BACKGROUND Gastric cancer is a common malignant tumor of the digestive system worldwide,and its early diagnosis is crucial to improve the survival rate of patients.Indocyanine green fluorescence imaging(ICG-FI),as a n...BACKGROUND Gastric cancer is a common malignant tumor of the digestive system worldwide,and its early diagnosis is crucial to improve the survival rate of patients.Indocyanine green fluorescence imaging(ICG-FI),as a new imaging technology,has shown potential application prospects in oncology surgery.The meta-analysis to study the application value of ICG-FI in the diagnosis of gastric cancer sentinel lymph node biopsy is helpful to comprehensively evaluate the clinical effect of this technology and provide more reliable guidance for clinical practice.AIM To assess the diagnostic efficacy of optical imaging in conjunction with indocya-nine green(ICG)-guided sentinel lymph node(SLN)biopsy for gastric cancer.METHODS Electronic databases such as PubMed,Embase,Medline,Web of Science,and the Cochrane Library were searched for prospective diagnostic tests of optical imaging combined with ICG-guided SLN biopsy.Stata 12.0 software was used for analysis by combining the"bivariable mixed effect model"with the"midas"command.The true positive value,false positive value,false negative value,true negative value,and other information from the included literature were extracted.A literature quality assessment map was drawn to describe the overall quality of the included literature.A forest plot was used for heterogeneity analysis,and P<0.01 was considered to indicate statistical significance.A funnel plot was used to assess publication bias,and P<0.1 was considered to indicate statistical significance.The summary receiver operating characteristic(SROC)curve was used to calculate the area under the curve(AUC)to determine the diagnostic accuracy.If there was interstudy heterogeneity(I2>50%),meta-regression analysis and subgroup analysis were performed.analysis were performed.RESULTS Optical imaging involves two methods:Near-infrared(NIR)imaging and fluorescence imaging.A combination of optical imaging and ICG-guided SLN biopsy was useful for diagnosis.The positive likelihood ratio was 30.39(95%CI:0.92-1.00),the sensitivity was 0.95(95%CI:0.82-0.99),and the specificity was 1.00(95%CI:0.92-1.00).The negative likelihood ratio was 0.05(95%CI:0.01-0.20),the diagnostic odds ratio was 225.54(95%CI:88.81-572.77),and the SROC AUC was 1.00(95%CI:The crucial values were sensitivity=0.95(95%CI:0.82-0.99)and specificity=1.00(95%CI:0.92-1.00).The Deeks method revealed that the"diagnostic odds ratio"funnel plot of SLN biopsy for gastric cancer was significantly asymmetrical(P=0.01),suggesting significant publication bias.Further meta-subgroup analysis revealed that,compared with fluorescence imaging,NIR imaging had greater sensitivity(0.98 vs 0.73).Compared with optical imaging immediately after ICG injection,optical imaging after 20 minutes obtained greater sensitivity(0.98 vs 0.70).Compared with that of patients with an average SLN detection number<4,the sensitivity of patients with a SLN detection number≥4 was greater(0.96 vs 0.68).Compared with hematoxylin-eosin(HE)staining,immunohistochemical(+HE)staining showed greater sensitivity(0.99 vs 0.84).Compared with subserous injection of ICG,submucosal injection achieved greater sensitivity(0.98 vs 0.40).Compared with 5 g/L ICG,0.5 and 0.05 g/L ICG had greater sensitivity(0.98 vs 0.83),and cT1 stage had greater sensitivity(0.96 vs 0.72)than cT2 to cT3 clinical stage.Compared with that of patients≤26,the sensitivity of patients>26 was greater(0.96 vs 0.65).Compared with the literature published before 2010,the sensitivity of the literature published after 2010 was greater(0.97 vs 0.81),and the differences were statistically significant(all P<0.05).CONCLUSION For the diagnosis of stomach cancer,optical imaging in conjunction with ICG-guided SLN biopsy is a therapeut-ically viable approach,especially for early gastric cancer.The concentration of ICG used in the SLN biopsy of gastric cancer may be too high.Moreover,NIR imaging is better than fluorescence imaging and may obtain higher sensitivity.展开更多
AIM： To investigate the relationship between H pylori infection, blood ammonia concentration and hepatic encephalopathy （HE）, and the effect of Hpylori eradication in cirrhotic patients. METHODS： From July 2003 to...AIM： To investigate the relationship between H pylori infection, blood ammonia concentration and hepatic encephalopathy （HE）, and the effect of Hpylori eradication in cirrhotic patients. METHODS： From July 2003 to January 2005, 457 cirrhotic patients in five regions of Zhejiang Province were enrolled. Patients were evaluated for demographics, number connection test, Hpylori infection, liver impairment, blood ammonia concentration and HE. Patients with Hpylori infection were given I wk therapy with omeprazole plus clarithromycin and tinidazole. ^14C urea breath test was performed and mental symptoms and blood ammonia level were reassessed after RESULTS： Overall H pylori infection rate was 60.6%, and HE occurred in 47.5% of cirrhotic patients. Subclinical HE （SHE） was detected in 55 of 117 cirrhotic patients. Blood ammonia concentration in H pylori negative （n = 180） and positive （n = 277） cirrhotic patients was 53.8 ± 51.4 and 78.4 ± 63.6 μmol/L, respectively （P 〈 0.01）, which was significantly reduced to 53.5 ± 37.7 μmol/L after bacterium eradication （n = 126） （P 〈 0.01）. Blood ammonia was 97.5 ± 81.0 μmol/L in H pylori-positive cirrhotic patients, and this did not significantly change in those with persistent infection after Hpylori eradication （n = 11）. HE was more frequently observed in patients with H pylori infection than in those without （58.5% vs 30.6%, P 〈 0.01）. HE rate significantly dropped to 34.1% after H pylori eradiation （P 〈 0.01）. H pylori prevalence significantly differed among cirrhotic patients with HE （74.4%）, SHE （69.1%）, and those without HE （53.2%） （P 〈 0.05）. Blood ammonia level was significantly different among cirrhotic patients with HE （94.5 ± 75.6 μmol/L）, SHE （59.9 ± 49.2 μmol/L）, and without HE （47.3 ± 33.5 μmol/L） （P 〈 0.05）. Logistic regression analysis showed that blood ammonia concentration, Child-Pugh stage, upper gastrointestinal bleeding, electrolyte disturbance, and urea nitrogen were risk factors for HE. CONCLUSION： H pylori infection is an important factor for inducing high blood ammonia concentration and HE in cirrhotic patients. H pylori eradication may be helpful for treatment and prevention of HE.展开更多
Peach(Prunus persica Batsch‘Yuhualu’)fruit are sensitive to chilling injury(CI).Proline,polyamine(PA),and nitric oxide(NO)are important small regulators of various metabolic pathways under chilling stress that mitig...Peach(Prunus persica Batsch‘Yuhualu’)fruit are sensitive to chilling injury(CI).Proline,polyamine(PA),and nitric oxide(NO)are important small regulators of various metabolic pathways under chilling stress that mitigate CI.Ethylene is known to promote senescence and CI,while 1-methylcyclopropene(1-MCP)is an antagonist that inhibits the effects of ethylene.However,how1-MCP and ethylene affect proline,PA,and NO levels under chilling stress remains unclear.To address these questions,1-MCP(1μL·L^(−1))and ethylene(1μL·L^(−1))treatments were applied to peach fruit.Fruit were stored at 4°C for 28 d,then moved to 25°C for 3 d immediately after cold storage.Peach fruit exhibited CI symptoms after 7 d of cold storage with enhanced electrolyte leakage and malondialdehyde contents.The 1-MCP treatment significantly(P<0.05)restrained peach CI,and fruit did not exhibit CI symptoms until 14 d of cold storage.Proline and PAs in peach under chilling stress weremostly synthesized from glutamate and arginine,which were catalyzed by1-pyrroline-5-carboxylate synthetase and arginine decarboxylase,respectively.1-MCPtreated fruit exhibited higher proline and PA contents and enhanced chilling tolerance compared to the control,while ethylene-treated fruit had lower proline and PA contents and reduced chilling tolerance.Ethylene-treated fruit,which exhibited more severe CI symptoms compared to the control,had significantly(P<0.05)lower NO contents and NO synthase activities.However,NOmay not be a direct acting factor in 1-MCPinduced chilling tolerance,as 1-MCP-treated fruit had lower NO contents and NO synthase activities compared to the control.In conclusion,proline and PA clearly played direct and important roles in 1-MCP-induced peach chilling tolerance,while NO may not be actively involved.展开更多
AIM:To investigate immunosuppressive agents used to treat inflammatory bowel disease(IBD)in East China. METHODS:A retrospective review was conducted, involving 227 patients with IBD admitted to Sir Run Run Shaw Hospit...AIM:To investigate immunosuppressive agents used to treat inflammatory bowel disease(IBD)in East China. METHODS:A retrospective review was conducted, involving 227 patients with IBD admitted to Sir Run Run Shaw Hospital,College of Medicine,Zhejiang University from June 2000 to December 2007.Data regarding demographic,clinical characteristics and immunosuppressants usage were analyzed. RESULTS:A total of 227 eligible patients were evaluated in this study,including 104 patients with Crohn’s disease and 123 with ulcerative colitis.Among the patients,61 had indications for immunosuppressive agents use.However,only 21 (34.4%)received immunosuppressive agents.Among the 21 patients,6(37.5%)received a subtherapeutic dose of azathioprine with no attempt to increase the dosage.Of the 20 patients that received immunosuppressive agent treatment longer than 6 mo,15 patients went into remission,four patients were not affected and one relapsed.Among these 20 patients,four patients suffered from myelotoxicity and one suffered from hepatotoxicity.CONCLUSION:Immunosuppressive agents are used less frequently to treat IBD patients from East China compared with Western countries.Monitoring immunosuppressive agent use is recommended to optimize dispensation of drugs for IBD in China.展开更多
AIM： To investigate the quality of care for a hospital based-cohort of patients with inflammatory bowel disease （IBD） from East China according to the current practice guidelines, METHODS： A retrospective review w...AIM： To investigate the quality of care for a hospital based-cohort of patients with inflammatory bowel disease （IBD） from East China according to the current practice guidelines, METHODS： A retrospective review was conducted, involving 177 patients with IBD admitted to Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University between June 2000 and June 2006. Data regarding demographic and clinical characteristics as well as medical therapy including use of oral aminosalisylates, topical therapy, corticosteroid agents, immunomodulatory agents （such as azathioprine） at admission and outpatient clinic visit were analyzed. RESULTS： A total of 177 eligible patients were evaluated in this study, including 71 patients with Crohn＇s disease （CD） and 106 with ulcerative colitis （UC）. All were the Han nationality Chinese with active disease at baseline. All the 106 patients with ulcerative colitis received optimal doses of aminosalisylate while 27 of 68 （39.7%） patients with ileal or colonic CD received the suboptimal doses of aminosalisylate. The incidence of suboptimal dose of aminosalisylate was significantly higher in CD patients with small intestine involvement only （52.8% vs 25.0%, P = 0.019）. Thirty-one （54.4%） patients with active distal or left-sided ulcerative colitis received topical therapy, and 27.8% of patients suffering from severe inflammatory bowel disease did not receive oral or intravenous steroid therapy. Among the 51 patients for whom thiopurine was indicated, only 10 （19.6%） received immunomodulatory agents, and more thanhalf of the 8 patients received a suboptimal dose of azathiopurine with no attempt to increase its dosage. CONCLUSION： The quality of care for IBD patients can be further improved. A suboptimal dose of aminosalicylate is used in treatment of patients with CD, especially in those with small intestine involved only. Topical mesalazine is inadequately used in patients with distal or left-sided colitis. Oral or intravenous steroid therapy is not used in some patients with severe IBD. Use of immunomodulatory medication is limited. Larger prospective studies are needed to investigate the quality of care for patients with IBD to establish our own evidence-based guidelines.展开更多
Climate exerts a dominant control over the distribution of species.Generally,species migrate to higher elevations to track thermal niches,but variations in morphological traits can result in trait-specific responses t...Climate exerts a dominant control over the distribution of species.Generally,species migrate to higher elevations to track thermal niches,but variations in morphological traits can result in trait-specific responses to climate change.Here we attempted to explore how three sympatrically distributed raptor species(the Upland Buzzard Buteo hemilasius,UB;the Common Kestrel,also called Eurasian Kestrel Falco tinnunculus,EK;and the Saker Falcon Falco cherrug,SF)would respond to climate change over time,and whether their responses would bias by different morphology.We tested the alternative hypotheses for Allen’s rule for UB,EK,and SF in Qinghai Province,China,by modeling their current and future habitat suitability and confirming whether a consistent pattern exists between climate-induced range shifts and morphological differences among species.The extent of the projected distribution range within protected areas was also calculated for each species.We identified the future downward elevation shift for all the species,but with the notable northeastward shifting of the suitable climate space for UB and SF.Climate change would induce range contraction in the future,and the most acute influence is always the result of the pessimistic SSP585 scenario.No obvious pattern in climate-induced range shift was found for EK,for whom the morphological traits were significantly smaller all the time.More seriously,the ratios of highly suitable habitats being protected for our three raptor species were almost at a deficient level(below 1%).This study firstly tested the alternative hypothesis of Allen’s rule among raptors in Qinghai Province unprecedently,confirmed the morphological basis for different responses to changing climate across species,and demonstrated the protection deficiency under the current protected area design.We advocate more related studies in the future to verify our findings across more taxa.展开更多
BACKGROUND Noninvasive methods have been developed to detect fibrosis in many liver diseases due to the limits of liver biopsy.However,previous studies have focused primarily on chronic viral hepatitis and nonalcoholi...BACKGROUND Noninvasive methods have been developed to detect fibrosis in many liver diseases due to the limits of liver biopsy.However,previous studies have focused primarily on chronic viral hepatitis and nonalcoholic fatty liver disease.The diagnostic value of transient elastography for autoimmune liver diseases(AILDs)is worth studying.AIM To compare the diagnostic accuracy of imaging techniques with serum biomarkers of fibrosis in AILD.METHODS The PubMed,Cochrane Library and EMBASE databases were searched.Studies evaluating the efficacy of noninvasive methods in the diagnosis of AILDs[autoimmune hepatitis(AIH),primary biliary cholangitis(PBC)and primary sclerosing cholangitis(PSC)]were included.The summary area under the receiver operating characteristic curve(AUROC),diagnostic odds ratio,sensitivity and specificity were used to assess the accuracy of these noninvasive methods for staging fibrosis.RESULTS A total of 60 articles were included in this study,and the number of patients with AIH,PBC and PSC was 1594,3126 and 501,respectively.The summary AUROC of transient elastography in the diagnosis of significant fibrosis,advanced fibrosis and cirrhosis in patients with AIH were 0.84,0.88 and 0.90,respectively,while those in patients with PBC were 0.93,0.93 and 0.91,respectively.The AUROC of cirrhosis for patients with PSC was 0.95.However,other noninvasive indices(aspartate aminotransferase to platelet ratio index,aspartate aminotransferase/alanine aminotransferase ratio,fibrosis-4 index)had corresponding AUROCs less than 0.80.CONCLUSION Transient elastography exerts better diagnostic accuracy in AILD patients,especially in PBC patients.The appropriate cutoff values for staging advanced fibrosis and cirrhosis ranged from 9.6 to 10.7 and 14.4 to 16.9 KPa for PBC patients.展开更多
This paper moves one step forward to build?a?numerical model to research quantitative characterization and dynamic law for interlayer interference factor (IIF) in the multilayer reservoir which was heavy oil reservoir...This paper moves one step forward to build?a?numerical model to research quantitative characterization and dynamic law for interlayer interference factor (IIF) in the multilayer reservoir which was heavy oil reservoirs and produced by directional wells. There are mainly four contributions of this paper to the existing body of literature. Firstly, an equivalent simulation method of the pseudo start pressure gradient (PSPG) is developed to quantitatively predict the value of?IIF?under different geological reservoir conditions. Secondly, the interlayer interference is extended in time, and the time period of the study extends from a water cut stage to the whole process from the oil well open to produce?a?high water cut. Thirdly, besides the conventional productivity interlayer interference factor (PIIF), a new parameter, that is, the oil recovery interlayer interference factor (RIIF) is put forward.?RIIF?can be used to evaluate the technical indexes of stratified development and multilayer co-production effectively. Fourthly,?the?effectsof various geological reservoir parameters such as reservoir permeability and crude oil viscosity, etc. on the?PIIF?and?RIIF’s?type curves?are?discussed in detail and the typical plate?is?plotted. The research results provide a foundation for the effective development of multilayer heavy oil reservoirs.展开更多
文摘BACKGROUND Gastric cancer is a common malignant tumor of the digestive system worldwide,and its early diagnosis is crucial to improve the survival rate of patients.Indocyanine green fluorescence imaging(ICG-FI),as a new imaging technology,has shown potential application prospects in oncology surgery.The meta-analysis to study the application value of ICG-FI in the diagnosis of gastric cancer sentinel lymph node biopsy is helpful to comprehensively evaluate the clinical effect of this technology and provide more reliable guidance for clinical practice.AIM To assess the diagnostic efficacy of optical imaging in conjunction with indocya-nine green(ICG)-guided sentinel lymph node(SLN)biopsy for gastric cancer.METHODS Electronic databases such as PubMed,Embase,Medline,Web of Science,and the Cochrane Library were searched for prospective diagnostic tests of optical imaging combined with ICG-guided SLN biopsy.Stata 12.0 software was used for analysis by combining the"bivariable mixed effect model"with the"midas"command.The true positive value,false positive value,false negative value,true negative value,and other information from the included literature were extracted.A literature quality assessment map was drawn to describe the overall quality of the included literature.A forest plot was used for heterogeneity analysis,and P<0.01 was considered to indicate statistical significance.A funnel plot was used to assess publication bias,and P<0.1 was considered to indicate statistical significance.The summary receiver operating characteristic(SROC)curve was used to calculate the area under the curve(AUC)to determine the diagnostic accuracy.If there was interstudy heterogeneity(I2>50%),meta-regression analysis and subgroup analysis were performed.analysis were performed.RESULTS Optical imaging involves two methods:Near-infrared(NIR)imaging and fluorescence imaging.A combination of optical imaging and ICG-guided SLN biopsy was useful for diagnosis.The positive likelihood ratio was 30.39(95%CI:0.92-1.00),the sensitivity was 0.95(95%CI:0.82-0.99),and the specificity was 1.00(95%CI:0.92-1.00).The negative likelihood ratio was 0.05(95%CI:0.01-0.20),the diagnostic odds ratio was 225.54(95%CI:88.81-572.77),and the SROC AUC was 1.00(95%CI:The crucial values were sensitivity=0.95(95%CI:0.82-0.99)and specificity=1.00(95%CI:0.92-1.00).The Deeks method revealed that the"diagnostic odds ratio"funnel plot of SLN biopsy for gastric cancer was significantly asymmetrical(P=0.01),suggesting significant publication bias.Further meta-subgroup analysis revealed that,compared with fluorescence imaging,NIR imaging had greater sensitivity(0.98 vs 0.73).Compared with optical imaging immediately after ICG injection,optical imaging after 20 minutes obtained greater sensitivity(0.98 vs 0.70).Compared with that of patients with an average SLN detection number<4,the sensitivity of patients with a SLN detection number≥4 was greater(0.96 vs 0.68).Compared with hematoxylin-eosin(HE)staining,immunohistochemical(+HE)staining showed greater sensitivity(0.99 vs 0.84).Compared with subserous injection of ICG,submucosal injection achieved greater sensitivity(0.98 vs 0.40).Compared with 5 g/L ICG,0.5 and 0.05 g/L ICG had greater sensitivity(0.98 vs 0.83),and cT1 stage had greater sensitivity(0.96 vs 0.72)than cT2 to cT3 clinical stage.Compared with that of patients≤26,the sensitivity of patients>26 was greater(0.96 vs 0.65).Compared with the literature published before 2010,the sensitivity of the literature published after 2010 was greater(0.97 vs 0.81),and the differences were statistically significant(all P<0.05).CONCLUSION For the diagnosis of stomach cancer,optical imaging in conjunction with ICG-guided SLN biopsy is a therapeut-ically viable approach,especially for early gastric cancer.The concentration of ICG used in the SLN biopsy of gastric cancer may be too high.Moreover,NIR imaging is better than fluorescence imaging and may obtain higher sensitivity.
文摘AIM： To investigate the relationship between H pylori infection, blood ammonia concentration and hepatic encephalopathy （HE）, and the effect of Hpylori eradication in cirrhotic patients. METHODS： From July 2003 to January 2005, 457 cirrhotic patients in five regions of Zhejiang Province were enrolled. Patients were evaluated for demographics, number connection test, Hpylori infection, liver impairment, blood ammonia concentration and HE. Patients with Hpylori infection were given I wk therapy with omeprazole plus clarithromycin and tinidazole. ^14C urea breath test was performed and mental symptoms and blood ammonia level were reassessed after RESULTS： Overall H pylori infection rate was 60.6%, and HE occurred in 47.5% of cirrhotic patients. Subclinical HE （SHE） was detected in 55 of 117 cirrhotic patients. Blood ammonia concentration in H pylori negative （n = 180） and positive （n = 277） cirrhotic patients was 53.8 ± 51.4 and 78.4 ± 63.6 μmol/L, respectively （P 〈 0.01）, which was significantly reduced to 53.5 ± 37.7 μmol/L after bacterium eradication （n = 126） （P 〈 0.01）. Blood ammonia was 97.5 ± 81.0 μmol/L in H pylori-positive cirrhotic patients, and this did not significantly change in those with persistent infection after Hpylori eradication （n = 11）. HE was more frequently observed in patients with H pylori infection than in those without （58.5% vs 30.6%, P 〈 0.01）. HE rate significantly dropped to 34.1% after H pylori eradiation （P 〈 0.01）. H pylori prevalence significantly differed among cirrhotic patients with HE （74.4%）, SHE （69.1%）, and those without HE （53.2%） （P 〈 0.05）. Blood ammonia level was significantly different among cirrhotic patients with HE （94.5 ± 75.6 μmol/L）, SHE （59.9 ± 49.2 μmol/L）, and without HE （47.3 ± 33.5 μmol/L） （P 〈 0.05）. Logistic regression analysis showed that blood ammonia concentration, Child-Pugh stage, upper gastrointestinal bleeding, electrolyte disturbance, and urea nitrogen were risk factors for HE. CONCLUSION： H pylori infection is an important factor for inducing high blood ammonia concentration and HE in cirrhotic patients. H pylori eradication may be helpful for treatment and prevention of HE.
基金This work was supported by the Natural Science Foundation of Jiangsu Province of China(Grant No.BK20140483)China Postdoctoral Science Foundation(Grant No.2014M560451).
文摘Peach(Prunus persica Batsch‘Yuhualu’)fruit are sensitive to chilling injury(CI).Proline,polyamine(PA),and nitric oxide(NO)are important small regulators of various metabolic pathways under chilling stress that mitigate CI.Ethylene is known to promote senescence and CI,while 1-methylcyclopropene(1-MCP)is an antagonist that inhibits the effects of ethylene.However,how1-MCP and ethylene affect proline,PA,and NO levels under chilling stress remains unclear.To address these questions,1-MCP(1μL·L^(−1))and ethylene(1μL·L^(−1))treatments were applied to peach fruit.Fruit were stored at 4°C for 28 d,then moved to 25°C for 3 d immediately after cold storage.Peach fruit exhibited CI symptoms after 7 d of cold storage with enhanced electrolyte leakage and malondialdehyde contents.The 1-MCP treatment significantly(P<0.05)restrained peach CI,and fruit did not exhibit CI symptoms until 14 d of cold storage.Proline and PAs in peach under chilling stress weremostly synthesized from glutamate and arginine,which were catalyzed by1-pyrroline-5-carboxylate synthetase and arginine decarboxylase,respectively.1-MCPtreated fruit exhibited higher proline and PA contents and enhanced chilling tolerance compared to the control,while ethylene-treated fruit had lower proline and PA contents and reduced chilling tolerance.Ethylene-treated fruit,which exhibited more severe CI symptoms compared to the control,had significantly(P<0.05)lower NO contents and NO synthase activities.However,NOmay not be a direct acting factor in 1-MCPinduced chilling tolerance,as 1-MCP-treated fruit had lower NO contents and NO synthase activities compared to the control.In conclusion,proline and PA clearly played direct and important roles in 1-MCP-induced peach chilling tolerance,while NO may not be actively involved.
基金Supported by Zhejiang Province Natural Science Foundationof China,R2080029 Caoqian Research Group
文摘AIM:To investigate immunosuppressive agents used to treat inflammatory bowel disease(IBD)in East China. METHODS:A retrospective review was conducted, involving 227 patients with IBD admitted to Sir Run Run Shaw Hospital,College of Medicine,Zhejiang University from June 2000 to December 2007.Data regarding demographic,clinical characteristics and immunosuppressants usage were analyzed. RESULTS:A total of 227 eligible patients were evaluated in this study,including 104 patients with Crohn’s disease and 123 with ulcerative colitis.Among the patients,61 had indications for immunosuppressive agents use.However,only 21 (34.4%)received immunosuppressive agents.Among the 21 patients,6(37.5%)received a subtherapeutic dose of azathioprine with no attempt to increase the dosage.Of the 20 patients that received immunosuppressive agent treatment longer than 6 mo,15 patients went into remission,four patients were not affected and one relapsed.Among these 20 patients,four patients suffered from myelotoxicity and one suffered from hepatotoxicity.CONCLUSION:Immunosuppressive agents are used less frequently to treat IBD patients from East China compared with Western countries.Monitoring immunosuppressive agent use is recommended to optimize dispensation of drugs for IBD in China.
基金National Natural Science Foundation of China (No. 30500244)Funtional study of two new allele variants of NOD2 in Han nationality
文摘AIM： To investigate the quality of care for a hospital based-cohort of patients with inflammatory bowel disease （IBD） from East China according to the current practice guidelines, METHODS： A retrospective review was conducted, involving 177 patients with IBD admitted to Sir Run Run Shaw Hospital, College of Medicine, Zhejiang University between June 2000 and June 2006. Data regarding demographic and clinical characteristics as well as medical therapy including use of oral aminosalisylates, topical therapy, corticosteroid agents, immunomodulatory agents （such as azathioprine） at admission and outpatient clinic visit were analyzed. RESULTS： A total of 177 eligible patients were evaluated in this study, including 71 patients with Crohn＇s disease （CD） and 106 with ulcerative colitis （UC）. All were the Han nationality Chinese with active disease at baseline. All the 106 patients with ulcerative colitis received optimal doses of aminosalisylate while 27 of 68 （39.7%） patients with ileal or colonic CD received the suboptimal doses of aminosalisylate. The incidence of suboptimal dose of aminosalisylate was significantly higher in CD patients with small intestine involvement only （52.8% vs 25.0%, P = 0.019）. Thirty-one （54.4%） patients with active distal or left-sided ulcerative colitis received topical therapy, and 27.8% of patients suffering from severe inflammatory bowel disease did not receive oral or intravenous steroid therapy. Among the 51 patients for whom thiopurine was indicated, only 10 （19.6%） received immunomodulatory agents, and more thanhalf of the 8 patients received a suboptimal dose of azathiopurine with no attempt to increase its dosage. CONCLUSION： The quality of care for IBD patients can be further improved. A suboptimal dose of aminosalicylate is used in treatment of patients with CD, especially in those with small intestine involved only. Topical mesalazine is inadequately used in patients with distal or left-sided colitis. Oral or intravenous steroid therapy is not used in some patients with severe IBD. Use of immunomodulatory medication is limited. Larger prospective studies are needed to investigate the quality of care for patients with IBD to establish our own evidence-based guidelines.
基金financial support and the invaluable field assistance from the Forestry and Grassland Bureau of local counties in Qinghai ProvinceNational Natural Science Foundation of China(Grant No.32101237 and Grant No.41871294)Tibet Major Science and Technology Project(Grant No.XZ201901-GA-06)supported this work。
文摘Climate exerts a dominant control over the distribution of species.Generally,species migrate to higher elevations to track thermal niches,but variations in morphological traits can result in trait-specific responses to climate change.Here we attempted to explore how three sympatrically distributed raptor species(the Upland Buzzard Buteo hemilasius,UB;the Common Kestrel,also called Eurasian Kestrel Falco tinnunculus,EK;and the Saker Falcon Falco cherrug,SF)would respond to climate change over time,and whether their responses would bias by different morphology.We tested the alternative hypotheses for Allen’s rule for UB,EK,and SF in Qinghai Province,China,by modeling their current and future habitat suitability and confirming whether a consistent pattern exists between climate-induced range shifts and morphological differences among species.The extent of the projected distribution range within protected areas was also calculated for each species.We identified the future downward elevation shift for all the species,but with the notable northeastward shifting of the suitable climate space for UB and SF.Climate change would induce range contraction in the future,and the most acute influence is always the result of the pessimistic SSP585 scenario.No obvious pattern in climate-induced range shift was found for EK,for whom the morphological traits were significantly smaller all the time.More seriously,the ratios of highly suitable habitats being protected for our three raptor species were almost at a deficient level(below 1%).This study firstly tested the alternative hypothesis of Allen’s rule among raptors in Qinghai Province unprecedently,confirmed the morphological basis for different responses to changing climate across species,and demonstrated the protection deficiency under the current protected area design.We advocate more related studies in the future to verify our findings across more taxa.
基金Natural Science and Technology Major Project of Fujian Province,No.2021D033Natural Science Foundation of Shanghai,No.20ZR1410900+1 种基金Medical Innovation Project of Fujian Province,No.2022CXB020National Science and Technology Major Project,No.2017ZX 10203202-003-002.
文摘BACKGROUND Noninvasive methods have been developed to detect fibrosis in many liver diseases due to the limits of liver biopsy.However,previous studies have focused primarily on chronic viral hepatitis and nonalcoholic fatty liver disease.The diagnostic value of transient elastography for autoimmune liver diseases(AILDs)is worth studying.AIM To compare the diagnostic accuracy of imaging techniques with serum biomarkers of fibrosis in AILD.METHODS The PubMed,Cochrane Library and EMBASE databases were searched.Studies evaluating the efficacy of noninvasive methods in the diagnosis of AILDs[autoimmune hepatitis(AIH),primary biliary cholangitis(PBC)and primary sclerosing cholangitis(PSC)]were included.The summary area under the receiver operating characteristic curve(AUROC),diagnostic odds ratio,sensitivity and specificity were used to assess the accuracy of these noninvasive methods for staging fibrosis.RESULTS A total of 60 articles were included in this study,and the number of patients with AIH,PBC and PSC was 1594,3126 and 501,respectively.The summary AUROC of transient elastography in the diagnosis of significant fibrosis,advanced fibrosis and cirrhosis in patients with AIH were 0.84,0.88 and 0.90,respectively,while those in patients with PBC were 0.93,0.93 and 0.91,respectively.The AUROC of cirrhosis for patients with PSC was 0.95.However,other noninvasive indices(aspartate aminotransferase to platelet ratio index,aspartate aminotransferase/alanine aminotransferase ratio,fibrosis-4 index)had corresponding AUROCs less than 0.80.CONCLUSION Transient elastography exerts better diagnostic accuracy in AILD patients,especially in PBC patients.The appropriate cutoff values for staging advanced fibrosis and cirrhosis ranged from 9.6 to 10.7 and 14.4 to 16.9 KPa for PBC patients.
文摘This paper moves one step forward to build?a?numerical model to research quantitative characterization and dynamic law for interlayer interference factor (IIF) in the multilayer reservoir which was heavy oil reservoirs and produced by directional wells. There are mainly four contributions of this paper to the existing body of literature. Firstly, an equivalent simulation method of the pseudo start pressure gradient (PSPG) is developed to quantitatively predict the value of?IIF?under different geological reservoir conditions. Secondly, the interlayer interference is extended in time, and the time period of the study extends from a water cut stage to the whole process from the oil well open to produce?a?high water cut. Thirdly, besides the conventional productivity interlayer interference factor (PIIF), a new parameter, that is, the oil recovery interlayer interference factor (RIIF) is put forward.?RIIF?can be used to evaluate the technical indexes of stratified development and multilayer co-production effectively. Fourthly,?the?effectsof various geological reservoir parameters such as reservoir permeability and crude oil viscosity, etc. on the?PIIF?and?RIIF’s?type curves?are?discussed in detail and the typical plate?is?plotted. The research results provide a foundation for the effective development of multilayer heavy oil reservoirs.
