Context: COVID-19 can spread rapidly in haemodialysis centres, leading to fatal outcomes. Implementing physical measures is crucial in limiting the spread of infection. Aims: To assess adherence to physical measures a...Context: COVID-19 can spread rapidly in haemodialysis centres, leading to fatal outcomes. Implementing physical measures is crucial in limiting the spread of infection. Aims: To assess adherence to physical measures against SARS-Cov2 in haemodialysis patients. Methods and Material: From 13 to 19 July 2021, we administered the questionnaire to haemodialysis patients during or immediately after the dialysis session. The dependent variables were adherence to wearing masks, hand washing outside the dialysis centre, social distancing of at least 1.5 meters, and cough and sneeze hygiene. Statistical Analysis Used: Data were analyzed using Epi info software;descriptive statistics were presented as mean, headcount, and percentage;related factors were determined by multi-logistic regression. The significance level was 5%. The Health Research Ethics Committee approved the research protocol. Results: 142 patients were included (mean age: 42.5 ± 14 years). Wearing masks, hand-washing, social distancing, and coughing and sneezing hygiene were observed by 88%, 75%, 47%, and 60% of patients, respectively. Conclusion: Wearing masks was the most respected physical measure, while social distancing was the least respected.展开更多
Introduction: Data on mortality in acute kidney injury (AKI) derives from high-income countries where AKI is hospital-acquired and occurs in elderly patients with a high burden of cardiovascular disease. In sub-Sahara...Introduction: Data on mortality in acute kidney injury (AKI) derives from high-income countries where AKI is hospital-acquired and occurs in elderly patients with a high burden of cardiovascular disease. In sub-Saharan Africa (SSA), AKI is community-acquired occurring in healthy young adults. We aimed to identify predictors of fatal outcomes in patients with AKI in two tertiary hospitals in Cameroon. Methods: Medical records of adults with confirmed AKI, from January 2018 to March 2020 were retrieved. The outcomes of interest were in-hospital deaths and presumed causes of death. We used multiple logistic regressions modeling to identify predictors of death. The study was approved by the ethics boards of both hospitals. Values were considered significant for a p-value of 0.05. Results: We included 285 patient records (37.2% females). The mean (SD) age was 50.1 (19.0) years. Hypertension (n = 97, 34.0%), organ failure (n = 88, 30.9%), and diabetes (n = 60, 21.1%) were the main comorbidities. The majority of patients had community-acquired AKI (78.6%, n = 224), were KDIGO stage 3 (88.8%, n = 253), and needed dialysis (52.6%, n = 150). Up to 16.7% (n = 25) did not receive what was needed. The in-hospital mortality rate was 29.1% (n = 83). Lack of access to dialysis (OR = 27.8;CI: 5.2 - 149.3, p = 0.001), hypotension (OR = 11.8;CI: 1.3 - 24.8;p = 0.001) and ICU admission (OR = 5.7;CI: 1.3 - 24.8, p = 0.001) were predictors of mortality. The presence of co-morbidities or underlying diseases (n = 46, 55%) were the main causes of death. Conclusions: In-hospital AKI mortality is high, as in other low- and middle-income economies. Lack of access to dialysis and the severity of the underlying illness are major predictors of death.展开更多
Background: The aim of this study was to evaluate the usefulness of two interferon-gamma release assays (IGRAs) (QuantiFERON-TB Plus (QFT-plus) and T-SPOT.TB assay) for patients suspected of having tuberculosis (TB) i...Background: The aim of this study was to evaluate the usefulness of two interferon-gamma release assays (IGRAs) (QuantiFERON-TB Plus (QFT-plus) and T-SPOT.TB assay) for patients suspected of having tuberculosis (TB) infection as supportive methods for diagnosing TB. Patients and Methods: The subjects consisted of 45 patients who required clinical differentiation of TB disease from June 2019 to August 2023. The final clinical diagnoses were: 14 patients with active TB disease, 4 with latent TB infection (LTBI), 17 with old (cured) TB disease, and 10 with pulmonary nontuberculous mycobacterial (NTM) disease. We used the two IGRAs for these patients and evaluated the data according to the manufacturer’s guidelines for interpretation or FDA-approved cutoffs. Results: Among the total of 14 patients with active TB disease (mean age: 64 years old, male: 9, and female: 5), a positive response was noted in 10 patients (71%) on QFT-plus and 9 (64%) on T-SPOT.TB. Four patients with a negative response on QFT-plus and T-SPOT.TB were elderly or cancer patients with lymphocytopenia or hypoalbuminemia. All four patients with LTBI showed a positive response (100%) on both QFT-plus and T-SPOT.TB. Among the seventeen patients with old (cured) TB disease, a positive response was noted in 8 patients (47%) on QFT-plus and 9 (53%) on T-SPOT.TB. All patients with pulmonary NTM disease showed a negative response on both QFT-plus and T-SPOT.TB. Conclusions: A false-negative response on QFT-plus as well as T-SPOT.TB was recognized in elderly patients and patients with an immunosuppressed condition, and half of patients with old (cured) TB showed no negative conversion after the completion of treatment through this study. Although it was recently reported that the positive response rate on QFT-plus of patients with active TB disease was high, we consider it necessary to be careful in diagnosing TB infection using IGRAs for patients with severe underlying diseases in a tertiary hospital based on the results.展开更多
The value of system assimilation is to improve working relationships between tutors and learners while increasing workflow efficiency among tertiary institutions with low operational costs. E-skills could be described...The value of system assimilation is to improve working relationships between tutors and learners while increasing workflow efficiency among tertiary institutions with low operational costs. E-skills could be described as electronic education development, to assist ICT professionals to reach their future career goals and aim to help users boost their ICT skills. In a society that is expanding, it is also a crucial issue to take into account. Researchers have turned their attention to this topic because of its significance and contribution to the empowerment of graduates in digital education. Many scholars have proposed many methods for integrating e-skills into society with impressive results, but the rising rate of graduate unemployment in South Africa is gradually becoming a big worry in our society. A model based on Activity Theory (AT) and e-skills will be developed in our tertiary institution to equip graduates with skills that will increase their employability and provide more individualized work opportunities as part of this study’s effort to solve this issue. With the use of the Statistical Package for the Social Sciences (SPSS) and Cronbach’s Alpha for validity and reliability testing, the study will create an experimental performance to assess the approach taken to measure e-skills in tertiary institutions to empower graduates in South Africa. The study established that system development and e-skilled models for tertiary institutions are growing gradually, especially in South African institutions, that empower graduates with profitable employability with experiences to improve work operation in the industries. In conclusion, system development and e-skills are very demanding but important to empower graduate employability to determine competency in the professional workforce.展开更多
Pressure on land tenure is having a negative impact on the coconut sector, reducing farmers’ incomes. Intercropping cultivars plantain under coconut based has been considered as a solution to this problem. The aim of...Pressure on land tenure is having a negative impact on the coconut sector, reducing farmers’ incomes. Intercropping cultivars plantain under coconut based has been considered as a solution to this problem. The aim of this work is to diversify the sources of income for coconut growers. The plantain variety PITA 3, popularised by the CNRA, was grown in coconut inter-rows (PB113<sup>+</sup>), with two types of manure (chemical, organic). Six (06) treatments D1, D2, D3, D4, D5 and D6 were studied. In the tenth month after planting, treatment D3, which included banana plants fertilised with 9 kg of manure/plant, got the best agromorphological performance: height (264.08 cm), neck circumference (57.68 cm) and 12 leaves. In terms of production parameters, D3 banana plants had a shorter production cycle (347 days) and the highest diet mass (9.3 kg). However, the plants that received no fertiliser (D6) showed stunted growth and were unable to produce brunch. The fertilization of plantain with 10 t/ha of laying hen droppings permitted good development and production of plantains on tertiary sands.展开更多
Background: Hypertension is a persistent elevation of blood pressure in the arteries which if not properly managed can lead to stroke, heart failure, atrial fibrillation, peripheral vascular disease and other life thr...Background: Hypertension is a persistent elevation of blood pressure in the arteries which if not properly managed can lead to stroke, heart failure, atrial fibrillation, peripheral vascular disease and other life threatening outcomes. This study investigated some haematological parameters of Primary hypertensive subjects. Objectives: To compare some haematological parameters (haematocrit, haemoglobin concentration, Platelets count, White Blood Cells count, red blood cell count and Red Cells Indices between hypertensive and normotensive subjects. Materials and methods: Blood samples were collected from 76 known hypertensive subjects between 30 - 70 years attending the Cardiology clinic of the University of Abuja Teaching Hospital Gwagwalada. Another 37 normotensive subjects between 30 - 65 years served as the control. All subjects gave their consents. Platelets count, Haemoglobin estimation, Packed Cell Volume, Red Blood Cell Count, Mean Cell Volume, Mean Cell Haemoglobin, Mean Cell Haemoglobin Concentration and White Blood Cell count were determined using Mythic 22 five parts haematology analyzer. Results: Results for Hypertensive and Control subjects were, White Blood Cell, 5.76 ± 1.45 × 10<sup>9</sup>/l and 4.76 ± 1.03 × 10<sup>9</sup>/l, Platelet count, 248.7552.45 × 10<sup>9</sup>/l and 284.95 ± 27.66 × 10<sup>9</sup>/l, Mean Cell Volume, 91.81 ± 3.05 fl and 85.68 ± 6.48 fl, Mean Cell Haemoglobin, 30.59 ± 1.04 pg and 27.922 ± 2.74 pg, Mean Cell Haemoglobin Concentration, 33.34 ± 0.61 g/dl and 32.32 ± 0.93 g/dl, Red Blood Cell, 4.33 ± 0.39 × 10<sup>9</sup>/l and 4.50 ± 0.52 × 10<sup>9</sup>/l, Packed Cell Volume, 39% ± 3.15% and 40% ± 4.41% and Haemoglobin, 13.21 ± 1.10 g/dl and 13.50 ± 1.63 g/dl respectively. Mean Cell Volume, Mean Cell Haemoglobin, Mean Cell Haemoglobin Concentration (Red cells indices) were significantly higher in hypertensive compared to normotensive subjects (P 0.05), total White Blood Cell count was also higher in hypertensive than normotensive but not statistically significant (P > 0.05). However, Platelet counts, Red Blood Cell, Packed Cell Volume and Haemoglobin were significantly lower in hypertensive compared to normotensive (P 0.05). All the parameters were within established reference ranges for the age and sex of the subjects. Our findings show that hypertension may lead to haematological derangement, if not properly managed. Conclusively, haematological parameters can be used to monitor the prognosis of the disease and manage hypertensive related complications. It is important to assess haematological parameters for hypertensive individuals which may help to prevent complications associated with haematological disorders.展开更多
The collecting power of tertiary amines(DRN,DEN and DPN) on kaolinite follows the order of DENDPNDRN.After reacting with DRN,DEN and DPN,the surface potentials of kaolinite increase remarkably,and the recruitments c...The collecting power of tertiary amines(DRN,DEN and DPN) on kaolinite follows the order of DENDPNDRN.After reacting with DRN,DEN and DPN,the surface potentials of kaolinite increase remarkably,and the recruitments caused by collectors also follow the order of DENDPNDRN.The results of dynamics simulation show that the geometries of substituent groups bonding to N are deflected and twisted,and some of bond angles are changed when tertiary amines cations adsorb on kaolinite(001) surface.Based on the results of dynamics simulations and quantum chemistry calculations,the electrostatic forces between three tertiary amines cations and 4×4×3(001) plane of kaolinite are 1.38×10?7 N(DRN12H+),1.44×10-6 N(DEN12H+),1.383×10-6 N(DPN12H+),respectively.展开更多
Eleven tertiarv alkaloids were isolated from Corvdalis decumbens rhizome Their structures were identified as protopine(Ⅶ),allocryptopine(Ⅷ),cryptopine (Ⅸ),muramine(ⅩⅦ);(+)-tetrahydropalmatine(Ⅲ),(+)-kikemanine (...Eleven tertiarv alkaloids were isolated from Corvdalis decumbens rhizome Their structures were identified as protopine(Ⅶ),allocryptopine(Ⅷ),cryptopine (Ⅸ),muramine(ⅩⅦ);(+)-tetrahydropalmatine(Ⅲ),(+)-kikemanine (Ⅳ),(一)-scoulerine (ⅩⅧ),(十)-bulbo- capnine (ⅩⅨ),and(一)一capnoidine(Ⅰ),(一)一bicuculline(Ⅴ),(+) coriumidine(ⅩⅣ), respecti vely。 Among these,cryptopine,muramine,(+)-kikemanine,(-)-scoulerine,(一)capnoidine,(一)一bicuculline were isolated for the first time from this plant展开更多
The special issue deals with the Cretaceous-Tertiary deserts in southwestern China and relevant sedimentological problems about deserts. The study area is located between 101°10'- 107°00'E and 28°00'...The special issue deals with the Cretaceous-Tertiary deserts in southwestern China and relevant sedimentological problems about deserts. The study area is located between 101°10'- 107°00'E and 28°00'-30°40′ N. The ancient desert study is so little in China that there has not been a systematic report about it up to now. Based on the study in many ways on Cretaceous-Tertiary deserts in southwestern China, plentiful data have been obtained. Though it is still a bit rough, the study is a good beginning of the ancient desert study in China. The main ideas and conclusions are summarized as follows.展开更多
Effective teaching has always been a goal pursued by teachers as a part of education both from the western and eastern society,for it to some extend is considered an effective way to improve society.In this essay,both...Effective teaching has always been a goal pursued by teachers as a part of education both from the western and eastern society,for it to some extend is considered an effective way to improve society.In this essay,both Chinese and western conceptions of teaching and learning will be discussed.In doing so,their differences and similarities can be seen clearly,which will help the cross-cultural educators to understand their teaching environment and learning styles.展开更多
The stretching process of some Tertiary rift basins in eastern China is characterized by multiphase rifting. A multiple instantaneous uniform stretching model is proposed in this paper to simulate the formation of the...The stretching process of some Tertiary rift basins in eastern China is characterized by multiphase rifting. A multiple instantaneous uniform stretching model is proposed in this paper to simulate the formation of the basins as the rifting process cannot be accurately described by a simple (one episode) stretching model. The study shows that the multiphase stretching model, combined with the back-stripping technique, can be used to reconstruct the subsidence history and the stretching process of the lithosphere, and to evaluate the depth to the top of the asthenosphere and the deep thermal evolution of the basins. The calculated results obtained by applying the quantitative model to the episodic rifting process of the Tertiary Qiongdongnan and Yinggehai basins in the South China Sea are in agreement with geophysical data and geological observations. This provides a new method for quantitative evaluation of the geodynamic process of multiphase rifting occurring during the Tertiary in eastern China.展开更多
Potassium-ion batteries(KIBs)are a potential candidate to lithium-ion batteries(LIBs)but possess unsatisfactory capacity and rate properties.Herein,the metallic cobalt selenide quantum dots(Co0.85Se-QDs)encapsulated i...Potassium-ion batteries(KIBs)are a potential candidate to lithium-ion batteries(LIBs)but possess unsatisfactory capacity and rate properties.Herein,the metallic cobalt selenide quantum dots(Co0.85Se-QDs)encapsulated in mesoporous carbon matrix were designed via a direct hydrothermal method.Specifically,the cobalt selenide/carbon composite(Co0.85Se-QDs/C)possesses tertiary hierarchical structure,which is the primary quantum dots,the secondary petals flake,and the tertiary hollow micropolyhedron framework.Co0.85Se-QDs are homogenously embedded into the carbon petals flake,which constitute the hollow polyhedral framework.This unique structure can take the advantages of both nanoscale and microscale features:Co0.85Se-QDs can expand in a multidimensional and ductile carbon matrix and reduce the K-intercalation stress in particle dimensions;the micropetals can restrain the agglomeration of active materials and promote the transportation of potassium ion and electron.In addition,the hollow carbon framework buffers volume expansion,maintains the structural integrity,and increases the electronic conductivity.Benefiting from this tertiary hierarchical structure,outstanding K-storage performance(402 mAh g?1 after 100 cycles at 50 mA g?1)is obtained when Co0.85Se-QDs/C is used as KIBs anode.More importantly,the selenization process in this work is newly reported and can be generally extended to prepare other quantum dots encapsulated in edge-limited frameworks for excellent energy storage.展开更多
Tertiary amine cationic polyacrylamide with high cationization degree was used as a new cationic agent to pretreat cotton with dip-pad-bake method. The obtained cationic cotton was dyed with reactive dyes in the ab-se...Tertiary amine cationic polyacrylamide with high cationization degree was used as a new cationic agent to pretreat cotton with dip-pad-bake method. The obtained cationic cotton was dyed with reactive dyes in the ab-sence of electrolyte. The effects of the characteristics of the cationic agent and the pretreatment conditions on dye-ability of reactive dye were investigated. The results showed that the fixation and K/S values of the reactive dyes on the cationic cotton were improved compared with those on the untreated one in the presence of salt. Tests on fast-ness properties of the dyed cotton and fabric quality of the pretreated cotton were carried out and the results showed that wash and rub fastness of the salt-free dyeing were both satisfactory. And anti-crease property,tensile and tear strength,and handling of the cationic cotton were also good compared with that of the untreated one.展开更多
Analysis of 2 D seismic data over 4 500 km in length from the Madura Strait Basin in the East Java Sea reveals seismic re?ection characteristics of reefs and associated sedimentary bodies, including asymmetrical or sy...Analysis of 2 D seismic data over 4 500 km in length from the Madura Strait Basin in the East Java Sea reveals seismic re?ection characteristics of reefs and associated sedimentary bodies, including asymmetrical or symmetrical dome re?ections, slope progradational re?ections, chaotic re?ections and discontinuous strong re?ections inside the reef, which onlap the ?ank of the reef. It is concluded that the developmental paleo-environment of most reefs is mainly conducive to shallow marine carbonate platform facies and platform margin facies, based on well core data, variations in seismic facies and strata thickness.The formation and evolution of all reefs are primarily in?uenced by the tectonic framework of the Madura Strait Basin. Platform margin reefs are principally controlled by two types of structures: one is a series of E-W trending Paleogene normal faults, and the other is an E-W trending Neogene inversion structures. In addition, wave actions, tidal currents and other ocean currents play an accelerated role in sorting, rounding and redeposition for the accumulation and evolution of reefs. Tertiary reefs in the MSB can be divided into four types: 1) an open platform coral reef of Late Oligocene to Early Miocene, 2) a platform margin coral reef controlled by normal faults in Late Oligocene to Early Miocene, 3) a platform margin Globigerina moundreef controlled by a "hidden" inversion structure in Early Pliocene, and 4) a platform margin Globigerina mound-reef controlled by thrust faults in the early Pliocene. Patterns of the formation and evolution of reefs are also suggested.展开更多
AIM: Prospective evaluation of repeat endoscopic retrograde cholangiopancreatography (ERCP) for failed Schutz grade 1 biliary cannulation in a high-volume center. METHODS: Prospective intention-to-treat analysis of pa...AIM: Prospective evaluation of repeat endoscopic retrograde cholangiopancreatography (ERCP) for failed Schutz grade 1 biliary cannulation in a high-volume center. METHODS: Prospective intention-to-treat analysis of patients referred for biliary cannulation following recent unsuccessful ERCP. RESULTS: Fifty-one patients (35 female; mean age: 62.5 years; age range: 40-87 years) with previous failed biliary cannulation were referred for repeat ERCP. The indication for ERCP was primarily choledocholithiasis (45%) or pancreatic malignancy (18%). Successful biliary can- nulation was 100%. The precut needle knife sphincterotomy (NKS) rate was 27.4%. Complications occurred in 3.9% (post-ERCP pancreatitis). An identif iable reason for initial unsuccessful biliary cannulation was present in 55% of cases. Compared to a cohort of 940 nave pa-pilla patients (female 61%; mean age: 59.9 years; age range: 18-94 years) who required sphincterotomy over the same time period, there was no statistical difference in the cannulation success rate (100% vs 98%) or postERCP pancreatitis (3.1% vs 3.9%). Precut NKS use was more frequent (27.4% vs 12.7%) (P = 0.017). CONCLUSION: Referral to a high-volume center following unsuccessful ERCP is associated with high technical success, with a favorable complication rate, compared to routine ERCP procedures.展开更多
Objective:To illustrate the clinical features and investigate the indicators associated with a fatal outcome in adult patients with severe Plasmodium falciparum malaria admitted to the Hospital for Tropical Diseases,B...Objective:To illustrate the clinical features and investigate the indicators associated with a fatal outcome in adult patients with severe Plasmodium falciparum malaria admitted to the Hospital for Tropical Diseases,Bangkok,Thailand.Methods:We studied 202 adult malaria patients admitted to the Intensive Care Unit.A total of 43 clinical variables were identified by univariate and logistic regression analyses,to eliminate confounding factors.Results:Regarding the statistical methods,only 6 variables-jaundice,cerebral malaria,metabolic acidosis,body mass index,initial respiratory rate,and white blood cell count-were significant indicators of death, with adjusted odds ratios(95%CI) of 15.2(2.1-32.3).4.3(2.3-12.6),3.3(2.3-5.7),2.4(1.9-3.5),2.2 (1.5-2.6),and 1.7(1.2-3.1),respectively.Conclusions:Our study found that jaundice,cerebral malaria,metabolic acidosis,body mass index,initial respiratory rate and white blood cell count were indicators of fatal outcome in severe Plasmodium falciparum malaria.Further studies on the fatal indicators in severe malaria need to be compared with data from different geographical areas,to construct practical measures to address potentially fatal indicators in different settings.展开更多
AIM: To assess the role of contrast enhanced ultrasonography in evaluation of hepatocellular carcinoma (HCC) at the first Indian tertiary liver center. METHODS: Retrospective analysis of contrast enhanced ultrasound (...AIM: To assess the role of contrast enhanced ultrasonography in evaluation of hepatocellular carcinoma (HCC) at the first Indian tertiary liver center. METHODS: Retrospective analysis of contrast enhanced ultrasound (CEUS) examinations over 24 mo for diagnosis, surveillance, characterization and follow up of 50 patients in the context of HCC was performed. The source and indication of referrals, change in referral rate, accuracy and usefulness of CEUS in a tertiary liver center equipped with a 64 slice dual energy computer tomography (CT) and 3 tesla magnetic resonance imaging (MRI) were studied. Sonovue (BR1, Bracco, Italy, a second generation contrast agent) was used for contrast US studies. Contrast enhanced CT/MRI or both were performed in all patients. The findings were taken as a baseline reference and correlation was done with respect to contrast US. Contrast enhanced MRI was performed using hepatocyte specific gadobenate dimeglumine (Gd-BOPTA). Iomeron (400 mg; w/v) was used for dynamic CT examinations. RESULTS: About 20 (40%) of the examinations were referred from clinicians for characterization of a mass from previous imaging. About 15 (30%) were performed for surveillance in chronic liver disease; 5 (10%) examinations were performed for monitoring lesions after radiofrequency ablation (RFA); 3 (6%) were post trans-arterial chemoembolization (TACE) assessments and 3 (6%) were patients with h/o iodinated contrast allergy. About 2(4%) were performed on hemodynamically unstable patients in the intensive care with raised alpha fetoprotein and 2(4%) patients were claustrophobic. The number of patients referred from clinicians steadily increased from 12 in the first 12 mo of the study to 38 in the last 12 mo. CEUS was able to diagnose 88% of positive cases of HCC as per reference standards. In the surveillance group, specificity was 53.3% vs 100% by CT/MRI. Post RFA and TACE specificity of lesion characterization by CEUS was 100% in single/large mass assessment, similar to CT/MRI. For non HCC lesions such as regenerative and dysplastic nodules, the specificity was 50% vs 90% by CT/MRI. The positive role of CEUS in imaging spectrum of HCC included a provisional urgent diagnosis of an incidentally detected mass. It further led to a decrease in time for further management. A confident diagnosis on CEUS was possible in cases of characterization of an indeterminate mass, in situations where the patient was unfit for CT/MRI, was allergic to iodinated contrast or had claustrophobia, etc.CEUS was also cost effective, radiation free and an easy modality for monitoring post RFA or TACE lesions. CONCLUSION: CEUS is a valuable augmentation to the practice of ultrasonography, and an irreplaceable modality for confounding cases and interpretation of indeterminate lesions in imaging of HCC.展开更多
Tertiary lymphoid structures(TLSs)are ectopic immune cell aggregations that develop in peripheral tissues in response to a wide range of chronic inflammatory conditions,including infection,autoimmune disease,and cance...Tertiary lymphoid structures(TLSs)are ectopic immune cell aggregations that develop in peripheral tissues in response to a wide range of chronic inflammatory conditions,including infection,autoimmune disease,and cancer.In the tumor microenvironment(TME),the structures of TLSs,including B-cell-and T-cell-enriched areas indicate that the TLSs might be the local site during the initiation and maintenance of humoral and cellular immune responses against cancers.Numerous studies have evaluated the expression of TLSs in different cancer patients and their association with prognoses of cancer patients.It was shown that welldeveloped TLSs characterized by mature B cells synthesized tumor specific antibodies,which were considered as specific markers for a good prognosis.However,there are still some immunosuppressive factors existing in the TLSs that may affect anti-tumor responses.These factors include dysfunctional B cells,regulatory T cells,and T follicular regulatory cells.The complexity and heterogeneity of the TLS composition may affect the function and activity of TLSs;it is therefore essential to fully understand the function and influencing factors in TLSs.It has been reported that checkpoint inhibitors and vaccines are currently being developed to reprogram the TME by establishing mature TLSs to improve cancer immunotherapies.In this review,we focused on recent advances in TLSs in human solid tumors,including structural characteristics and classes,antitumor mechanisms,immunosuppressive factors,and TLSbased therapeutic approaches.展开更多
Objective:Recent studies have highlighted the distinct value of tertiary lymphoid structure(TLS)for immunotherapeutic response prediction.However,it remains unclear whether TLS could play such roles in gastric cancer(...Objective:Recent studies have highlighted the distinct value of tertiary lymphoid structure(TLS)for immunotherapeutic response prediction.However,it remains unclear whether TLS could play such roles in gastric cancer(GC).Methods:In this study,tumor tissue slices from 292 GC patients from Zhongshan Hospital were firstly reviewed to explore the correlation between TLS and clinical characteristics.Subsequently,we curated 38 reported genes that may function as triggers of TLS and performed consensus molecular subtyping in public RNA-seq datasets to determine TLS patterns in GC.Based on the differentially expressed genes acquired from two TLS patterns,we quantified TLS-related genes on the principal component analysis(PCA)algorithm to develop TLS score.A Zhongshan immunotherapy cohort including 13 patients who received programmed cell death 1(PD1)blockade therapy was established to conduct RNA sequencing analysis and multiplex immunohistochemistry(mIHC)tests using formalin-fixed and paraffin-embedded(FFPE)tissues.The corresponding TLS score and immune cell counts were further compared based on therapeutic response variations.Results:Mature TLS was revealed as an independent prognostic factor in 292 GC patients.Patients with higher TLS score was characterized by prolonged survival time and superior response to immunotherapy.TLS score was correlated with immunotherapy-related characters,such as microsatellite instability(MSI)and tumor mutation burden(TMB).In addition,RNA-seq data analysis in the Zhongshan immunotherapy cohort indicated that a higher TLS score was correlated with a superior response to PD1 blockade therapy.mIHC tests also revealed that PD1+CD8+T cell counts were significantly increased in the high-TLS score group.Conclusions:This study highlighted that TLS was significantly associated with immune landscape diversity and complexity.Quantitatively evaluating TLS patterns of individual tumor will strengthen our understanding of TME characteristics and promote more effective immunotherapy strategies.展开更多
The East China Sea shelf basin is a key area for setting up the sea level changes of Cenozoic in the West Pacific. Based upon the characteristics of seismic reflection, the analysis of sequence stratigraphy and depos...The East China Sea shelf basin is a key area for setting up the sea level changes of Cenozoic in the West Pacific. Based upon the characteristics of seismic reflection, the analysis of sequence stratigraphy and depositional system, the high resolution chronostratigraphic framework has been set up by using the data of micropaleontologic biozone fossils. The relative sea level change curve has been set up by combining analysis of paleoecology, genetic facies, specific sedimentary structures and on lap recognized from the seismic profiles with study of geochemical characteristics. There are 4 2nd order basin cycles showing the long term sea level changes, and 22 3rd order cycles showing short term ones with relative changing ranges of 0-150 m. Transgression and regression showing long term sea level changes bear asymmetric feature, which indicates that the speed of transgression is faster than that of regression. There are a lot of differences when compared with Haq ’s curve. The sequence stratigraphic framework has also been set up and 3 tectonic sequences, 7 supersequences and 19 sequences have been subdivided for Tertiary in the East China Sea shelf basin. On the basis of detailed analysis of genetic facies and log facies, 9 sedimentary systems, 20 depositional assemblages and many genetic facies have also been recognized and investigated. Based on the studies mentioned above, the favorable source and reservoir facies of gas and petroleum are indicated.展开更多
文摘Context: COVID-19 can spread rapidly in haemodialysis centres, leading to fatal outcomes. Implementing physical measures is crucial in limiting the spread of infection. Aims: To assess adherence to physical measures against SARS-Cov2 in haemodialysis patients. Methods and Material: From 13 to 19 July 2021, we administered the questionnaire to haemodialysis patients during or immediately after the dialysis session. The dependent variables were adherence to wearing masks, hand washing outside the dialysis centre, social distancing of at least 1.5 meters, and cough and sneeze hygiene. Statistical Analysis Used: Data were analyzed using Epi info software;descriptive statistics were presented as mean, headcount, and percentage;related factors were determined by multi-logistic regression. The significance level was 5%. The Health Research Ethics Committee approved the research protocol. Results: 142 patients were included (mean age: 42.5 ± 14 years). Wearing masks, hand-washing, social distancing, and coughing and sneezing hygiene were observed by 88%, 75%, 47%, and 60% of patients, respectively. Conclusion: Wearing masks was the most respected physical measure, while social distancing was the least respected.
文摘Introduction: Data on mortality in acute kidney injury (AKI) derives from high-income countries where AKI is hospital-acquired and occurs in elderly patients with a high burden of cardiovascular disease. In sub-Saharan Africa (SSA), AKI is community-acquired occurring in healthy young adults. We aimed to identify predictors of fatal outcomes in patients with AKI in two tertiary hospitals in Cameroon. Methods: Medical records of adults with confirmed AKI, from January 2018 to March 2020 were retrieved. The outcomes of interest were in-hospital deaths and presumed causes of death. We used multiple logistic regressions modeling to identify predictors of death. The study was approved by the ethics boards of both hospitals. Values were considered significant for a p-value of 0.05. Results: We included 285 patient records (37.2% females). The mean (SD) age was 50.1 (19.0) years. Hypertension (n = 97, 34.0%), organ failure (n = 88, 30.9%), and diabetes (n = 60, 21.1%) were the main comorbidities. The majority of patients had community-acquired AKI (78.6%, n = 224), were KDIGO stage 3 (88.8%, n = 253), and needed dialysis (52.6%, n = 150). Up to 16.7% (n = 25) did not receive what was needed. The in-hospital mortality rate was 29.1% (n = 83). Lack of access to dialysis (OR = 27.8;CI: 5.2 - 149.3, p = 0.001), hypotension (OR = 11.8;CI: 1.3 - 24.8;p = 0.001) and ICU admission (OR = 5.7;CI: 1.3 - 24.8, p = 0.001) were predictors of mortality. The presence of co-morbidities or underlying diseases (n = 46, 55%) were the main causes of death. Conclusions: In-hospital AKI mortality is high, as in other low- and middle-income economies. Lack of access to dialysis and the severity of the underlying illness are major predictors of death.
文摘Background: The aim of this study was to evaluate the usefulness of two interferon-gamma release assays (IGRAs) (QuantiFERON-TB Plus (QFT-plus) and T-SPOT.TB assay) for patients suspected of having tuberculosis (TB) infection as supportive methods for diagnosing TB. Patients and Methods: The subjects consisted of 45 patients who required clinical differentiation of TB disease from June 2019 to August 2023. The final clinical diagnoses were: 14 patients with active TB disease, 4 with latent TB infection (LTBI), 17 with old (cured) TB disease, and 10 with pulmonary nontuberculous mycobacterial (NTM) disease. We used the two IGRAs for these patients and evaluated the data according to the manufacturer’s guidelines for interpretation or FDA-approved cutoffs. Results: Among the total of 14 patients with active TB disease (mean age: 64 years old, male: 9, and female: 5), a positive response was noted in 10 patients (71%) on QFT-plus and 9 (64%) on T-SPOT.TB. Four patients with a negative response on QFT-plus and T-SPOT.TB were elderly or cancer patients with lymphocytopenia or hypoalbuminemia. All four patients with LTBI showed a positive response (100%) on both QFT-plus and T-SPOT.TB. Among the seventeen patients with old (cured) TB disease, a positive response was noted in 8 patients (47%) on QFT-plus and 9 (53%) on T-SPOT.TB. All patients with pulmonary NTM disease showed a negative response on both QFT-plus and T-SPOT.TB. Conclusions: A false-negative response on QFT-plus as well as T-SPOT.TB was recognized in elderly patients and patients with an immunosuppressed condition, and half of patients with old (cured) TB showed no negative conversion after the completion of treatment through this study. Although it was recently reported that the positive response rate on QFT-plus of patients with active TB disease was high, we consider it necessary to be careful in diagnosing TB infection using IGRAs for patients with severe underlying diseases in a tertiary hospital based on the results.
文摘The value of system assimilation is to improve working relationships between tutors and learners while increasing workflow efficiency among tertiary institutions with low operational costs. E-skills could be described as electronic education development, to assist ICT professionals to reach their future career goals and aim to help users boost their ICT skills. In a society that is expanding, it is also a crucial issue to take into account. Researchers have turned their attention to this topic because of its significance and contribution to the empowerment of graduates in digital education. Many scholars have proposed many methods for integrating e-skills into society with impressive results, but the rising rate of graduate unemployment in South Africa is gradually becoming a big worry in our society. A model based on Activity Theory (AT) and e-skills will be developed in our tertiary institution to equip graduates with skills that will increase their employability and provide more individualized work opportunities as part of this study’s effort to solve this issue. With the use of the Statistical Package for the Social Sciences (SPSS) and Cronbach’s Alpha for validity and reliability testing, the study will create an experimental performance to assess the approach taken to measure e-skills in tertiary institutions to empower graduates in South Africa. The study established that system development and e-skilled models for tertiary institutions are growing gradually, especially in South African institutions, that empower graduates with profitable employability with experiences to improve work operation in the industries. In conclusion, system development and e-skills are very demanding but important to empower graduate employability to determine competency in the professional workforce.
文摘Pressure on land tenure is having a negative impact on the coconut sector, reducing farmers’ incomes. Intercropping cultivars plantain under coconut based has been considered as a solution to this problem. The aim of this work is to diversify the sources of income for coconut growers. The plantain variety PITA 3, popularised by the CNRA, was grown in coconut inter-rows (PB113<sup>+</sup>), with two types of manure (chemical, organic). Six (06) treatments D1, D2, D3, D4, D5 and D6 were studied. In the tenth month after planting, treatment D3, which included banana plants fertilised with 9 kg of manure/plant, got the best agromorphological performance: height (264.08 cm), neck circumference (57.68 cm) and 12 leaves. In terms of production parameters, D3 banana plants had a shorter production cycle (347 days) and the highest diet mass (9.3 kg). However, the plants that received no fertiliser (D6) showed stunted growth and were unable to produce brunch. The fertilization of plantain with 10 t/ha of laying hen droppings permitted good development and production of plantains on tertiary sands.
文摘Background: Hypertension is a persistent elevation of blood pressure in the arteries which if not properly managed can lead to stroke, heart failure, atrial fibrillation, peripheral vascular disease and other life threatening outcomes. This study investigated some haematological parameters of Primary hypertensive subjects. Objectives: To compare some haematological parameters (haematocrit, haemoglobin concentration, Platelets count, White Blood Cells count, red blood cell count and Red Cells Indices between hypertensive and normotensive subjects. Materials and methods: Blood samples were collected from 76 known hypertensive subjects between 30 - 70 years attending the Cardiology clinic of the University of Abuja Teaching Hospital Gwagwalada. Another 37 normotensive subjects between 30 - 65 years served as the control. All subjects gave their consents. Platelets count, Haemoglobin estimation, Packed Cell Volume, Red Blood Cell Count, Mean Cell Volume, Mean Cell Haemoglobin, Mean Cell Haemoglobin Concentration and White Blood Cell count were determined using Mythic 22 five parts haematology analyzer. Results: Results for Hypertensive and Control subjects were, White Blood Cell, 5.76 ± 1.45 × 10<sup>9</sup>/l and 4.76 ± 1.03 × 10<sup>9</sup>/l, Platelet count, 248.7552.45 × 10<sup>9</sup>/l and 284.95 ± 27.66 × 10<sup>9</sup>/l, Mean Cell Volume, 91.81 ± 3.05 fl and 85.68 ± 6.48 fl, Mean Cell Haemoglobin, 30.59 ± 1.04 pg and 27.922 ± 2.74 pg, Mean Cell Haemoglobin Concentration, 33.34 ± 0.61 g/dl and 32.32 ± 0.93 g/dl, Red Blood Cell, 4.33 ± 0.39 × 10<sup>9</sup>/l and 4.50 ± 0.52 × 10<sup>9</sup>/l, Packed Cell Volume, 39% ± 3.15% and 40% ± 4.41% and Haemoglobin, 13.21 ± 1.10 g/dl and 13.50 ± 1.63 g/dl respectively. Mean Cell Volume, Mean Cell Haemoglobin, Mean Cell Haemoglobin Concentration (Red cells indices) were significantly higher in hypertensive compared to normotensive subjects (P 0.05), total White Blood Cell count was also higher in hypertensive than normotensive but not statistically significant (P > 0.05). However, Platelet counts, Red Blood Cell, Packed Cell Volume and Haemoglobin were significantly lower in hypertensive compared to normotensive (P 0.05). All the parameters were within established reference ranges for the age and sex of the subjects. Our findings show that hypertension may lead to haematological derangement, if not properly managed. Conclusively, haematological parameters can be used to monitor the prognosis of the disease and manage hypertensive related complications. It is important to assess haematological parameters for hypertensive individuals which may help to prevent complications associated with haematological disorders.
基金Project (2005CB623701) supported by the National Basic Research Program of China Project (201011031) supported by National Department Public Benefit Research Foundation from Ministry of Land and Resources of China+1 种基金 Project (2935) supported by the Foundation for the Author of Zhengzhou Institute of Multipurpose Utilization of Mineral Resources CAGS, China Project (1212011120304) supported by the Geological Surrey Program
文摘The collecting power of tertiary amines(DRN,DEN and DPN) on kaolinite follows the order of DENDPNDRN.After reacting with DRN,DEN and DPN,the surface potentials of kaolinite increase remarkably,and the recruitments caused by collectors also follow the order of DENDPNDRN.The results of dynamics simulation show that the geometries of substituent groups bonding to N are deflected and twisted,and some of bond angles are changed when tertiary amines cations adsorb on kaolinite(001) surface.Based on the results of dynamics simulations and quantum chemistry calculations,the electrostatic forces between three tertiary amines cations and 4×4×3(001) plane of kaolinite are 1.38×10?7 N(DRN12H+),1.44×10-6 N(DEN12H+),1.383×10-6 N(DPN12H+),respectively.
文摘Eleven tertiarv alkaloids were isolated from Corvdalis decumbens rhizome Their structures were identified as protopine(Ⅶ),allocryptopine(Ⅷ),cryptopine (Ⅸ),muramine(ⅩⅦ);(+)-tetrahydropalmatine(Ⅲ),(+)-kikemanine (Ⅳ),(一)-scoulerine (ⅩⅧ),(十)-bulbo- capnine (ⅩⅨ),and(一)一capnoidine(Ⅰ),(一)一bicuculline(Ⅴ),(+) coriumidine(ⅩⅣ), respecti vely。 Among these,cryptopine,muramine,(+)-kikemanine,(-)-scoulerine,(一)capnoidine,(一)一bicuculline were isolated for the first time from this plant
文摘The special issue deals with the Cretaceous-Tertiary deserts in southwestern China and relevant sedimentological problems about deserts. The study area is located between 101°10'- 107°00'E and 28°00'-30°40′ N. The ancient desert study is so little in China that there has not been a systematic report about it up to now. Based on the study in many ways on Cretaceous-Tertiary deserts in southwestern China, plentiful data have been obtained. Though it is still a bit rough, the study is a good beginning of the ancient desert study in China. The main ideas and conclusions are summarized as follows.
文摘Effective teaching has always been a goal pursued by teachers as a part of education both from the western and eastern society,for it to some extend is considered an effective way to improve society.In this essay,both Chinese and western conceptions of teaching and learning will be discussed.In doing so,their differences and similarities can be seen clearly,which will help the cross-cultural educators to understand their teaching environment and learning styles.
文摘The stretching process of some Tertiary rift basins in eastern China is characterized by multiphase rifting. A multiple instantaneous uniform stretching model is proposed in this paper to simulate the formation of the basins as the rifting process cannot be accurately described by a simple (one episode) stretching model. The study shows that the multiphase stretching model, combined with the back-stripping technique, can be used to reconstruct the subsidence history and the stretching process of the lithosphere, and to evaluate the depth to the top of the asthenosphere and the deep thermal evolution of the basins. The calculated results obtained by applying the quantitative model to the episodic rifting process of the Tertiary Qiongdongnan and Yinggehai basins in the South China Sea are in agreement with geophysical data and geological observations. This provides a new method for quantitative evaluation of the geodynamic process of multiphase rifting occurring during the Tertiary in eastern China.
基金financially supported by Beijing Natural Science Foundation(No.2192034)China Postdoctoral Science Foundation(No.2018M631335)National Key R&D Program of China(No.2018YFB0905600).
文摘Potassium-ion batteries(KIBs)are a potential candidate to lithium-ion batteries(LIBs)but possess unsatisfactory capacity and rate properties.Herein,the metallic cobalt selenide quantum dots(Co0.85Se-QDs)encapsulated in mesoporous carbon matrix were designed via a direct hydrothermal method.Specifically,the cobalt selenide/carbon composite(Co0.85Se-QDs/C)possesses tertiary hierarchical structure,which is the primary quantum dots,the secondary petals flake,and the tertiary hollow micropolyhedron framework.Co0.85Se-QDs are homogenously embedded into the carbon petals flake,which constitute the hollow polyhedral framework.This unique structure can take the advantages of both nanoscale and microscale features:Co0.85Se-QDs can expand in a multidimensional and ductile carbon matrix and reduce the K-intercalation stress in particle dimensions;the micropetals can restrain the agglomeration of active materials and promote the transportation of potassium ion and electron.In addition,the hollow carbon framework buffers volume expansion,maintains the structural integrity,and increases the electronic conductivity.Benefiting from this tertiary hierarchical structure,outstanding K-storage performance(402 mAh g?1 after 100 cycles at 50 mA g?1)is obtained when Co0.85Se-QDs/C is used as KIBs anode.More importantly,the selenization process in this work is newly reported and can be generally extended to prepare other quantum dots encapsulated in edge-limited frameworks for excellent energy storage.
基金Supported by the National Science Foundation for Distinguished Young Scholar of China(20525620) the National Natural Science Foundation of China(20806013) the Program for Changjiang Scholar and Innovative Research Team in University(IRT 0711)
文摘Tertiary amine cationic polyacrylamide with high cationization degree was used as a new cationic agent to pretreat cotton with dip-pad-bake method. The obtained cationic cotton was dyed with reactive dyes in the ab-sence of electrolyte. The effects of the characteristics of the cationic agent and the pretreatment conditions on dye-ability of reactive dye were investigated. The results showed that the fixation and K/S values of the reactive dyes on the cationic cotton were improved compared with those on the untreated one in the presence of salt. Tests on fast-ness properties of the dyed cotton and fabric quality of the pretreated cotton were carried out and the results showed that wash and rub fastness of the salt-free dyeing were both satisfactory. And anti-crease property,tensile and tear strength,and handling of the cationic cotton were also good compared with that of the untreated one.
基金Supported by the Qingdao National Laboratory for Marine Science and Technology(Nos.QNLM201708,QNLM2016ORP0206)the Scientific and Technological Innovation Project Financially Supported by Qingdao National Laboratory for Marine Science and Technology(Nos.2017ASKJ02,2017ASKJ01,2016ASKJ13)+2 种基金the Special Fund for Land&Resources Scientific Research in the Public Interest(No.201511037)the Natural Science Foundation of Shandong Province of China(No.ZR2016DB33)the National Key Research and Development Program(No.2017YFC0306706-04)
文摘Analysis of 2 D seismic data over 4 500 km in length from the Madura Strait Basin in the East Java Sea reveals seismic re?ection characteristics of reefs and associated sedimentary bodies, including asymmetrical or symmetrical dome re?ections, slope progradational re?ections, chaotic re?ections and discontinuous strong re?ections inside the reef, which onlap the ?ank of the reef. It is concluded that the developmental paleo-environment of most reefs is mainly conducive to shallow marine carbonate platform facies and platform margin facies, based on well core data, variations in seismic facies and strata thickness.The formation and evolution of all reefs are primarily in?uenced by the tectonic framework of the Madura Strait Basin. Platform margin reefs are principally controlled by two types of structures: one is a series of E-W trending Paleogene normal faults, and the other is an E-W trending Neogene inversion structures. In addition, wave actions, tidal currents and other ocean currents play an accelerated role in sorting, rounding and redeposition for the accumulation and evolution of reefs. Tertiary reefs in the MSB can be divided into four types: 1) an open platform coral reef of Late Oligocene to Early Miocene, 2) a platform margin coral reef controlled by normal faults in Late Oligocene to Early Miocene, 3) a platform margin Globigerina moundreef controlled by a "hidden" inversion structure in Early Pliocene, and 4) a platform margin Globigerina mound-reef controlled by thrust faults in the early Pliocene. Patterns of the formation and evolution of reefs are also suggested.
文摘AIM: Prospective evaluation of repeat endoscopic retrograde cholangiopancreatography (ERCP) for failed Schutz grade 1 biliary cannulation in a high-volume center. METHODS: Prospective intention-to-treat analysis of patients referred for biliary cannulation following recent unsuccessful ERCP. RESULTS: Fifty-one patients (35 female; mean age: 62.5 years; age range: 40-87 years) with previous failed biliary cannulation were referred for repeat ERCP. The indication for ERCP was primarily choledocholithiasis (45%) or pancreatic malignancy (18%). Successful biliary can- nulation was 100%. The precut needle knife sphincterotomy (NKS) rate was 27.4%. Complications occurred in 3.9% (post-ERCP pancreatitis). An identif iable reason for initial unsuccessful biliary cannulation was present in 55% of cases. Compared to a cohort of 940 nave pa-pilla patients (female 61%; mean age: 59.9 years; age range: 18-94 years) who required sphincterotomy over the same time period, there was no statistical difference in the cannulation success rate (100% vs 98%) or postERCP pancreatitis (3.1% vs 3.9%). Precut NKS use was more frequent (27.4% vs 12.7%) (P = 0.017). CONCLUSION: Referral to a high-volume center following unsuccessful ERCP is associated with high technical success, with a favorable complication rate, compared to routine ERCP procedures.
文摘Objective:To illustrate the clinical features and investigate the indicators associated with a fatal outcome in adult patients with severe Plasmodium falciparum malaria admitted to the Hospital for Tropical Diseases,Bangkok,Thailand.Methods:We studied 202 adult malaria patients admitted to the Intensive Care Unit.A total of 43 clinical variables were identified by univariate and logistic regression analyses,to eliminate confounding factors.Results:Regarding the statistical methods,only 6 variables-jaundice,cerebral malaria,metabolic acidosis,body mass index,initial respiratory rate,and white blood cell count-were significant indicators of death, with adjusted odds ratios(95%CI) of 15.2(2.1-32.3).4.3(2.3-12.6),3.3(2.3-5.7),2.4(1.9-3.5),2.2 (1.5-2.6),and 1.7(1.2-3.1),respectively.Conclusions:Our study found that jaundice,cerebral malaria,metabolic acidosis,body mass index,initial respiratory rate and white blood cell count were indicators of fatal outcome in severe Plasmodium falciparum malaria.Further studies on the fatal indicators in severe malaria need to be compared with data from different geographical areas,to construct practical measures to address potentially fatal indicators in different settings.
文摘AIM: To assess the role of contrast enhanced ultrasonography in evaluation of hepatocellular carcinoma (HCC) at the first Indian tertiary liver center. METHODS: Retrospective analysis of contrast enhanced ultrasound (CEUS) examinations over 24 mo for diagnosis, surveillance, characterization and follow up of 50 patients in the context of HCC was performed. The source and indication of referrals, change in referral rate, accuracy and usefulness of CEUS in a tertiary liver center equipped with a 64 slice dual energy computer tomography (CT) and 3 tesla magnetic resonance imaging (MRI) were studied. Sonovue (BR1, Bracco, Italy, a second generation contrast agent) was used for contrast US studies. Contrast enhanced CT/MRI or both were performed in all patients. The findings were taken as a baseline reference and correlation was done with respect to contrast US. Contrast enhanced MRI was performed using hepatocyte specific gadobenate dimeglumine (Gd-BOPTA). Iomeron (400 mg; w/v) was used for dynamic CT examinations. RESULTS: About 20 (40%) of the examinations were referred from clinicians for characterization of a mass from previous imaging. About 15 (30%) were performed for surveillance in chronic liver disease; 5 (10%) examinations were performed for monitoring lesions after radiofrequency ablation (RFA); 3 (6%) were post trans-arterial chemoembolization (TACE) assessments and 3 (6%) were patients with h/o iodinated contrast allergy. About 2(4%) were performed on hemodynamically unstable patients in the intensive care with raised alpha fetoprotein and 2(4%) patients were claustrophobic. The number of patients referred from clinicians steadily increased from 12 in the first 12 mo of the study to 38 in the last 12 mo. CEUS was able to diagnose 88% of positive cases of HCC as per reference standards. In the surveillance group, specificity was 53.3% vs 100% by CT/MRI. Post RFA and TACE specificity of lesion characterization by CEUS was 100% in single/large mass assessment, similar to CT/MRI. For non HCC lesions such as regenerative and dysplastic nodules, the specificity was 50% vs 90% by CT/MRI. The positive role of CEUS in imaging spectrum of HCC included a provisional urgent diagnosis of an incidentally detected mass. It further led to a decrease in time for further management. A confident diagnosis on CEUS was possible in cases of characterization of an indeterminate mass, in situations where the patient was unfit for CT/MRI, was allergic to iodinated contrast or had claustrophobia, etc.CEUS was also cost effective, radiation free and an easy modality for monitoring post RFA or TACE lesions. CONCLUSION: CEUS is a valuable augmentation to the practice of ultrasonography, and an irreplaceable modality for confounding cases and interpretation of indeterminate lesions in imaging of HCC.
基金This study was supported by grants from the National Key R&D Program of China(Grant No.2018YFC1313400)the National Natural Science Foundation of China(Grant No.U20A20375).
文摘Tertiary lymphoid structures(TLSs)are ectopic immune cell aggregations that develop in peripheral tissues in response to a wide range of chronic inflammatory conditions,including infection,autoimmune disease,and cancer.In the tumor microenvironment(TME),the structures of TLSs,including B-cell-and T-cell-enriched areas indicate that the TLSs might be the local site during the initiation and maintenance of humoral and cellular immune responses against cancers.Numerous studies have evaluated the expression of TLSs in different cancer patients and their association with prognoses of cancer patients.It was shown that welldeveloped TLSs characterized by mature B cells synthesized tumor specific antibodies,which were considered as specific markers for a good prognosis.However,there are still some immunosuppressive factors existing in the TLSs that may affect anti-tumor responses.These factors include dysfunctional B cells,regulatory T cells,and T follicular regulatory cells.The complexity and heterogeneity of the TLS composition may affect the function and activity of TLSs;it is therefore essential to fully understand the function and influencing factors in TLSs.It has been reported that checkpoint inhibitors and vaccines are currently being developed to reprogram the TME by establishing mature TLSs to improve cancer immunotherapies.In this review,we focused on recent advances in TLSs in human solid tumors,including structural characteristics and classes,antitumor mechanisms,immunosuppressive factors,and TLSbased therapeutic approaches.
基金supported by grants from the National Natural Science Foundation of China(No.82172803 and No.82072679)the 2020 Zhongshan Hospital Clinical Research Special Fund(No.2020ZSLC15)。
文摘Objective:Recent studies have highlighted the distinct value of tertiary lymphoid structure(TLS)for immunotherapeutic response prediction.However,it remains unclear whether TLS could play such roles in gastric cancer(GC).Methods:In this study,tumor tissue slices from 292 GC patients from Zhongshan Hospital were firstly reviewed to explore the correlation between TLS and clinical characteristics.Subsequently,we curated 38 reported genes that may function as triggers of TLS and performed consensus molecular subtyping in public RNA-seq datasets to determine TLS patterns in GC.Based on the differentially expressed genes acquired from two TLS patterns,we quantified TLS-related genes on the principal component analysis(PCA)algorithm to develop TLS score.A Zhongshan immunotherapy cohort including 13 patients who received programmed cell death 1(PD1)blockade therapy was established to conduct RNA sequencing analysis and multiplex immunohistochemistry(mIHC)tests using formalin-fixed and paraffin-embedded(FFPE)tissues.The corresponding TLS score and immune cell counts were further compared based on therapeutic response variations.Results:Mature TLS was revealed as an independent prognostic factor in 292 GC patients.Patients with higher TLS score was characterized by prolonged survival time and superior response to immunotherapy.TLS score was correlated with immunotherapy-related characters,such as microsatellite instability(MSI)and tumor mutation burden(TMB).In addition,RNA-seq data analysis in the Zhongshan immunotherapy cohort indicated that a higher TLS score was correlated with a superior response to PD1 blockade therapy.mIHC tests also revealed that PD1+CD8+T cell counts were significantly increased in the high-TLS score group.Conclusions:This study highlighted that TLS was significantly associated with immune landscape diversity and complexity.Quantitatively evaluating TLS patterns of individual tumor will strengthen our understanding of TME characteristics and promote more effective immunotherapy strategies.
文摘The East China Sea shelf basin is a key area for setting up the sea level changes of Cenozoic in the West Pacific. Based upon the characteristics of seismic reflection, the analysis of sequence stratigraphy and depositional system, the high resolution chronostratigraphic framework has been set up by using the data of micropaleontologic biozone fossils. The relative sea level change curve has been set up by combining analysis of paleoecology, genetic facies, specific sedimentary structures and on lap recognized from the seismic profiles with study of geochemical characteristics. There are 4 2nd order basin cycles showing the long term sea level changes, and 22 3rd order cycles showing short term ones with relative changing ranges of 0-150 m. Transgression and regression showing long term sea level changes bear asymmetric feature, which indicates that the speed of transgression is faster than that of regression. There are a lot of differences when compared with Haq ’s curve. The sequence stratigraphic framework has also been set up and 3 tectonic sequences, 7 supersequences and 19 sequences have been subdivided for Tertiary in the East China Sea shelf basin. On the basis of detailed analysis of genetic facies and log facies, 9 sedimentary systems, 20 depositional assemblages and many genetic facies have also been recognized and investigated. Based on the studies mentioned above, the favorable source and reservoir facies of gas and petroleum are indicated.