Long-term prognosis and its associated predictive factors in patients with eosinophilic gastroenteritis

BACKGROUND Eosinophilic gastroenteritis(EGE)is a chronic recurrent disease with abnormal eosinophilic infiltration in the gastrointestinal tract.Glucocorticoids remain the most common treatment method.However,disease relapse and glucocorticoid dependence remain notable problems.To date,few studies have illuminated the prognosis of EGE and risk factors for disease relapse.AIM To describe the clinical characteristics of EGE and possible predictive factors for disease relapse based on long-term follow-up.METHODS This was a retrospective cohort study of 55 patients diagnosed with EGE admitted to one medical center between 2013 and 2022.Clinical records were collected and analyzed.Kaplan-Meier curves and log-rank tests were conducted to reveal the risk factors for long-term relapse-free survival(RFS).RESULTS EGE showed a median onset age of 38 years and a slight female predominance(56.4%).The main clinical symptoms were abdominal pain(89.1%),diarrhea(61.8%),nausea(52.7%),distension(49.1%)and vomiting(47.3%).Forty-three(78.2%)patients received glucocorticoid treatment,and compared with patients without glucocorticoid treatments,they were more likely to have elevated serum immunoglobin E(IgE)(86.8%vs 50.0%,P=0.022)and descending duodenal involvement(62.8%vs 27.3%,P=0.046)at diagnosis.With a median follow-up of 67 mo,all patients survived,and 56.4%had at least one relapse.Six variables at baseline might have been associated with the overall RFS rate,including age at diagnosis<40 years[hazard ratio(HR)2.0408,95%confidence interval(CI):1.0082–4.1312,P=0.044],body mass index(BMI)>24 kg/m^(2)(HR 0.3922,95%CI:0.1916-0.8027,P=0.014),disease duration from symptom onset to diagnosis>3.5 mo(HR 2.4725,95%CI:1.220-5.0110,P=0.011),vomiting(HR 3.1259,95%CI:1.5246-6.4093,P=0.001),total serum IgE>300 KU/L at diagnosis(HR 0.2773,95%CI:0.1204-0.6384,P=0.022)and glucocorticoid treatment(HR 6.1434,95%CI:2.8446-13.2676,P=0.003).CONCLUSION In patients with EGE,younger onset age,longer disease course,vomiting and glucocorticoid treatment were risk factors for disease relapse,whereas higher BMI and total IgE level at baseline were protective.

Impact of prosthesis-patient mismatch on early and late outcomes after mitral valve replacement:a meta-analysis

Background Prognostic significance of prosthesis-patient mismatch(PPM)after mitral valve replacement(MVR)remains uncertain because of the limited studies reporting inconsistent or even contrary results.This meta-analysis pooled results of all available studies comparing early and late prognoses between patients with significant mitral PPM and those without.Methods Studies were identified by searching Pubmed,Excerpta Medica Database,Cochrane Central Register of Controlled Trials,and Clinical Trials.gov.Impact of PPM on postoperative hemodynamic results,thirty-day mortality,overall mortality,mortality of thirty-day survivors,and primary morbidity after MVR was evaluated via meta-analysis.Robustness of pooled estimates,source of heterogeneity,and publication bias were assessed via sensitivity analyses,meta-regression as well as subgroup analysis stratified according to methodological or clinical heterogeneity,or sequential omission method,and funnel plot or Begg's and Egger's tests,respectively.Results Nineteen cohort studies involving 9302 individuals(PPM group:n=5109,Control group:n=4193)were included for meta-analysis.Total PPM and severe PPM prevalence were 3.8%–85.9%and 1%–27%,with a mean value of 54.9%and 14.1%,respectively.As compared with control group,mitral PPM group demonstrated a poorer postoperative hemodynamic status of higher mean and peak residual transprosthetic pressure gradients(TPG),higher postoperative systolic pulmonary artery pressure(SPAP)and less reduction,higher postoperative pulmonary hypertension(PH)prevalence and less PH regression,smaller net atrioventricular compliance,less NYHA class decrease,higher postoperative functional tricuspid regurgitation prevalence and less regression.The PPM group also revealed a higher thirty-day mortality,long-term overall mortality,mortality of thirty-day survivors,and postoperative congestive heart failure prevalence,which were positively correlated with the severity of PPM if it was classified into tri-level subgroups.Left ventricular end-diastolic diameter,postoperative atrial fibrillation(AF)prevalence,and the AF regression were analogous between groups.Most pooled estimates were robust according to sensitivity analyses.Male patients and bioprosthesis implantation proportion were prominent source of between-study heterogeneity on thirty-day mortality.Publication bias was not significant in tests for all the outcomes,except for SPAP and TPG.Conclusions Mitral PPM would result in poorer postoperative hemodynamics and worse early and late prognosis.Severe PPM must be avoided since deleterious impact of mitral PPM was severity dependent.

医疗救助政策实施过程中的福利可获得性研究——以唇腭裂儿童救助“重生行动”项目为例

在医疗救助政策实施过程中，良好的政策文本并不必然导致政策对象群体受益。本研究以民政部与李嘉诚基金会合作开展的“重生行动——全国贫困家庭唇腭裂儿童手术康复计划”为例，运用福利可获得性的理论分析框架，从服务的存在状态与福利资源的丰歉、服务对象对于福利政策信息的获得途径、政策主体的目标端正与相互契合、服务设施充足且可及性强、政策措施随情势变化而做调整五个维度，研究分析了社会政策服务对象福利获得性的影响因素，为类似的医疗救助性社会政策的实施提供可资借鉴的经验。

Alcohol-assisted synthesis of high-silica zeolites in the absence of organic structure-directing agents

In this work,we show for the first time that high-silica zeolites(MFI,TON,MTT,and*MRE)could be synthesized from a combined strategy of both zeolite seeding and alcohol filling in the absence of organic structure-directing agents(OSDAs).High-silica ZSM-5 zeolites with Si/Al ratios ranging from 38 to 240(TF-Al-ZSM-5)could be synthesized via this route.The key to the success of this technique was the employment of an aluminosilicate precursor with a fully 4-coordinated aluminum species as the initial source,wherein the rearrangement and condensation of the silicate species,rather than the aluminate species,occurred during zeolite crystallization.In addition,heteroatoms,such as Fe and B,could be incorporated into the zeolite frameworks.Catalytic tests for the methanol-to-propylene(MTP)reaction exhibited good catalytic performance for TF-Al-ZSM-5,which was comparable to that of the aluminosilicate ZSM-5 zeolite synthesized with OSDAs.Hence,this method offers viable opportunities for the industrial production and catalytic application of high-silica zeolites in the future.

Chemoprevention of colorectal cancer in general population and high-risk population: a systematic review and network meta-analysis

Background:Many nutritional supplements and pharmacological agents have been reported to show preventive effects on colorectal adenoma and colorectal cancer(CRC).We performed a network meta-analysis to summarize such evidence and assess the efficacy and safety of these agents.Methods:We searched PubMed,Embase,and the Cochrane Library for studies published in English until October 31,2021 that fit our inclusion criteria.We performed a systematic review and network meta-analysis to assess the comparative efficacy and safety of candidate agents(low-dose aspirin[Asp],high-dose Asp,cyclooxygenase-2 inhibitors[coxibs],calcium,vitamin D,folic acid,ursodeoxycholic acid[UDCA],estrogen,and progesterone,alone or in combination)for preventing colorectal adenoma and CRC.Cochrane risk-of-bias assessment tool was employed to evaluate the quality of each included study.Results:Thirty-two randomized controlled trials(278,694 participants)comparing 13 different interventions were included.Coxibs significantly reduced the risk of colorectal adenoma(risk ratio[RR]:0.59,95%confidence interval[CI]:0.44–0.79,six trials involving 5486 participants),advanced adenoma(RR:0.63,95%CI:0.43–0.92,four trials involving 4723 participants),and metachronous adenoma(RR:0.58,95%CI:0.43–0.79,five trials involving 5258 participants)compared with placebo.Coxibs also significantly increased the risk of severe adverse events(RR:1.29,95%CI:1.13–1.47,six trials involving 7109 participants).Other interventions,including Asp,folic acid,UDCA,vitamin D,and calcium,did not reduce the risk of colorectal adenoma in the general and high-risk populations compared with placebo.Conclusions:Considering the balance between benefits and harms,regular use of coxibs for prevention of colorectal adenoma was not supported by the current evidence.Benefit of low-dose Asp for chemoprevention of colorectal adenoma still requires further evidence.

Design and experiment of fuzzy-PID based tillage depth control system for a self-propelled electric tiller

The research on the self-propelled electric tiller is vital for further improving the quality and efficiency of greenhouse rotary tillage operation,reducing the work intensity and operation risk of operators,and achieving environmentally friendly characteristics.Most of the existing self-propelled tillers rely on manual adjustment of the tillage depth.Moreover,the consistency and stability of the tillage depth are difficult to guarantee.In this study,the automatic control method of tillage depth of a self-propelled electric tiller is investigated.A method of applying the fuzzy PID(Proportional Integral Derivative)control method to the tillage depth adjustment system of a tiller is also proposed to realize automatic control.The system uses the real-time detection of the resistance sensor and angle sensor.The controller runs the electronically controlled hydraulic system to adjust the force and position comprehensively.The fuzzy control algorithm is used in the operation error control to realize the double-parameter control of the tillage depth.The simulation and experimental verification of the system are conducted.Results show that the control system applying fuzzy PID can improve the soil breaking rate by 3%in the operation process based on reducing the stability variation of tillage depth by 24%.The control strategy can reach the set value of tillage depth quickly and accurately.It can also meet the requirement of tillage depth consistency during the operation.

Comparative evaluation of the physicochemical properties of nano-hydroxyapatite/collagen and natural bone ceramic/collagen scaffolds and their osteogenesis-promoting effect on MC3T3-E1 cells

The use of various types of calcium phosphate has been reported in the preparation of repairing materials for bone defects.However,the physicochemical and biological properties among them might be vastly different.In this study,we prepared two types of calcium phosphates,nano-hydroxyapatite(nHA)and natural bone ceramic(NBC),into 3D scaffolds by mixing with type I collagen(CoL),resulting in the nHA/CoL and NBC/CoL scaffolds.We then evaluated and compared the physicochemical and biological properties of these two calcium phosphates and their composite scaffold with CoL.Scanning electron microscopy(SEM),X-ray photoelectron spectroscopy(XPS),Fourier-transform infrared spectroscopy(FTIR),X-ray diffraction spectroscopy(XRD)and compressive tests were used to,respectively,characterize the morphology,composition,distribution and the effect of nHA and NBC to collagen.Next,we examined the biological properties of the scaffolds using cytotoxicity testing,flow cytometry,immunofluorescence staining,biocompatibility testing,CCK-8 assays and RT-PCR.The results reflected that the Ca2t released from nHA and NBC could bind chemically with collagen and affect its physicochemical properties,including the infrared absorption spectrum and compression modulus,among others.Furthermore,the two kinds of scaffolds could promote the expression of osteo-relative genes,but showed different gene induction properties.In short,NBC/CoL could promote the expression of early osteogenic genes,while nHA/CoL could upregulate late osteogenic genes.Conclusively,these two composite scaffolds could provide MC3T3-E1 cells with a biomimetic surface for adhesion,proliferation and the formation of mineralized extracellular matrices.Moreover,nHA/CoL and NBC/CoL had different effects on the period and extent ofMC3T3-E1 cell mineralization.

Progress Towards the 90-90-90 Targets for Controlling HIV --China, 2018

What is already known about this topic?Since the Joint United Nations Programme on HIV and AIDS(UNAIDS)announced the 90-90-90 targets to control the global HIV epidemic in 2014,many countries have undertaken innovative measures to achieve this goal.The National Center for AIDS/STD Control and Prevention(NCAIDS)of China CDC convenes experts annually to evaluate the national progress towards these indicators.The most recent progress of 90-90-90 targets in China has not been previously published.What is added by this report?At the end of 2018,the percentage of living with HIV(PLWH)who had received a confirmed HIV diagnosis in China was 68.9%(61.5%-78.3%).The antiretroviral treatment coverage of diagnosed PLWH was 83.4%,and among patients on treatment for at least 12 months,94.2%achieved viral suppression.This provides most recent progress of 90-90-90 target in China.What are the implications for public health practice?China has made significant strides in curbing the HIV epidemic,but analysis on progress for the first 90 target for HIV testing remains out of reach.Innovative testing strategies may need to be developed to ensure that more PLWH can be identified.

GNPs/Al nanocomposites with high strength and ductility and electrical conductivity fabricated by accumulative roll-compositing

Aluminum matrix composites(AMCs) reinforced with graphene nanoplatelets(GNPs) were fabricated by using an accumulative roll-compositing(ARC) process.Microstructure, mechanical and electrical properties of the nanostructured AMCs were characterized. The results showed that small addition(0.2 vol% and 0.5 vol%) of GNPs can lead to a simultaneous increase in the tensile strength and ductility of the GNPs/Al nanocomposites, as compared with the same processed pure Al. With increasing GNPs content, the tensile strength of the GNPs/Al nanocomposites can be enhanced to 387 MPa with retained elongation of 15%. Meanwhile, the GNPs/Al nanocomposites exhibited a good electrical conductivity of77.8%–86.1% that of annealed pure Al. The excellent properties(high strength, high ductility and high conductivity) of the GNPs/Al are associated with the particular ARC process, which facilitates the uniform dispersion of GNPs in the matrix and formation of ultrafine-grained Al matrix. The strengthening and toughening of the GNPs/Al nanocomposites were discussed considering different mechanisms and the unique effect of GNPs.