Background:Stroke is the second leading cause of death and third leading cause of disability worldwide and is the leading cause of death and disability among adults in China,with its incidence rate continuing to rise....Background:Stroke is the second leading cause of death and third leading cause of disability worldwide and is the leading cause of death and disability among adults in China,with its incidence rate continuing to rise.In China,the average age of firsttime stroke patients is 66.4 years,and the intravenous thrombolysis rate using recombinant tissue plasminogen activator within 3 h of onset is only 16%.Given this fact,there is a pressing need for real‐time predictive tools,particularly for elderly individuals at home,that can provide early warnings for potential strokes.Methods:We collected continuous monitoring data from nonintrusive smart beds and multimodal temporal data from electronic medical records at the National Center for Neurological Disorders.The data included smart bed monitoring indicators,laboratory tests,nurse observations,and static data as potential predictors,with stroke as the outcome.We applied feature representation and feature selection techniques and then input the predictors into machine learning models.Additionally,deep learning models were used after preprocessing the irregular temporal data.Finally,we evaluated the performance of the stroke prediction models and assessed the importance of the features.We used continuously updated vital signs and clinical data during hospitalization to generate timely stroke risk alerts during the same period of admission.Results:A total of 37,041 samples were analyzed,of which 7020 patients were diagnosed with stroke.When only the smart bed features were used for prediction,the model achieved an area under the receiver operating characteristic curve(AUROC)of 0.59−0.63,with an accuracy ranging from 60%−65%.Among the four artificial intelligence algorithms,the random forest model demonstrated the best performance.After all the available features were incorporated,the AUROC increased to 0.94,and the accuracy improved to 92%.Conclusions:In this study,the occurrence of stroke was successfully identified by integrating multimodal temporal data from electronic medical records.Noncontact monitoring of respiration and heart rate offers a promising approach for daily stroke surveillance in home‐based populations,particularly for elderly individuals living alone.展开更多
AIM:To investigate the outcome of palliative chemotherapy in old patients with gastroesophageal cancer at the National Center for Tumor Diseases,Heidelberg.METHODS:Using a prospectively generated database,we retrospec...AIM:To investigate the outcome of palliative chemotherapy in old patients with gastroesophageal cancer at the National Center for Tumor Diseases,Heidelberg.METHODS:Using a prospectively generated database,we retrospectively analyzed 55 patients≥70years under palliative chemotherapy for advanced gastroesophageal cancer at the outpatient clinic of the National Center for Tumor Diseases Heidelberg,Germany between January 2006 and December2013.Further requirements for inclusion were(1)histologically proven diagnosis of gastroesophageal cancer;(2)advanced(metastatic or inoperable)disease;and(3)no history of radiation or radiochemotherapy.The clinical information included Eastern Cooperative Oncology Group performance status(ECOG PS),presence and site of metastases at diagnosis,date of previous surgery and perioperative chemotherapy,start and stop date of first-line treatment,toxicities and consecutive dosage reductions of first-line treatment,response to first-line therapy,date of progression,usage of second-line therapies and date and cause of death.Survival times[progression-free survival(PFS),overall survival(OS)and residual survival(RS)]were calculated.Toxicity and safety were examined.Prognostic factors including ECOG PS,age and previousperioperative treatment were analyzed.RESULTS:Median age of our cohort was 76 years.86%of patients received a combination of two cytotoxic drugs.76 percent of patients had an oxaliplatin-based first-line therapy with the oxaliplatin and 5-fluorouracil regimen being the predominantely chosen regimen(69%).Drug modifications due to toxicity were necessary in 56%of patients,and 11%of patients stopped treatment due to toxicities.Survival times of our cohort are in good accordance with the major phaseⅢtrials that included mostly younger patients:PFS and OS were 5.8 and 9.5 mo,respectively.Survival differed significantly between patient groups with low(≤1)and high(≥2)ECOG PS(12.7 mo vs 3.8 mo,P<0.001).Very old patients(≥75 years)did not show a worse outcome in terms of survival.Patients receiving secondline treatment(51%)had a significantly longer RS than patients with best supportive care(6.8 vs 1.4 mo,P=0.001).Initial ECOG PS was a strong prognostic factor for PFS,OS and RS.CONCLUSION:Old patients with non-curable gastroesophageal cancer should be offered chemotherapy,and ECOG PS is a tool for balancing benefit and harm upfront.Second-line treatment is reasonable.展开更多
Background After pediatric cardiac surgery,many patients require a prolonged stay in the intensive care unit.These patients require tremendous resources,which adds an additional burden to the healthcare systems.To dat...Background After pediatric cardiac surgery,many patients require a prolonged stay in the intensive care unit.These patients require tremendous resources,which adds an additional burden to the healthcare systems.To date,few studies have investigated risk factors in pediatric patients with congenital heart disease,especially in developing countries.This study aimed to explore the risk factors for prolonged intensive care unit stay after pediatric cardiac surgery to improve care planning and resource management.Methods This retrospective study included pediatric patients with congenital heart disease who underwent surgical repair at our single center from January 2021 to December 2022.We analyzed 44 potential risk factors across pre-operative,intra-operative,and post-operative variables using logistic regression to identify independent risk factors.Results Prolonged intensive care unit stay was defined as≥95th percentile(≥12 d).Of the 4348 patients studied,246 experienced prolonged intensive care unit stay or hospital death after surgery were categorized as Group 1,while 4102 patients without prolonged stay or hospital death after surgery were designated as Group 2.Multivariable analysis identified 14 independent risk factors:age,pre-operative data cystatin C,palliative procedure,duration of cardiopulmonary bypass,lactic acid at weaning from cardiopulmonary bypass,postoperative arrhythmia,renal replacement therapy,re-operation,cardiopulmonary resuscitation,re-intubation,central venous pressure 2 h after transferred to the intensive care unit,volume of chest tube drainage 2 h after transferred to the intensive care unit,vasoactive-inotropic score on post-operative day 1,left ventricular ejection fraction on post-operative day 1.Conclusions This study identified 14 risk factors associated with prolonged intensive care unit stays after pediatric cardiac surgery.These findings can help identify at-risk patients for targeted interventions to reduce intensive care unit duration and associated costs.展开更多
Neurological disorders pose a severe public health challenge in China,with substantial impacts on mortality,disability,and socioeconomic burden,especially in the context of population aging.This study synthesizes key ...Neurological disorders pose a severe public health challenge in China,with substantial impacts on mortality,disability,and socioeconomic burden,especially in the context of population aging.This study synthesizes key findings from the China Neurological Disorders Report 2024(compiled by the National Center for Neurological Disorders)to systematically outline the epidemiology of ten major neurological disorders in China,including cerebrovascular disease,dementia/Alzheimer's disease(AD),Parkinson's disease,epilepsy,central nervous system(CNS)tumors,traumatic brain injury(TBI),multiple sclerosis(MS),myasthenia gravis(MG),headache and pain syndromes,and amyotrophic lateral sclerosi(ALS).Cerebrovascular disease remains a leading cause of death,with ischemic stroke accounting for approximately 72.8% of stroke cases and distinct north-south geographic disparities in China.AD and related dementias affect 16.99 million Chinese(29.8% of the global total),with higher prevalence and mortality in females.Parkinson's disease prevalence is rising rapidly,with an estimated 3.62 million current patients and forecasts of 4.79 million by 2030.Epilepsy impacts over nine million people,while CNS tumors,TBI,MS,and MG exhibit unique demographic patterns.Notable trends include increasing disease burdens from neurodegenerative disorders linked to aging,sex disparities(higher female prevalence in AD,higher male incidence in Parkinson's disease and CNS tumors),and regional variations.These standardized,multi-source data address gaps in fragmented prior research,providing a robust scientific basis for healthcare resource allocation,clinical practice optimization,and policy development.Future efforts should focus on expanding data coverage,long-term cohort studies,and interdisciplinary research to enhance precise prevention and management of neurological disorders in China.展开更多
Objective This study aimed to determine the temporal trends in sleep duration among Chinese adults.Methods In this series of repeated nationally representative cross-sectional surveys(China Chronic Disease and Risk Fa...Objective This study aimed to determine the temporal trends in sleep duration among Chinese adults.Methods In this series of repeated nationally representative cross-sectional surveys(China Chronic Disease and Risk Factors Surveillance)conducted between 2010 and 2018,a total of 645,420 adult participants(97,741 in 2010;175,749 in 2013;187,777 in 2015;and 184,153 in 2018)were included in the trend analysis.Linear and logistic regression models were utilized to assess trends in sleep duration.Results In 2018,the estimated overall mean sleep duration among the Chinese adult population was7.58(SD,1.45)hours per day,with no significant trend from 2010.A significant increase in short sleep duration(≤6 hours)was observed in the total population,from 15.3%(95%CI:14.1%–16.5%)in 2010 to18.5%(95%CI:17.7%–19.3%)in 2018(P<0.001).Similarly,the trend in long sleep duration(>9 hours)was also significant,increasing in weighted prevalence from 7.2%(95%CI:6.3%–8.1%)in 2010 to 9.0%(95%CI:8.2%–9.9%)in 2018(P<0.001).Conclusion The prevalence of both short and long sleep durations significantly increased among Chinese adults from 2010 to 2018,highlighting the urgency of health initiatives to promote optimal sleep duration in China.展开更多
Background:Laparoscopic anatomic hepatectomy of segment 7(LAH-S7)is a challenging surgery.In this study we aimed to investigate surgical and oncological outcomes of various approaches of LAH-S7 in patients with hepato...Background:Laparoscopic anatomic hepatectomy of segment 7(LAH-S7)is a challenging surgery.In this study we aimed to investigate surgical and oncological outcomes of various approaches of LAH-S7 in patients with hepatocellular carcinoma(HCC).A particular focus was placed on identifying the Glissonean pedicle of segment 7(G7)and the intersegmental plane.Given the scarcity of comprehensive reviews or comparative studies on clinical outcomes,we also sought to analyze the experiences and advantages associated with different approaches in relation to the anatomic variations of G7.Methods:The clinical data of 124 patients who underwent LAH-S7 for HCC across seven tertiary referral medical centers in China were retrospectively analyzed.Three surgical approaches were categorized based on the procedures used for G7 identification:the indocyanine green(ICG)fluorescence positive staining approach(IFPA),the Glissonean approach(GA),and the hepatic vein-guided approach(HVGA).Subsequently,the postoperative short-term results and oncological outcomes of the three different approaches were compared.Results:The distribution of surgical approaches among the patients was as follows:IFPA in 16(12.9%),GA in 62(50.0%),and HVGA in 46(37.1%)patients.Complications were observed in 27(21.8%)patients.The 1-,3-,and 5-year overall survival(OS)rates were 99.1%,89.2%,and 84.7%,respectively.The 1-,3-,and 5-year recurrence-free survival(RFS)rates were 99.0%,84.7%,and 69.3%,respectively.The OS and RFS rates were comparable across the three approaches.Conclusions:Following a standardized surgical procedure,LAH-S7 is demonstrated to be safe and yields favorable oncological outcomes.Surgeons performing LAH-S7 should select the appropriate surgical approach based on the anatomical characteristics and variations of G7.展开更多
Objective： The aim of this study was to investigate the prognostic factors and to evaluate the impact of adjuvant therapy on clinical outcome for early-stage cervical cancer. Methods： The clinical-pathological data ...Objective： The aim of this study was to investigate the prognostic factors and to evaluate the impact of adjuvant therapy on clinical outcome for early-stage cervical cancer. Methods： The clinical-pathological data of all 1,335 patients with the International Federation of Gynecology and Obstetrics （FIGO） Ib-[Ia cervical cancer treated with primary radical surgery at the Chinese National Cancer Center between May 2007 and Dec 2013 were retrospectively reviewed. The median follow-up was 70 months. Results： Of all the patients, 61.6% of the cases received adjuvant therapy, with 5-year disease-free survival （DFS） of 92.1% and 5-year overall survival （OS） of 95.0%. In multivariate analysis, differentiation of G3 （P〈0.05）, lymph node metastasis （LNM, P〈0.05） and lymphovascular space invasion （LVSI, P〈0.05） were independent predictors for OS, while LNM （P〈0.05）, deep stroma invasion （DSI, P〈0.05） and LVSI （P〈0.05） were independent factors for DFS. The samples were stratified by histologic type, and cervical squamous cell carcinoma （SCC） was found to share the same independent factors except for differentiation of OS. As to patients with cervical adenocarcinoma/adenosquamons carcinoma （AC/ASC）, differentiation was the independent predictor of OS （P〈0.05）; and LVSI of DFS （P〈0.05）. Of 236 patients with high-risk factors, there was no significant difference in survival between concurrent chemoradiotherapy （CCRT, n=195）, radiotherapy （RT, n=24）, and chemotherapy （CT, n=17）. Among the 190 patients with LNM who underwent CCRT, 124 cases showed improved DFS after sequential CT （P=0.118）, with a recurrence rate decrease of 14%, though the difference was not statistically significant. Patients with single intermediate-risk factors like DSI or LVSI were found to partially benefit from adjuvant therapy, but the difference was not statistically significant. Conclusions： LNM, LVSI, DSI and differentiation were found to be independent prognostic factors for operable cervical cancer. Aggressive postoperative adjuvant therapy based on single risk factors in Chinese National Cancer Center could benefit survival. CCRT＋CT outperformed CCRT in high-risk patients. For patients with single non-high-risk factor, the role of adjuvant therapy needs to be further discussed.展开更多
AIM: To examine the impact of body mass index(BMI)on outcomes following pancreatic resection in the Chinese population.METHODS: A retrospective cohort study using prospectively collected data was conducted at the Canc...AIM: To examine the impact of body mass index(BMI)on outcomes following pancreatic resection in the Chinese population.METHODS: A retrospective cohort study using prospectively collected data was conducted at the Cancer Hospital of the Chinese Academy of Medical Sciences, China National Cancer Center. Individuals who underwent pancreatic resection between January2004 and December 2013 were identified and included in the study. Persons were classified as having a normal weight if their BMI was < 24 kg/m2 and overweight/obese if their BMI was ≥ 24 kg/m2 as defined by the International Life Sciences Institute Focal Point in China. A χ 2 test(for categorical variables) or a t test(for continuous variables) was used to examine the differences in patients' characteristics between normal weight and overweight/obese groups. Multiple logistic regression models were used to assess the associationsof postoperative complications, operative difficulty,length of hospital stay, and cost with BMI, adjusting for age, sex, and type of surgery procedures.RESULTS: A total of 362 consecutive patients with data available for BMI calculation underwent pancreatic resection for benign or malignant disease from January1, 2004 to December 31, 2013. Of the 362 patients,156 were overweight or obese and 206 were of normal weight. One or more postoperative complications occurred in 35.4% of the patients following pancreatic resection. Among patients who were overweight or obese, 42.9% experienced one or more complications,significantly higher than normal weight(29.6%)individuals(P = 0.0086). Compared with individuals who had normal weight, those with a BMI ≥ 24.0kg/m2 had higher delayed gastric emptying(19.9% vs5.8%, P < 0.0001) and bile leak(7.7% vs 1.9%, P =0.0068). There were no significant differences seen in pancreatic fistula, gastrointestinal hemorrhage, reoperation,readmission, or other complications. BMI did not show a significant association with intraoperative blood loss, operative time, length of hospital stay, or cost.CONCLUSION: Higher BMI increases the risk for postoperative complications after pancreatectomy in the Chinese population. The findings require replication in future studies with larger sample sizes.展开更多
AIM:To assess the effectiveness of hepatitis B virus(HBV) vaccination program among fully vaccinated children.METHODS:A national community based crosssectional study was carried out in 6 governorates representing Egyp...AIM:To assess the effectiveness of hepatitis B virus(HBV) vaccination program among fully vaccinated children.METHODS:A national community based crosssectional study was carried out in 6 governorates representing Egypt. A total of 3600 children aged from 9 mo to 16 years who were fully vaccinated with HBV vaccine during infancy were recruited. Face to face interviews were carried out and sera were evaluated for hepatitis B surface antigen(HBsA g),anti-HBV core antibodies(total) and quantitative detection of hepatitis B surface antibody using enzyme linked immunoassays techniques. Samples positive to HBs Ag/anti-HBV core antibodies were subjected to quantitative HBV-DNA detection by real time polymerase chain reaction with 3.8 IU/L detection limit. RESULTS:Sero-protection was detected among 2059 children(57.2%) with geometric mean titers 75.4 ± 3.6 IU/L compared to 3.1 ± 2.1 IU/L among nonseroprotected children. Multivariate logistic analysis revealed that older age and female gender were the significant predicting variables for having non seroprotective level,with adjusted odds ratio 3.3,9.1and 14.2 among children aged 5 to < 10,10 to < 15 and ≥ 15 years respectively compared to those < 5 years and 1.1 among girls compared to boys with P < 0.01. HBs Ag was positive in 0.11% and breakthrough infection was 0.36% and 0.39% depending on positivity of anti-HBc and DNA detection respectively. The prevalence of HBV infection was significantly higher among children aged ≥ 7 years(0.59%) compared to 0.07% among younger children with odds ratio equal to 8.4(95%CI:1.1-64.2) and P < 0.01.The prevalence was higher among girls(0.48%) than boys(0.29%) with P > 0.05. C ON C LU S I ON :T he E gy pt ian c ompuls or y H B V vaccination program provides adequate protection. Occult HBV infection exists among apparently healthy vaccinated children. Adherence to infection control measures is mandatory.展开更多
DEAR EDITOR,Since the first reported severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection in December 2019,coronavirus disease 2019(COVID-19)has become a global pandemic,spreading to more than 200 coun...DEAR EDITOR,Since the first reported severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection in December 2019,coronavirus disease 2019(COVID-19)has become a global pandemic,spreading to more than 200 countries and regions worldwide.With continued research progress and virus detection,SARS-CoV-2 genomes and sequencing data have been reported and accumulated at an unprecedented rate.展开更多
The journey to implement cancer genomic medicine(CGM)in oncology practice began in the 1980s,which is considered the dawn of genetic and genomic cancer research.At the time,a variety of activating oncogenic alteration...The journey to implement cancer genomic medicine(CGM)in oncology practice began in the 1980s,which is considered the dawn of genetic and genomic cancer research.At the time,a variety of activating oncogenic alterations and their functional significance were unveiled in cancer cells,which led to the development of molecular targeted therapies in the 2000s and beyond.Although CGM is still a relatively new discipline and it is difficult to predict to what extent CGM will benefit the diverse pool of cancer patients,the National Cancer Center(NCC)of Japan has already contributed considerably to CGM advancement for the conquest of cancer.Looking back at these past achievements of the NCC,we predict that the future of CGM will involve the following:1)A biobank of paired cancerous and non-cancerous tissues and cells from various cancer types and stages will be developed.The quantity and quality of these samples will be compatible with omics analyses.All biobank samples will be linked to longitudinal clinical information.2)New technologies,such as whole-genome sequencing and artificial intelligence,will be introduced and new bioresources for functional and pharmacologic analyses(e.g.,a patient-derived xenograft library)will be systematically deployed.3)Fast and bidirectional translational research(bench-to-bedside and bedside-to-bench)performed by basic researchers and clinical investigators,preferably working alongside each other at the same institution,will be implemented;4)Close collaborations between academia,industry,regulatory bodies,and funding agencies will be established.5)There will be an investment in the other branch of CGM,personalized preventive medicine,based on the individual's genetic predisposition to cancer.展开更多
Traditional Chinese Medicine (TCM)and Acupuncture & Moxibustion (A & M)originated in China,with a history of severalthousand years.They have made great con-tributions to the human health with theunique theoret...Traditional Chinese Medicine (TCM)and Acupuncture & Moxibustion (A & M)originated in China,with a history of severalthousand years.They have made great con-tributions to the human health with theunique theoretical system and excellent clini-al efficacy,and therefore,are drawing greatattention of the international medicalcircles.At present,TCM and A &展开更多
Precision medicine is a growing field worldwide.Despite its potential benefit to many patients,several major obstacles must be overcome before precision medicine can be more widely used in clinical practice.The main o...Precision medicine is a growing field worldwide.Despite its potential benefit to many patients,several major obstacles must be overcome before precision medicine can be more widely used in clinical practice.The main obstacles are associated with the quality of samples used for genomic analysis。展开更多
Background Big data challenges In the late 1980s and early 1990s,three major international biological data centers were created:the DNA Database of Japan(DDBJ)[1],the European Bioinformatics Institute(EMBL-EBI)in the ...Background Big data challenges In the late 1980s and early 1990s,three major international biological data centers were created:the DNA Database of Japan(DDBJ)[1],the European Bioinformatics Institute(EMBL-EBI)in the United Kingdom(UK)[2],and the National Center for Biotechnology Information(NCBI)in the United States(US)[3].展开更多
National Center for Nanoscience and Technology(NCNST),China,established in December 2003,is co-founded by the Chinese Academy of Sciences(CAS)and the Ministry of Education as an institution dedicated to fundamental an...National Center for Nanoscience and Technology(NCNST),China,established in December 2003,is co-founded by the Chinese Academy of Sciences(CAS)and the Ministry of Education as an institution dedicated to fundamental and applied researches in the field of nanoscience and technology,especially those with important potential applications.NCNST is operated under the supervision of the Governing Board and aims to become a world-class research center,as well as public technological platform and young talents training center in the field,and to act as an important bridge for international academic exchange and collaboration.The NCNST currently has three CAS Key Laboratories:the CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety,the CAS Key Laboratory for Standardization and Measurement for Nanotechnology and the CAS Key Laboratory for Nanosystem and Hierarchical Fabrication.In 2020,the CAS Key Laboratory of Nanophotonic Materials and Devices started construction.Besides,there are Division of Nanotechnology Development,Nanofabrication Laboratory,Intelligent Nanosensing Laboratory and Theoretical Laboratory.展开更多
Background:China accounts for one-quarter of the world’s diabetes population,with significant subnational disparities.However,none of the available data have provided comprehensive estimates and projections at both r...Background:China accounts for one-quarter of the world’s diabetes population,with significant subnational disparities.However,none of the available data have provided comprehensive estimates and projections at both regional and national levels in diabetes prevention and management.This study aimed to explore the temporal trends and geographical variations in the prevalence and non-fatal burden of diabetes by age and sex across China from 2005 to 2023,and to forecast diabetes prevalence through 2050.Methods:We conducted a population-based study based on the nationally representative surveys,and literature reviews.Using the DisMod-MR model and Chinese-specific disease disability weights,we estimated the non-fatal burdens of diabetes,including prevalence and years lived with disability(YLDs),across sexes,age groups,and locations.The temporal trend change was measured as the average annual percent change.The effect of the human development index on burdens was assessed by applying Spearman’s rank correlation analysis.We further projected diabetes prevalence to 2050 under 2 scenarios,the natural trend and the effective intervention on body mass index(BMI).Results:In 2023,an estimated 233 million individuals in China were living with diabetes.Compared to 2005,the agestandardized rate(ASR)of prevalence has increased by nearly 50%,from 7.53%(95%CI 7.00-8.10)to 13.7%(95%CI 12.6-14.8)in 2023.The ASR of YLDs was estimated at 19.1 per 1000 population(95%CI 18.6-19.5)in 2023,compared to 10.5 per 1000 population in 2005.The ASR of prevalence and YLDs was consistently higher in males than in females.The provinces with the highest diabetes prevalence and disease burden were Beijing,Tianjin,and Shanghai.Our forecast results suggest that if existing trends continue,the prevalence of obesity will reach 29.1%(95%CI 22.2-38.2)nationally by 2050,with some provinces in the northern region observing a prevalence of over 40%.Conversely,if effective obesity interventions were implemented,the growth in diabetes prevalence could potentially be suppressed by nearly 50%.Conclusions:The health burden and economic cost associated with diabetes are profound.There is an urgent need to scale up preventive efforts and improve population awareness to enhance disease management and achieve optimal treatment outcomes.展开更多
THE 2020 China International Fair for Trade in Services(CIFTIS)successfully concluded on September 9.The China National Convention Center was not only the main venue for the opening ceremony,summits,exhibition tour,fo...THE 2020 China International Fair for Trade in Services(CIFTIS)successfully concluded on September 9.The China National Convention Center was not only the main venue for the opening ceremony,summits,exhibition tour,forums,supporting exhibitions,and other activities of the event,but also guaranteed the smooth operation of 70,000 square meters of temporary outdoor venues under the coordination of the organizing committee.展开更多
<strong>Introduction:</strong> Primary open angle glaucoma (POAG) is an anterior optic neuropathy of chronic and progressive course, characterized by perimeter alteration and excavation of the specific opt...<strong>Introduction:</strong> Primary open angle glaucoma (POAG) is an anterior optic neuropathy of chronic and progressive course, characterized by perimeter alteration and excavation of the specific optic disc. This neuropathy is usually accompanied by ocular hypertonia. The iridocorneal angle remains open in gonioscopy. POAG is the primary cause of irreversible blindness in adults around the world, posing a real public health and quality of life problem as well as an economic problem. The progressive and irreversible loss of vision makes POAG a disease that can lead to blindness. The main objective of our study is to describe the epidemiological, clinical and therapeutic aspects of primary open angle glaucoma in the ophthalmology department of the National Hospital Center of Nouakchott. <strong>Materials and Methods:</strong> It was a prospective descriptive study of 6 months (March 1<sup>st</sup> 2017 to August 30<sup>th</sup> 2017), on patients with a POAG with the presence of at least one of the three signs (intraocular pressure > 21 mmHg, papillary cup/disc vertical excavation ≥ 0.5 and a field altered apart from all other causes). All glaucoma patients seen during the study period benefited from a complete eye examination. The studied variables were the family history of glaucoma, age, intra ocular pressure (IOP) and pachymeter. <strong>Results:</strong> The mean age was 58.7 years. About 2/3 of the patients had a lower pachymeter to normal (63% of cases), a genetically thinner cornea results in an underestimation of the IOP measurement. The male was the most represented with a sex ratio M/F (1.42), the main characteristic factors were family history of glaucoma (39.7%), artery hypertension, diabetic and headache. The success rate of surgery was 69.8%, while 11% of our patients had refused any kind of treatment, no complications were noted, <strong>Conclusion:</strong> POAG is a multifactorial condition which can lead to blindness if not early diagnosed or if treatment is poorly conducted, hence the importance of prevention by screening and informing the population about this pathology.展开更多
Introduction: For several years, the fight against the human immunodeficiency virus (HIV) has been a major public health issue in Africa. Since 2012, Senegal has adopted WHO option B+, consisting of systematic triple ...Introduction: For several years, the fight against the human immunodeficiency virus (HIV) has been a major public health issue in Africa. Since 2012, Senegal has adopted WHO option B+, consisting of systematic triple therapy for HIV-positive pregnant women, combined with breastfeeding and antiretroviral (ARV) prophylaxis for exposed newborns. It is in this dynamic that we set ourselves the objectives of evaluating the rate of transmission of HIV from mother to child and taking stock of the monitoring of children born to HIV-positive mothers at the Pediatric Department of the CHN of Pikine located in the Dakar suburbs. Methodology: Thus, we conducted a descriptive and analytical cross-sectional cohort follow-up study from 11/25/2014 to 03/09/2022 including all children born to HIV-positive mothers followed at the Pikine CHN since the start of care. Results: We had collected 51 children exposed to HIV and followed in our structure. They were exposed to HIV1 in 92% of cases. The HIV status of the mothers was known before pregnancy in more than half of the cases. The couples were serodiscordant in 56% of cases. The mothers were in clinical stage 1 of the disease in 69.6% of cases and were already under treatment in 47% of cases. The most used treatment regimen was ATRIPLA with Tenofovir (TDF) + Emtracitabine (FTC) + Efavirenz (EFV) in 59% of cases. Compliance was good in the majority of cases. The CD4 count during pregnancy was low in 10.6% of cases. The pregnancy was well followed in only 36.2% of cases. The mothers had given birth in our structure in 91.4% of cases. The vaginal route was found in 72.5% of cases and delivery was carried out by a midwife in 69.4% of cases. The average birth weight was 2733 ± 564. The majority of newborns had received antiretroviral (ARV) prophylaxis after birth, half of them between 12 and 24 hours. The most used therapeutic protocol was Zidovudine (AZT) + Lamivudine (3TC) + Lopinavir/Ritonavir (LPV/r). Protected breastfeeding was the option chosen in 76.8% of cases. The PCR performed at 6 weeks was negative in more than half of the cases. Retroviral serology was carried out after 14 months in 43% of cases. We noted a single positive case with a negative initial PCR, representing an overall transmission rate of 1.96%. Conclusion: Senegal’s current policy targeting EMTCT of HIV is on good momentum with a fairly low transmission rate thanks to screening of pregnant women and prophylaxis with antiretrovirals (ARV) for HIV-positive mothers during pregnancy and for life. And children exposed from birth and during breastfeeding up to 6 weeks with regular monitoring.展开更多
Introduction: Sickle cell disease is a real public health problem in the world and particularly in Niger where the prevalence of the S gene is estimated at 25% and that of the homozygous forms at between 1% and 2%. Tr...Introduction: Sickle cell disease is a real public health problem in the world and particularly in Niger where the prevalence of the S gene is estimated at 25% and that of the homozygous forms at between 1% and 2%. Treatment combines quarterly follow-up of patients and management of complications. The objective of this study was to identify the potential explanatory factors of non-adherence to treatment in sickle cell patients followed at the national reference center for sickle cell disease in Niger. Methods: This is a cross-sectional study of sickle cell cases followed at the CNRD in Niger. The population consisted of all sickle cell patients followed in this center in 2021. The data collection techniques were individual interviews and documentary reviews. Non-adherence was assessed with the Girerd test. Descriptive statistical tests and simple and multiple logistic regression models were performed. Results: A total of 368 patients were enrolled. The median age is 7 years (4;10) and the sex ratio is 1.04. Ninety-eight (98) or 26.6% were compliant and 270 (73.4%) were non-compliant. In multivariate analysis, the factors independently and negatively associated with non-adherence to treatment were schooling (adjusted OR [95% CI], p-value), 0.17 [0.10 - 0.30];p Conclusion: The factors influencing treatment compliance identified in this study are all modifiable. To prevent the complications of sickle cell disease, we must fight against ignorance, make care services accessible and make care free.展开更多
基金supported by the National Natural Science Foundation of China(72204169,82425101,82271516,81801187)Noncommunicable Chronic Diseases‐National Science and Technology Major Project(2023ZD0504800,2023ZD0504801,2023ZD0504802,2023ZD0504803,2023ZD0504804)+2 种基金Beijing Municipal Science&Technology Commission(Z231100004823036)Capital's Funds for Health Improvement and Research(2022‐2‐2045)National Key R&D Program of China(2024YFC3044800,2022YFF1501500,2022YFF1501501,2022YFF1501502,2022YFF1501503,2022YFF1501504,2022YFF1501505).
文摘Background:Stroke is the second leading cause of death and third leading cause of disability worldwide and is the leading cause of death and disability among adults in China,with its incidence rate continuing to rise.In China,the average age of firsttime stroke patients is 66.4 years,and the intravenous thrombolysis rate using recombinant tissue plasminogen activator within 3 h of onset is only 16%.Given this fact,there is a pressing need for real‐time predictive tools,particularly for elderly individuals at home,that can provide early warnings for potential strokes.Methods:We collected continuous monitoring data from nonintrusive smart beds and multimodal temporal data from electronic medical records at the National Center for Neurological Disorders.The data included smart bed monitoring indicators,laboratory tests,nurse observations,and static data as potential predictors,with stroke as the outcome.We applied feature representation and feature selection techniques and then input the predictors into machine learning models.Additionally,deep learning models were used after preprocessing the irregular temporal data.Finally,we evaluated the performance of the stroke prediction models and assessed the importance of the features.We used continuously updated vital signs and clinical data during hospitalization to generate timely stroke risk alerts during the same period of admission.Results:A total of 37,041 samples were analyzed,of which 7020 patients were diagnosed with stroke.When only the smart bed features were used for prediction,the model achieved an area under the receiver operating characteristic curve(AUROC)of 0.59−0.63,with an accuracy ranging from 60%−65%.Among the four artificial intelligence algorithms,the random forest model demonstrated the best performance.After all the available features were incorporated,the AUROC increased to 0.94,and the accuracy improved to 92%.Conclusions:In this study,the occurrence of stroke was successfully identified by integrating multimodal temporal data from electronic medical records.Noncontact monitoring of respiration and heart rate offers a promising approach for daily stroke surveillance in home‐based populations,particularly for elderly individuals living alone.
基金Supported by Zentrum für Geriatrische Onkologie und Biologie in der Metropolregion Rhein Neckar(ZOBEL)
文摘AIM:To investigate the outcome of palliative chemotherapy in old patients with gastroesophageal cancer at the National Center for Tumor Diseases,Heidelberg.METHODS:Using a prospectively generated database,we retrospectively analyzed 55 patients≥70years under palliative chemotherapy for advanced gastroesophageal cancer at the outpatient clinic of the National Center for Tumor Diseases Heidelberg,Germany between January 2006 and December2013.Further requirements for inclusion were(1)histologically proven diagnosis of gastroesophageal cancer;(2)advanced(metastatic or inoperable)disease;and(3)no history of radiation or radiochemotherapy.The clinical information included Eastern Cooperative Oncology Group performance status(ECOG PS),presence and site of metastases at diagnosis,date of previous surgery and perioperative chemotherapy,start and stop date of first-line treatment,toxicities and consecutive dosage reductions of first-line treatment,response to first-line therapy,date of progression,usage of second-line therapies and date and cause of death.Survival times[progression-free survival(PFS),overall survival(OS)and residual survival(RS)]were calculated.Toxicity and safety were examined.Prognostic factors including ECOG PS,age and previousperioperative treatment were analyzed.RESULTS:Median age of our cohort was 76 years.86%of patients received a combination of two cytotoxic drugs.76 percent of patients had an oxaliplatin-based first-line therapy with the oxaliplatin and 5-fluorouracil regimen being the predominantely chosen regimen(69%).Drug modifications due to toxicity were necessary in 56%of patients,and 11%of patients stopped treatment due to toxicities.Survival times of our cohort are in good accordance with the major phaseⅢtrials that included mostly younger patients:PFS and OS were 5.8 and 9.5 mo,respectively.Survival differed significantly between patient groups with low(≤1)and high(≥2)ECOG PS(12.7 mo vs 3.8 mo,P<0.001).Very old patients(≥75 years)did not show a worse outcome in terms of survival.Patients receiving secondline treatment(51%)had a significantly longer RS than patients with best supportive care(6.8 vs 1.4 mo,P=0.001).Initial ECOG PS was a strong prognostic factor for PFS,OS and RS.CONCLUSION:Old patients with non-curable gastroesophageal cancer should be offered chemotherapy,and ECOG PS is a tool for balancing benefit and harm upfront.Second-line treatment is reasonable.
基金supported by the Artificial Intelligence and Information Application Foundation of Fuwai Hospital,Chinese Academy of Medical Sciences(2024-AI17)the National High Level Hospital Clinical Research Funding(2025-GSP-QN-7).
文摘Background After pediatric cardiac surgery,many patients require a prolonged stay in the intensive care unit.These patients require tremendous resources,which adds an additional burden to the healthcare systems.To date,few studies have investigated risk factors in pediatric patients with congenital heart disease,especially in developing countries.This study aimed to explore the risk factors for prolonged intensive care unit stay after pediatric cardiac surgery to improve care planning and resource management.Methods This retrospective study included pediatric patients with congenital heart disease who underwent surgical repair at our single center from January 2021 to December 2022.We analyzed 44 potential risk factors across pre-operative,intra-operative,and post-operative variables using logistic regression to identify independent risk factors.Results Prolonged intensive care unit stay was defined as≥95th percentile(≥12 d).Of the 4348 patients studied,246 experienced prolonged intensive care unit stay or hospital death after surgery were categorized as Group 1,while 4102 patients without prolonged stay or hospital death after surgery were designated as Group 2.Multivariable analysis identified 14 independent risk factors:age,pre-operative data cystatin C,palliative procedure,duration of cardiopulmonary bypass,lactic acid at weaning from cardiopulmonary bypass,postoperative arrhythmia,renal replacement therapy,re-operation,cardiopulmonary resuscitation,re-intubation,central venous pressure 2 h after transferred to the intensive care unit,volume of chest tube drainage 2 h after transferred to the intensive care unit,vasoactive-inotropic score on post-operative day 1,left ventricular ejection fraction on post-operative day 1.Conclusions This study identified 14 risk factors associated with prolonged intensive care unit stays after pediatric cardiac surgery.These findings can help identify at-risk patients for targeted interventions to reduce intensive care unit duration and associated costs.
文摘Neurological disorders pose a severe public health challenge in China,with substantial impacts on mortality,disability,and socioeconomic burden,especially in the context of population aging.This study synthesizes key findings from the China Neurological Disorders Report 2024(compiled by the National Center for Neurological Disorders)to systematically outline the epidemiology of ten major neurological disorders in China,including cerebrovascular disease,dementia/Alzheimer's disease(AD),Parkinson's disease,epilepsy,central nervous system(CNS)tumors,traumatic brain injury(TBI),multiple sclerosis(MS),myasthenia gravis(MG),headache and pain syndromes,and amyotrophic lateral sclerosi(ALS).Cerebrovascular disease remains a leading cause of death,with ischemic stroke accounting for approximately 72.8% of stroke cases and distinct north-south geographic disparities in China.AD and related dementias affect 16.99 million Chinese(29.8% of the global total),with higher prevalence and mortality in females.Parkinson's disease prevalence is rising rapidly,with an estimated 3.62 million current patients and forecasts of 4.79 million by 2030.Epilepsy impacts over nine million people,while CNS tumors,TBI,MS,and MG exhibit unique demographic patterns.Notable trends include increasing disease burdens from neurodegenerative disorders linked to aging,sex disparities(higher female prevalence in AD,higher male incidence in Parkinson's disease and CNS tumors),and regional variations.These standardized,multi-source data address gaps in fragmented prior research,providing a robust scientific basis for healthcare resource allocation,clinical practice optimization,and policy development.Future efforts should focus on expanding data coverage,long-term cohort studies,and interdisciplinary research to enhance precise prevention and management of neurological disorders in China.
基金supported by the National Natural Science Foundation of China(82341245,82371491)the Chinese Central Government(Key Project of Public Health Program)the National Key Research and Development Program of China(2018YFC1311706,2018YFC1311702)。
文摘Objective This study aimed to determine the temporal trends in sleep duration among Chinese adults.Methods In this series of repeated nationally representative cross-sectional surveys(China Chronic Disease and Risk Factors Surveillance)conducted between 2010 and 2018,a total of 645,420 adult participants(97,741 in 2010;175,749 in 2013;187,777 in 2015;and 184,153 in 2018)were included in the trend analysis.Linear and logistic regression models were utilized to assess trends in sleep duration.Results In 2018,the estimated overall mean sleep duration among the Chinese adult population was7.58(SD,1.45)hours per day,with no significant trend from 2010.A significant increase in short sleep duration(≤6 hours)was observed in the total population,from 15.3%(95%CI:14.1%–16.5%)in 2010 to18.5%(95%CI:17.7%–19.3%)in 2018(P<0.001).Similarly,the trend in long sleep duration(>9 hours)was also significant,increasing in weighted prevalence from 7.2%(95%CI:6.3%–8.1%)in 2010 to 9.0%(95%CI:8.2%–9.9%)in 2018(P<0.001).Conclusion The prevalence of both short and long sleep durations significantly increased among Chinese adults from 2010 to 2018,highlighting the urgency of health initiatives to promote optimal sleep duration in China.
基金supported by grants from the Scientific Research Fund of Education Department of Yunnan Province(2023J767)the National Natural Science Foundation of China(82272963 and 82472718)+6 种基金Health Research Project of Hunan Provincial Health Commission(W20242019)Hunan Provincial Health High-Level Talent Scientific Research Project(R2023096)Hunan Provincial Department of Science and Technology Health Industry Joint Fund(2024JJ9479)Guangdong Province Basic and Applied Basic Research Foundation Project-Guangdong Province Natural Science Foundation(2024A1515220154)"Leading Goose"Project of the Science and Technology Department of Zhejiang Province(2024C03049)Major Project of Health Science and Technology Program of Zhejiang Province(WKJ-ZJ-2407)the National Key Research and Development Program(2024YFB331170204).
文摘Background:Laparoscopic anatomic hepatectomy of segment 7(LAH-S7)is a challenging surgery.In this study we aimed to investigate surgical and oncological outcomes of various approaches of LAH-S7 in patients with hepatocellular carcinoma(HCC).A particular focus was placed on identifying the Glissonean pedicle of segment 7(G7)and the intersegmental plane.Given the scarcity of comprehensive reviews or comparative studies on clinical outcomes,we also sought to analyze the experiences and advantages associated with different approaches in relation to the anatomic variations of G7.Methods:The clinical data of 124 patients who underwent LAH-S7 for HCC across seven tertiary referral medical centers in China were retrospectively analyzed.Three surgical approaches were categorized based on the procedures used for G7 identification:the indocyanine green(ICG)fluorescence positive staining approach(IFPA),the Glissonean approach(GA),and the hepatic vein-guided approach(HVGA).Subsequently,the postoperative short-term results and oncological outcomes of the three different approaches were compared.Results:The distribution of surgical approaches among the patients was as follows:IFPA in 16(12.9%),GA in 62(50.0%),and HVGA in 46(37.1%)patients.Complications were observed in 27(21.8%)patients.The 1-,3-,and 5-year overall survival(OS)rates were 99.1%,89.2%,and 84.7%,respectively.The 1-,3-,and 5-year recurrence-free survival(RFS)rates were 99.0%,84.7%,and 69.3%,respectively.The OS and RFS rates were comparable across the three approaches.Conclusions:Following a standardized surgical procedure,LAH-S7 is demonstrated to be safe and yields favorable oncological outcomes.Surgeons performing LAH-S7 should select the appropriate surgical approach based on the anatomical characteristics and variations of G7.
文摘Objective： The aim of this study was to investigate the prognostic factors and to evaluate the impact of adjuvant therapy on clinical outcome for early-stage cervical cancer. Methods： The clinical-pathological data of all 1,335 patients with the International Federation of Gynecology and Obstetrics （FIGO） Ib-[Ia cervical cancer treated with primary radical surgery at the Chinese National Cancer Center between May 2007 and Dec 2013 were retrospectively reviewed. The median follow-up was 70 months. Results： Of all the patients, 61.6% of the cases received adjuvant therapy, with 5-year disease-free survival （DFS） of 92.1% and 5-year overall survival （OS） of 95.0%. In multivariate analysis, differentiation of G3 （P〈0.05）, lymph node metastasis （LNM, P〈0.05） and lymphovascular space invasion （LVSI, P〈0.05） were independent predictors for OS, while LNM （P〈0.05）, deep stroma invasion （DSI, P〈0.05） and LVSI （P〈0.05） were independent factors for DFS. The samples were stratified by histologic type, and cervical squamous cell carcinoma （SCC） was found to share the same independent factors except for differentiation of OS. As to patients with cervical adenocarcinoma/adenosquamons carcinoma （AC/ASC）, differentiation was the independent predictor of OS （P〈0.05）; and LVSI of DFS （P〈0.05）. Of 236 patients with high-risk factors, there was no significant difference in survival between concurrent chemoradiotherapy （CCRT, n=195）, radiotherapy （RT, n=24）, and chemotherapy （CT, n=17）. Among the 190 patients with LNM who underwent CCRT, 124 cases showed improved DFS after sequential CT （P=0.118）, with a recurrence rate decrease of 14%, though the difference was not statistically significant. Patients with single intermediate-risk factors like DSI or LVSI were found to partially benefit from adjuvant therapy, but the difference was not statistically significant. Conclusions： LNM, LVSI, DSI and differentiation were found to be independent prognostic factors for operable cervical cancer. Aggressive postoperative adjuvant therapy based on single risk factors in Chinese National Cancer Center could benefit survival. CCRT＋CT outperformed CCRT in high-risk patients. For patients with single non-high-risk factor, the role of adjuvant therapy needs to be further discussed.
基金Supported by National Natural Science Foundation of China,No.81401947the Specialized Research Fund for the Doctoral Program of Higher Education,No.20131106120011The Cancer Hospital/Institute of the Chinese Academy of Medical Sciences,No.JK2011B13,Beijing Nova Program
文摘AIM: To examine the impact of body mass index(BMI)on outcomes following pancreatic resection in the Chinese population.METHODS: A retrospective cohort study using prospectively collected data was conducted at the Cancer Hospital of the Chinese Academy of Medical Sciences, China National Cancer Center. Individuals who underwent pancreatic resection between January2004 and December 2013 were identified and included in the study. Persons were classified as having a normal weight if their BMI was < 24 kg/m2 and overweight/obese if their BMI was ≥ 24 kg/m2 as defined by the International Life Sciences Institute Focal Point in China. A χ 2 test(for categorical variables) or a t test(for continuous variables) was used to examine the differences in patients' characteristics between normal weight and overweight/obese groups. Multiple logistic regression models were used to assess the associationsof postoperative complications, operative difficulty,length of hospital stay, and cost with BMI, adjusting for age, sex, and type of surgery procedures.RESULTS: A total of 362 consecutive patients with data available for BMI calculation underwent pancreatic resection for benign or malignant disease from January1, 2004 to December 31, 2013. Of the 362 patients,156 were overweight or obese and 206 were of normal weight. One or more postoperative complications occurred in 35.4% of the patients following pancreatic resection. Among patients who were overweight or obese, 42.9% experienced one or more complications,significantly higher than normal weight(29.6%)individuals(P = 0.0086). Compared with individuals who had normal weight, those with a BMI ≥ 24.0kg/m2 had higher delayed gastric emptying(19.9% vs5.8%, P < 0.0001) and bile leak(7.7% vs 1.9%, P =0.0068). There were no significant differences seen in pancreatic fistula, gastrointestinal hemorrhage, reoperation,readmission, or other complications. BMI did not show a significant association with intraoperative blood loss, operative time, length of hospital stay, or cost.CONCLUSION: Higher BMI increases the risk for postoperative complications after pancreatectomy in the Chinese population. The findings require replication in future studies with larger sample sizes.
基金The Science and Technology Development Fund(STDF),Egypt,No.1611
文摘AIM:To assess the effectiveness of hepatitis B virus(HBV) vaccination program among fully vaccinated children.METHODS:A national community based crosssectional study was carried out in 6 governorates representing Egypt. A total of 3600 children aged from 9 mo to 16 years who were fully vaccinated with HBV vaccine during infancy were recruited. Face to face interviews were carried out and sera were evaluated for hepatitis B surface antigen(HBsA g),anti-HBV core antibodies(total) and quantitative detection of hepatitis B surface antibody using enzyme linked immunoassays techniques. Samples positive to HBs Ag/anti-HBV core antibodies were subjected to quantitative HBV-DNA detection by real time polymerase chain reaction with 3.8 IU/L detection limit. RESULTS:Sero-protection was detected among 2059 children(57.2%) with geometric mean titers 75.4 ± 3.6 IU/L compared to 3.1 ± 2.1 IU/L among nonseroprotected children. Multivariate logistic analysis revealed that older age and female gender were the significant predicting variables for having non seroprotective level,with adjusted odds ratio 3.3,9.1and 14.2 among children aged 5 to < 10,10 to < 15 and ≥ 15 years respectively compared to those < 5 years and 1.1 among girls compared to boys with P < 0.01. HBs Ag was positive in 0.11% and breakthrough infection was 0.36% and 0.39% depending on positivity of anti-HBc and DNA detection respectively. The prevalence of HBV infection was significantly higher among children aged ≥ 7 years(0.59%) compared to 0.07% among younger children with odds ratio equal to 8.4(95%CI:1.1-64.2) and P < 0.01.The prevalence was higher among girls(0.48%) than boys(0.29%) with P > 0.05. C ON C LU S I ON :T he E gy pt ian c ompuls or y H B V vaccination program provides adequate protection. Occult HBV infection exists among apparently healthy vaccinated children. Adherence to infection control measures is mandatory.
基金supported by the Strategic Priority Research Program of the Chinese Academy of Sciences(XDB38030200,XDB38050300,XDA19090116,XDA19050302)National Key R&D Program of China(2020YFC0848900,2020YFC0847000)。
文摘DEAR EDITOR,Since the first reported severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection in December 2019,coronavirus disease 2019(COVID-19)has become a global pandemic,spreading to more than 200 countries and regions worldwide.With continued research progress and virus detection,SARS-CoV-2 genomes and sequencing data have been reported and accumulated at an unprecedented rate.
文摘The journey to implement cancer genomic medicine(CGM)in oncology practice began in the 1980s,which is considered the dawn of genetic and genomic cancer research.At the time,a variety of activating oncogenic alterations and their functional significance were unveiled in cancer cells,which led to the development of molecular targeted therapies in the 2000s and beyond.Although CGM is still a relatively new discipline and it is difficult to predict to what extent CGM will benefit the diverse pool of cancer patients,the National Cancer Center(NCC)of Japan has already contributed considerably to CGM advancement for the conquest of cancer.Looking back at these past achievements of the NCC,we predict that the future of CGM will involve the following:1)A biobank of paired cancerous and non-cancerous tissues and cells from various cancer types and stages will be developed.The quantity and quality of these samples will be compatible with omics analyses.All biobank samples will be linked to longitudinal clinical information.2)New technologies,such as whole-genome sequencing and artificial intelligence,will be introduced and new bioresources for functional and pharmacologic analyses(e.g.,a patient-derived xenograft library)will be systematically deployed.3)Fast and bidirectional translational research(bench-to-bedside and bedside-to-bench)performed by basic researchers and clinical investigators,preferably working alongside each other at the same institution,will be implemented;4)Close collaborations between academia,industry,regulatory bodies,and funding agencies will be established.5)There will be an investment in the other branch of CGM,personalized preventive medicine,based on the individual's genetic predisposition to cancer.
文摘Traditional Chinese Medicine (TCM)and Acupuncture & Moxibustion (A & M)originated in China,with a history of severalthousand years.They have made great con-tributions to the human health with theunique theoretical system and excellent clini-al efficacy,and therefore,are drawing greatattention of the international medicalcircles.At present,TCM and A &
基金the Japan Agency for Medical Research and Development(Grant Nos.20lk0201002j0001,21lk0201005j0001,and 22lk0201007j0001)。
文摘Precision medicine is a growing field worldwide.Despite its potential benefit to many patients,several major obstacles must be overcome before precision medicine can be more widely used in clinical practice.The main obstacles are associated with the quality of samples used for genomic analysis。
基金funded by the“Strategic Priority Research Program”of CAS(Grant No.XDB38030200)the Open Biodiversity and Health Big Data Programme of International Union of Biological Sciences awarded to YB.
文摘Background Big data challenges In the late 1980s and early 1990s,three major international biological data centers were created:the DNA Database of Japan(DDBJ)[1],the European Bioinformatics Institute(EMBL-EBI)in the United Kingdom(UK)[2],and the National Center for Biotechnology Information(NCBI)in the United States(US)[3].
文摘National Center for Nanoscience and Technology(NCNST),China,established in December 2003,is co-founded by the Chinese Academy of Sciences(CAS)and the Ministry of Education as an institution dedicated to fundamental and applied researches in the field of nanoscience and technology,especially those with important potential applications.NCNST is operated under the supervision of the Governing Board and aims to become a world-class research center,as well as public technological platform and young talents training center in the field,and to act as an important bridge for international academic exchange and collaboration.The NCNST currently has three CAS Key Laboratories:the CAS Key Laboratory for Biological Effects of Nanomaterials and Nanosafety,the CAS Key Laboratory for Standardization and Measurement for Nanotechnology and the CAS Key Laboratory for Nanosystem and Hierarchical Fabrication.In 2020,the CAS Key Laboratory of Nanophotonic Materials and Devices started construction.Besides,there are Division of Nanotechnology Development,Nanofabrication Laboratory,Intelligent Nanosensing Laboratory and Theoretical Laboratory.
基金supported by the National Key Research and Development Program of China(2023YFC3605000).
文摘Background:China accounts for one-quarter of the world’s diabetes population,with significant subnational disparities.However,none of the available data have provided comprehensive estimates and projections at both regional and national levels in diabetes prevention and management.This study aimed to explore the temporal trends and geographical variations in the prevalence and non-fatal burden of diabetes by age and sex across China from 2005 to 2023,and to forecast diabetes prevalence through 2050.Methods:We conducted a population-based study based on the nationally representative surveys,and literature reviews.Using the DisMod-MR model and Chinese-specific disease disability weights,we estimated the non-fatal burdens of diabetes,including prevalence and years lived with disability(YLDs),across sexes,age groups,and locations.The temporal trend change was measured as the average annual percent change.The effect of the human development index on burdens was assessed by applying Spearman’s rank correlation analysis.We further projected diabetes prevalence to 2050 under 2 scenarios,the natural trend and the effective intervention on body mass index(BMI).Results:In 2023,an estimated 233 million individuals in China were living with diabetes.Compared to 2005,the agestandardized rate(ASR)of prevalence has increased by nearly 50%,from 7.53%(95%CI 7.00-8.10)to 13.7%(95%CI 12.6-14.8)in 2023.The ASR of YLDs was estimated at 19.1 per 1000 population(95%CI 18.6-19.5)in 2023,compared to 10.5 per 1000 population in 2005.The ASR of prevalence and YLDs was consistently higher in males than in females.The provinces with the highest diabetes prevalence and disease burden were Beijing,Tianjin,and Shanghai.Our forecast results suggest that if existing trends continue,the prevalence of obesity will reach 29.1%(95%CI 22.2-38.2)nationally by 2050,with some provinces in the northern region observing a prevalence of over 40%.Conversely,if effective obesity interventions were implemented,the growth in diabetes prevalence could potentially be suppressed by nearly 50%.Conclusions:The health burden and economic cost associated with diabetes are profound.There is an urgent need to scale up preventive efforts and improve population awareness to enhance disease management and achieve optimal treatment outcomes.
文摘THE 2020 China International Fair for Trade in Services(CIFTIS)successfully concluded on September 9.The China National Convention Center was not only the main venue for the opening ceremony,summits,exhibition tour,forums,supporting exhibitions,and other activities of the event,but also guaranteed the smooth operation of 70,000 square meters of temporary outdoor venues under the coordination of the organizing committee.
文摘<strong>Introduction:</strong> Primary open angle glaucoma (POAG) is an anterior optic neuropathy of chronic and progressive course, characterized by perimeter alteration and excavation of the specific optic disc. This neuropathy is usually accompanied by ocular hypertonia. The iridocorneal angle remains open in gonioscopy. POAG is the primary cause of irreversible blindness in adults around the world, posing a real public health and quality of life problem as well as an economic problem. The progressive and irreversible loss of vision makes POAG a disease that can lead to blindness. The main objective of our study is to describe the epidemiological, clinical and therapeutic aspects of primary open angle glaucoma in the ophthalmology department of the National Hospital Center of Nouakchott. <strong>Materials and Methods:</strong> It was a prospective descriptive study of 6 months (March 1<sup>st</sup> 2017 to August 30<sup>th</sup> 2017), on patients with a POAG with the presence of at least one of the three signs (intraocular pressure > 21 mmHg, papillary cup/disc vertical excavation ≥ 0.5 and a field altered apart from all other causes). All glaucoma patients seen during the study period benefited from a complete eye examination. The studied variables were the family history of glaucoma, age, intra ocular pressure (IOP) and pachymeter. <strong>Results:</strong> The mean age was 58.7 years. About 2/3 of the patients had a lower pachymeter to normal (63% of cases), a genetically thinner cornea results in an underestimation of the IOP measurement. The male was the most represented with a sex ratio M/F (1.42), the main characteristic factors were family history of glaucoma (39.7%), artery hypertension, diabetic and headache. The success rate of surgery was 69.8%, while 11% of our patients had refused any kind of treatment, no complications were noted, <strong>Conclusion:</strong> POAG is a multifactorial condition which can lead to blindness if not early diagnosed or if treatment is poorly conducted, hence the importance of prevention by screening and informing the population about this pathology.
文摘Introduction: For several years, the fight against the human immunodeficiency virus (HIV) has been a major public health issue in Africa. Since 2012, Senegal has adopted WHO option B+, consisting of systematic triple therapy for HIV-positive pregnant women, combined with breastfeeding and antiretroviral (ARV) prophylaxis for exposed newborns. It is in this dynamic that we set ourselves the objectives of evaluating the rate of transmission of HIV from mother to child and taking stock of the monitoring of children born to HIV-positive mothers at the Pediatric Department of the CHN of Pikine located in the Dakar suburbs. Methodology: Thus, we conducted a descriptive and analytical cross-sectional cohort follow-up study from 11/25/2014 to 03/09/2022 including all children born to HIV-positive mothers followed at the Pikine CHN since the start of care. Results: We had collected 51 children exposed to HIV and followed in our structure. They were exposed to HIV1 in 92% of cases. The HIV status of the mothers was known before pregnancy in more than half of the cases. The couples were serodiscordant in 56% of cases. The mothers were in clinical stage 1 of the disease in 69.6% of cases and were already under treatment in 47% of cases. The most used treatment regimen was ATRIPLA with Tenofovir (TDF) + Emtracitabine (FTC) + Efavirenz (EFV) in 59% of cases. Compliance was good in the majority of cases. The CD4 count during pregnancy was low in 10.6% of cases. The pregnancy was well followed in only 36.2% of cases. The mothers had given birth in our structure in 91.4% of cases. The vaginal route was found in 72.5% of cases and delivery was carried out by a midwife in 69.4% of cases. The average birth weight was 2733 ± 564. The majority of newborns had received antiretroviral (ARV) prophylaxis after birth, half of them between 12 and 24 hours. The most used therapeutic protocol was Zidovudine (AZT) + Lamivudine (3TC) + Lopinavir/Ritonavir (LPV/r). Protected breastfeeding was the option chosen in 76.8% of cases. The PCR performed at 6 weeks was negative in more than half of the cases. Retroviral serology was carried out after 14 months in 43% of cases. We noted a single positive case with a negative initial PCR, representing an overall transmission rate of 1.96%. Conclusion: Senegal’s current policy targeting EMTCT of HIV is on good momentum with a fairly low transmission rate thanks to screening of pregnant women and prophylaxis with antiretrovirals (ARV) for HIV-positive mothers during pregnancy and for life. And children exposed from birth and during breastfeeding up to 6 weeks with regular monitoring.
文摘Introduction: Sickle cell disease is a real public health problem in the world and particularly in Niger where the prevalence of the S gene is estimated at 25% and that of the homozygous forms at between 1% and 2%. Treatment combines quarterly follow-up of patients and management of complications. The objective of this study was to identify the potential explanatory factors of non-adherence to treatment in sickle cell patients followed at the national reference center for sickle cell disease in Niger. Methods: This is a cross-sectional study of sickle cell cases followed at the CNRD in Niger. The population consisted of all sickle cell patients followed in this center in 2021. The data collection techniques were individual interviews and documentary reviews. Non-adherence was assessed with the Girerd test. Descriptive statistical tests and simple and multiple logistic regression models were performed. Results: A total of 368 patients were enrolled. The median age is 7 years (4;10) and the sex ratio is 1.04. Ninety-eight (98) or 26.6% were compliant and 270 (73.4%) were non-compliant. In multivariate analysis, the factors independently and negatively associated with non-adherence to treatment were schooling (adjusted OR [95% CI], p-value), 0.17 [0.10 - 0.30];p Conclusion: The factors influencing treatment compliance identified in this study are all modifiable. To prevent the complications of sickle cell disease, we must fight against ignorance, make care services accessible and make care free.
