BACKGROUND Renal cell carcinomas are usually unilateral.However,they are bilateral in 2%to 4%of sporadic cases and is considerably more common in familial cases.Synchronous sporadic bilateral multiple chromophobe rena...BACKGROUND Renal cell carcinomas are usually unilateral.However,they are bilateral in 2%to 4%of sporadic cases and is considerably more common in familial cases.Synchronous sporadic bilateral multiple chromophobe renal cell carcinoma(CHRCC)with different subtypes is rare.CASE SUMMARY In this case report,we describe a case of synchronous bilateral CHRCC with two histological variants,accompanied by a clear cell carcinoma and a cyst in a 50-year-old male.The patient underwent retroperitoneal laparoscopic bilateral nephron-sparing surgery and there was no serious postoperative renal dysfunction.CONCLUSION We report a rare case of synchronous bilateral CHRCC with two histological variants associated with a clear cell carcinoma and a cyst.展开更多
BACKGROUND Catheter ablation for atrial fibrillation(AF)is commonly performed worldwide.However,the clinical charac-teristics of hospitalized patients with AF and national trends in catheter ablation at tertiary hospi...BACKGROUND Catheter ablation for atrial fibrillation(AF)is commonly performed worldwide.However,the clinical charac-teristics of hospitalized patients with AF and national trends in catheter ablation at tertiary hospitals in China remain unreported.METHODS This study used the Chinese national database(Hospital Quality Monitoring System)from 2013 to 2016,which is a mandatory database that collects the front page of patients’medical records for hospital accreditation,to describe the clinical cha-racteristics of patients with AF as an overall cohort and as subgroups divided by catheter ablation and sex.RESULTS Of 597,919 AF patients first admitted,57,983 patients underwent catheter ablation[56,384 cases(97.2%)of radiofre-quency ablation and 1599 cases(2.8%)of cryoablation]at 746 tertiary hospitals.Nearly 10%of patients hospitalized with AF at ter-tiary hospitals in China underwent catheter ablation,and the percentage of patients undergoing catheter ablation was on the rise bet-ween 2013 and 2016,and the number of cases increased by 2.5 times.Compared with AF patients who did not undergo catheter ablation,those who did were younger,more frequently male,and had fewer baseline comorbidities.Although the overall CHA_(2)DS_(2)-VASc score revealed over half of the patients were high-risk,patients who underwent catheter ablation were mostly low-risk(71.2%of males and 59.1%of females).Considering in-hospital adverse events,the overall pericardial tamponade and all-cause death incidences were 0.2%(0.6%in the ablation group)and 1.2%(0.1%in the ablation group),respectively;both of which were higher in females than males.CONCLUSIONS In this study,AF patients who underwent catheter ablation were relatively young,had a low thrombosis risk,and had few comorbidities and adverse events.Females were older and experienced more complications than males.展开更多
BACKGROUND Arterial stiffness,as assessed by aortic ultrasound and pulse wave velocity,is associated with incident hypertension.However,there is still no consensus on whether the augmentation index(AI)affects new onse...BACKGROUND Arterial stiffness,as assessed by aortic ultrasound and pulse wave velocity,is associated with incident hypertension.However,there is still no consensus on whether the augmentation index(AI)affects new onset of hypertension.This study investigated the relationship of radial AI(r AI)and incident hypertension in a Chinese community-based population without hypertension at baseline.METHOD A total of 1,615 Chinese non-hypertensive participants from an atherosclerosis cohort in Beijing,China were included in our analysis.Baseline r AI normalized to heart rate of 75 beats/min(r AIp75)was obtained using HEM-9000 AI.New-onset hypertension was defined as blood pressure≥140/90 mm Hg or self-reported hypertension or taking anti-hypertensive medications at the follow up survey.Multivariate regression models were used to evaluate the impact of r AIp75 on the risk of new-onset hypertension.RESULTS After a mean 2.35-year follow-up,213(13.19%)participants developed incident hypertension.No significant relation between r AIp75 and incident hypertension was observed in the whole population after adjustment for possible confounders(adjusted odds ratio(OR)and 95%confidence interval(CI):1.09[0.95-1.27];P=0.2260).However,r AIp75 was significantly associated with incident hypertension in women,but not in men(adjusted OR and 95%CI:1.29[1.06-1.56],P=0.0113 for women;0.91[0.72-1.15],P=0.4244 for men;P for interaction=0.0133).CONCLUSIONS Sex modified the effect of the r AI on incident hypertension in a Chinese,community-based,non-hypertensive population.Screening of the r AI could be considered in women with a high risk of hypertension for the purpose of primary intervention.展开更多
Microplastic fibers(MPFs)featuring mean sizes of 11-5,000μm and lengths of less than 500μm have been regarded as ubiquitous and hazardous contaminants in the ecosystem[1,2].Nowadays,nearly 35% of MPFs come from text...Microplastic fibers(MPFs)featuring mean sizes of 11-5,000μm and lengths of less than 500μm have been regarded as ubiquitous and hazardous contaminants in the ecosystem[1,2].Nowadays,nearly 35% of MPFs come from textile washing[3],threatening freshwater,marine fauna,human life,and even ecological balance on multiple scales.The controllable release of MPFs during garment washing has become increasingly urgent[4].展开更多
Background:The effect of short-segment decompression/fusion versus long-segment decompression/fusion and osteotomy for Lenke-Silva type Ⅵ adult degenerative scoliosis(ADS)has not been clarified.This study aimed to co...Background:The effect of short-segment decompression/fusion versus long-segment decompression/fusion and osteotomy for Lenke-Silva type Ⅵ adult degenerative scoliosis(ADS)has not been clarified.This study aimed to compare the clinical and radiographic results of short-segment fusion vs.long-segment fusion and osteotomy for patients with Lenke-Silva type Ⅵ ADS.Methods:Data of 28 patients who underwent spinal surgery for ADS from January 2012 to January 2014 in the General Hospital of Northern Theater Command were reviewed.Of the 28 patients,12 received long-segment fusion and osteotomy and 16 received short-segment fusion.Radiographic imaging parameters and clinical outcomes,including the sagittal vertical axis(SVA),lumbar lordosis(LL)angle,pelvic tilt(PT),sacral slope(SS),the visual analog scale(VAS),Japanese Orthopedic Association(JOA),Oswestry disability index(ODI),and lumbar stiffness disability index(LSDI)scores,were recorded.The difference between groups was compared using the dependent t test or Chi-squared test.Results:The Cobb and LL angles and SVA improved in both groups;however,PT and SS angles did not improve following short fusion.There were significant differences in the post-operative SVA(26.8±5.4mm vs.47.5±7.6 mm,t=–8.066,P<0.001),PT(14.7±1.8°vs.29.1±3.4°,t=–13.277,P<0.001),and SS(39.8±7.2°vs.26.1±3.3°,t=6.175,P<0.001)between the long and short fusion groups.All patients had improved ODI,JOA,and VAS scores post-operatively(all P<0.001),with no significant difference between the groups(all P>0.05).The post-operative LSDI score was 3.5±0.5 in the long fusion group,which was significantly higher than that of the short fusion group(1.4±0.7;P<0.001).Conclusions:The clinical outcomes of patients with Lenke-Silva type Ⅵ ADS who underwent short-segment decompression/fusion were comparable to those of patients who underwent long-segment decompression/fusion and osteotomy despite poor correction of sagittal imbalance.Moreover,short-segment decompression/fusion showed a short operation time and reduced surgical trauma.展开更多
Background： Congenital heart disease （CHD） is the most common congenital malformations with high mortality and morbidity. The prevalence of CHD reported previously ranged from 4 per 1000 live births to 50 per 1000 ...Background： Congenital heart disease （CHD） is the most common congenital malformations with high mortality and morbidity. The prevalence of CHD reported previously ranged from 4 per 1000 live births to 50 per 1000 live births. In this cross-sectional study, we aimed to document the prevalence of CHD in Langfang district of Hebei Province, China by analyzing data collected by hospitals located in 11 the counties of the district, as supported by a public health campaign. Methods： A total of 67,718 consecutive 3-month-old infants were included from July 19,2012 to July 18, 2014. Structural abnormalities were diagnosed based on echocardiography findings, including two-dimensional and color Doppler echocardiography results. Results： Of the 67,718 infants, 1554 were found to have cardiac structural abnormalities. The total prevalence of CHD was 22.9 per 1000 live births, a value significantly higher than the previously reported prevalence of 8 cases per 1000 live births. The top five most common cardiac abnormalities were as follows： atrial septal defect （ASD, 605 cases, 8.93‰）; ventricular septal defect （550 cases, 8.12‰）; patent ductus arteriosus （228 cases, 3.37‰）; pulmonary stenosis （66 cases, 0.97‰）; and tetralogy of Fallot （32 cases, 0.47‰）. The CHD prevalence differed by gender in this study （x^2 = 23.498, P 〈 0.001）, and the majority of ASD cases were females. Regional differences in prevalence were also found （x^2 = 24.602, P 〈 0.001）; a higher prevalence was found in urban areas （32.2 cases per 1000 live births） than in rural areas （21. 1 cases per 1000 live births）. There was a significant difference in the prevalence of CHD in preterm versus full-term infants （x^2 - 133.443, P 〈 0.001 ）. Prevalence of CHD in infants of maternal aged 35 years or over was significantly higher （x^2 86.917, P 〈 0.001）. Conclusions： The prevalence of CHD in Langfang district was within the range reported using echocardiography. Echocardiography can be used to early diagnose the CHD.展开更多
Ulinastatin(UTI),a broad-spectrum elastase inhibitor,can stabilize lysosomal membranes and inhibit the activation and release of various inflammatory cytokines caused by cardiopulmonary bypass(CPB).[1,2]UTI has recent...Ulinastatin(UTI),a broad-spectrum elastase inhibitor,can stabilize lysosomal membranes and inhibit the activation and release of various inflammatory cytokines caused by cardiopulmonary bypass(CPB).[1,2]UTI has recently been considered to be an effective anti-inflammatory agent and has been widely used in clinical settings,[3-5]but the optimal dose has not been defined.Therefore,we conducted a prospective,randomized,controlled trial involving 60 patients undergoing cardiac surgeries with CPB and investigated the serum levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and interleukin-8(IL-8),at different time points in order to evaluate the antiinflammatory efficacy of high-dose UTI and explore the optimum dose.展开更多
Lithium-ion batteries(LIBs)have been used to power various electric devices and store energy,but their toxic components by using inorganic materials generally cause serious environmental issues when disused.Recently,e...Lithium-ion batteries(LIBs)have been used to power various electric devices and store energy,but their toxic components by using inorganic materials generally cause serious environmental issues when disused.Recently,environmentally friendly and naturally abundant organic compounds have been adopted as promising electrode materials for next-generation LIBs.Herein,a new organic anode electrode based on sodium citrate is proposed,which shows gradually activated electrochemical behavior and delivers a high reversible capacity of 776.8 mAh·g^(-1)after 1770 cycles at a current density of 2 A·g^(-1).With the aid of the electrochemical characterization,Fourier-transform infrared(FTIR)and X-ray photoelectron spectroscopy(XPS)analysis,the lithium uptake mechanism of sodium citrate-based anodes is identified to be a combination of three-electron lithiation/delithiation and fast Li+intercalation/deintercalation processes,in which Faradaic reactions could offer a theoretical contribution of312 mAh·g^(-1)and intercalation pseudocapacitance would provide extra capacity.This work demonstrates the great potential for developing high-capacity organic electrodes for LIBs in future.展开更多
Few-shot intent detection is a practical challenge task,because new intents are frequently emerging and collecting large-scale data for them could be costly.Meta-learning,a promising technique for leveraging data from...Few-shot intent detection is a practical challenge task,because new intents are frequently emerging and collecting large-scale data for them could be costly.Meta-learning,a promising technique for leveraging data from previous tasks to enable efficient learning of new tasks,has been a popular way to tackle this problem.However,the existing meta-learning models have been evidenced to be overfitting when the meta-training tasks are insufficient.To overcome this challenge,we present a novel self-supervised task augmentation with meta-learning framework,namely STAM.Firstly,we introduce the task augmentation,which explores two different strategies and combines them to extend meta-training tasks.Secondly,we devise two auxiliary losses for integrating self-supervised learning into meta-learning to learn more generalizable and transferable features.Experimental results show that STAM can achieve consistent and considerable performance improvement to existing state-of-the-art methods on four datasets.展开更多
文摘BACKGROUND Renal cell carcinomas are usually unilateral.However,they are bilateral in 2%to 4%of sporadic cases and is considerably more common in familial cases.Synchronous sporadic bilateral multiple chromophobe renal cell carcinoma(CHRCC)with different subtypes is rare.CASE SUMMARY In this case report,we describe a case of synchronous bilateral CHRCC with two histological variants,accompanied by a clear cell carcinoma and a cyst in a 50-year-old male.The patient underwent retroperitoneal laparoscopic bilateral nephron-sparing surgery and there was no serious postoperative renal dysfunction.CONCLUSION We report a rare case of synchronous bilateral CHRCC with two histological variants associated with a clear cell carcinoma and a cyst.
基金supported by the China-WHO Biennial Collaborative Projects 2016–2017(No.2016/648722–0).
文摘BACKGROUND Catheter ablation for atrial fibrillation(AF)is commonly performed worldwide.However,the clinical charac-teristics of hospitalized patients with AF and national trends in catheter ablation at tertiary hospitals in China remain unreported.METHODS This study used the Chinese national database(Hospital Quality Monitoring System)from 2013 to 2016,which is a mandatory database that collects the front page of patients’medical records for hospital accreditation,to describe the clinical cha-racteristics of patients with AF as an overall cohort and as subgroups divided by catheter ablation and sex.RESULTS Of 597,919 AF patients first admitted,57,983 patients underwent catheter ablation[56,384 cases(97.2%)of radiofre-quency ablation and 1599 cases(2.8%)of cryoablation]at 746 tertiary hospitals.Nearly 10%of patients hospitalized with AF at ter-tiary hospitals in China underwent catheter ablation,and the percentage of patients undergoing catheter ablation was on the rise bet-ween 2013 and 2016,and the number of cases increased by 2.5 times.Compared with AF patients who did not undergo catheter ablation,those who did were younger,more frequently male,and had fewer baseline comorbidities.Although the overall CHA_(2)DS_(2)-VASc score revealed over half of the patients were high-risk,patients who underwent catheter ablation were mostly low-risk(71.2%of males and 59.1%of females).Considering in-hospital adverse events,the overall pericardial tamponade and all-cause death incidences were 0.2%(0.6%in the ablation group)and 1.2%(0.1%in the ablation group),respectively;both of which were higher in females than males.CONCLUSIONS In this study,AF patients who underwent catheter ablation were relatively young,had a low thrombosis risk,and had few comorbidities and adverse events.Females were older and experienced more complications than males.
基金supported by the University of Michigan-Peking University Health Science Centre(UMHS-PUHSC)Joint Institute for Translational and Clinical Research and the Fundamental Research Funds for the Central Universities(grant numbers:BMU20110177 and BMU20160530)the National Key Research and Development Program of China(grant number:2017YFC1307704)+2 种基金the Scientific Research Seed Fund of Peking University First Hospital(grant numbers:2018SF003 and 2018SF071)Projects of the National Natural Science Foundation of China(grant number:81703288)the Key Laboratory of Molecular Cardiovascular Sciences(Peking University),Ministry of Education and NHC Key Laboratory of Cardiovascular Molecular Biology and Regulatory Peptides。
文摘BACKGROUND Arterial stiffness,as assessed by aortic ultrasound and pulse wave velocity,is associated with incident hypertension.However,there is still no consensus on whether the augmentation index(AI)affects new onset of hypertension.This study investigated the relationship of radial AI(r AI)and incident hypertension in a Chinese community-based population without hypertension at baseline.METHOD A total of 1,615 Chinese non-hypertensive participants from an atherosclerosis cohort in Beijing,China were included in our analysis.Baseline r AI normalized to heart rate of 75 beats/min(r AIp75)was obtained using HEM-9000 AI.New-onset hypertension was defined as blood pressure≥140/90 mm Hg or self-reported hypertension or taking anti-hypertensive medications at the follow up survey.Multivariate regression models were used to evaluate the impact of r AIp75 on the risk of new-onset hypertension.RESULTS After a mean 2.35-year follow-up,213(13.19%)participants developed incident hypertension.No significant relation between r AIp75 and incident hypertension was observed in the whole population after adjustment for possible confounders(adjusted odds ratio(OR)and 95%confidence interval(CI):1.09[0.95-1.27];P=0.2260).However,r AIp75 was significantly associated with incident hypertension in women,but not in men(adjusted OR and 95%CI:1.29[1.06-1.56],P=0.0113 for women;0.91[0.72-1.15],P=0.4244 for men;P for interaction=0.0133).CONCLUSIONS Sex modified the effect of the r AI on incident hypertension in a Chinese,community-based,non-hypertensive population.Screening of the r AI could be considered in women with a high risk of hypertension for the purpose of primary intervention.
文摘Microplastic fibers(MPFs)featuring mean sizes of 11-5,000μm and lengths of less than 500μm have been regarded as ubiquitous and hazardous contaminants in the ecosystem[1,2].Nowadays,nearly 35% of MPFs come from textile washing[3],threatening freshwater,marine fauna,human life,and even ecological balance on multiple scales.The controllable release of MPFs during garment washing has become increasingly urgent[4].
文摘Background:The effect of short-segment decompression/fusion versus long-segment decompression/fusion and osteotomy for Lenke-Silva type Ⅵ adult degenerative scoliosis(ADS)has not been clarified.This study aimed to compare the clinical and radiographic results of short-segment fusion vs.long-segment fusion and osteotomy for patients with Lenke-Silva type Ⅵ ADS.Methods:Data of 28 patients who underwent spinal surgery for ADS from January 2012 to January 2014 in the General Hospital of Northern Theater Command were reviewed.Of the 28 patients,12 received long-segment fusion and osteotomy and 16 received short-segment fusion.Radiographic imaging parameters and clinical outcomes,including the sagittal vertical axis(SVA),lumbar lordosis(LL)angle,pelvic tilt(PT),sacral slope(SS),the visual analog scale(VAS),Japanese Orthopedic Association(JOA),Oswestry disability index(ODI),and lumbar stiffness disability index(LSDI)scores,were recorded.The difference between groups was compared using the dependent t test or Chi-squared test.Results:The Cobb and LL angles and SVA improved in both groups;however,PT and SS angles did not improve following short fusion.There were significant differences in the post-operative SVA(26.8±5.4mm vs.47.5±7.6 mm,t=–8.066,P<0.001),PT(14.7±1.8°vs.29.1±3.4°,t=–13.277,P<0.001),and SS(39.8±7.2°vs.26.1±3.3°,t=6.175,P<0.001)between the long and short fusion groups.All patients had improved ODI,JOA,and VAS scores post-operatively(all P<0.001),with no significant difference between the groups(all P>0.05).The post-operative LSDI score was 3.5±0.5 in the long fusion group,which was significantly higher than that of the short fusion group(1.4±0.7;P<0.001).Conclusions:The clinical outcomes of patients with Lenke-Silva type Ⅵ ADS who underwent short-segment decompression/fusion were comparable to those of patients who underwent long-segment decompression/fusion and osteotomy despite poor correction of sagittal imbalance.Moreover,short-segment decompression/fusion showed a short operation time and reduced surgical trauma.
文摘Background： Congenital heart disease （CHD） is the most common congenital malformations with high mortality and morbidity. The prevalence of CHD reported previously ranged from 4 per 1000 live births to 50 per 1000 live births. In this cross-sectional study, we aimed to document the prevalence of CHD in Langfang district of Hebei Province, China by analyzing data collected by hospitals located in 11 the counties of the district, as supported by a public health campaign. Methods： A total of 67,718 consecutive 3-month-old infants were included from July 19,2012 to July 18, 2014. Structural abnormalities were diagnosed based on echocardiography findings, including two-dimensional and color Doppler echocardiography results. Results： Of the 67,718 infants, 1554 were found to have cardiac structural abnormalities. The total prevalence of CHD was 22.9 per 1000 live births, a value significantly higher than the previously reported prevalence of 8 cases per 1000 live births. The top five most common cardiac abnormalities were as follows： atrial septal defect （ASD, 605 cases, 8.93‰）; ventricular septal defect （550 cases, 8.12‰）; patent ductus arteriosus （228 cases, 3.37‰）; pulmonary stenosis （66 cases, 0.97‰）; and tetralogy of Fallot （32 cases, 0.47‰）. The CHD prevalence differed by gender in this study （x^2 = 23.498, P 〈 0.001）, and the majority of ASD cases were females. Regional differences in prevalence were also found （x^2 = 24.602, P 〈 0.001）; a higher prevalence was found in urban areas （32.2 cases per 1000 live births） than in rural areas （21. 1 cases per 1000 live births）. There was a significant difference in the prevalence of CHD in preterm versus full-term infants （x^2 - 133.443, P 〈 0.001 ）. Prevalence of CHD in infants of maternal aged 35 years or over was significantly higher （x^2 86.917, P 〈 0.001）. Conclusions： The prevalence of CHD in Langfang district was within the range reported using echocardiography. Echocardiography can be used to early diagnose the CHD.
基金This study was supported by the grant from Science and Technology Development Plan of Yantai City(No.2015WS033).
文摘Ulinastatin(UTI),a broad-spectrum elastase inhibitor,can stabilize lysosomal membranes and inhibit the activation and release of various inflammatory cytokines caused by cardiopulmonary bypass(CPB).[1,2]UTI has recently been considered to be an effective anti-inflammatory agent and has been widely used in clinical settings,[3-5]but the optimal dose has not been defined.Therefore,we conducted a prospective,randomized,controlled trial involving 60 patients undergoing cardiac surgeries with CPB and investigated the serum levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),and interleukin-8(IL-8),at different time points in order to evaluate the antiinflammatory efficacy of high-dose UTI and explore the optimum dose.
基金financially supported by the National Natural Science Foundation of China(Nos.21875155,51675275 and 21473119)the Scientific and Technological Research Program of Chongqing Municipal Education Commission(No.KJQN201900527)the support from the Key Laboratory for Advanced Carbon Materials and Wearable Energy Technologies of Jiangsu Province,Suzhou,China。
文摘Lithium-ion batteries(LIBs)have been used to power various electric devices and store energy,but their toxic components by using inorganic materials generally cause serious environmental issues when disused.Recently,environmentally friendly and naturally abundant organic compounds have been adopted as promising electrode materials for next-generation LIBs.Herein,a new organic anode electrode based on sodium citrate is proposed,which shows gradually activated electrochemical behavior and delivers a high reversible capacity of 776.8 mAh·g^(-1)after 1770 cycles at a current density of 2 A·g^(-1).With the aid of the electrochemical characterization,Fourier-transform infrared(FTIR)and X-ray photoelectron spectroscopy(XPS)analysis,the lithium uptake mechanism of sodium citrate-based anodes is identified to be a combination of three-electron lithiation/delithiation and fast Li+intercalation/deintercalation processes,in which Faradaic reactions could offer a theoretical contribution of312 mAh·g^(-1)and intercalation pseudocapacitance would provide extra capacity.This work demonstrates the great potential for developing high-capacity organic electrodes for LIBs in future.
基金the National Natural Science Foundation of China under Grant Nos.61936012 and 61976114。
文摘Few-shot intent detection is a practical challenge task,because new intents are frequently emerging and collecting large-scale data for them could be costly.Meta-learning,a promising technique for leveraging data from previous tasks to enable efficient learning of new tasks,has been a popular way to tackle this problem.However,the existing meta-learning models have been evidenced to be overfitting when the meta-training tasks are insufficient.To overcome this challenge,we present a novel self-supervised task augmentation with meta-learning framework,namely STAM.Firstly,we introduce the task augmentation,which explores two different strategies and combines them to extend meta-training tasks.Secondly,we devise two auxiliary losses for integrating self-supervised learning into meta-learning to learn more generalizable and transferable features.Experimental results show that STAM can achieve consistent and considerable performance improvement to existing state-of-the-art methods on four datasets.
