electrostatic spraying as an advanced technology tailored for poorly water-soluble drugs,enabling the fabrication of nanoparticles with fine and uniform particle size distribution.Regorafenib(1 g),as a model drug,copovidone(5 g),and sodium dodecyl sulfate(0.1 g)were dissolved in 200 ml ethanol and subjected to conventional-spray-dryer and electrostatic spray dryer.The electrostatic spray-dried nanoparticles(ESDN)showed smaller particle sizes with better uniformity compared to conventional spray-dried nanoparticles(CSDN).ESDN demonstrated significantly enhanced solubility and rapid release in water.In vitro studies revealed that ESDN induced apoptosis in HCT-116 cells to a greater extent,exhibiting superior cytotoxicity compared to CSDN.Furthermore,ESDN substantially improved oral bioavailability and antitumor efficacy compared to CSDN.These findings suggest that ESD shows potential in developing enhanced drug delivery systems for poorly water-soluble drugs,effectively addressing the limitations associated with CSD methods.
文摘BACKGROUND Carcinosarcoma of the gallbladder is a rare malignant tumor with a very poor prognosis.To date,only approximately 100 patients have been reported in the English literature.The prognosis of this tumor type is poor,the preoperative diagnosis is difficult,and there is a possibility of a misdiagnosis.We present an unsuccessful case of carcinosarcoma of the gallbladder with a preoperative misdiagnosis and rapid early postoperative recurrence.Therefore,we have a deeper understanding of the poor prognosis of gallbladder carcinosarcoma(GBC)patients.CASE SUMMARY The patient is a 65-year-old male.He was admitted to the hospital because of right upper abdomen distending pain and discomfort for half a month.Abdominal magnetic resonance imaging revealed a polycystic mass in the right lobe of the liver and the fossa of the gallbladder.After admission,the patient was diagnosed with a liver abscess,which was treated by abscess puncture drainage.Obviously,this treatment was unsuccessful.Hepatectomy and cholecystectomy were performed one month after the puncture.Postoperative pathologic examination revealed carcinosarcoma of the gallbladder,and the resected specimen contained two tumor components.One month after surgery,the patient's tumor recurred in situ and started to compress the duodenum,resulting in duodenal obstruction and bleeding.The treatment was not effective.The patient died of gastrointestinal hemorrhage and hypovolemic shock.CONCLUSION Carcinosarcoma of the gallbladder is a rare malignant tumor that is easily misdiagnosed preoperatively and has a poor prognosis.
文摘Introduction: Hypertension is a real public health issue and its control is very difficult. We aim to determine the frequency of uncontrolled hypertension in hypertensive patients followed up as an outpatient at the campus university hospital of Lome (Togo) and to search for the associated factors. Methodology: The study was cross-sectional, descriptive and analytical, carried out from February (2022) to August 2022 in 260 hypertensive patients aged 22 years old, followed up (on an) as an outpatient for at least 3 months at the Lome University Hospital campus. A univariate then multivariate analysis were conducted in order to highlight the most common factors significantly linked to uncontrolled. Results: The mean age of hypertensives was 56.4 ± 12.7 years, the sex ratio (M/F) was 0.59. Prevalence of uncontrolled blood pressure was 42%. Associated Factors to poor blood pressure control in our study were age > 60 years (OR = 1.6 CI [1.17 - 2.50]), low socio-economic level (OR = 2.2 CI [1.96 - 4.33]), high cardiovascular risk level (OR = 3.1 CI [2.18 - 4.52]), non-adherence to regular blood pressure monitoring (OR = 3.3 CI [2.21 - 5.55]), low compliance to treatment (OR = 4.1 CI [2.33 - 6.76]) and a chronic renal failure (OR = 2.1 CI [1.21 - 3.10]). Conclusion: Nearly half of the hypertensives in our study had poorly controlled blood pressure by antihypertensive treatment medication. The factors of this poor control were age > 60 years, low socio-economic level, high or very high level of cardiovascular risk, low compliance to treatment, and renal failure.
文摘Introduction: Autosomal dominant polycystic kidney disease (ADPKD) is a common, multisystemic, and progressive hereditary disease. It accounts for 6 to 8% of incident cases of end-stage chronic renal disease (ESRD) in developed countries. The aim of this study is to describe the predictive factors for the development of end-stage chronic kidney disease (CKD) in the course of this disease. Material and Methods: This is a retrospective, descriptive, and analytical study including 300 cases of ADPKD collected at the Nephrology Department of Ibn-Sina Hospital in Rabat over a period of 30 years (1993 to 2023). Included in the study are all patients with ADPKD meeting the ultrasound diagnostic criteria. The analysis focused on demographic, clinical, paraclinical, evolutionary data, as well as prognostic factors associated with renal function deterioration. Results: The mean age of patients at diagnosis is 51.53 +/− 17 years [16 - 93] with a male predominance. The median serum creatinine at diagnosis is 15.5 mg/l [10 - 34]. 21% of patients had ESRD (eGFR 300 mg/24h (21%). The most common cystic complication is hemorrhage (12.3%). 21.3% of patients had hepatorenal polycystic disease. In adjusted analysis, the predictive risk factors for the occurrence of ESRD were smoking (p = 0.019), anemia (p Conclusion: ADPKD can progress insidiously to ESRD. Identification and early treatment of predictive factors for poor renal prognosis could contribute to a better outcome for this disease.
文摘At present,ideological and political education is significant for poor college students.The focus of funding for poor students has gradually transformed from providing economic support for them to ideological and spiritual help,which puts forward higher requirements on how to carry out ideological and political work.It also requires us to advance the work of ideological and moral education and put it in the most important position in the ideological and educational work for poor college students.Combined with the reality of poor college students,we will adhere to the idea of being student-oriented and endeavor to enhance the effectiveness,pertinence,and relevance of the work of ideological and political education.This paper analyzes the significance and problems of ideological and political education for poor college students and puts forward effective ways to solve the problems from the levels of ideology,cognition,and teaching staff.
基金Supported by Project Supported by National Science and Technology Ministry(2013BAD05B00)National Cotton Industry System(CARS-18-21)~~
文摘The year of 2013 is a typical rainy and poor sunshine year, and the monthly sunshine hours from May to October were all lower than the average, which from July to September was only 69.3%,71.1% and 56.2% of average, respectively. In cotton-wheat system 10 cotton varieties （lines） were planted to select the most suitable varieties for cotton-wheat system in rainy and poor sunshine years through investigating cotton growing traits in 2013. The results showed that in cotton-wheat system the vegetative growth of cotton was mainly from late June to middle July especially in rainy and poor sunshine years. And with the increase of the cotton growth period the peak of vegetative growth delayed, the ratio of the autumn bolls increased, and the ratio of pre-frost yield decreased. In all the varieties unginned cottonyield of Zhongmiansuo 50 with shorter growth period, higher rate of summer bolls and better fiber quality, seed yield reached 3 814.1 kg/hm2, higher than that of other varieties （lines） significantly, and the rate of pre-frost yield reached 83.4%, which was the most suitable variety for cotton-wheat system in rainy and poor sunshine years.
基金sponsored by the Youth Program of the National Social Sciences Fund of China (NSSFC)“Study on the Multidimensional Poverty of Rural Elderly Population and Targeted Poverty Reduction”(Grant No. 17CGL030)the Youth Research Start-Up Program of the Chinese Academy of Social Sciences (CASS)“Study on the Development Mechanism of Inclusive E-Commerce in the Countryside”Program of the National Natural Science Foundation of China (NSFC)“Research on the Mechanism and Effects of Precise Poverty Alleviation and Internet Poverty Alleviation in Rural China”(Grant No. 71661147001)。
文摘Sense of economic gain of e-commerce participation is an important aspect for evaluating the inclusiveness of e-commerce development.Based on the data of 6,242 rural households collected from the 2017 summer surveys conducted by the China Institute for Rural Studies(CIRS),Tsinghua University,this paper evaluates the effects of e-commerce participation on rural households’sense of economic gain with the propensity score matching(PSM)method,and carries out grouped comparisons between poor and non-poor households.Speci fically,the“Self-evaluated income level relative to fellow villagers”measures respondents’sense of economic gain in the relative sense,and“Percentage of expected household income growth(reduction)in 2018 over 2017”measures future income growth expectation.Findings suggest that e-commerce participation signi ficantly increased sample households’sense of economic gain relative to their fellow villagers and their future income growth expectation.Yet grouped comparisons offer different conclusions:E-commerce participation increased poor households’sense of economic gain compared with fellow villagers more than it did for non-poor households.E-commerce participation did little to increase poor households’future income growth expectation.Like many other poverty reduction programs,pro-poor e-commerce helps poor households with policy preferences but have yet to help them foster skills to prosper in the long run.The sustainability and quality of perceived relative economic gain for poor households are yet to be further observed and examined.All poverty reduction initiatives including pro-poor e-commerce must help poor households develop endogenous growth momentum to prosper beyond the effects of short-term pro-poor policies.
基金funded with research grants from projects of UNLP 11N/689 and 790, CONICET PID 00688the Spanish Ministry of Science and Innovation (Projects CGL2013-48408-C3-1-P) (LITHOS)
文摘Trace elements, isotopic modeling and U-Th-Pb SHRIMP zircon age constraints are used to reconstruct the eruption history and magmatic processes of the Piedra Parada Caldera. In the early Eocene, the crystal-poor Barda Colorada ignimbrite(BCI), having >>15% micro-porphyritic crystals with respect to magmatic components, erupted a volume estimated in more than 300 km^3. The Piedra Parada caldera is located in the Patagonian Andes foreland, at the southern end of the calderas field of the Pilcaniyeu Volcanic Belt(PVB). This belt is related to an extensional tectonic setting as a result of the collision of the Farallon-Aluk ridge with South America, which enabled the development of a transform ocean/continental plate margin followed by the detachment of the Aluk plate and the opening of a slab window. The BCI extra-caldera Plateau is a >100 m thick deposit, having a lower unit with high silica(Si O_2> 76 wt.%),potassium poor rhyolitic composition(trondhjemitic like magma), and an upper unit with normal to high potassium rhyolitic composition(granitic like magma). A trace elements modeling of the BCI units shows that the BCI lower and upper units did not evolve from fractionation or immiscibility in the shallow magma reservoir. The BCI also have a primitive isotopic signature(initial87 Sr/86 Sr =0.7031-0.7049 and ε_(Nd)= +3.4 to +3.65). Thus, tectonic, compositional and isotopic constraints suggest the fast ascent of high silica magmas to a shallow reservoir, and point to an upper mantle origin for these rhyolitic magmas in a transitional(Orogenic-Anorogenic) tectono-magmatic setting. U-Th-Pb SHRIMP zircon crystallization ages of the Syn-caldera stage BCI units(56 -51.5 Ma) show a protracted life of 5 Ma for this caldera reservoir. The age of 52.9 ± 0.3 Ma is considered the best fit for the possible maximum age for the caldera collapse. The Late-caldera magmatism has trachyandesitic and rhyolitic compositions.The trace element modeling suggests that these rhyolites evolve from the trachyandesites and do not evolve from the BCI residual magma. The trachyandesites have U-Th-Pb SHRIMP zircon crystallization ages of 52 ± 1 Ma, suggesting that the caldera eruption was triggered by the arrival of the trachyandesitic magma.
文摘My parents used to take us to all of the local weddings.Man,we got better at picking up the ricethan the birds did.We thought that running water was when you ran back to the house with a bucket of water from theneighbors hour.
文摘BACKGROUND Pancreatic cancer is a major cause of cancer-related death,with a 5-year overall survival rate being below 5%.The main causes of poor prognosis in pancreatic cancer include easy metastasis,high recurrence rate,and robust drug resistance.Gemcitabine is a first-line drug for patients with unresectable pancreatic cancer.However,due to drug resistance,the clinical effect is not satisfactory.ADAM28 is reported as a tumor promoter in some cancers,but its role in pancreatic cancer and gemcitabine chemoresistance in pancreatic cancer has not been elucidated.AIM To identify if ADAM28 can act as an important target to reverse the gemcitabine drug resistance in pancreatic cancer.METHODS RNA-sequence analysis was applied to explore the potential targets involved in the gemcitabine of pancreatic cancer.SW1990 pancreatic cancer cells were treated with an increased dose of gemcitabine,and the mRNA levels of ADAM28 were evaluated by RT-PCR.The protein and mRNA levels of ADAM28 were confirmed in the gemcitabine resistant and parallel SW1990 cells.The ADAM28 expression was also assessed in TCGA and GEO databases,and the results were confirmed in the collected tumor and adjacent normal tissues.The overall survival(OS)rate and relapse-free survival(RFS)rate of pancreatic cancer patients with high ADAM28 level and low ADAM28 level in TCGA were evaluated with Kaplan-Meier Plotter.Furthermore,the OS rate was calculated in pancreatic cancer patients with high tumor mutation burden(TMB)and low TMB.CCK-8 assay was used to examine the effect of ADAM28 on the viability of SW1990 cells.The ADAM28 and its co-expressed genes were analyzed in the cBioPortal for cancer genomics and subjected to GSEA pathway analysis.The correlations of ADAM28 with GSTP1,ABCC1,GSTM4,and BCL2 were analyzed based on TCGA data on pancreatic cancer.RESULTS RNA-sequence analysis identified that ADAM28 was overexpressed in gemcitabine-resistant cells,and gemcitabine treatment could induce the expression of ADAM28.The mRNA and protein levels of ADAM28 were elevated in gemcitabine-resistant SW1990 cells compared with parallel cells.Also,the expression of ADAM28 was upregulated in pancreatic tumor tissues against normal pancreatic tissues.Notably,ADAM28 was highly expressed in the classical type than in the basal tumor type.Furthermore,the high expression of ADAM28 was associated with low OS and RFS rates.Interestingly,the high levels of ADAM28 was associated with a significantly lower OS rate in the high TMB patients,but not in the low TMB patients.Moreover,overexpression of ADAM28 could reduce the cell viability inhibition by gemcitabine,and knockdown of ADAM28 could enhance the proliferation inhibition by gemcitabine.The GSEA analysis showed that ADAM28 was related to the regulation of drug metabolism,and ADAM28 was significantly positively correlated with GSTP1,ABCC1,GSTM4,and BCL2.CONCLUSION This study demonstrates that ADAM28 is overexpressed in pancreatic cancer,and closely involved in the regulation of gemcitabine resistance.Overexpression of ADAM28 is a novel prognostic biomarker in pancreatic cancer.
基金This study was supported by a grant from the Shanghai Science and Technology Commission Foundation, China(No.O14119002).
文摘BACKGROUND: In the early period of orthotopic liver transplantation (OLT), initial poor graft function (IPGF) is one of the complications which leads to primary graft non-function (PGNF) in serious cases. This study set out to establish the clinical risk factors resulting in IPGF after OLT. METHODS: Eighty cases of OLT were analyzed. The IPGF group consisted of patients with alanine aminotransferase (ALT) and/or aspartate aminotransferase (AST) above 1500 IU/L within 72 hours after OLT, while those in the non-IPGF group had values below 1500 IU/L. Recipient-associated factors before OLT analyzed were age, sex, primary liver disease and Child-Pugh classification; factors analyzed within the peri-operative period were non-heart beating time (NHBT), cold ischemia time (CIT), rewarming ischemic time (RWIT), liver biopsy at the end of cold ischemia; and factors analyzed within 72 hours after OLT were ALT and/or AST values. A logistic regression model was applied to filter the possible factors resulting in IPGF. RESULTS: Donor NHBT, CIT and RWIT were significantly longer in the IPGF group than in the non-IPGF group; in the logistic regression model, NHBT was the risk factor leading to IPGF (P < 0.05), while CIT and RWIT were possible risk factors. In one case in the IPGF group, PGNF appeared with moderate hepatic steatosis. CONCLUSIONS: Longer NHBT is an important risk factor leading to IPGF, while serious steatosis in the donor liver, CIT and RWIT are potential risk factors.
文摘AIM: To determine the prognostic risk factors of gastrointestinal bleeding in emergency department cases.METHODS: The trial was a retrospective single-center study involving 600 patients over 18-years-old and carried out with approval by the Institutional Ethics Committee. Patient data included demographic characteristics, symptoms at admission, past medical history, vital signs, laboratory results, endoscopy and colonoscopy results, length of hospital stay, need of intensive care unit(ICU) admission, and mortality. Mortality rate was the principal endpoint of the study, while duration of hospital stay, required interventional treatment, and admission to the ICU were secondary endpoints.RESULTS: The mean age of patients was 61.92-yearsold. Among the 600 total patients, 363(60.5%) underwent upper gastrointestinal endoscopy and the most frequent diagnoses were duodenal ulcer(19.2%) and gastric ulcer(12.8%). One-hundred-and-fifteen(19.2%) patients required endoscopic treatment, 20(3.3%) required surgical treatment, and 5(0.8%) required angiographic embolization. The mean length of hospital stay was 5.21 ± 5.85 d. The mortality rate was 6.3%. The ICU admission rate was 5.3%. Patients with syncope, higher blood glucose levels, and coronary artery disease had significantly higher ICU admission rates(P = 0.029, P = 0.043, and P = 0.002, respectively). Patients with low thrombocyte levels, high creatinine, high international normalized ratio, and high serum transaminase levels had significantly longer hospital stay(P = 0.02, P = 0.001, P = 0.019, and P = 0.005, respectively). Patients who died had significantly higher serum blood urea nitrogen and creatinine levels(P = 0.016 and P = 0.038), and significantly lower mean blood pressure and oxygen saturation(P = 0.004 and P = 0.049). Malignancy and low Glasgow coma scale(GCS) were independent predictive factors of mortality.CONCLUSION: Prognostic factors for gastrointestinal bleeding in emergency room cases are malignancy, hypotension on admission, low GCS, and impaired kidney function.
