腹腔镜和开腹手术治疗中国老年宫颈癌疗效的Meta分析

目的比较腹腔镜与开腹手术治疗中国老年宫颈癌的疗效。方法计算机检索中国生物医学文摘数据库(CBM)、万方全文数据库(wanfangdata)、中国知网全文数据库(CNKI)、维普中文期刊数据库(VIP)和Pub Med,根据入选标准筛选文献。从文献提取数据,采用Rev Man 5.2.9软件进行统计学分析。结果最终纳入符合标准的文献10篇,均为临床对照研究(CCT),无随机对照研究(RCT)。腹腔镜手术组与开腹手术组患者年龄、体重、肿瘤分期等基本特征无明显差异。与开腹手术相比,腹腔镜手术组手术时间长(MD=32.60,95%CI:5.65~59.55,P=0.020),术中失血量少(MD=-94.01,95%CI:-130.65^-57.37,P=0.000),清除淋巴结数量少(MD=1.69,95%CI:0.67~2.72,P=0.001),术后排气时间早(MD=-17.09,95%CI:-21.19^-12.98,P=0.000),住院时间短(MD=-4.30,95%CI:-5.57^-3.02,P=0.000),差异有统计学意义。而术后留置尿管时间(MD=-0.67,95%CI:-1.92~0.58,P=0.290)、手术并发症发生率(OR^=0.62,95%CI:0.27~1.42,P=0.260),差异无统计学意义。结论腹腔镜手术具有创伤小、恢复快等优势,并不增加手术并发症发生率,是治疗中国老年宫颈癌的理想术式。

Intravoxel incoherent motion diffusion-weighted imaging for monitoring chemotherapeutic efficacy in gastric cancer

AIM: To assess intravoxel incoherent motion diffusionweighted imaging(IVIM-DWI) for monitoring early efficacy of chemotherapy in a human gastric cancer mouse model.METHODS: IVIM-DWI was performed with 12 b-values(0-800 s/mm2) in 25 human gastric cancer-bearing nude mice at baseline(day 0), and then they were randomly divided into control and 1-, 3-, 5- and 7-d treatment groups(n = 5 per group). The control group underwent longitudinal MRI scans at days 1, 3, 5 and 7, and the treatment groups underwent subsequent MRI scans after a specified 5-fluorouracil/calciumfolinate treatment. Together with tumor volumes(TV), the apparent diffusion coefficient(ADC) and IVIM parameters [true water molecular diffusion coefficient(D), perfusion fraction(f) and pseudo-related diffusion coefficient(D*)] were measured. The differences in those parameters from baseline to each measurement(ΔTV%, ΔADC%, ΔD%, Δf% and ΔD*%) were calculated. After image acquisition, tumor necrosis, microvessel density(MVD) and cellular apoptosis were evaluated by hematoxylin-eosin(HE), CD31 and terminal-deoxynucleotidyl transferase mediated nick end labeling(TUNEL) staining respectively, to confirm the imaging findings. Mann-Whitney test and Spearman's correlation coefficient analysis were performed.RESULTS: The observed relative volume increase(ΔTV%) in the treatment group were significantly smaller than those in the control group at day 5(ΔTV_(treatment)% = 19.63% ± 3.01% and ΔTVcontrol% = 83.60% ± 14.87%, P = 0.008) and day 7(ΔTV_(treatment)% = 29.07% ± 10.01% and ΔTV_(control)% = 177.06% ± 63.00%, P = 0.008). The difference in ΔTV% between the treatment and the control groups was not significant at days 1 and 3 after a short duration of treatment. Increases in ADC in the treatment group(ΔADC%_(treatment), median, 30.10% ± 18.32%, 36.11% ± 21.82%, 45.22% ± 24.36%) were significantly higher compared with the control group(ΔADC%_(control), median, 4.98% ± 3.39%, 6.26% ± 3.08%, 9.24% ± 6.33%) at days 3, 5 and 7(P = 0.008, P = 0.016, P = 0.008, respectively). Increases in D in the treatment group(ΔD%_(treatment), median 17.12% ± 8.20%, 24.16% ± 16.87%, 38.54% ± 19.36%) were higher than those in the control group(ΔD%_(control), median-0.13% ± 4.23%, 5.89% ± 4.56%, 5.54% ± 4.44%) at days 1, 3, and 5(P = 0.032, P = 0.008, P = 0.016, respectively). Relative changes in f were significantly lower in the treatment group compared with the control group at days 1, 3, 5 and 7 follow-up(median,-34.13% ± 16.61% vs 1.68% ± 3.40%, P = 0.016;-50.64% ± 6.82% vs 3.01% ± 6.50%, P = 0.008;-49.93% ± 6.05% vs 0.97% ± 4.38%, P = 0.008, and-46.22% ± 7.75% vs 8.14% ± 6.75%, P = 0.008, respectively). D* in the treatment group decreased significantly compared to those in the control group at all time points(median,-32.10% ± 12.22% vs 1.85% ± 5.54%, P = 0.008;-44.14% ± 14.83% vs 2.29% ± 10.38%, P = 0.008;-59.06% ± 19.10% vs 3.86% ± 5.10%, P = 0.008 and-47.20% ± 20.48% vs 7.13% ± 9.88%, P = 0.016, respectively). Furthermore, histopathologic findings showed positive correlations with ADC and D and tumor necrosis(r_s = 0.720, P < 0.001; r_s = 0.522, P = 0.007, respectively). The cellular apoptosis of the tumor also showed positive correlations with ADC and D(r_s = 0.626, P = 0.001; r_s = 0.542, P = 0.005, respectively). Perfusionrelated parameters(f and D*) were positively correlated to MVD(r_s = 0.618, P = 0.001; r_s = 0.538, P = 0.006, respectively), and negatively correlated to cellular apoptosis of the tumor(r_s =-0.550, P = 0.004; r_s =-0.692, P < 0.001, respectively).CONCLUSION: IVIM-DWI is potentially useful for predicting the early efficacy of chemotherapy in a human gastric cancer mouse model.

Degradation of benzothiophene in diesel oil by LaZnAl layered double hydroxide: photocatalytic performance and mechanism

A new type of photocatalytic La^(3+)–Zn^(2+)–Al^(3+)–MoO_4^(2-) layered double hydroxide(LDH) material(molar ratio, La/Zn/Al = 1:7:2) was prepared by a complexing agent-assisted homogeneous precipitation technique. The structure of the prepared LDH material was systematically studied. Under UV irradiation, the desulfurization efficiency of the LDH material was 87% in 2 h. For La^(3+)–Zn^(2+)–Al^(3+)–MoO_4^(2-) LDH material, the introduction of MoO_4^(2-) increased the interlayer space for promoting the adsorption of benzothiophene(BT), and MoO_4^(2-) might provide active sites for the oxidation of BT, resulting in the high desulfurization efficiency.

H_∞ controller design for a 4-meter direct-drive azimuth axis

To pursue a higher imaging resolution for exploring more details in the information conveyed by the Universe, the next generation of optical telescopes based on a direct drive widely employ the extremely large aperture structure, which also introduces more disturbances and uncertain factors to the control system. Facing this new challenge, the PID control method in main-axis control systems of traditional astronomical telescopes cannot suffice for the requirement of the tracking precision and disturbance sensitivity in angular velocity. To overcome this shortcoming, we establish a dynamic model and propose an H∞ controller for a 4-meter azimuth direct drive control system that consists of a revolving platform(azimuth axis), a three-phase torque motor, a motor drive, an encoder, a data acquisition card and a small computers. Simulations are carried out to analyze the model and guide the real experiments.Experimental results show that the proposed H∞ controller reduces the tracking error by a maximum of 80.69%(average 57.8%) and the disturbance sensitivity by a maximum of 82.3%(average 50.96%) compared with the traditional tuned PI controller;furthermore, the order of the model describing the proposed controller can be reduced to three, thus its feasibility in real systems is guaranteed.

Azimuth Control for Large Aperture Telescope Based on Segmented Arc Permanent Magnet Synchronous Motors

A tracking control algorithm based on active disturbance rejection controller(ADRC) is proposed to overcome the telescope's mount fluctuation. The fluctuations are caused by internal and external disturbance when the large aperture telescope runs at ultra-low speed with direct drive. According to the high-precision and high-stability requirements of a large aperture telescope, the ADRC position controller is designed based on segmented arc Permanent Magnet Synchronous Motors(arc PMSMs). The tracking differentiator of ADRC is designed to undergo a transition process to avoid overshoot in the position loop.The speed of target tracking process is observed by the extended state observer and the position information in the system is estimated in real time. The current control variable of the segmented arc PMSM is generated by implementing a non-linear state error feedback control law. The simulation results demonstrate that the proposed control strategy can not only accurately estimate the position and speed of the tracking target, but also estimate the disturbance to compensate the control variables. Experiments showed that the speed error is less than 0.05′′s^(-1) when using the ADRC, and it can realize high tracking performance when compared with PID controller, which improves the robustness of a large aperture telescope control system.

Prevalence of polymyxin-induced nephrotoxicity and its predictors in critically ill adult patients:A meta-analysis

BACKGROUND Polymyxin-induced nephrotoxicity is a major safety concern in clinical practice due to long-term adverse outcomes and high mortality.AIM To conducted a systematic review and meta-analysis of the prevalence and potential predictors of polymyxin-induced nephrotoxicity in adult intensive care unit(ICU)patients.METHODS PubMed,EMBASE,the Cochrane Library and Reference Citation Analysis database were searched for relevant studies from inception through May 30,2022.The pooled prevalence of polymyxin-induced nephrotoxicity and pooled risk ratios of associated factors were analysed using a random-effects or fixed-effects model by Stata SE ver.12.1.Additionally,subgroup analyses and meta-regression were conducted to assess heterogeneity.RESULTS A total of 89 studies involving 12234 critically ill adult patients were included in the meta-analysis.The overall pooled incidence of polymyxin-induced nephrotoxicity was 34.8%.The pooled prevalence of colistin-induced nephrotoxicity was not higher than that of polymyxin B(PMB)-induced nephrotoxicity.The subgroup analyses showed that nephrotoxicity was significantly associated with dosing interval,nephrotoxicity criteria,age,publication year,study quality and sample size,which were confirmed in the univariable meta-regression analysis.Nephrotoxicity was significantly increased when the total daily dose was divided into 2 doses but not 3 or 4 doses.Furthermore,older age,the presence of sepsis or septic shock,hypoalbuminemia,and concomitant vancomycin or vasopressor use were independent risk factors for polymyxin-induced nephrotoxicity,while an elevated baseline glomerular filtration rate was a protective factor against colistin-induced nephrotoxicity.CONCLUSION Our findings indicated that the incidence of polymyxin-induced nephrotoxicity among ICU patients was high.It emphasizes the importance of additional efforts to manage ICU patients receiving polymyxins to decrease the risk of adverse outcomes.

Synthesis of novel hydrated ferric oxide biochar nanohybrids for efficient arsenic removal from wastewater

Hydrated ferric oxide(HFO)has high adsorption efficiency for As(Ⅲ).However,its high self-aggregation usually reduces the efficiency and limits the scaledup application.Herein,biochar(BC),with large surface area and amounts of surface functional groups was used to tune the loading and distribution of HFO to prepare an efficient adsorbent(HFO/BC)via in-situ synthesis method.The influence of the mass ratio of iron salt to BC on HFO/BC morphology was investigated,and the mechanism was discussed.The results showed that novel HFO was formed and distributed uniformly on the surface of BC when the mass ratio of iron salt to BC was 5:1.The adsorption kinetics and isotherms studies show that the novel HFO/BC(5:1)composite can fast treat As(Ⅲ)with a high adsorption capacity of 104.55 mg·g^(-1),indicating that it is a potential material for removing arsenic from polluted water.