OBJECTIVE:To find more influencing factors Qideficiency constitution of Traditional Chinese Medicine(TCM)using dynamic and comprehensive information.METHODS:Because grey relational analysis(GRA)is good at processing i...OBJECTIVE:To find more influencing factors Qideficiency constitution of Traditional Chinese Medicine(TCM)using dynamic and comprehensive information.METHODS:Because grey relational analysis(GRA)is good at processing incomplete information and has no special requirements for sample size and distribution.We acquired 2122 pieces of valid Qi-deficiency constitution dynamic data after preprocessing,and used GRA combing withχ~2 test and multivariate logistic regression analysis to discover and sort the influencing factors of Qideficiency constitution.RESULTS:For the calculation results of GRA,there were 10(62.5%)aspects whose grey correlation degrees were greater than 0.6.The results ofχ~2 test showed that all the above 10 aspects were statistically significant with Qideficiency constitution.The analysis results of multivariate logistic regression analysis showed the following factors were positively correlated with Qi-deficiency constitution:premature birth,sleeping late and getting up early,sleeping late and getting up late,irregular sleeping,sleeping 6.0-6.9 h per day,artificial feeding,female,age at 18-19,and father's age at 18-19 years old when a baby at birth.The following factors were negatively correlated with Qi-deficiency constitution:sleeping 8.0-8.9 h per day and≥9.0 h per day,and age at 30-39 and 40-49 years old.CONCLUSIONS:It is necessary to pay attention to these innate and acquired information of individuals which may lead to Qi-deficiency constitution.And our research also provides a novel methodological thinking for analyzing the influential factors of TCM constitution.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)has been shown to increase the risk of stroke.However,the prevalence and risk of recurrent stroke in COVID-19 patients with prior stroke/transient ischemic attack(TIA),as w...BACKGROUND Coronavirus disease 2019(COVID-19)has been shown to increase the risk of stroke.However,the prevalence and risk of recurrent stroke in COVID-19 patients with prior stroke/transient ischemic attack(TIA),as well as its impact on mor-tality,are not established.AIM To evaluate the impact of COVID-19 on in-hospital mortality,length of stay,and healthcare costs in patients with recurrent strokes.METHODS We identified admissions of recurrent stroke(current acute ischemic stroke admissions with at least one prior TIA or stroke)in patients with and without COVID-19 using ICD-10-CM codes using the National Inpatient Sample(2020).We analyzed the impact of COVID-19 on mortality following recurrent stroke admissions by subgroups.RESULTS Of 97455 admissions with recurrent stroke,2140(2.2%)belonged to the COVID-19-positive group.The COVID-19-positive group had a higher prevalence of diabetes and chronic kidney disease vs the COVID-19 negative group(P<0.001).Among the subgroups,patients aged>65 years,patients aged 45–64 years,Asians,Hispanics,whites,and blacks in the COVID-19 positive group had higher rates of all-cause mortality than the COVID-19 negative group(P<0.01).Higher odds of in-hospital mortality were seen in the group aged 45-64(OR:8.40,95%CI:4.18-16.91)vs the group aged>65(OR:7.04,95%CI:5.24-9.44),males(OR:7.82,95%CI:5.38-11.35)compared to females(OR:6.15,95%CI:4.12-9.18),and in Hispanics(OR:15.47,95%CI:7.61-31.44)and Asians/Pacific Islanders(OR:14.93,95%CI:7.22-30.87)compared to blacks(OR:5.73,95%CI:3.08-10.68),and whites(OR:5.54,95%CI:3.79-8.09).CONCLUSION The study highlights the increased risk of all-cause in-hospital mortality in recurrent stroke patients with COVID-19,with a more pronounced increase in middle-aged patients,males,Hispanics,or Asians.展开更多
Noise is one of the environmental factors with mental and physical effects.The workload is also the multiple mental and physical demands of the task.Therefore,his study investigated the relationship between noise expo...Noise is one of the environmental factors with mental and physical effects.The workload is also the multiple mental and physical demands of the task.Therefore,his study investigated the relationship between noise exposure and mood states at different levels of workload.The study recruited 50 workers from the manufacturing sector(blue-collar workers)as the exposed group and 50 workers from the office sector(white-collar workers)as the control group.Their occupational noise exposure was measured by dosimetry.The Stress-Arousal Checklist(SACL)and the NASA Task Load Index(NASA-TLX)were used to measure mood and workload,respectively.The equivalent noise exposure level of the exposed group at high and very high workload levels was 85 and 87 dBA,respectively.The mean mood score of the exposed group was 76 at very high workload.The correlation coefficient between noise exposure level and mood state based on workload levels ranged from 0.3 at medium workload to 0.57 at very high workload.Noise exposure at high workload levels can increase its adverse effects,so controlling and optimizing the multiple demands of the task in the workplace can be used as a privative measure to reduce the adverse effects of noise.展开更多
AIM： To describe the trend in duodenal biopsy performance during routine upper gastrointestinal endoscopy in an adult Spanish population, and to analyze its value for the diagnosis of celiac disease in clinical pract...AIM： To describe the trend in duodenal biopsy performance during routine upper gastrointestinal endoscopy in an adult Spanish population, and to analyze its value for the diagnosis of celiac disease in clinical practice. METHODS： A 15 year-trend （1990 to 2004） in duodenal biopsy performed when undertaking upper gastrointestinal endoscopy was studied. We analysed the prevalence of celiac disease in the overall group, and in the subgroups with anaemia and/or chronic diarrhoea. RESULTS： Duodenal biopsy was performed in 1033 of 13 678 upper gastrointestinal endoscopies （7.6%）; an increase in the use of such was observed over the study period （1.9% in 1990-1994, 5% in 1995-1999 and 12.8% in 2000-2004）. Celiac disease was diagnosed in 22 patients （2.2%）, this being more frequent in women than in men （3% and 1% respectively）. Fourteen out of 514 （2.7%） patients with anaemia, 12 out of 141 （8.5%） with chronic diarrhoea and 8 out of 42 （19%） with anaemia plus chronic diarrhoea had celiac disease. A classical clinical presentation was observed in 55% of the cases, 23% of the patients had associated dermatitis herpetiformis and 64% presented anaemia; 9% were diagnosed by familial screening and 5% by cryptogenetic hypertransaminasaemia. CONCLUSION： Duodenal biopsy undertaken during routine upper gastrointestinal endoscopy in adults, has been gradually incorporated into clinical practice, and is a useful tool for the diagnosis of celiac disease in high risk groups such as those with anaemia and/or chronic diarrhoea.展开更多
AIM: To distinguish upper from lower gastrointestinal(GI) bleeding. METHODS: Patient records between April 2011 and March 2014 were analyzed retrospectively(3296 upper endoscopy, and 1520 colonoscopy). Seventysix pati...AIM: To distinguish upper from lower gastrointestinal(GI) bleeding. METHODS: Patient records between April 2011 and March 2014 were analyzed retrospectively(3296 upper endoscopy, and 1520 colonoscopy). Seventysix patients had upper GI bleeding(Upper group) and 65 had lower GI bleeding(Lower group). Variables were compared between the groups using one-way analysis of variance. Logistic regression was performed to identify variables significantly associated with the diagnosis of upper vs lower GI bleeding. Receiveroperator characteristic(ROC) analysis was performed to determine the threshold value that could distinguish upper from lower GI bleeding. RESULTS: Hemoglobin(P = 0.023), total protein(P = 0.0002), and lactate dehydrogenase(P = 0.009) were significantly lower in the Upper group than in the Lower group. Blood urea nitrogen(BUN) was higher in the Upper group than in the Lower group(P = 0.0065). Logistic regression analysis revealed that BUN was most strongly associated with the diagnosis of upper vslower GI bleeding. ROC analysis revealed a threshold BUN value of 21.0 mg/d L, with a specificity of 93.0%.CONCLUSION: The threshold BUN value for distinguishing upper from lower GI bleeding was 21.0 mg/d L.展开更多
In this paper, the investigation is focused on a （3＋1）-dimensional variable-coefficient Kadomtsev- Petviashvili （vcKP） equation, which can describe the realistic nonlinear phenomena in the fluid dynamics and plas...In this paper, the investigation is focused on a （3＋1）-dimensional variable-coefficient Kadomtsev- Petviashvili （vcKP） equation, which can describe the realistic nonlinear phenomena in the fluid dynamics and plasma in three spatial dimensions. In order to study the integrability property of such an equation, the Painlevé analysis is performed on it. And then, based on the truncated Painlevé expansion, the bilinear form of the （3＋1）-dimensionaJ vcKP equation is obtained under certain coefficients constraint, and its solution in the Wronskian determinant form is constructed and verified by virtue of the Wronskian technique. Besides the Wronskian determinant solution, it is shown that the （3＋1）-dimensional vcKP equation also possesses a solution in the form of the Grammian determinant.展开更多
Intracerebral hemorrhage is often accompanied by oxidative stress induced by reactive oxygen species,which causes abnormal mitochondrial function and secondary reactive oxygen species generation.This creates a vicious...Intracerebral hemorrhage is often accompanied by oxidative stress induced by reactive oxygen species,which causes abnormal mitochondrial function and secondary reactive oxygen species generation.This creates a vicious cycle leading to reactive oxygen species accumulation,resulting in progression of the pathological process.Therefore,breaking the cycle to inhibit reactive oxygen species accumulation is critical for reducing neuronal death after intracerebral hemorrhage.Our previous study found that increased expression of nicotinamide adenine dinucleotide phosphate oxidase 4(NADPH oxidase 4,NOX4)led to neuronal apoptosis and damage to the blood-brain barrier after intracerebral hemorrhage.The purpose of this study was to investigate the role of NOX4 in the circle involving the neuronal tolerance to oxidative stress,mitochondrial reactive oxygen species and modes of neuronal death other than apoptosis after intracerebral hemorrhage.We found that NOX4 knockdown by adeno-associated virus(AAV-NOX4)in rats enhanced neuronal tolerance to oxidative stress,enabling them to better resist the oxidative stress caused by intracerebral hemorrhage.Knockdown of NOX4 also reduced the production of reactive oxygen species in the mitochondria,relieved mitochondrial damage,prevented secondary reactive oxygen species accumulation,reduced neuronal pyroptosis and contributed to relieving secondary brain injury after intracerebral hemorrhage in rats.Finally,we used a mitochondria-targeted superoxide dismutase mimetic to explore the relationship between reactive oxygen species and NOX4.The mitochondria-targeted superoxide dismutase mimetic inhibited the expression of NOX4 and neuronal pyroptosis,which is similar to the effect of AAV-NOX4.This indicates that NOX4 is likely to be an important target for inhibiting mitochondrial reactive oxygen species production,and NOX4 inhibitors can be used to alleviate oxidative stress response induced by intracerebral hemorrhage.展开更多
Background: Electroacupuncture(EA) may reduce the severity of acute pancreatitis(AP) and provide additional pain relief in patients with chronic pancreatitis. However, the ability of EA to relieve pain in patients wit...Background: Electroacupuncture(EA) may reduce the severity of acute pancreatitis(AP) and provide additional pain relief in patients with chronic pancreatitis. However, the ability of EA to relieve pain in patients with AP has not been well documented.Objective: This study was undertaken to compare the pain-relieving effects of EA and conventional treatment in patients with AP.Design, setting, participants and interventions: This study was conducted using a randomized, controlled,three-arm, parallel-group and multi-center design. Patients diagnosed with AP were randomly and equally assigned to EA1, EA2 or control groups. All participants received conventional standard-of-care therapy for AP. Local EA alone was administered in EA1, and local plus distal EA was given in EA2.Local EA included two abdominal acupoints, while distal EA included twelve peripheral acupoints. EA groups underwent one session of EA daily for 4 days(days 1–4), or until pain was resolved or discharged.Main outcome measures: The primary outcome measure was the change in the visual analogue scale(VAS;0–100) pain score between baseline and day 5.Results: Eighty-nine participants were randomized into EA1, EA2 and control groups, and 88(EA1, 30;EA2, 29;control, 29) were included in the full-analysis set. VAS score change(median [interquartile range]) on day 5 was(12.3 ± 22.5) in the EA1 group,(10.3 ± 21.5) in the EA2 group, and(8.9 ± 15.2) in the control group. There were not significant differences in the change in VAS score among treatments(P = 0.983). However, time to food intake was significantly shorter in the EA group(EA1 + EA2) than in the control group(median 2.0 days vs 3.0 days), with a hazard ratio of 0.581(P = 0.022;95% CI,0.366–0.924). No significant adverse events occurred.Conclusion: EA treatment did not significantly reduce pain after 4 days of treatment in patients with AP-associated abdominal pain but significantly reduced time to first food intake.展开更多
BACKGROUND Surgical site infections(SSIs)increase mortality,hospital stays,additional medical treatment,and medical costs.Subcutaneous drains prevent SSIs in gynecological and breast surgeries;however,their clinical i...BACKGROUND Surgical site infections(SSIs)increase mortality,hospital stays,additional medical treatment,and medical costs.Subcutaneous drains prevent SSIs in gynecological and breast surgeries;however,their clinical impact in abdominal surgery remains unclear.AIM To investigate whether subcutaneous drains were beneficial in abdominal surgery using a systematic review and meta-analysis.METHODS The database search used PubMed,MEDLINE,and the Cochrane Library.The following inclusion criteria were set for the systematic review:(1)Randomized controlled trial studies comparing SSIs after abdominal surgery with or without subcutaneous drains;and(2)Studies that described clinical outcomes,such as SSIs,seroma formation,the length of hospital stays,and mortality.RESULTS Eight studies were included in this meta-analysis.The rate of total SSIs was significantly lower in the drained group(54/771,7.0%)than in the control group(89/759,11.7%),particularly in gastrointestinal surgery.Furthermore,the rate of superficial SSIs was slightly lower in the drained group(31/517,6.0%)than in the control group(49/521,9.4%).No significant differences were observed in seroma formation between the groups.Hospital stays were shorter in the drained group than in the control group.CONCLUSION Subcutaneous drains after abdominal surgery prevented SSIs and reduced hospital stays but did not significantly affect seroma formation.The timing of drain removal needs to be reconsidered in future studies.展开更多
Lentil(Lens culinaris Medikus subsp.culinaris,2 n=14)is a cool-season legume with high production potential for multiple uses.However,limited molecular research has been conducted in this species owing to its large ge...Lentil(Lens culinaris Medikus subsp.culinaris,2 n=14)is a cool-season legume with high production potential for multiple uses.However,limited molecular research has been conducted in this species owing to its large genome,which impedes the generation of genome sequences and the development of molecular markers.In this study,more than 1.37 billion filtered clean reads were collected by RNA-Seq of six diverse lentil accessions and217,836 transcripts and 161,095 unigenes were de novo assembled,yielding respectively 257.1 and 240.6 million nucleotides.The mean transcript length was 1180 bp and the N50 and N90 lengths were respectively 2075 and 479 bp.The mean length of the unigenes was 1494 bp and their N50 and N90 values were respectively 2203 and 714 bp.The unigenes were annotated against seven databases.The FLOWERING LOCUS T(FT)gene homolog in lentil showed high protein sequence similarity to the FT gene homologs of pea and alfalfa.On the basis of the RNA-Seq analysis,26,449 EST-SSR markers were designed in silico,and 276 preliminarily screened markers were selected to evaluate polymorphism in 94 diverse lentil accessions.In total,125(45.29%)of 276 EST-SSR markers were found to be polymorphic.A total of 130,073 SNP loci were detected and 78(61.41%)of 127 SNPs were successfully converted to KASP markers.Population genetic analyses of the lentil accessions with EST-SSR and KASP markers revealed similar genetic structures,suggesting that the RNA-Seq-generated resources and the developed markers are reliable for use in molecular marker-assisted breeding of lentil.展开更多
A novel microwave cloak using circular split ring resonator(SRR)based metamaterial structure has been proposed in this paper.The cloak which operates at a frequency of 10.6 GHz is composed of cylindrical dielectric sh...A novel microwave cloak using circular split ring resonator(SRR)based metamaterial structure has been proposed in this paper.The cloak which operates at a frequency of 10.6 GHz is composed of cylindrical dielectric sheets printed with circular split ring resonators of spatially varying and anisotropic material properties.The article also focuses on the phenomenon of resonant splitting in circular SRR microwave cloak.A detailed analysis of various linear metamaterial arrays and their response has also been elucidated.展开更多
AIM: To investigate efficacy and safety of second-line treatment with irinotecan-loaded drug-eluting beads(DEBIRI) and cetuximab(DEBIRITUX) of unresectable colorectal liver metastases.METHODS: Patients with the follow...AIM: To investigate efficacy and safety of second-line treatment with irinotecan-loaded drug-eluting beads(DEBIRI) and cetuximab(DEBIRITUX) of unresectable colorectal liver metastases.METHODS: Patients with the following characteristics were included in the study: unresectable hepatic metastases from colorectal carcinoma(CRC-LM), progression after first line chemotherapy(any type of chemotherapeutic drug and combination was allowed), second line treatment(mandatory), which included for each patient(unregarding the KRas status) two cycles of DEBIRI(using 100-300 μm beads loaded with irinotecan at a total dose 200 mg) followed by 12 cycles of cetuximab that was administered weekly at a first dose of 400 mg/m2 and then 250 mg/m2; good performance status(0-2) and liver functionality(alanine aminotransferase and gamma-glutamyl transferase not exceeding three times the upper limit of normal, total bilirubin not exceeding 2.5 mg/m L). Data were collected retrospectively and included: tumor response(evaluated monthly for 6 mo then every 3 mo), overall response rate(ORR), KRas status, type and intensity of adverse events(G according to the Common Terminology Criteria for Adverse Events v3.0, CTCAE), overall survival(OS) and progression free survival(PFS).RESULTS: Forty consecutive cases of CRC hepatic metastases were included in the study. Median duration of DEBIRITUX was 4.4 mo(range, 4.0-6.5). Sixteen patients(40%) received the planned 2 cycles of DEBIRI and an average of 10 cetuximab cycles. ORR of the whole sample was 50%, in particular 4 patients were complete responders(10%) and 16(40%) partial responders. The most observed side effects(G2) were: post-embolization syndrome(30%), diarrhea(25%), skin rushes(38%) and asthenia(35%). The retrospective evaluation of KRas status(24 wild type, 16 mutated) showed that the group of patients with wild type KRas had ORR significantly higher than mutant KRas. Median follow-up was 29 mo(8-48 range); median PFS was 9.8 mo and OS was 20.4 mo. Future randomized trials are required in this setting to establish a role for DEBIRITUX compared with systemic chemotherapy.CONCLUSION: DEBIRITUX seems to be efficacious after first line chemotherapy for the treatment of unresectable CRC-LM.展开更多
Atherosclerosis is a major cause of mortality and morbidity,and rupture can lead to myocardial infarction and stroke.The vulnerability assessment of atherosclerosis plaques is important for providing medical treatment...Atherosclerosis is a major cause of mortality and morbidity,and rupture can lead to myocardial infarction and stroke.The vulnerability assessment of atherosclerosis plaques is important for providing medical treatment.Identifying vulnerable plaques requires noninvasive,high-resolution imaging techniques for capturing and locating high-risk markers.Photoacoustic imaging(PAI)is a hybrid and novel imaging modality that uses nonionizing excitation and has substantial promise for vulnerability assessment of atherosclerosis.The current review examined current applications of multimodal PAI for identification of atherosclerosis plaques.Furthermore,we discuss the challenges and limitations in the implementation this method and future research directions to overcome these difficulties.First,we discuss two aspects of vulnerable plaque characterization:large necrotic cores and thin degraded cap component identification.Then,we then discuss applications of high-risk plaque characterization,including intraplaque hemorrhage and heme degradation markers detection.We hope that this review will shed light on the potential application of optical imaging techniques in atherosclerosis identification and facilitate further studies that will ultimately lead to the broader application of multimodal PAI in clinical practice.展开更多
<strong>Introduction: </strong>Stress and burnout are a reality which nurses encounter and try to cope with especially in the Emergency Department (ED) so that they can provide optimal patient care. Nurses...<strong>Introduction: </strong>Stress and burnout are a reality which nurses encounter and try to cope with especially in the Emergency Department (ED) so that they can provide optimal patient care. Nurses who work in ED are front line providers of immediate medical care needed to stabilize patients. With the known critical shortage of health workforce in Cameroon, nurses are overloaded with work and often experience stress and burnout. <strong>Aim: </strong>This study aimed at determining the causes, effects and management strategies of stress and burnout among nurses working in the ED in hospitals in the Fako Division, Cameroon. <strong>Methods:</strong> This study was a descriptive cross-sectional study. The sample consisted of seventy nurses from five different hospitals. A purposive sampling technique was used and data was analyzed using SPSS version 16.0. Data was collected using a structured questionnaire developed from the International Stress Management Scale. <strong>Results: </strong>The highest reported cause of stress in this study was heavy workload (12.88%) and the least was no experience in handling the challenges of the department. The leading reported effect of stress was the development of musculoskeletal disorders such as joint and back pain (16.48%) and the least effect was contemplating quitting the profession (5.99%). The major management strategy used was humour (8.27%), while the least was crying out stress to feel relieved (2.18%).<strong> Conclusion: </strong>The major cause of stress and burnout among nurses in our study setting was heavy workload, which mostly results in joint and back pain. Moreover, humour was the prime management strategy for stress and burnout among nurses in the emergency department in the study setting. Thus more nurses should be employed and the working conditions of nurses improved to reduce the workload in the study hospitals.展开更多
WS_(2),a two-dimensional layered material,is promising as sodium-ion batteries(SIBs)anode due to its large lnterlamellar spacing and high sodium storage capacity.However,its low electronic conductivity and high Na^(+)...WS_(2),a two-dimensional layered material,is promising as sodium-ion batteries(SIBs)anode due to its large lnterlamellar spacing and high sodium storage capacity.However,its low electronic conductivity and high Na^(+)adsorption energy hinder reaction kinetics.Here we demonstrate that substituting Se for part of the S in WS_(2)reduces interlayer Na^(+)adsorption and increases electronic conductivity.Based on this finding,lamellar WSSe,grown in situ on peanut shell-derived carbon(PSDC/WSSe),is elaborately designed as a highly stable SIB anode with a fast kinetic.PSDC/WSSe with carbon matrix and Se substitution simultaneously provides fast electron transport channels and lowered Na^(+)transport barriers(0.22 eV).The PSDC/WSSe anode offers a considerable reversible sodium storage capacity(288.0 mAh g^(-1)after 1000 cycles at 1.0 A g^(-1))and a fast kinetic reaction.A SIB full-cell using a PSDC/WSSe anode and Na_(3)V_(2)(PO_(4))_(3)cathode achieves a 215.4 Wh kg^(-1)high energy density,and successfully powers LEDs.This work offers new strategies to lower sodium ion transportation barrier in two-dimensional layered materials.展开更多
Over the past few years,there has been an emerging number of new psychoactive drugs.These drugs are frequently mentioned as“legal highs”,“herbal highs”,“bath salts”and“research chemicals”.They are mostly sold ...Over the past few years,there has been an emerging number of new psychoactive drugs.These drugs are frequently mentioned as“legal highs”,“herbal highs”,“bath salts”and“research chemicals”.They are mostly sold and advertised on online forums and on the dark web.The emerging new psychoactive substances are designed to mimic the effects of psychoactive groups,which are often abused drugs.Novel synthetic opioids are a new trend in this context and represent an alarming threat to public health.Given the wide number of fatalities related to these compounds reported within the last few years,it is an important task to accurately identify these compounds in biologic matrices in order to administer an effective treatment and reverse the respiratory depression caused by opioid related substances.Clinicians dealing with fentanyl intoxication cases should consider that it could,in fact,be a fentanyl analogue.For this reason,it is a helpful recommendation to include synthetic opioids in the routine toxicological screening procedures,including analysis in alternative matrices,if available,to investigate poly-drug use and possible tolerance to opioids.To address this public health problem,better international collaboration,effective legislation,effective investigation,control of suspicious“research chemicals”online forums and continuous community alertness are required.This article aims to review diverse reported fatalities associated with new synthetic opioids describing them in terms of pharmacology,metabolism,posology,available forms,as well as their toxic effects,highlighting the sample procedures and analytical techniques available for their detection and quantification in biological matrices.展开更多
基金National Natural Science:Grey Correlation Analysis based on Dynamic Data to Construct A Knowledge Map of the Dynamic Change Law of Chinese Medicine Constitution(No.81904324)National Natural Science Foundation:Discovery and Algorithm Research of"Hierarchical Feature Association Network"for Subjective and Objective Symptoms of Diseases and Bioinformatics based on Data Lake Technology-Taking Diabetes as an Example(No.82174236)。
文摘OBJECTIVE:To find more influencing factors Qideficiency constitution of Traditional Chinese Medicine(TCM)using dynamic and comprehensive information.METHODS:Because grey relational analysis(GRA)is good at processing incomplete information and has no special requirements for sample size and distribution.We acquired 2122 pieces of valid Qi-deficiency constitution dynamic data after preprocessing,and used GRA combing withχ~2 test and multivariate logistic regression analysis to discover and sort the influencing factors of Qideficiency constitution.RESULTS:For the calculation results of GRA,there were 10(62.5%)aspects whose grey correlation degrees were greater than 0.6.The results ofχ~2 test showed that all the above 10 aspects were statistically significant with Qideficiency constitution.The analysis results of multivariate logistic regression analysis showed the following factors were positively correlated with Qi-deficiency constitution:premature birth,sleeping late and getting up early,sleeping late and getting up late,irregular sleeping,sleeping 6.0-6.9 h per day,artificial feeding,female,age at 18-19,and father's age at 18-19 years old when a baby at birth.The following factors were negatively correlated with Qi-deficiency constitution:sleeping 8.0-8.9 h per day and≥9.0 h per day,and age at 30-39 and 40-49 years old.CONCLUSIONS:It is necessary to pay attention to these innate and acquired information of individuals which may lead to Qi-deficiency constitution.And our research also provides a novel methodological thinking for analyzing the influential factors of TCM constitution.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)has been shown to increase the risk of stroke.However,the prevalence and risk of recurrent stroke in COVID-19 patients with prior stroke/transient ischemic attack(TIA),as well as its impact on mor-tality,are not established.AIM To evaluate the impact of COVID-19 on in-hospital mortality,length of stay,and healthcare costs in patients with recurrent strokes.METHODS We identified admissions of recurrent stroke(current acute ischemic stroke admissions with at least one prior TIA or stroke)in patients with and without COVID-19 using ICD-10-CM codes using the National Inpatient Sample(2020).We analyzed the impact of COVID-19 on mortality following recurrent stroke admissions by subgroups.RESULTS Of 97455 admissions with recurrent stroke,2140(2.2%)belonged to the COVID-19-positive group.The COVID-19-positive group had a higher prevalence of diabetes and chronic kidney disease vs the COVID-19 negative group(P<0.001).Among the subgroups,patients aged>65 years,patients aged 45–64 years,Asians,Hispanics,whites,and blacks in the COVID-19 positive group had higher rates of all-cause mortality than the COVID-19 negative group(P<0.01).Higher odds of in-hospital mortality were seen in the group aged 45-64(OR:8.40,95%CI:4.18-16.91)vs the group aged>65(OR:7.04,95%CI:5.24-9.44),males(OR:7.82,95%CI:5.38-11.35)compared to females(OR:6.15,95%CI:4.12-9.18),and in Hispanics(OR:15.47,95%CI:7.61-31.44)and Asians/Pacific Islanders(OR:14.93,95%CI:7.22-30.87)compared to blacks(OR:5.73,95%CI:3.08-10.68),and whites(OR:5.54,95%CI:3.79-8.09).CONCLUSION The study highlights the increased risk of all-cause in-hospital mortality in recurrent stroke patients with COVID-19,with a more pronounced increase in middle-aged patients,males,Hispanics,or Asians.
文摘Noise is one of the environmental factors with mental and physical effects.The workload is also the multiple mental and physical demands of the task.Therefore,his study investigated the relationship between noise exposure and mood states at different levels of workload.The study recruited 50 workers from the manufacturing sector(blue-collar workers)as the exposed group and 50 workers from the office sector(white-collar workers)as the control group.Their occupational noise exposure was measured by dosimetry.The Stress-Arousal Checklist(SACL)and the NASA Task Load Index(NASA-TLX)were used to measure mood and workload,respectively.The equivalent noise exposure level of the exposed group at high and very high workload levels was 85 and 87 dBA,respectively.The mean mood score of the exposed group was 76 at very high workload.The correlation coefficient between noise exposure level and mood state based on workload levels ranged from 0.3 at medium workload to 0.57 at very high workload.Noise exposure at high workload levels can increase its adverse effects,so controlling and optimizing the multiple demands of the task in the workplace can be used as a privative measure to reduce the adverse effects of noise.
文摘AIM： To describe the trend in duodenal biopsy performance during routine upper gastrointestinal endoscopy in an adult Spanish population, and to analyze its value for the diagnosis of celiac disease in clinical practice. METHODS： A 15 year-trend （1990 to 2004） in duodenal biopsy performed when undertaking upper gastrointestinal endoscopy was studied. We analysed the prevalence of celiac disease in the overall group, and in the subgroups with anaemia and/or chronic diarrhoea. RESULTS： Duodenal biopsy was performed in 1033 of 13 678 upper gastrointestinal endoscopies （7.6%）; an increase in the use of such was observed over the study period （1.9% in 1990-1994, 5% in 1995-1999 and 12.8% in 2000-2004）. Celiac disease was diagnosed in 22 patients （2.2%）, this being more frequent in women than in men （3% and 1% respectively）. Fourteen out of 514 （2.7%） patients with anaemia, 12 out of 141 （8.5%） with chronic diarrhoea and 8 out of 42 （19%） with anaemia plus chronic diarrhoea had celiac disease. A classical clinical presentation was observed in 55% of the cases, 23% of the patients had associated dermatitis herpetiformis and 64% presented anaemia; 9% were diagnosed by familial screening and 5% by cryptogenetic hypertransaminasaemia. CONCLUSION： Duodenal biopsy undertaken during routine upper gastrointestinal endoscopy in adults, has been gradually incorporated into clinical practice, and is a useful tool for the diagnosis of celiac disease in high risk groups such as those with anaemia and/or chronic diarrhoea.
文摘AIM: To distinguish upper from lower gastrointestinal(GI) bleeding. METHODS: Patient records between April 2011 and March 2014 were analyzed retrospectively(3296 upper endoscopy, and 1520 colonoscopy). Seventysix patients had upper GI bleeding(Upper group) and 65 had lower GI bleeding(Lower group). Variables were compared between the groups using one-way analysis of variance. Logistic regression was performed to identify variables significantly associated with the diagnosis of upper vs lower GI bleeding. Receiveroperator characteristic(ROC) analysis was performed to determine the threshold value that could distinguish upper from lower GI bleeding. RESULTS: Hemoglobin(P = 0.023), total protein(P = 0.0002), and lactate dehydrogenase(P = 0.009) were significantly lower in the Upper group than in the Lower group. Blood urea nitrogen(BUN) was higher in the Upper group than in the Lower group(P = 0.0065). Logistic regression analysis revealed that BUN was most strongly associated with the diagnosis of upper vslower GI bleeding. ROC analysis revealed a threshold BUN value of 21.0 mg/d L, with a specificity of 93.0%.CONCLUSION: The threshold BUN value for distinguishing upper from lower GI bleeding was 21.0 mg/d L.
基金Supported by the Specialized Research Fund for the Doctoral Program of Higher Education under Grant Nos. 20060006024 and 20080013006Chinese Ministry of Education, by the National Natural Science Foundation of China under Grant No. 60772023+2 种基金by the Open Fund of the State Key Laboratory of Software Development Environment under Grant No. SKLSDE-07-001Beijing University of Aeronautics and Astronauticsby the National Basic Research Program of China (973 Program) under Grant No. 2005CB321901
文摘In this paper, the investigation is focused on a （3＋1）-dimensional variable-coefficient Kadomtsev- Petviashvili （vcKP） equation, which can describe the realistic nonlinear phenomena in the fluid dynamics and plasma in three spatial dimensions. In order to study the integrability property of such an equation, the Painlevé analysis is performed on it. And then, based on the truncated Painlevé expansion, the bilinear form of the （3＋1）-dimensionaJ vcKP equation is obtained under certain coefficients constraint, and its solution in the Wronskian determinant form is constructed and verified by virtue of the Wronskian technique. Besides the Wronskian determinant solution, it is shown that the （3＋1）-dimensional vcKP equation also possesses a solution in the form of the Grammian determinant.
基金supported by the National Natural Science Foundation of China,No.81671125the Natural Science Foundation of Guangdong Province,No.2021A1515011115Guangzhou Science and Technology Project,No.202102010346(all to YZC)。
文摘Intracerebral hemorrhage is often accompanied by oxidative stress induced by reactive oxygen species,which causes abnormal mitochondrial function and secondary reactive oxygen species generation.This creates a vicious cycle leading to reactive oxygen species accumulation,resulting in progression of the pathological process.Therefore,breaking the cycle to inhibit reactive oxygen species accumulation is critical for reducing neuronal death after intracerebral hemorrhage.Our previous study found that increased expression of nicotinamide adenine dinucleotide phosphate oxidase 4(NADPH oxidase 4,NOX4)led to neuronal apoptosis and damage to the blood-brain barrier after intracerebral hemorrhage.The purpose of this study was to investigate the role of NOX4 in the circle involving the neuronal tolerance to oxidative stress,mitochondrial reactive oxygen species and modes of neuronal death other than apoptosis after intracerebral hemorrhage.We found that NOX4 knockdown by adeno-associated virus(AAV-NOX4)in rats enhanced neuronal tolerance to oxidative stress,enabling them to better resist the oxidative stress caused by intracerebral hemorrhage.Knockdown of NOX4 also reduced the production of reactive oxygen species in the mitochondria,relieved mitochondrial damage,prevented secondary reactive oxygen species accumulation,reduced neuronal pyroptosis and contributed to relieving secondary brain injury after intracerebral hemorrhage in rats.Finally,we used a mitochondria-targeted superoxide dismutase mimetic to explore the relationship between reactive oxygen species and NOX4.The mitochondria-targeted superoxide dismutase mimetic inhibited the expression of NOX4 and neuronal pyroptosis,which is similar to the effect of AAV-NOX4.This indicates that NOX4 is likely to be an important target for inhibiting mitochondrial reactive oxygen species production,and NOX4 inhibitors can be used to alleviate oxidative stress response induced by intracerebral hemorrhage.
基金supported by the Korean Health Technology R&D Project,Ministry of Health&Welfare,Republic of Korea(Grant No.HI16C0887).
文摘Background: Electroacupuncture(EA) may reduce the severity of acute pancreatitis(AP) and provide additional pain relief in patients with chronic pancreatitis. However, the ability of EA to relieve pain in patients with AP has not been well documented.Objective: This study was undertaken to compare the pain-relieving effects of EA and conventional treatment in patients with AP.Design, setting, participants and interventions: This study was conducted using a randomized, controlled,three-arm, parallel-group and multi-center design. Patients diagnosed with AP were randomly and equally assigned to EA1, EA2 or control groups. All participants received conventional standard-of-care therapy for AP. Local EA alone was administered in EA1, and local plus distal EA was given in EA2.Local EA included two abdominal acupoints, while distal EA included twelve peripheral acupoints. EA groups underwent one session of EA daily for 4 days(days 1–4), or until pain was resolved or discharged.Main outcome measures: The primary outcome measure was the change in the visual analogue scale(VAS;0–100) pain score between baseline and day 5.Results: Eighty-nine participants were randomized into EA1, EA2 and control groups, and 88(EA1, 30;EA2, 29;control, 29) were included in the full-analysis set. VAS score change(median [interquartile range]) on day 5 was(12.3 ± 22.5) in the EA1 group,(10.3 ± 21.5) in the EA2 group, and(8.9 ± 15.2) in the control group. There were not significant differences in the change in VAS score among treatments(P = 0.983). However, time to food intake was significantly shorter in the EA group(EA1 + EA2) than in the control group(median 2.0 days vs 3.0 days), with a hazard ratio of 0.581(P = 0.022;95% CI,0.366–0.924). No significant adverse events occurred.Conclusion: EA treatment did not significantly reduce pain after 4 days of treatment in patients with AP-associated abdominal pain but significantly reduced time to first food intake.
基金Supported by Grants-in-Aid from JSPS KAKENHI,No.JP 21K10715 and No.JP 20K10404Northern Advancement Center for Science&Technology,No.T-2-2+9 种基金the Yasuda Medical Foundation,No.31010316the Okawa Foundation for Information and Telecommunications,No.41111042Taiju Life Social Welfare Foundation,No.50811490Japan Keirin Autorace Foundation,No.2023M-378Project Mirai Cancer Research Grants,No.31010269Takahashi Industrial and Economic Research Foundation,No.50411278Sapporo Doto Hospital,No.50311211Noguchi Hospital,No.40310551Doki-kai Tomakomai Hospital,No.40710739Tsuchida Hospital,No.50811478.
文摘BACKGROUND Surgical site infections(SSIs)increase mortality,hospital stays,additional medical treatment,and medical costs.Subcutaneous drains prevent SSIs in gynecological and breast surgeries;however,their clinical impact in abdominal surgery remains unclear.AIM To investigate whether subcutaneous drains were beneficial in abdominal surgery using a systematic review and meta-analysis.METHODS The database search used PubMed,MEDLINE,and the Cochrane Library.The following inclusion criteria were set for the systematic review:(1)Randomized controlled trial studies comparing SSIs after abdominal surgery with or without subcutaneous drains;and(2)Studies that described clinical outcomes,such as SSIs,seroma formation,the length of hospital stays,and mortality.RESULTS Eight studies were included in this meta-analysis.The rate of total SSIs was significantly lower in the drained group(54/771,7.0%)than in the control group(89/759,11.7%),particularly in gastrointestinal surgery.Furthermore,the rate of superficial SSIs was slightly lower in the drained group(31/517,6.0%)than in the control group(49/521,9.4%).No significant differences were observed in seroma formation between the groups.Hospital stays were shorter in the drained group than in the control group.CONCLUSION Subcutaneous drains after abdominal surgery prevented SSIs and reduced hospital stays but did not significantly affect seroma formation.The timing of drain removal needs to be reconsidered in future studies.
基金supported by the funding of Subject Team of Science and Technology Innovation Project of Shandong Academy of Agricultural Sciences(CXGC2018E15)National Key Research and Development Program of China(2017YFE0105100)+5 种基金Industry Team of Science and Technology Innovation Project of Shandong Academy of Agricultural Sciences(CXGC2016A02)Crop Germplasm Resources Protection(2130135)Coarse Cereals Innovation Team of Modern Agricultural Industry Technology System of Shandong Province(SDAIT-15-01)China Agriculture Research System(CARS-08)Youth Research Fund of Shandong Academy of Agricultural Sciences(2016YQN19)Agricultural Science and Technology Innovation Program(ASTIP)of CAAS。
文摘Lentil(Lens culinaris Medikus subsp.culinaris,2 n=14)is a cool-season legume with high production potential for multiple uses.However,limited molecular research has been conducted in this species owing to its large genome,which impedes the generation of genome sequences and the development of molecular markers.In this study,more than 1.37 billion filtered clean reads were collected by RNA-Seq of six diverse lentil accessions and217,836 transcripts and 161,095 unigenes were de novo assembled,yielding respectively 257.1 and 240.6 million nucleotides.The mean transcript length was 1180 bp and the N50 and N90 lengths were respectively 2075 and 479 bp.The mean length of the unigenes was 1494 bp and their N50 and N90 values were respectively 2203 and 714 bp.The unigenes were annotated against seven databases.The FLOWERING LOCUS T(FT)gene homolog in lentil showed high protein sequence similarity to the FT gene homologs of pea and alfalfa.On the basis of the RNA-Seq analysis,26,449 EST-SSR markers were designed in silico,and 276 preliminarily screened markers were selected to evaluate polymorphism in 94 diverse lentil accessions.In total,125(45.29%)of 276 EST-SSR markers were found to be polymorphic.A total of 130,073 SNP loci were detected and 78(61.41%)of 127 SNPs were successfully converted to KASP markers.Population genetic analyses of the lentil accessions with EST-SSR and KASP markers revealed similar genetic structures,suggesting that the RNA-Seq-generated resources and the developed markers are reliable for use in molecular marker-assisted breeding of lentil.
文摘A novel microwave cloak using circular split ring resonator(SRR)based metamaterial structure has been proposed in this paper.The cloak which operates at a frequency of 10.6 GHz is composed of cylindrical dielectric sheets printed with circular split ring resonators of spatially varying and anisotropic material properties.The article also focuses on the phenomenon of resonant splitting in circular SRR microwave cloak.A detailed analysis of various linear metamaterial arrays and their response has also been elucidated.
文摘AIM: To investigate efficacy and safety of second-line treatment with irinotecan-loaded drug-eluting beads(DEBIRI) and cetuximab(DEBIRITUX) of unresectable colorectal liver metastases.METHODS: Patients with the following characteristics were included in the study: unresectable hepatic metastases from colorectal carcinoma(CRC-LM), progression after first line chemotherapy(any type of chemotherapeutic drug and combination was allowed), second line treatment(mandatory), which included for each patient(unregarding the KRas status) two cycles of DEBIRI(using 100-300 μm beads loaded with irinotecan at a total dose 200 mg) followed by 12 cycles of cetuximab that was administered weekly at a first dose of 400 mg/m2 and then 250 mg/m2; good performance status(0-2) and liver functionality(alanine aminotransferase and gamma-glutamyl transferase not exceeding three times the upper limit of normal, total bilirubin not exceeding 2.5 mg/m L). Data were collected retrospectively and included: tumor response(evaluated monthly for 6 mo then every 3 mo), overall response rate(ORR), KRas status, type and intensity of adverse events(G according to the Common Terminology Criteria for Adverse Events v3.0, CTCAE), overall survival(OS) and progression free survival(PFS).RESULTS: Forty consecutive cases of CRC hepatic metastases were included in the study. Median duration of DEBIRITUX was 4.4 mo(range, 4.0-6.5). Sixteen patients(40%) received the planned 2 cycles of DEBIRI and an average of 10 cetuximab cycles. ORR of the whole sample was 50%, in particular 4 patients were complete responders(10%) and 16(40%) partial responders. The most observed side effects(G2) were: post-embolization syndrome(30%), diarrhea(25%), skin rushes(38%) and asthenia(35%). The retrospective evaluation of KRas status(24 wild type, 16 mutated) showed that the group of patients with wild type KRas had ORR significantly higher than mutant KRas. Median follow-up was 29 mo(8-48 range); median PFS was 9.8 mo and OS was 20.4 mo. Future randomized trials are required in this setting to establish a role for DEBIRITUX compared with systemic chemotherapy.CONCLUSION: DEBIRITUX seems to be efficacious after first line chemotherapy for the treatment of unresectable CRC-LM.
基金National Natural Science Foundation of China,Grant/Award Numbers:62105255,62275210Key Research and Development Program of Shaanxi,Grant/Award Numbers:2023-YBSF-293,2023-YBSF-258+2 种基金Fundamental Research Funds for Central Universities of the Central South University,Grant/Award Number:ZYTS23187National Young Talent Program:Shaanxi Young Top-notch Talent ProgramNational Key R&D Program of China,Grant/Award Number:2022YFB3203800。
文摘Atherosclerosis is a major cause of mortality and morbidity,and rupture can lead to myocardial infarction and stroke.The vulnerability assessment of atherosclerosis plaques is important for providing medical treatment.Identifying vulnerable plaques requires noninvasive,high-resolution imaging techniques for capturing and locating high-risk markers.Photoacoustic imaging(PAI)is a hybrid and novel imaging modality that uses nonionizing excitation and has substantial promise for vulnerability assessment of atherosclerosis.The current review examined current applications of multimodal PAI for identification of atherosclerosis plaques.Furthermore,we discuss the challenges and limitations in the implementation this method and future research directions to overcome these difficulties.First,we discuss two aspects of vulnerable plaque characterization:large necrotic cores and thin degraded cap component identification.Then,we then discuss applications of high-risk plaque characterization,including intraplaque hemorrhage and heme degradation markers detection.We hope that this review will shed light on the potential application of optical imaging techniques in atherosclerosis identification and facilitate further studies that will ultimately lead to the broader application of multimodal PAI in clinical practice.
文摘<strong>Introduction: </strong>Stress and burnout are a reality which nurses encounter and try to cope with especially in the Emergency Department (ED) so that they can provide optimal patient care. Nurses who work in ED are front line providers of immediate medical care needed to stabilize patients. With the known critical shortage of health workforce in Cameroon, nurses are overloaded with work and often experience stress and burnout. <strong>Aim: </strong>This study aimed at determining the causes, effects and management strategies of stress and burnout among nurses working in the ED in hospitals in the Fako Division, Cameroon. <strong>Methods:</strong> This study was a descriptive cross-sectional study. The sample consisted of seventy nurses from five different hospitals. A purposive sampling technique was used and data was analyzed using SPSS version 16.0. Data was collected using a structured questionnaire developed from the International Stress Management Scale. <strong>Results: </strong>The highest reported cause of stress in this study was heavy workload (12.88%) and the least was no experience in handling the challenges of the department. The leading reported effect of stress was the development of musculoskeletal disorders such as joint and back pain (16.48%) and the least effect was contemplating quitting the profession (5.99%). The major management strategy used was humour (8.27%), while the least was crying out stress to feel relieved (2.18%).<strong> Conclusion: </strong>The major cause of stress and burnout among nurses in our study setting was heavy workload, which mostly results in joint and back pain. Moreover, humour was the prime management strategy for stress and burnout among nurses in the emergency department in the study setting. Thus more nurses should be employed and the working conditions of nurses improved to reduce the workload in the study hospitals.
基金financially supported by the Key R&D Plan of Shaanxi Province(Grant No.2023-YBGY-492)financial support from the Australian Research Councilthe QUT Capacity Building Professor Program。
文摘WS_(2),a two-dimensional layered material,is promising as sodium-ion batteries(SIBs)anode due to its large lnterlamellar spacing and high sodium storage capacity.However,its low electronic conductivity and high Na^(+)adsorption energy hinder reaction kinetics.Here we demonstrate that substituting Se for part of the S in WS_(2)reduces interlayer Na^(+)adsorption and increases electronic conductivity.Based on this finding,lamellar WSSe,grown in situ on peanut shell-derived carbon(PSDC/WSSe),is elaborately designed as a highly stable SIB anode with a fast kinetic.PSDC/WSSe with carbon matrix and Se substitution simultaneously provides fast electron transport channels and lowered Na^(+)transport barriers(0.22 eV).The PSDC/WSSe anode offers a considerable reversible sodium storage capacity(288.0 mAh g^(-1)after 1000 cycles at 1.0 A g^(-1))and a fast kinetic reaction.A SIB full-cell using a PSDC/WSSe anode and Na_(3)V_(2)(PO_(4))_(3)cathode achieves a 215.4 Wh kg^(-1)high energy density,and successfully powers LEDs.This work offers new strategies to lower sodium ion transportation barrier in two-dimensional layered materials.
基金funded by FEDER funds through the POCI-COMPETE 2020-Operational Programme Competitiveness and Internationalization in Axis IStrengthening Research,Technological Development and Innovation[grant number:Project POCI-01-0145-FEDER-007491]National Funds by FCT-Fundac¸ão para a Ciência e a Tecnologia[grant number:Project UID/Multi/00709/2013]S.Soares and J.Gonc¸alves acknowledge Program Santander-Totta Universidades in the form of a fellowship grant number[Bolsa BID/UBISantander Universidades/2018].Â.Luís acknowledges the contract in the scientific area of Microbiology(Scientific Employment)financed by FCT.
文摘Over the past few years,there has been an emerging number of new psychoactive drugs.These drugs are frequently mentioned as“legal highs”,“herbal highs”,“bath salts”and“research chemicals”.They are mostly sold and advertised on online forums and on the dark web.The emerging new psychoactive substances are designed to mimic the effects of psychoactive groups,which are often abused drugs.Novel synthetic opioids are a new trend in this context and represent an alarming threat to public health.Given the wide number of fatalities related to these compounds reported within the last few years,it is an important task to accurately identify these compounds in biologic matrices in order to administer an effective treatment and reverse the respiratory depression caused by opioid related substances.Clinicians dealing with fentanyl intoxication cases should consider that it could,in fact,be a fentanyl analogue.For this reason,it is a helpful recommendation to include synthetic opioids in the routine toxicological screening procedures,including analysis in alternative matrices,if available,to investigate poly-drug use and possible tolerance to opioids.To address this public health problem,better international collaboration,effective legislation,effective investigation,control of suspicious“research chemicals”online forums and continuous community alertness are required.This article aims to review diverse reported fatalities associated with new synthetic opioids describing them in terms of pharmacology,metabolism,posology,available forms,as well as their toxic effects,highlighting the sample procedures and analytical techniques available for their detection and quantification in biological matrices.
