With the continuous development of the economy and societal progress,the economic census,as an important aspect of national statistical work,is directly influenced by the quality of grassroots infrastructure.This pape...With the continuous development of the economy and societal progress,the economic census,as an important aspect of national statistical work,is directly influenced by the quality of grassroots infrastructure.This paper thoroughly discusses the importance of strengthening the statistical foundation to improve the efficiency of economic census work,analyzes the existing issues in current infrastructure and census processes,and proposes corresponding solutions.By enhancing the professional training of grassroots statisticians,updating data collection technologies,and optimizing workflows,the aim is to significantly improve the accuracy and efficiency of the economic census,providing strong support for the healthy development of the national economy and informed decision-making.展开更多
BACKGROUND Rectal neuroendocrine tumors(NETs)smaller than 10 mm and well-differentiated tumors are generally considered to have a low risk of lymph node and distant metastasis,making them suitable for endoscopic resec...BACKGROUND Rectal neuroendocrine tumors(NETs)smaller than 10 mm and well-differentiated tumors are generally considered to have a low risk of lymph node and distant metastasis,making them suitable for endoscopic resection.In contrast,tumors≥20 mm in size typically require surgical resection.However,the optimal management of intermediate-sized(10-15 mm)rectal NETs remains controversial.AIM To compare the clinical outcomes of endoscopic resection of rectal NETs<1 cm and those 1-1.5 cm in size.METHODS A retrospective study was conducted on 1056 patients with rectal NETs treated at the Samsung Medical Center between January 2005 and June 2021.After propensity score matching(1:10)for age,sex,and type of endoscopic resection,225 patients with tumors<1 cm in size and 27 patients with tumors 1-1.5 cm in size were analyzed.RESULTS Surgical resection was more frequent in the 1-1.5 cm group(37.2%)than in the<1 cm group(10.7%)(P<0.01).Endoscopic submucosal dissection was also more commonly performed in the 1-1.5 cm group(48.1%vs 18.5%,P<0.01).Negative resection margins were achieved in 97.2%of the patients,with no significant difference between the groups(P=0.22).No lymphovascular invasion was observed.During a median follow-up of 54 months,no recurrence occurred in the 1-1.5 cm group,while one case of metachronous recurrence was noted in the<1 cm group(P=1.00).There was no significant difference in recurrence-free survival(P=0.48).CONCLUSION Endoscopic resection of 1-1.5 cm grade 1 rectal NETs yielded comparable outcomes to those<1 cm in size,suggesting its feasibility as a treatment.展开更多
BACKGROUND Glucagon-like peptide-1 receptor agonists(GLP-1RAs)are increasingly being used to treat type 2 diabetes mellitus(T2DM)and obesity.Although GLP-1RAs delay gastric emptying,their impact on gastric mucosal vis...BACKGROUND Glucagon-like peptide-1 receptor agonists(GLP-1RAs)are increasingly being used to treat type 2 diabetes mellitus(T2DM)and obesity.Although GLP-1RAs delay gastric emptying,their impact on gastric mucosal visibility during upper endoscopy remains uncertain,especially in Asian patients.AIM To investigate the association between GLP-1RA treatment and gastric mucosal visibility during upper endoscopy in Asian patients with T2DM.METHODS The study population included Korean patients who underwent esophagogastroduodenoscopy(EGD)with concomitant GLP-1RA or dipeptidyl peptidase 4 inhibitor(DPP4i)for the treatment of T2DM.A 1:2 propensity score matching between GLP-1RA and DPP4i users resulted in 198 matched patients and 295 matched patients in each group,respectively.Gastric mucosal visibility was assessed by reviewing endoscopy images with a validated scale(POLPREP).In addition,the rates of aborted and repeat EGD and pulmonary aspiration were also assessed.RESULTS Of the 493 matched patients,mean body mass index was 26.0 kg/m^(2).The rate of inadequate gastric mucosal visibility(gastric POLPREP score 0 or 1)was significantly higher in GLP-1RA group than matched DPP4i group(8.6%vs 1.4%,P=0.0007).The rates of aborted EGD and repeat EGD were also significantly higher in GLP-1RA than DPP4i group(7.6%vs 0.7%in both aborted and repeat EGD,P=0.0011).Multivariable logistic regression revealed GLP-1RA use as an independent risk factor for both inadequate gastric mucosal visibility(odds ratio=6.143,95%confidence interval:2.289,20.318,P=0.0008)and aborted EGD(odds ratio=11.099,95%confidence interval:3.172,63.760,P=0.0010).Despite gastric residue,no pulmonary aspiration was reported in either group.CONCLUSION GLP-1RA use was associated with a higher risk of inadequate gastric mucosal visibility and aborted and repeat procedures during upper gastrointestinal endoscopy in Korean patients with T2DM while pulmonary aspiration was not observed.展开更多
We introduce a new generalization of the exponentiated power Lindley distribution,called the exponentiated power Lindley power series(EPLPS)distribution.The new distribution arises on a latent complementary risks scen...We introduce a new generalization of the exponentiated power Lindley distribution,called the exponentiated power Lindley power series(EPLPS)distribution.The new distribution arises on a latent complementary risks scenario,in which the lifetime associated with a particular risk is not observable;rather,we observe only the maximum lifetime value among all risks.The distribution exhibits decreasing,increasing,unimodal and bathtub shaped hazard rate functions,depending on its parameters.Several properties of the EPLPS distribution are investigated.Moreover,we discuss maximum likelihood estimation and provide formulas for the elements of the Fisher information matrix.Finally,applications to three real data sets show the flexibility and potentiality of the EPLPS distribution.展开更多
This paper is concerned with the existence of nontrivial homoclinic solutions for a class of second order Hamiltonian systems with external forc-ing perturbations q+Aq+Vq(t,q)=f(t),where q=(q1,q2,..qN)∈R^(N),A is an ...This paper is concerned with the existence of nontrivial homoclinic solutions for a class of second order Hamiltonian systems with external forc-ing perturbations q+Aq+Vq(t,q)=f(t),where q=(q1,q2,..qN)∈R^(N),A is an antisymmetric constant N×N matrix,V(t,q)=-K(t,q)+W(t,q)with K,W ∈C^(1)(R,R^(N))and satisfying b1|q|^(2)≤K(t,q)≤b_(2)|q|^(2)for some positive constants b_(2)≥b_(1)>0 and external forcing term f∈C(R,R^(N))being small enough.Under some new weak superquadratic conditions for W,by using the mountain pass theorem,we obtain the existence of at least one nontrivial homoclinic solution.展开更多
Objective： The aim of this prospective, single-arm phase II trial was to confirm the safety and efficacy of neoadjuvant chemotherapy（NAC） using oxaliplatin plus capecitabine（Cap OX） for patients with operable loc...Objective： The aim of this prospective, single-arm phase II trial was to confirm the safety and efficacy of neoadjuvant chemotherapy（NAC） using oxaliplatin plus capecitabine（Cap OX） for patients with operable locally advanced colon cancer（CC）.Methods： Patients with computed tomography-defined T4 or lymph node-positive CCs were enrolled. After radiological staging, patients were treated with at least 2 cycles of NAC consisting of 130 mg/m2 oxaliplatin on d 1,plus 1,000 mg/m2 capecitabine twice daily for 14 d every 3 weeks, followed by surgery, and then with the rest cycles of adjuvant chemotherapy. Radiological response was evaluated after 2 cycles of NAC. Tumor response, treatment toxicity, and surgical complications were recorded. The pathological response to therapy was evaluated according to the tumor regression grade（TRG） score. The primary endpoint was pathologic tumor response. This trial is registered in Clinical Trials.gov（No： NCT02415829）.Results： Forty-seven patients were enrolled in the study. Forty-two patients completed the planned treatments.The total radiological response rate was 68%（32/47）, including complete and partial response rates of 2%（1/47）and 66%（31/47）, respectively. Stable disease was observed in 32%（15/47） and progressive disease was observed in none. Complete pathologic response, major regression, and at least moderate regression were achieved in 1（2%）, 2（4%）, and 29（62%） patients, respectively. Four patients developed grade 3 treatment toxicities. One patient with wound infection occurred after operation（1/47, 2%）. There was no treatment-related death.Conclusions： Our results suggest that NAC with Cap OX is an effective and safe treatment option for patients with locally advanced CCs.展开更多
BACKGROUND Non-magnifying endoscopy with narrow-band imaging(NM-NBI)has been frequently used in routine screening of esophagus squamous cell carcinoma(ESCC).The performance of NBI for screening of early ESCC is,howeve...BACKGROUND Non-magnifying endoscopy with narrow-band imaging(NM-NBI)has been frequently used in routine screening of esophagus squamous cell carcinoma(ESCC).The performance of NBI for screening of early ESCC is,however,significantly affected by operator experience.Artificial intelligence may be a unique approach to compensate for the lack of operator experience.AIM To construct a computer-aided detection(CAD)system for application in NMNBI to identify early ESCC and to compare it with our previously reported CAD system with endoscopic white-light imaging(WLI).METHODS A total of 2167 abnormal NM-NBI images of early ESCC and 2568 normal images were collected from three institutions(Zhongshan Hospital of Fudan University,Xuhui Hospital,and Kiang Wu Hospital)as the training dataset,and 316 pairs of images,each pair including images obtained by WLI and NBI(same part),were collected for validation.Twenty endoscopists participated in this study to review the validation images with or without the assistance of the CAD systems.The diagnostic results of the two CAD systems and improvement in diagnostic efficacy of endoscopists were compared in terms of sensitivity,specificity,accuracy,positive predictive value,and negative predictive value.RESULTS The area under receiver operating characteristic curve for CAD-NBI was 0.9761.For the validation dataset,the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of CAD-NBI were 91.0%,96.7%,94.3%,95.3%,and 93.6%,respectively,while those of CAD-WLI were 98.5%,83.1%,89.5%,80.8%,and 98.7%,respectively.CAD-NBI showed superior accuracy and specificity than CAD-WLI(P=0.028 and P≤0.001,respectively),while CAD-WLI had higher sensitivity than CAD-NBI(P=0.006).By using both CAD-WLI and CAD-NBI,the endoscopists could improve their diagnostic efficacy to the highest level,with accuracy,sensitivity,and specificity of 94.9%,92.4%,and 96.7%,respectively.CONCLUSION The CAD-NBI system for screening early ESCC has higher accuracy and specificity than CAD-WLI.Endoscopists can achieve the best diagnostic efficacy using both CAD-WLI and CAD-NBI.展开更多
ObjectiveTo present the geographical map of malaria and identify some of the important environmental factors of this disease in Sistan and Baluchistan province, Iran.MethodsWe used the registered malaria data to compu...ObjectiveTo present the geographical map of malaria and identify some of the important environmental factors of this disease in Sistan and Baluchistan province, Iran.MethodsWe used the registered malaria data to compute the standard incidence rates (SIRs) of malaria in different areas of Sistan and Baluchistan province for a nine-year period (from 2001 to 2009). Statistical analyses consisted of two different parts: geographical mapping of malaria incidence rates, and modeling the environmental factors. The empirical Bayesian estimates of malaria SIRs were utilized for geographical mapping of malaria and a Poisson random effects model was used for assessing the effect of environmental factors on malaria SIRs.ResultsIn general, 64 926 new cases of malaria were registered in Sistan and Baluchistan Province from 2001 to 2009. Among them, 42 695 patients (65.8%) were male and 22 231 patients (34.2%) were female. Modeling the environmental factors showed that malaria incidence rates had positive relationship with humidity, elevation, average minimum temperature and average maximum temperature, while rainfall had negative effect on malaria SIRs in this province.ConclusionsThe results of the present study reveals that malaria is still a serious health problem in Sistan and Baluchistan province, Iran. Geographical map and related environmental factors of malaria can help the health policy makers to intervene in high risk areas more efficiently and allocate the resources in a proper manner.展开更多
African swine fever(ASF),a fatal disease outbroken in China in August 2018,has widely attracted social concern especially in the information era.The occurrence of ASF led to an imbalance between supply and demand in p...African swine fever(ASF),a fatal disease outbroken in China in August 2018,has widely attracted social concern especially in the information era.The occurrence of ASF led to an imbalance between supply and demand in pork and other meat markets.As a result,meat prices fluctuated greatly during the past year in 2019.To measure ASF quantitatively,the internet public concern index about ASF was created using web crawler methods.The relationships between ASF and meat prices were analyzed based on time-varying parameter vector auto-regressive(TVP-VAR)model.The results showed that there were some differences in the impact size,direction and duration of ASF on the prices of pork,chicken,beef and mutton,and the characteristics of time variability and heterogeneity were obvious.At the same time,the impact of ASF on meat prices is not consistent with the trend and degree of ASF.The impulse intensity is strongly correlated with the strength and duration of ASF,and it is generally weak in the early stage and much stronger in the middle and late periods.The results indicate that macro regulations,monitoring and early-warning system,standardizing production and circulation,and the public opinion monitoring and guidance about ASF should be given more attention in future to stabilize the market expectations and to promote a smooth functioning of the livestock markets.展开更多
BACKGROUND Crohn’s disease(CD)is a chronic nonspecific intestinal inflammatory disease.The aetiology and pathogenesis of CD are still unclear.Anal fistula is the main complication of CD and is a difficult problem to ...BACKGROUND Crohn’s disease(CD)is a chronic nonspecific intestinal inflammatory disease.The aetiology and pathogenesis of CD are still unclear.Anal fistula is the main complication of CD and is a difficult problem to solve at present.The main limitation of developing new therapies is bound up with the short of preclinical security and effectiveness data.Therefore,an ideal animal model is needed to establish persistent anal fistula and an inflamed rectal mucosa.AIM To improve the induction method of colitis and establish a reliable and reproducible perianal fistulizing Crohn’s disease animal model to evaluate new treatment strategies.METHODS Twenty male New Zealand rabbits underwent rectal enema with different doses of 2,4,6-trinitrobenzene sulfonic acid to induce proctitis.Group A was treated with an improved equal interval small dose increasing method.The dosage of group B was constant.Seven days later,the rabbits underwent surgical creation of a transsphincteric fistula.Then,three rabbits were randomly selected from each group every 7 d to remove the seton from the fistula.The rabbits were examined by endoscopy every 7 days,and biopsy forceps were used to obtain tissue samples from the obvious colon lesions for histological analysis.The disease activity index(DAI),colonoscopy and histological scores were recorded.Perianal endoscopic ultrasonography(EUS)was used to evaluate the healing of fistulas.RESULTS Except for the DAI score,the colonoscopy and histological scores in group A were significantly higher than those in group B(P<0.05).In the ideal model rabbit group,on the 7 th day after the removal of the seton,all animals had persistent lumens on EUS imaging,showing continuous fullthickness high signals.Histological inspection of the fistula showed acute and chronic inflammation,fibrosis,epithelialization and peripheral proctitis of the adjoining rectum.CONCLUSION The improved method of CD colitis induction successfully established a rabbit perianal fistula CD preclinical model,which was confirmed by endoscopy and pathology.展开更多
Objective： Irinotecan in combination with cisplatin for extensive-stage disease small-ceU lung cancer （ED-SCLC） patients has gained wide interest. Varying results for this treatment underpin the need for a synthesi...Objective： Irinotecan in combination with cisplatin for extensive-stage disease small-ceU lung cancer （ED-SCLC） patients has gained wide interest. Varying results for this treatment underpin the need for a synthesis of evidence. Methods： We conducted a literature-based meta-analysis to quantify the magnitude of the benefit comparing irinotecan in combination with cisplatin （IP） with etoposide in combination with cisplatin （EP） in ED-SCLC patients. The primary outcome was overall survival （OS） and progression-free survival （PFS）; secondary outcomes included overall response rate, 1- and 2-year survival rates, disease control rate and toxicity. Results： Four trials including 1,541 patients were identified in the analysis. No positive results （P〈0.05） were seen： OS （HR=0.85, CI95%=0.71-1.01; P=-0.08） with high heterogeneity （Chi2=7.76, dr=-3 [P=-0.05]; I2=61%）, PFS （HR=0.91, CI95%=0.74-1.28; P=-0.36） with high heterogeneity （Chi2=11.96, df=3 [P=-0.008]; I2=75%）, overall response rate（OR=1.16; CI95%=0.79-1.70; P=0.45）, disease control rate （OR=1.01; CI95%=0.74-1.38; P=0.95）, 1-year survival rate （OR = 1.30; CI95%=0.98-1.72; P=0.07） and 2-year survival rate （OR=1.97; CI95%=0.95-4.09; P=-0.07）. Fewer patients who received IP suffered severe hematologic toxicities （grade≥3）, such as neutropenia, thrombocytopenia and leucopenia. However, severe non-hematologic toxicities （grade≥3）, such as diarrhea, nausea, vomiting, fatigue, anorexia, and dehydration, were more common among patients who received IP. Conclusion： IP does not lengthen the overall survival or progression-free survival compared with EP in patients with ED-SCLC Fewer patients receiving IP had grade ≥ 3 hematological toxicities of nentropenia, leucopenia and thrombocytopenia, but more had grade≥3 diarrhea, nausea, vomiting, fatigue, anorexia and dehydration.展开更多
This paper gives a tutorial on how to prove Lyapunov type criteria by optimal control methods. Firstly, we consider stability criteria on Hill’s equations with nonnegative potential. By optimal control methods develo...This paper gives a tutorial on how to prove Lyapunov type criteria by optimal control methods. Firstly, we consider stability criteria on Hill’s equations with nonnegative potential. By optimal control methods developed in 1990s, we obtain several stability criteria including Lyapunov’s criterion, Neǐgauz and Lidskiǐ’s criterion. Secondly, we present stability criteria on Hill’s equations with sign-changing potential in which Brog’s criterion and Krein’s criterion are included.展开更多
Objective:To determine the influence of geographic,knowledge and behavioral factors on Opisthorchis(O.)viverrini infection in the Northeast of Thailand.Methods:This cross-sectional study was conducted by using four da...Objective:To determine the influence of geographic,knowledge and behavioral factors on Opisthorchis(O.)viverrini infection in the Northeast of Thailand.Methods:This cross-sectional study was conducted by using four datasets of years 2016 and 2017.Generalized linear mixed model was employed to analyze association between geographic,knowledge and behavioral factors and O.viverrini infection.Results:Totally there were 1885 participants.The prevalence of O.viverrini infection was 10.03%.Geographic factors that showed statistically significant association with O.viverrini infection in the Northeast region were featured by at least a dam and reservoir(Adj.OR=4.21,95%CI:2.49-7.13,P<0.001),at least a weir(Adj.OR=1.74,95%CI:1.09-2.77,P=0.020),>50 dogs and cats per village(Adj.OR=3.40,95%CI:2.17-5.31,P<0.001),and rice fields covered>50%of its areas(Adj.OR=1.91,95%CI:1.04-4.01,P=0.036),as well as low to moderate levels of knowledge(Adj.OR=1.60,95%CI:1.32 to 1.94,P<0.001),consumed raw fish(Adj.OR=1.90,95%CI:1.02 to 3.52,P=0.040)and consumed processed raw fish(Adj.OR=3.03,95%CI:2.20 to 4.18,P<0.001).Other significant covariates were gender and age of the respondents.Conclusions:O.viverrini infection still remains a public health problem of the Northeast of Thailand.Geographic and demographic factors,knowledge,and consumption behaviors of raw fish products are significantly associated with O.viverrini infection.展开更多
BACKGROUND The incidence of colorectal cancer(CRC)and preinvasive CRC(e.g.,early colon cancer and advanced adenoma)is gradually increasing in several countries.AIM To evaluate the trend in incidence of CRC and preinva...BACKGROUND The incidence of colorectal cancer(CRC)and preinvasive CRC(e.g.,early colon cancer and advanced adenoma)is gradually increasing in several countries.AIM To evaluate the trend in incidence of CRC and preinvasive CRC according to the increase in the number of colonoscopies performed in Korea.METHODS This retrospective cohort study enrolled Korean patients from 2002 to 2020 to evaluate the incidence of CRC and preinvasive CRC,and assess the numbers of diagnostic colonoscopies and colonoscopic polypectomies.Colonoscopy-related complications by age group were also determined.RESULTS The incidence of CRC showed a rapid increase,then decreased after 2012 in the 50-75 year-age group.During the study period,the rate of incidence of preinvasive CRC increased at a similar level in patients under 50 and 50-75 years of age.Since 2009,the increase has been rapid,showing a pattern similar to the increase in colonoscopies.The rate of colonoscopic polypectomy in patients aged under 50 was similar to the rate in patients over 75 years of age after 2007.The rate of complications after colonoscopy and related deaths within 3 mo was high for those over 75 years of age.CONCLUSION The diagnosis of preinvasive CRC increased with the increase in the number of colonoscopies performed.As the risk of colonoscopy-related hospitalization and death is high in the elderly,if early lesions at risk of developing CRC are diagnosed and treated under or at the age of 75,colonoscopy-related complications can be reduced for those aged 76 years or over.展开更多
Objective:This study aims to analyze how changes in pathological diagnosis practice and molecular detection technology have affected clinical outcomes for colorectal cancer(CRC)patients in Fudan University Shanghai Ca...Objective:This study aims to analyze how changes in pathological diagnosis practice and molecular detection technology have affected clinical outcomes for colorectal cancer(CRC)patients in Fudan University Shanghai Cancer Center(FUSCC).Methods:This retrospective cohort study analyzed 21,141 pathologically confirmed CRC cases diagnosed at FUSCC from 2008 to 2020.Patients were divided into five groups for different analytical purposes:(1)the before vs.since 2014 groups to analyze the influence of the changes in the classification criteria of pT3 and pT4 staging on the survival of patients;(2)the partial vs.total mesorectal excision(TME)groups to analyze whether evaluation of completeness of the mesorectum have impact on the survival of patients;(3)the tumor deposit(TD)(+)N0 vs.TD(+)N1c groups to analyze the influence of the changes in the pN staging on the survival of patients with positive TD and negative regional lymph node metastasis(LNM);(4)the before vs.since 2013 groups to analyze the influence of the changes in the testing process of deficient mismatch repair on the survival of patients;and(5)the groups with vs.without RAS/BRAF gene mutation testing to analyze the influence of these testing on the survival of patients.Patients’clinicopathological parameters,including age at diagnosis,sex,tumor size,location,differentiation,mucinous subtype,TD,lymphovascular invasion,perineural invasion,tumor depth,LNM and distant metastasis,and tumor-node-metastasis(TNM)stage,were compared between groups.Kaplan-Meier analysis with log rank method was performed for patients’overall survival(OS)and disease-free survival(DFS)analyses.Results:In pathological reports,there were three parameter changes that impacted patient outcomes.Firstly,changes in the pT staging criteria led to a shift of the ratio of patients with stage pT3 to stage pT4 from 1:110.9 to 1:0.26.In comparison to patients admitted before 2014(n=4,754),a significant difference in prognosis between pT3 and pT4 stages was observed since 2014(n=9,965).Secondly,we began to evaluate the completeness of the mesorectum since 2016.As a result,91.0%of patients with low rectal cancer underwent TME(n=4,111)surgery,and patients with TME had significantly better OS compared with partial mesorectal excision(PME,n=409).Thirdly,we began to stage TD(+)LNM(-)as N1c since 2017.The results showed that N1c(n=127)but not N0(n=39)can improve the prognosis of patients without LNM and distal metastasis.In molecular testing,there have been three and five iterations of updates regarding mismatch repair(MMR)/microsatellite instability(MSI)status and RAS/BRAF gene mutation detection,respectively.The standardization of MMR status testing has sharply decreased the proportion of deficient MMR(dMMR)patients(from 32.5%to 7.4%)since 2013.The prognosis of patients underwent MMR status testing since 2013(n=867)were significantly better than patients before 2013(n=1,313).In addition,detection of RAS/BRAF gene mutation status(n=5,041)resulted in better DFS but not OS,for patients with stage I-III disease(n=16,557).Conclusion:Over the past few decades,updates in elements in pathological reports,as well as the development of standardized tests for MMR/MSI status and RAS/BRAF gene mutations have significantly improved patient outcomes.展开更多
Objective:To provide the mechanism-based pharmacotherapy of the Huatan Qushi formula(HTQS for-mula),for the health management and treatment of non-alcoholic fatty liver disease(NAFLD).Methods:A rat model of NAFLD was ...Objective:To provide the mechanism-based pharmacotherapy of the Huatan Qushi formula(HTQS for-mula),for the health management and treatment of non-alcoholic fatty liver disease(NAFLD).Methods:A rat model of NAFLD was employed to examine the efficacy and safety of the HTQS formula.In vivo active components and potential mechanisms of the HTQS formula were identified using UPLC‒MS/MS combined with network pharmacology.The influence of the HTQS formula on the dominating proteins in PI3K/Akt pathway was validated in vivo using western blot.Finally,16S rRNA sequencing of the gut microbiome was conducted followed by targeted metabolomics detecting fecal short-chain fatty acids(SCFAs)and bile acids to determine the impact of the HTQS formula on gut microbiota.Results:The HTQS formula reduced weight gain and hepatic steatosis in NAFLD rats and decreased serum total cholesterol(TC),triglycerides,blood glucose,and insulin resistance(IR)without causing liver or kidney injury.We detected 28 components using UPLC‒MS/MS and identified 439 shared targets be-tween NAFLD and the HTQS formula.Primarily,we focused on the PI3K/Akt signaling pathway based on protein‒protein interaction network analysis.We validated that the HTQS formula inhibited liver stea-tosis and inflammation by increasing the phosphorylation levels of PI3K,AKT,P27,GSK3b in the PI3K/Akt signaling pathway.16S rRNA sequencing revealed that the HTQS formula reduced the abundance of the genus Family_XIII_AD3011_group,which was positively correlated with IR and taurodeoxycholic acid.In addition,Lachnospiraceae_UCG_010 inversely correlated with TC and five bile acids,which could be essential to the therapeutic effect of the HTQS formula against NAFLD.Conclusions:The HTQS formula proved to be an effective pharmacotherapy for NAFLD without causing liver or kidney injury.Multiple potent components of the HTQS formula could alleviate liver steatosis and lipid metabolism disorder by modulating the PI3K/Akt signaling pathway and restoring gut microbiota composition.展开更多
How many imputations are sufficient in multiple imputations? The answer given by different researchers varies from as few as 2 - 3 to as many as hundreds. Perhaps no single number of imputations would fit all situatio...How many imputations are sufficient in multiple imputations? The answer given by different researchers varies from as few as 2 - 3 to as many as hundreds. Perhaps no single number of imputations would fit all situations. In this study, η, the minimally sufficient number of imputations, was determined based on the relationship between m, the number of imputations, and ω, the standard error of imputation variances using the 2012 National Ambulatory Medical Care Survey (NAMCS) Physician Workflow mail survey. Five variables of various value ranges, variances, and missing data percentages were tested. For all variables tested, ω decreased as m increased. The m value above which the cost of further increase in m would outweigh the benefit of reducing ω was recognized as the η. This method has a potential to be used by anyone to determine η that fits his or her own data situation.展开更多
This paper examines the current costs, benefits and intensity of China＇s industrial environment regulation, as well as the path of regulatory enhancement. Regulatory intensity has been on the rise since 1997. The int...This paper examines the current costs, benefits and intensity of China＇s industrial environment regulation, as well as the path of regulatory enhancement. Regulatory intensity has been on the rise since 1997. The intensity was only 43 in 1997 and then reached 68 by 2007. This paper for the first time compares the treatment costs at the front and rear ends of pollution chain, employs the concept of regulatory benefit multiplier, and calculates the benefit multipliers for different pollutants. Results indicate that enhanced environmental protection since 1997 makes social and economic sense, particularly for the front end treatment of various pollutants since 2004, which have considerable economic benefits. After comparing the benefit multipliers, we have prioritized the pollutants for regulatory consideration： environmental regulation shouM be made tougher for waste water first, and then dust and fumes, followed by SO2 and lastly CO2. This will help to achieve the best environmental outcomes while incurring no additional economic costs.展开更多
Many studies have shown that chlorophyll meter readings （CMRs） can be used to diagnose deficiencies of nitrogen （N） during the growth of corn （Zea mays L.） in small-plot trials, but there is need to address addi...Many studies have shown that chlorophyll meter readings （CMRs） can be used to diagnose deficiencies of nitrogen （N） during the growth of corn （Zea mays L.） in small-plot trials, but there is need to address additional problems encountered when diagnoses are made in fields of the size managed in production agriculture. A noteworthy difference between smallplot trials and production agriculture is the extent to which the effects of N are confounded with the effects of other factors such as tillage, landscape, soil organic matter and moisture content. We illustrate how some of these factors can cause differences in the physiological age of plants and introduce errors in the diagnoses of N deficiencies. We suggest methods （measuring the height to the youngest leaf collar and assigning leaf numbers by using the first leaf with pubescence and the ear leaf as references to identify growth stages） for minimizing these errors. The simplified method of growth stage identification can be used to select appropriate plants and leaves for making diagnoses in fields and to distinguish the effects of N from the effects of other factors that influence plant growth.展开更多
In his 1987 classic book on multiple imputation (MI), Rubin used the fraction of missing information, γ, to define the relative efficiency (RE) of MI as RE = (1 + γ/m)?1/2, where m is the number of imputations, lead...In his 1987 classic book on multiple imputation (MI), Rubin used the fraction of missing information, γ, to define the relative efficiency (RE) of MI as RE = (1 + γ/m)?1/2, where m is the number of imputations, leading to the conclusion that a small m (≤5) would be sufficient for MI. However, evidence has been accumulating that many more imputations are needed. Why would the apparently sufficient m deduced from the RE be actually too small? The answer may lie with γ. In this research, γ was determined at the fractions of missing data (δ) of 4%, 10%, 20%, and 29% using the 2012 Physician Workflow Mail Survey of the National Ambulatory Medical Care Survey (NAMCS). The γ values were strikingly small, ranging in the order of 10?6 to 0.01. As δ increased, γ usually increased but sometimes decreased. How the data were analysed had the dominating effects on γ, overshadowing the effect of δ. The results suggest that it is impossible to predict γ using δ and that it may not be appropriate to use the γ-based RE to determine sufficient m.展开更多
文摘With the continuous development of the economy and societal progress,the economic census,as an important aspect of national statistical work,is directly influenced by the quality of grassroots infrastructure.This paper thoroughly discusses the importance of strengthening the statistical foundation to improve the efficiency of economic census work,analyzes the existing issues in current infrastructure and census processes,and proposes corresponding solutions.By enhancing the professional training of grassroots statisticians,updating data collection technologies,and optimizing workflows,the aim is to significantly improve the accuracy and efficiency of the economic census,providing strong support for the healthy development of the national economy and informed decision-making.
文摘BACKGROUND Rectal neuroendocrine tumors(NETs)smaller than 10 mm and well-differentiated tumors are generally considered to have a low risk of lymph node and distant metastasis,making them suitable for endoscopic resection.In contrast,tumors≥20 mm in size typically require surgical resection.However,the optimal management of intermediate-sized(10-15 mm)rectal NETs remains controversial.AIM To compare the clinical outcomes of endoscopic resection of rectal NETs<1 cm and those 1-1.5 cm in size.METHODS A retrospective study was conducted on 1056 patients with rectal NETs treated at the Samsung Medical Center between January 2005 and June 2021.After propensity score matching(1:10)for age,sex,and type of endoscopic resection,225 patients with tumors<1 cm in size and 27 patients with tumors 1-1.5 cm in size were analyzed.RESULTS Surgical resection was more frequent in the 1-1.5 cm group(37.2%)than in the<1 cm group(10.7%)(P<0.01).Endoscopic submucosal dissection was also more commonly performed in the 1-1.5 cm group(48.1%vs 18.5%,P<0.01).Negative resection margins were achieved in 97.2%of the patients,with no significant difference between the groups(P=0.22).No lymphovascular invasion was observed.During a median follow-up of 54 months,no recurrence occurred in the 1-1.5 cm group,while one case of metachronous recurrence was noted in the<1 cm group(P=1.00).There was no significant difference in recurrence-free survival(P=0.48).CONCLUSION Endoscopic resection of 1-1.5 cm grade 1 rectal NETs yielded comparable outcomes to those<1 cm in size,suggesting its feasibility as a treatment.
文摘BACKGROUND Glucagon-like peptide-1 receptor agonists(GLP-1RAs)are increasingly being used to treat type 2 diabetes mellitus(T2DM)and obesity.Although GLP-1RAs delay gastric emptying,their impact on gastric mucosal visibility during upper endoscopy remains uncertain,especially in Asian patients.AIM To investigate the association between GLP-1RA treatment and gastric mucosal visibility during upper endoscopy in Asian patients with T2DM.METHODS The study population included Korean patients who underwent esophagogastroduodenoscopy(EGD)with concomitant GLP-1RA or dipeptidyl peptidase 4 inhibitor(DPP4i)for the treatment of T2DM.A 1:2 propensity score matching between GLP-1RA and DPP4i users resulted in 198 matched patients and 295 matched patients in each group,respectively.Gastric mucosal visibility was assessed by reviewing endoscopy images with a validated scale(POLPREP).In addition,the rates of aborted and repeat EGD and pulmonary aspiration were also assessed.RESULTS Of the 493 matched patients,mean body mass index was 26.0 kg/m^(2).The rate of inadequate gastric mucosal visibility(gastric POLPREP score 0 or 1)was significantly higher in GLP-1RA group than matched DPP4i group(8.6%vs 1.4%,P=0.0007).The rates of aborted EGD and repeat EGD were also significantly higher in GLP-1RA than DPP4i group(7.6%vs 0.7%in both aborted and repeat EGD,P=0.0011).Multivariable logistic regression revealed GLP-1RA use as an independent risk factor for both inadequate gastric mucosal visibility(odds ratio=6.143,95%confidence interval:2.289,20.318,P=0.0008)and aborted EGD(odds ratio=11.099,95%confidence interval:3.172,63.760,P=0.0010).Despite gastric residue,no pulmonary aspiration was reported in either group.CONCLUSION GLP-1RA use was associated with a higher risk of inadequate gastric mucosal visibility and aborted and repeat procedures during upper gastrointestinal endoscopy in Korean patients with T2DM while pulmonary aspiration was not observed.
文摘We introduce a new generalization of the exponentiated power Lindley distribution,called the exponentiated power Lindley power series(EPLPS)distribution.The new distribution arises on a latent complementary risks scenario,in which the lifetime associated with a particular risk is not observable;rather,we observe only the maximum lifetime value among all risks.The distribution exhibits decreasing,increasing,unimodal and bathtub shaped hazard rate functions,depending on its parameters.Several properties of the EPLPS distribution are investigated.Moreover,we discuss maximum likelihood estimation and provide formulas for the elements of the Fisher information matrix.Finally,applications to three real data sets show the flexibility and potentiality of the EPLPS distribution.
基金supported by the National Natural Science Foundation of China(Grant No.12171253).
文摘This paper is concerned with the existence of nontrivial homoclinic solutions for a class of second order Hamiltonian systems with external forc-ing perturbations q+Aq+Vq(t,q)=f(t),where q=(q1,q2,..qN)∈R^(N),A is an antisymmetric constant N×N matrix,V(t,q)=-K(t,q)+W(t,q)with K,W ∈C^(1)(R,R^(N))and satisfying b1|q|^(2)≤K(t,q)≤b_(2)|q|^(2)for some positive constants b_(2)≥b_(1)>0 and external forcing term f∈C(R,R^(N))being small enough.Under some new weak superquadratic conditions for W,by using the mountain pass theorem,we obtain the existence of at least one nontrivial homoclinic solution.
基金supported by grants from the National Natural Science Foundation of China (Grant No. 81472620)Shanghai Science and Technology Planning Fund (No. 13140902100)+1 种基金Shanghai Combination Study Project for Major Diseases (No. 2014ZYJB0101)Shanghai Health and Family Planning Commission (No. JGY1404)
文摘Objective： The aim of this prospective, single-arm phase II trial was to confirm the safety and efficacy of neoadjuvant chemotherapy（NAC） using oxaliplatin plus capecitabine（Cap OX） for patients with operable locally advanced colon cancer（CC）.Methods： Patients with computed tomography-defined T4 or lymph node-positive CCs were enrolled. After radiological staging, patients were treated with at least 2 cycles of NAC consisting of 130 mg/m2 oxaliplatin on d 1,plus 1,000 mg/m2 capecitabine twice daily for 14 d every 3 weeks, followed by surgery, and then with the rest cycles of adjuvant chemotherapy. Radiological response was evaluated after 2 cycles of NAC. Tumor response, treatment toxicity, and surgical complications were recorded. The pathological response to therapy was evaluated according to the tumor regression grade（TRG） score. The primary endpoint was pathologic tumor response. This trial is registered in Clinical Trials.gov（No： NCT02415829）.Results： Forty-seven patients were enrolled in the study. Forty-two patients completed the planned treatments.The total radiological response rate was 68%（32/47）, including complete and partial response rates of 2%（1/47）and 66%（31/47）, respectively. Stable disease was observed in 32%（15/47） and progressive disease was observed in none. Complete pathologic response, major regression, and at least moderate regression were achieved in 1（2%）, 2（4%）, and 29（62%） patients, respectively. Four patients developed grade 3 treatment toxicities. One patient with wound infection occurred after operation（1/47, 2%）. There was no treatment-related death.Conclusions： Our results suggest that NAC with Cap OX is an effective and safe treatment option for patients with locally advanced CCs.
基金Supported by National Key R&D Program of China,No.2018YFC1315000,No.2018YFC1315005,No.2019YFC1315800,and No.2019YFC1315802National Natural Science Foundation of China,No.81861168036 and No.81702305+2 种基金Science and Technology Commission Foundation of Shanghai Municipality,No.19411951600,and No.19411951601Macao SAR Science and Technology Development Foundation,No.0023/2018/AFJDawn Program of Shanghai Education Commission,No.18SG08.
文摘BACKGROUND Non-magnifying endoscopy with narrow-band imaging(NM-NBI)has been frequently used in routine screening of esophagus squamous cell carcinoma(ESCC).The performance of NBI for screening of early ESCC is,however,significantly affected by operator experience.Artificial intelligence may be a unique approach to compensate for the lack of operator experience.AIM To construct a computer-aided detection(CAD)system for application in NMNBI to identify early ESCC and to compare it with our previously reported CAD system with endoscopic white-light imaging(WLI).METHODS A total of 2167 abnormal NM-NBI images of early ESCC and 2568 normal images were collected from three institutions(Zhongshan Hospital of Fudan University,Xuhui Hospital,and Kiang Wu Hospital)as the training dataset,and 316 pairs of images,each pair including images obtained by WLI and NBI(same part),were collected for validation.Twenty endoscopists participated in this study to review the validation images with or without the assistance of the CAD systems.The diagnostic results of the two CAD systems and improvement in diagnostic efficacy of endoscopists were compared in terms of sensitivity,specificity,accuracy,positive predictive value,and negative predictive value.RESULTS The area under receiver operating characteristic curve for CAD-NBI was 0.9761.For the validation dataset,the sensitivity,specificity,accuracy,positive predictive value,and negative predictive value of CAD-NBI were 91.0%,96.7%,94.3%,95.3%,and 93.6%,respectively,while those of CAD-WLI were 98.5%,83.1%,89.5%,80.8%,and 98.7%,respectively.CAD-NBI showed superior accuracy and specificity than CAD-WLI(P=0.028 and P≤0.001,respectively),while CAD-WLI had higher sensitivity than CAD-NBI(P=0.006).By using both CAD-WLI and CAD-NBI,the endoscopists could improve their diagnostic efficacy to the highest level,with accuracy,sensitivity,and specificity of 94.9%,92.4%,and 96.7%,respectively.CONCLUSION The CAD-NBI system for screening early ESCC has higher accuracy and specificity than CAD-WLI.Endoscopists can achieve the best diagnostic efficacy using both CAD-WLI and CAD-NBI.
文摘ObjectiveTo present the geographical map of malaria and identify some of the important environmental factors of this disease in Sistan and Baluchistan province, Iran.MethodsWe used the registered malaria data to compute the standard incidence rates (SIRs) of malaria in different areas of Sistan and Baluchistan province for a nine-year period (from 2001 to 2009). Statistical analyses consisted of two different parts: geographical mapping of malaria incidence rates, and modeling the environmental factors. The empirical Bayesian estimates of malaria SIRs were utilized for geographical mapping of malaria and a Poisson random effects model was used for assessing the effect of environmental factors on malaria SIRs.ResultsIn general, 64 926 new cases of malaria were registered in Sistan and Baluchistan Province from 2001 to 2009. Among them, 42 695 patients (65.8%) were male and 22 231 patients (34.2%) were female. Modeling the environmental factors showed that malaria incidence rates had positive relationship with humidity, elevation, average minimum temperature and average maximum temperature, while rainfall had negative effect on malaria SIRs in this province.ConclusionsThe results of the present study reveals that malaria is still a serious health problem in Sistan and Baluchistan province, Iran. Geographical map and related environmental factors of malaria can help the health policy makers to intervene in high risk areas more efficiently and allocate the resources in a proper manner.
基金This study was supported by the National Natural Science Foundation of China(72073131)the Central Public-Interest Scientific Institution Basal Research Fund,China(2020JKY025)the Agricultural Science and Technology Innovation Program of Chinese Academy of Agricultural Sciences(CAAS-ASTIP-2016-AII).
文摘African swine fever(ASF),a fatal disease outbroken in China in August 2018,has widely attracted social concern especially in the information era.The occurrence of ASF led to an imbalance between supply and demand in pork and other meat markets.As a result,meat prices fluctuated greatly during the past year in 2019.To measure ASF quantitatively,the internet public concern index about ASF was created using web crawler methods.The relationships between ASF and meat prices were analyzed based on time-varying parameter vector auto-regressive(TVP-VAR)model.The results showed that there were some differences in the impact size,direction and duration of ASF on the prices of pork,chicken,beef and mutton,and the characteristics of time variability and heterogeneity were obvious.At the same time,the impact of ASF on meat prices is not consistent with the trend and degree of ASF.The impulse intensity is strongly correlated with the strength and duration of ASF,and it is generally weak in the early stage and much stronger in the middle and late periods.The results indicate that macro regulations,monitoring and early-warning system,standardizing production and circulation,and the public opinion monitoring and guidance about ASF should be given more attention in future to stabilize the market expectations and to promote a smooth functioning of the livestock markets.
文摘BACKGROUND Crohn’s disease(CD)is a chronic nonspecific intestinal inflammatory disease.The aetiology and pathogenesis of CD are still unclear.Anal fistula is the main complication of CD and is a difficult problem to solve at present.The main limitation of developing new therapies is bound up with the short of preclinical security and effectiveness data.Therefore,an ideal animal model is needed to establish persistent anal fistula and an inflamed rectal mucosa.AIM To improve the induction method of colitis and establish a reliable and reproducible perianal fistulizing Crohn’s disease animal model to evaluate new treatment strategies.METHODS Twenty male New Zealand rabbits underwent rectal enema with different doses of 2,4,6-trinitrobenzene sulfonic acid to induce proctitis.Group A was treated with an improved equal interval small dose increasing method.The dosage of group B was constant.Seven days later,the rabbits underwent surgical creation of a transsphincteric fistula.Then,three rabbits were randomly selected from each group every 7 d to remove the seton from the fistula.The rabbits were examined by endoscopy every 7 days,and biopsy forceps were used to obtain tissue samples from the obvious colon lesions for histological analysis.The disease activity index(DAI),colonoscopy and histological scores were recorded.Perianal endoscopic ultrasonography(EUS)was used to evaluate the healing of fistulas.RESULTS Except for the DAI score,the colonoscopy and histological scores in group A were significantly higher than those in group B(P<0.05).In the ideal model rabbit group,on the 7 th day after the removal of the seton,all animals had persistent lumens on EUS imaging,showing continuous fullthickness high signals.Histological inspection of the fistula showed acute and chronic inflammation,fibrosis,epithelialization and peripheral proctitis of the adjoining rectum.CONCLUSION The improved method of CD colitis induction successfully established a rabbit perianal fistula CD preclinical model,which was confirmed by endoscopy and pathology.
文摘Objective： Irinotecan in combination with cisplatin for extensive-stage disease small-ceU lung cancer （ED-SCLC） patients has gained wide interest. Varying results for this treatment underpin the need for a synthesis of evidence. Methods： We conducted a literature-based meta-analysis to quantify the magnitude of the benefit comparing irinotecan in combination with cisplatin （IP） with etoposide in combination with cisplatin （EP） in ED-SCLC patients. The primary outcome was overall survival （OS） and progression-free survival （PFS）; secondary outcomes included overall response rate, 1- and 2-year survival rates, disease control rate and toxicity. Results： Four trials including 1,541 patients were identified in the analysis. No positive results （P〈0.05） were seen： OS （HR=0.85, CI95%=0.71-1.01; P=-0.08） with high heterogeneity （Chi2=7.76, dr=-3 [P=-0.05]; I2=61%）, PFS （HR=0.91, CI95%=0.74-1.28; P=-0.36） with high heterogeneity （Chi2=11.96, df=3 [P=-0.008]; I2=75%）, overall response rate（OR=1.16; CI95%=0.79-1.70; P=0.45）, disease control rate （OR=1.01; CI95%=0.74-1.38; P=0.95）, 1-year survival rate （OR = 1.30; CI95%=0.98-1.72; P=0.07） and 2-year survival rate （OR=1.97; CI95%=0.95-4.09; P=-0.07）. Fewer patients who received IP suffered severe hematologic toxicities （grade≥3）, such as neutropenia, thrombocytopenia and leucopenia. However, severe non-hematologic toxicities （grade≥3）, such as diarrhea, nausea, vomiting, fatigue, anorexia, and dehydration, were more common among patients who received IP. Conclusion： IP does not lengthen the overall survival or progression-free survival compared with EP in patients with ED-SCLC Fewer patients receiving IP had grade ≥ 3 hematological toxicities of nentropenia, leucopenia and thrombocytopenia, but more had grade≥3 diarrhea, nausea, vomiting, fatigue, anorexia and dehydration.
基金supported by NSFC(11401089,11671071)the Scientific Technological Project of Jilin Province’s Education Department in Thirteenth Five-Year(JJKH20170535KJ)+1 种基金supported by NSFC(11571065)the National Basic Research Program of China(2013CB834102)
文摘This paper gives a tutorial on how to prove Lyapunov type criteria by optimal control methods. Firstly, we consider stability criteria on Hill’s equations with nonnegative potential. By optimal control methods developed in 1990s, we obtain several stability criteria including Lyapunov’s criterion, Neǐgauz and Lidskiǐ’s criterion. Secondly, we present stability criteria on Hill’s equations with sign-changing potential in which Brog’s criterion and Krein’s criterion are included.
文摘Objective:To determine the influence of geographic,knowledge and behavioral factors on Opisthorchis(O.)viverrini infection in the Northeast of Thailand.Methods:This cross-sectional study was conducted by using four datasets of years 2016 and 2017.Generalized linear mixed model was employed to analyze association between geographic,knowledge and behavioral factors and O.viverrini infection.Results:Totally there were 1885 participants.The prevalence of O.viverrini infection was 10.03%.Geographic factors that showed statistically significant association with O.viverrini infection in the Northeast region were featured by at least a dam and reservoir(Adj.OR=4.21,95%CI:2.49-7.13,P<0.001),at least a weir(Adj.OR=1.74,95%CI:1.09-2.77,P=0.020),>50 dogs and cats per village(Adj.OR=3.40,95%CI:2.17-5.31,P<0.001),and rice fields covered>50%of its areas(Adj.OR=1.91,95%CI:1.04-4.01,P=0.036),as well as low to moderate levels of knowledge(Adj.OR=1.60,95%CI:1.32 to 1.94,P<0.001),consumed raw fish(Adj.OR=1.90,95%CI:1.02 to 3.52,P=0.040)and consumed processed raw fish(Adj.OR=3.03,95%CI:2.20 to 4.18,P<0.001).Other significant covariates were gender and age of the respondents.Conclusions:O.viverrini infection still remains a public health problem of the Northeast of Thailand.Geographic and demographic factors,knowledge,and consumption behaviors of raw fish products are significantly associated with O.viverrini infection.
文摘BACKGROUND The incidence of colorectal cancer(CRC)and preinvasive CRC(e.g.,early colon cancer and advanced adenoma)is gradually increasing in several countries.AIM To evaluate the trend in incidence of CRC and preinvasive CRC according to the increase in the number of colonoscopies performed in Korea.METHODS This retrospective cohort study enrolled Korean patients from 2002 to 2020 to evaluate the incidence of CRC and preinvasive CRC,and assess the numbers of diagnostic colonoscopies and colonoscopic polypectomies.Colonoscopy-related complications by age group were also determined.RESULTS The incidence of CRC showed a rapid increase,then decreased after 2012 in the 50-75 year-age group.During the study period,the rate of incidence of preinvasive CRC increased at a similar level in patients under 50 and 50-75 years of age.Since 2009,the increase has been rapid,showing a pattern similar to the increase in colonoscopies.The rate of colonoscopic polypectomy in patients aged under 50 was similar to the rate in patients over 75 years of age after 2007.The rate of complications after colonoscopy and related deaths within 3 mo was high for those over 75 years of age.CONCLUSION The diagnosis of preinvasive CRC increased with the increase in the number of colonoscopies performed.As the risk of colonoscopy-related hospitalization and death is high in the elderly,if early lesions at risk of developing CRC are diagnosed and treated under or at the age of 75,colonoscopy-related complications can be reduced for those aged 76 years or over.
基金supported by National Natural Science Foundation of China(grant numbers:82273370,82202899,82172702,81972249,81902430,82002543,82002946,U1932145)Shanghai Clinical Science and Technology Innovation Project of Municipal Hospital(grant number:SHDC12020102)+5 种基金Natural Science Foundation of Shanghai(grant numbers:22ZR1413000,21ZR1414900)Artificial Intelligence Medical Hospital Cooperation Project of Xuhui District(grant number:2021-017)Shanghai Science and Technology Development Fund(grant number:19MC1911000)Shanghai Municipal Key Clinical Specialty(grant number:shslczdzk01301)Science and Technology Commission of Shanghai Municipality(grant number:18401933402)“Chenguang Program”supported by Shanghai Education Development Foundation and Shanghai Municipal Education Commission(grant number:20CG08).
文摘Objective:This study aims to analyze how changes in pathological diagnosis practice and molecular detection technology have affected clinical outcomes for colorectal cancer(CRC)patients in Fudan University Shanghai Cancer Center(FUSCC).Methods:This retrospective cohort study analyzed 21,141 pathologically confirmed CRC cases diagnosed at FUSCC from 2008 to 2020.Patients were divided into five groups for different analytical purposes:(1)the before vs.since 2014 groups to analyze the influence of the changes in the classification criteria of pT3 and pT4 staging on the survival of patients;(2)the partial vs.total mesorectal excision(TME)groups to analyze whether evaluation of completeness of the mesorectum have impact on the survival of patients;(3)the tumor deposit(TD)(+)N0 vs.TD(+)N1c groups to analyze the influence of the changes in the pN staging on the survival of patients with positive TD and negative regional lymph node metastasis(LNM);(4)the before vs.since 2013 groups to analyze the influence of the changes in the testing process of deficient mismatch repair on the survival of patients;and(5)the groups with vs.without RAS/BRAF gene mutation testing to analyze the influence of these testing on the survival of patients.Patients’clinicopathological parameters,including age at diagnosis,sex,tumor size,location,differentiation,mucinous subtype,TD,lymphovascular invasion,perineural invasion,tumor depth,LNM and distant metastasis,and tumor-node-metastasis(TNM)stage,were compared between groups.Kaplan-Meier analysis with log rank method was performed for patients’overall survival(OS)and disease-free survival(DFS)analyses.Results:In pathological reports,there were three parameter changes that impacted patient outcomes.Firstly,changes in the pT staging criteria led to a shift of the ratio of patients with stage pT3 to stage pT4 from 1:110.9 to 1:0.26.In comparison to patients admitted before 2014(n=4,754),a significant difference in prognosis between pT3 and pT4 stages was observed since 2014(n=9,965).Secondly,we began to evaluate the completeness of the mesorectum since 2016.As a result,91.0%of patients with low rectal cancer underwent TME(n=4,111)surgery,and patients with TME had significantly better OS compared with partial mesorectal excision(PME,n=409).Thirdly,we began to stage TD(+)LNM(-)as N1c since 2017.The results showed that N1c(n=127)but not N0(n=39)can improve the prognosis of patients without LNM and distal metastasis.In molecular testing,there have been three and five iterations of updates regarding mismatch repair(MMR)/microsatellite instability(MSI)status and RAS/BRAF gene mutation detection,respectively.The standardization of MMR status testing has sharply decreased the proportion of deficient MMR(dMMR)patients(from 32.5%to 7.4%)since 2013.The prognosis of patients underwent MMR status testing since 2013(n=867)were significantly better than patients before 2013(n=1,313).In addition,detection of RAS/BRAF gene mutation status(n=5,041)resulted in better DFS but not OS,for patients with stage I-III disease(n=16,557).Conclusion:Over the past few decades,updates in elements in pathological reports,as well as the development of standardized tests for MMR/MSI status and RAS/BRAF gene mutations have significantly improved patient outcomes.
基金supported by the General Program of National Natural Science Foundation of China(82374308)National Key Research and Development Program(NKRDP)(2022YFC2010104)Henan Province Special Projects of Traditional Chinese Medicine Science Research(2024ZY2067),and National Talent Precision Cultivation Plan of the Beijing University of Chinese Medicine.
文摘Objective:To provide the mechanism-based pharmacotherapy of the Huatan Qushi formula(HTQS for-mula),for the health management and treatment of non-alcoholic fatty liver disease(NAFLD).Methods:A rat model of NAFLD was employed to examine the efficacy and safety of the HTQS formula.In vivo active components and potential mechanisms of the HTQS formula were identified using UPLC‒MS/MS combined with network pharmacology.The influence of the HTQS formula on the dominating proteins in PI3K/Akt pathway was validated in vivo using western blot.Finally,16S rRNA sequencing of the gut microbiome was conducted followed by targeted metabolomics detecting fecal short-chain fatty acids(SCFAs)and bile acids to determine the impact of the HTQS formula on gut microbiota.Results:The HTQS formula reduced weight gain and hepatic steatosis in NAFLD rats and decreased serum total cholesterol(TC),triglycerides,blood glucose,and insulin resistance(IR)without causing liver or kidney injury.We detected 28 components using UPLC‒MS/MS and identified 439 shared targets be-tween NAFLD and the HTQS formula.Primarily,we focused on the PI3K/Akt signaling pathway based on protein‒protein interaction network analysis.We validated that the HTQS formula inhibited liver stea-tosis and inflammation by increasing the phosphorylation levels of PI3K,AKT,P27,GSK3b in the PI3K/Akt signaling pathway.16S rRNA sequencing revealed that the HTQS formula reduced the abundance of the genus Family_XIII_AD3011_group,which was positively correlated with IR and taurodeoxycholic acid.In addition,Lachnospiraceae_UCG_010 inversely correlated with TC and five bile acids,which could be essential to the therapeutic effect of the HTQS formula against NAFLD.Conclusions:The HTQS formula proved to be an effective pharmacotherapy for NAFLD without causing liver or kidney injury.Multiple potent components of the HTQS formula could alleviate liver steatosis and lipid metabolism disorder by modulating the PI3K/Akt signaling pathway and restoring gut microbiota composition.
文摘How many imputations are sufficient in multiple imputations? The answer given by different researchers varies from as few as 2 - 3 to as many as hundreds. Perhaps no single number of imputations would fit all situations. In this study, η, the minimally sufficient number of imputations, was determined based on the relationship between m, the number of imputations, and ω, the standard error of imputation variances using the 2012 National Ambulatory Medical Care Survey (NAMCS) Physician Workflow mail survey. Five variables of various value ranges, variances, and missing data percentages were tested. For all variables tested, ω decreased as m increased. The m value above which the cost of further increase in m would outweigh the benefit of reducing ω was recognized as the η. This method has a potential to be used by anyone to determine η that fits his or her own data situation.
文摘This paper examines the current costs, benefits and intensity of China＇s industrial environment regulation, as well as the path of regulatory enhancement. Regulatory intensity has been on the rise since 1997. The intensity was only 43 in 1997 and then reached 68 by 2007. This paper for the first time compares the treatment costs at the front and rear ends of pollution chain, employs the concept of regulatory benefit multiplier, and calculates the benefit multipliers for different pollutants. Results indicate that enhanced environmental protection since 1997 makes social and economic sense, particularly for the front end treatment of various pollutants since 2004, which have considerable economic benefits. After comparing the benefit multipliers, we have prioritized the pollutants for regulatory consideration： environmental regulation shouM be made tougher for waste water first, and then dust and fumes, followed by SO2 and lastly CO2. This will help to achieve the best environmental outcomes while incurring no additional economic costs.
基金the Iowa Soybean Association, USA through the ISA On-Farm NetworkTM and Watershed Programming.
文摘Many studies have shown that chlorophyll meter readings （CMRs） can be used to diagnose deficiencies of nitrogen （N） during the growth of corn （Zea mays L.） in small-plot trials, but there is need to address additional problems encountered when diagnoses are made in fields of the size managed in production agriculture. A noteworthy difference between smallplot trials and production agriculture is the extent to which the effects of N are confounded with the effects of other factors such as tillage, landscape, soil organic matter and moisture content. We illustrate how some of these factors can cause differences in the physiological age of plants and introduce errors in the diagnoses of N deficiencies. We suggest methods （measuring the height to the youngest leaf collar and assigning leaf numbers by using the first leaf with pubescence and the ear leaf as references to identify growth stages） for minimizing these errors. The simplified method of growth stage identification can be used to select appropriate plants and leaves for making diagnoses in fields and to distinguish the effects of N from the effects of other factors that influence plant growth.
文摘In his 1987 classic book on multiple imputation (MI), Rubin used the fraction of missing information, γ, to define the relative efficiency (RE) of MI as RE = (1 + γ/m)?1/2, where m is the number of imputations, leading to the conclusion that a small m (≤5) would be sufficient for MI. However, evidence has been accumulating that many more imputations are needed. Why would the apparently sufficient m deduced from the RE be actually too small? The answer may lie with γ. In this research, γ was determined at the fractions of missing data (δ) of 4%, 10%, 20%, and 29% using the 2012 Physician Workflow Mail Survey of the National Ambulatory Medical Care Survey (NAMCS). The γ values were strikingly small, ranging in the order of 10?6 to 0.01. As δ increased, γ usually increased but sometimes decreased. How the data were analysed had the dominating effects on γ, overshadowing the effect of δ. The results suggest that it is impossible to predict γ using δ and that it may not be appropriate to use the γ-based RE to determine sufficient m.
