In the last two decades the study of red blood cell elasticity using optical tweezers has known a rise appearing in the scientific research with regard to the various works carried out. Despite the various work done, ...In the last two decades the study of red blood cell elasticity using optical tweezers has known a rise appearing in the scientific research with regard to the various works carried out. Despite the various work done, no study has been done so far to study the influence of friction on the red blood cell indentation response using optical tweezers. In this study, we have developed a new approach to determine the coefficient of friction as well as the frictional forces of the red blood cell. This approach therefore allowed us to simultaneously carry out the indentation and traction test, which allowed us to extract the interfacial properties of the microbead red blood cell couple, among other things, the friction coefficient. This property would be extremely important to investigate the survival and mechanical features of cells, which will be of great physiological and pathological significance. But taking into account the hypothesis of friction as defined by the isotropic Coulomb law. The experiment performed for this purpose is the Brinell Hardness Test (DB).展开更多
Photodynamic therapy(PDT)has been increasingly used in the clinical treatment of neoplastic,inflammatory and infectious skin diseases.However,the generation of reactive oxygen species(ROS)may induce undesired side eff...Photodynamic therapy(PDT)has been increasingly used in the clinical treatment of neoplastic,inflammatory and infectious skin diseases.However,the generation of reactive oxygen species(ROS)may induce undesired side effects in normal tissue surrounding the treatment lesion,which is a big challenge for the clinical application of PDT.To date,(–)-Epigallocatechin gallate(EGCG)has been widely proposed as an antiangiogenic and antitumor agent for the protection of normal tissue from ROS-mediated oxidative damage.This study evaluates the regulation ability of EGCG for photodynamic damage of blood vessels during hematoporphyrin monomethyl ether(Hemoporfin)-mediated PDT.The quenching rate constants of EGCG for the triplet-state Hemoporfin and photosensitized 1O2 generation are determined to be 6.8×10^(8)M^(−1)S^(−1),respectively.The vasoconstriction of blood vessels in the protected region treated with EGCG hydrogel after PDT is lower than that of the control region treated with pure hydrogel,suggesting an efficiently reduced photodamage of Hemoporfin for blood vessels treated with EGCG.This study indicates that EGCG is an efficient quencher for triplet-state Hemoporfin and 1O2,and EGCG could be potentially used to reduce the undesired photodamage of normal tissue in clinical PDT.展开更多
The tumor microenvironment is a complex network of cells,extracellular matrix,and signaling molecules that plays a critical role in tumor progression and metastasis.Lymphatic and blood vessels are major routes for sol...The tumor microenvironment is a complex network of cells,extracellular matrix,and signaling molecules that plays a critical role in tumor progression and metastasis.Lymphatic and blood vessels are major routes for solid tumor metastasis and essential parts of tumor drainage conduits.However,recent studies have shown that lymphatic endothelial cells(LECs)and blood endothelial cells(BECs)also play multifaceted roles in the tumor microenvironment beyond their structural functions,particularly in hepatocellular carcinoma(HCC).This comprehensive review summarizes the diverse roles played by LECs and BECs in HCC,including their involvement in angiogenesis,immune modulation,lymphangiogenesis,and metastasis.By providing a detailed account of the complex interplay between LECs,BECs,and tumor cells,this review aims to shed light on future research directions regarding the immune regulatory function of LECs and potential therapeutic targets for HCC.展开更多
BACKGROUND In China,the prevalence of type 2 diabetes mellitus(T2DM)among diabetic patients is estimated to be between 90%-95%.Additionally,China is among the 22 countries burdened by a high number of tuberculosis cas...BACKGROUND In China,the prevalence of type 2 diabetes mellitus(T2DM)among diabetic patients is estimated to be between 90%-95%.Additionally,China is among the 22 countries burdened by a high number of tuberculosis cases,with approximately 4.5 million individuals affected by active tuberculosis.Notably,T2DM poses a significant risk factor for the development of tuberculosis,as evidenced by the increased incidence of T2DM coexisting with pulmonary tuberculosis(T2DMPTB),which has risen from 19.3%to 24.1%.It is evident that these two diseases are intricately interconnected and mutually reinforcing in nature.AIM To elucidate the clinical features of individuals diagnosed with both T2DM and tuberculosis(T2DM-PTB),as well as to investigate the potential risk factors associated with active tuberculosis in patients with T2DM.METHODS T2DM-PTB patients who visited our hospital between January 2020 and January 2023 were selected as the observation group,Simple DM patients presenting to our hospital in the same period were the control group,Controls and case groups were matched 1:2 according to the principle of the same sex,age difference(±3)years and disease duration difference(±5)years,patients were investigated for general demographic characteristics,diabetes-related characteristics,body immune status,lifestyle and behavioral habits,univariate and multivariate analysis of the data using conditional logistic regression,calculate the odds ratio(OR)values and 95%CI of OR values.RESULTS A total of 315 study subjects were included in this study,including 105 subjects in the observation group and 210 subjects in the control group.Comparison of the results of both anthropometric and biochemical measures showed that the constitution index,systolic blood pressure,diastolic blood pressure and lymphocyte count were significantly lower in the case group,while fasting blood glucose and high-density lipoprotein cholesterol levels were significantly higher than those in the control group.The results of univariate analysis showed that poor glucose control,hypoproteinemia,lymphopenia,TB contact history,high infection,smoking and alcohol consumption were positively associated with PTB in T2DM patients;married,history of hypertension,treatment of oral hypoglycemic drugs plus insulin,overweight,obesity and regular exercise were negatively associated with PTB in T2DM patients.Results of multivariate stepwise regression analysis found lymphopenia(OR=17.75,95%CI:3.40-92.74),smoking(OR=12.25,95%CI:2.53-59.37),history of TB contact(OR=6.56,95%CI:1.23-35.03)and poor glycemic control(OR=3.37,95%CI:1.11-10.25)was associated with an increased risk of developing PTB in patients with T2DM,While being overweight(OR=0.23,95%CI:0.08-0.72)and obesity(OR=0.11,95%CI:0.02-0.72)was associated with a reduced risk of developing PTB in patients with T2DM.CONCLUSION T2DM-PTB patients are prone to worse glycemic control,higher infection frequency,and a higher proportion of people smoking,drinking alcohol,and lack of exercise.Lymphopenia,smoking,history of TB exposure,poor glycemic control were independent risk factors for T2DM-PTB,and overweight and obesity were associated with reduced risk of concurrent PTB in patients with T2DM.展开更多
Background:High blood pressure(BP)is a major contributor to mortality and cardiovascular diseases.Despite the known benefits of exercise for reducing BP,it is crucial to identify the most effective physical activity(P...Background:High blood pressure(BP)is a major contributor to mortality and cardiovascular diseases.Despite the known benefits of exercise for reducing BP,it is crucial to identify the most effective physical activity(PA)intervention.This systematic review and network meta-analysis(NMA)aimed to evaluate the available evidence on the effectiveness of various PA interventions for reducing BP and to determine their hierarchy based on their impact on BP.Methods:A search of PubMed,SPORTDiscus,PsycINFO,Web of Science,CINAHL,Cochrane,and Eric databases was conducted up to December 2022 for this systematic review and NMA.Randomized controlled trials and quasi-experimental studies targeting healthy children and adolescents aged 6-12 years old were included in this study.Only studies that compared controlled and intervention groups using PA or exercise as the major influence were included.We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines.Three independent investigators performed the literature screening,data extraction,and risk of bias assessment.We used Bayesian arm-based NMA to synthesize the data.The primary outcomes were systolic BP and diastolic BP.We calculated the mean differences(MDs)in systolic BP and diastolic BP before and after treatment.Mean treatment differences were estimated using NMA and random-effect models.Results:We synthesized 27 studies involving 15,220 children and adolescents.PA combined with nutrition and behavior change was the most effective intervention for reducing both systolic BP and diastolic BP(MD=-8.64,95%credible interval(95%CI):-11.44 to-5.84;MD=-6.75,95%CI:-10.44 to-3.11),followed by interventions with multiple components(MD=-1.39,95%CI:-1.94 to-0.84;MD=-2.54,95%CI:-4.89 to-0.29).Conclusion:Our findings suggest that PA interventions incorporating nutrition and behavior change,followed by interventions with multiple components,are most effective for reducing both systolic BP and diastolic BP in children and adolescents.展开更多
Di(2-ethylhexyl)phthalate(DEHP)is a widely used plasticizer known for its reproductive developmental and immune system toxicity,mainly through esophagal,dermal,and respiratory exposure^([1-3]).Maternal exposure to DEH...Di(2-ethylhexyl)phthalate(DEHP)is a widely used plasticizer known for its reproductive developmental and immune system toxicity,mainly through esophagal,dermal,and respiratory exposure^([1-3]).Maternal exposure to DEHP during pregnancy can lead to adverse birth outcomes in offspring,including impacts on the thyroid system of adolescent offspring^([2-4]).展开更多
Quasi-2D Dion-Jacobson(DJ)tin halide perovskite has attracted much attention due to its elimination of Van der Waals gap and enhanced environmental stability.However,the bulky organic spacers usually form a natural qu...Quasi-2D Dion-Jacobson(DJ)tin halide perovskite has attracted much attention due to its elimination of Van der Waals gap and enhanced environmental stability.However,the bulky organic spacers usually form a natural quantum well structure,which brings a large quantum barrier and poor film quality,further limiting the carrier transport and device performance.Here,we designed three organic spacers with different chain lengths(ethylenediamine(EDA),1,3-propanediamine(PDA),and 1,4-butanediamine(BDA))to investigate the quantum barrier dependence.Theoretical and experimental characterizations indicate that EDA with short chain can reduce the lattice distortion and dielectric confinement effect,which is beneficial to the effective dissociation of excitons and the inhibition of trap-free non-radiative relaxation.In addition,EDA cation shows strong interaction with the inorganic octahedron,realizing large aggregates in precursor solution and high-quality films with improved structural stability.Furthermore,femtosecond transient absorption proves that EDA cations can also weaken the formation of small n-phases with large quantum barrier to achieve effective carrier transport between different nphases.Finally,the quasi-2D DJ(EDA)FA_(9)Sn_(10)I_(31)solar cells achieves a 7.07%power conversion efficiency with good environment stability.Therefore,this work sheds light on the regulation of the quantum barrier and carrier transport through the chain length of organic spacer for qua si-2D DJ lead-free perovskites.展开更多
Context/Objective: High blood pressure (HBP) currently represents the most widespread chronic non-communicable disease in Cameroon. The increase in its prevalence in the country is the result of multiple factors inclu...Context/Objective: High blood pressure (HBP) currently represents the most widespread chronic non-communicable disease in Cameroon. The increase in its prevalence in the country is the result of multiple factors including economic stress imposed by precariousness, poor living conditions, sources of anxiety, anguish, depression and other behavioral disorders. Economic stress is a globalizing concept that integrates into a purely hermeneutic approach, a particular functioning of the nervous system of an individual who faces employment problems and precarious remuneration conditions. The non-satisfaction by an individual of his basic needs due to insufficient financial means can cause him to become irritable, aggressive, and socially and symbolically isolated, thereby increasing the desire to resort to morbid life models such as excessive consumption of narcotics and other psychoactive substances often associated with high blood pressure. The fight against the emergence of BPH is a complex, multifaceted and multifactorial reality that requires taking into account economic stress. The main objective of this survey is to describe the situation of economic stress within the Cameroonian population, which imposes precariousness and life models at risk of high blood pressure. Specifically, we determined the level of household income and the sources of income. Methods: A cross-sectional survey with a descriptive aim among five hundred households in the Central Region of Cameroon was conducted. A probabilistic technique called simple randomness was used. The number of households to be surveyed was determined indirectly using the Cochrane formula. Data collection in face-to-face mode using a physical questionnaire took place from July 1 to August 31, 2023, after obtaining ethical clearance from the Regional Health Research Ethics Committee, Human from the Center and an administrative authorization for data collection. Regarding their processing, the data was grouped during processing in Excel sheets. Normality and reliability tests of the collected data were carried out. For this, the Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value. Descriptive analysis was possible using R software version 3.2, SPSS version 25.0, XLSTAT 2016, PAST and EXCEL programs from Microsoft Office 2013. Results: The main results highlight economic stress, with 45.60% of households surveyed earning less than US$154 per month;55% of household heads were women in single-parent families;14% of household heads were unemployed, 22% worked in the private sector and 19% were self-employed. This general economic situation leads to precarious living conditions, thereby increasing the risk of high blood pressure among the Cameroonian population.展开更多
BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to deco...BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to decompensated advanced chronic liver disease(dACLD)can occur through two modalities referred to as acute decompensation(AD)and non-AD(NAD),respectively.Clinically Significant Portal Hypertension(CSPH)is considered the strongest predictor of decompensation in these patients.However,due to its invasiveness and costs,CSPH is almost never evaluated in clinical practice.Therefore,recognizing noninvasively predicting tools still have more appeal across healthcare systems.The red cell distribution width to platelet ratio(RPR)has been reported to be an indicator of hepatic fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD).However,its predictive role for the decompensation has never been explored.AIM In this observational study,we investigated the clinical usage of RPR in predicting DEs in MASLD-related cACLD patients.METHODS Fourty controls and 150 MASLD-cACLD patients were consecutively enrolled and followed up(FUP)semiannually for 3 years.At baseline,biochemical,clinical,and Liver Stiffness Measurement(LSM),Child-Pugh(CP),Model for End-Stage Liver Disease(MELD),aspartate aminotransferase/platelet count ratio index(APRI),Fibrosis-4(FIB-4),Albumin-Bilirubin(ALBI),ALBI-FIB-4,and RPR were collected.During FUP,DEs(timing and modaities)were recorded.CSPH was assessed at the baseline and on DE occurrence according to the available Clinical Practice Guidelines.RESULTS Of 150 MASLD-related cACLD patients,43(28.6%)progressed to dACLD at a median time of 28.9 months(29 NAD and 14 AD).Baseline RPR values were significantly higher in cACLD in comparison to controls,as well as MELD,CP,APRI,FIB-4,ALBI,ALBI-FIB-4,and LSM in dACLD-progressing compared to cACLD individuals[all P<0.0001,except for FIB-4(P:0.007)and ALBI(P:0.011)].Receiving operator curve analysis revealed RPR>0.472 and>0.894 as the best cut-offs in the prediction respectively of 3-year first DE,as well as its superiority compared to the other non-invasive tools examined.RPR(P:0.02)and the presence of baseline-CSPH(P:0.04)were significantly and independently associated with the DE.Patients presenting baseline-CSPH and RPR>0.472 showed higher risk of decompensation(P:0.0023).CONCLUSION Altogether these findings suggest the RPR as a valid and potentially applicable non-invasive tool in the prediction of timing and modalities of decompensation in MASLD-related cACLD patients.展开更多
We report the case of a 20-year-old female patient presenting with a totally occluded coarctation of the aorta. The patient was admitted for the evaluation of resistant grade III high blood pressure. The physical exam...We report the case of a 20-year-old female patient presenting with a totally occluded coarctation of the aorta. The patient was admitted for the evaluation of resistant grade III high blood pressure. The physical examination revealed a blood pressure gradient between the upper and lower limbs, absent femoral pulses, a diffuse continuous murmur over the chest, and hyperpulsatility of the carotid arteries and sternal notch. A transthoracic echocardiography outlined a narrowing in the caliber of the isthmic aorta without acceleration of flow or gradient. Thoracic CT angiography revealed a complete aortic coarctation with interruption of continuity between segment 3 and the descending aorta.展开更多
Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determin...Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determine the factors associated with blood pressure control. Methodology: This was a descriptive cross-sectional study with an analytical focus over 7 months. Patients were recruited as outpatients and all underwent ambulatory blood pressure measure, glycated hemoglobin and creatinine measurements, and assessment of compliance with treatment. Results: During this period 116 patients were collected. The predominance was female 69%. The mean age of the patients was 62 ± 7 years with a peak between 60 and 70 years. The average age of hypertension was 12 years and that of diabetes 6 1/2 years. The most frequently associated cardiovascular risk factor was a sedentary lifestyle (71.5%) after age. 57.8% of patients were not controlled at the office, with a predominance of systolic hypertension (58.2%). 61.6% of patients were controlled by ambulatory blood pressure measure, a rate of 47.8% of white coat hypertension. Glycemic control was observed in 42.2% of cases and 87% of patients had good renal function (glomerular filter rate ≥ 60 ml/mn). Therapeutic compliance was good in 53.4% of cases and dual therapy was the most used therapeutic modality 44.8% (52 patients) followed by triple therapy. The factors associated with poor blood pressure control were glycemic imbalance, non-compliance and monotherapy. Dual therapy had a protective effect. Conclusion: The association of hypertension and type 2 diabetes is frequent. The risk of occurrence increases with age. Ambulatory blood pressure measure is the best method to assess blood pressure control. Optimization of blood pressure control should also include optimization of glycemic control.展开更多
Measurement of bloodflow velocity is key to understanding physiology and pathology in vivo.While most measurements are performed at the middle of the blood vessel,little research has been done on characterizing the in...Measurement of bloodflow velocity is key to understanding physiology and pathology in vivo.While most measurements are performed at the middle of the blood vessel,little research has been done on characterizing the instantaneous bloodflow velocity distribution.This is mainly due to the lack of measurement technology with high spatial and temporal resolution.Here,we tackle this problem with our recently developed dual-wavelength line-scan third-harmonic generation(THG)imaging technology.Simultaneous acquisition of dual-wavelength THG line-scanning signals enables measurement of bloodflow velocities at two radially symmetric positions in both venules and arterioles in mouse brain in vivo.Our results clearly show that the instantaneous bloodflow velocity is not symmetric under general conditions.展开更多
Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of sk...Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.展开更多
Objective: To develop and internally validate a nomogram to predict recurrence-free survival (RFS) including the time to radical cystectomy (RC) and perioperative blood transfusion (PBT) as potential predictors.Method...Objective: To develop and internally validate a nomogram to predict recurrence-free survival (RFS) including the time to radical cystectomy (RC) and perioperative blood transfusion (PBT) as potential predictors.Methods: Patients who underwent open RC and ileal conduit between January 1996 to December 2016 were split into developing (n=948) and validating (n=237) cohorts. The time to radical cystectomy (TTC) was defined as the interval between the onset of symptoms and RC. The regression coefficients of the independent predictors obtained by Cox regression were used to construct the nomogram. Discrimination, validation, and clinical usefulness in the validation cohort were assessed by the area under the curve, the calibration plot, and decision curve analysis.Results: In the developing dataset, the 1-, 5-, and 10-year RFS were 83.0%, 47.2%, and 44.4%, respectively. On multivariate analysis, independent predictors were TTC (hazards ratio [HR] 1.07, 95% confidence interval [CI] 1.05-1.08, p<0.001), PBT (one unit: HR 1.40, 95% CI 1.03-1.90, p=0.03;two or more units: HR 1.72, 95% CI 1.29-2.29, p<0.001), bilateral hydronephrosis (HR 1.54, 95% CI 1.21-1.97, p<0.001), squamous cell carcinoma (HR 0.60, 95% CI 0.45-0.81, p=0.001), pT3-T4 (HR 1.77, 95% CI 1.41-2.22, p<0.001), lymph node status (HR 1.53, 95% CI 1.21-1.95, p<0.001), and lymphovascular invasion (HR 1.28, 95% CI 1.01-1.62, p=0.044). The areas under the curve in the validation dataset were 79.3%, 69.6%, and 76.2%, for 1-, 5-, and 10-year RFS, respectively. Calibration plots showed considerable correspondence between predicted and actual survival probabilities. The decision curve analysis revealed a better net benefit of the nomogram.Conclusion: A nomogram with good discrimination, validation, and clinical utility was constructed utilizing TTC and PBT in addition to standard pathological criteria.展开更多
The breakdown of the Heisenberg Uncertainty Principle occurs when energies approach the Planck scale, and the corresponding Schwarzschild radius becomes similar to the Compton wavelength. Both of these quantities are ...The breakdown of the Heisenberg Uncertainty Principle occurs when energies approach the Planck scale, and the corresponding Schwarzschild radius becomes similar to the Compton wavelength. Both of these quantities are approximately equal to the Planck length. In this context, we have introduced a model that utilizes a combination of Schwarzschild’s radius and Compton length to quantify the gravitational length of an object. This model has provided a novel perspective in generalizing the uncertainty principle. Furthermore, it has elucidated the significance of the deforming linear parameter β and its range of variation from unity to its maximum value.展开更多
Background: Glycine dehydrogenase(GLDC) plays an important role in the initiation and proliferation of several human cancers. In this study, we aimed to detect the methylation status of GLDC promoter and its diagnosti...Background: Glycine dehydrogenase(GLDC) plays an important role in the initiation and proliferation of several human cancers. In this study, we aimed to detect the methylation status of GLDC promoter and its diagnostic value for hepatitis B virus-associated hepatocellular carcinoma(HBV-HCC). Methods: We enrolled 197 patients, 111 with HBV-HCC, 51 with chronic hepatitis B(CHB), and 35 healthy controls(HCs). The methylation status of GLDC promoter in peripheral mononuclear cells(PBMCs) was identified by methylation specific polymerase chain reaction(MSP). The mRNA expression was examined using real-time quantitative polymerase chain reaction(q PCR). Results: The methylation frequency of the GLDC promoter was significantly lower in HBV-HCC patients(27.0%) compared to that in CHB patients(68.6%) and HCs(74.3%)( P < 0.001). The methylated group had lower alanine aminotransferase level( P = 0.035) and lower rates of tumor node metastasis(TNM) Ⅲ/Ⅳ( P = 0.043) and T3/T4( P = 0.026). TNM stage was identified to be an independent factor for GLDC promoter methylation. GLDC mRNA levels in CHB patients and HCs were significantly lower than those in HBV-HCC patients( P = 0.022 and P < 0.001, respectively). GLDC mRNA levels were significantly higher in HBV-HCC patients with unmethylated GLDC promoters than those with methylated GLDC promoters( P = 0.003). The diagnostic accuracy of alpha-fetoprotein(AFP) combined with GLDC promoter methylation for HBV-HCC was improved compared with that of AFP alone(AUC: 0.782 vs. 0.630, P < 0.001). In addition, GLDC promoter methylation was an independent predictor for overall survival of HBV-HCC patients( P = 0.038). Conclusions: The methylation frequency of GLDC promoter was lower in PBMCs from HBV-HCC patients than that from patients with CHB and HCs. The combination of AFP and GLDC promoter hypomethylation significantly improved the diagnostic accuracy of HBV-HCC.展开更多
In this letter,we discuss the topic of necessity of routine laboratory monitoring during isotretinoin treatment for acne.According to Park and colleagues,it is advisable to monitor the levels of triglycerides,alanine ...In this letter,we discuss the topic of necessity of routine laboratory monitoring during isotretinoin treatment for acne.According to Park and colleagues,it is advisable to monitor the levels of triglycerides,alanine aminotransferase,and aspartate aminotransferase every 5 to 6 months.Additionally,the levels of total cholesterol and low-density lipoprotein should be checked within the first two months of treatment.Isotretinoin is a commonly prescribed agent mainly used to treat acne.Despite its high effectiveness,it necessitates regular monitoring of laboratory parameters due to its side effect profile.Currently,there remains a lack of consensus on the appropriate frequency for monitoring these parameters during treatment with isotretinoin.This letter will provide insight into this complex and controversial topic.Based on existing literature,we concluded that the incidence of changes in lipid and liver aminotransferase levels during isotretinoin treatment for acne was low and likely clinically insignificant.For generally healthy people,we recommend testing lipid and liver profiles once at baseline and a second time at the peak dosage.However,frequent testing might still be beneficial in certain populations of patients.展开更多
Blood transfusion is a complex activity, involving many actors. As a high-risk activity, it necessitates the implementation of specific methods for effective control. The safety of blood transfusion is significantly i...Blood transfusion is a complex activity, involving many actors. As a high-risk activity, it necessitates the implementation of specific methods for effective control. The safety of blood transfusion is significantly influenced by the beliefs of healthcare workers and organizational factors, constituting two major considerations. We conducted a cross-sectional, descriptive, and analytical survey to examine the knowledge and practices related to transfusion among the medical and paramedical staff at the Pediatric Department (Mother-Child) of CHU Mohammed VI from September 1, 2022, to December 31, 2022. Among the 135 staff members interviewed, only 41% had received training in blood transfusion. A majority (65.2%) of the staff noted that a mismatch in cross-matching led to transfusion complications. Two-thirds (66.7%) identified chills as the primary clinical sign of potential accidents. Regarding elements to monitor during a reaction, hemolysis (78.5%) and temperature (76.3%) were most commonly mentioned. Surprisingly, more than half (53.3%) of the personnel interviewed did not conduct post-transfusion monitoring. This survey highlighted significant deficiencies in knowledge and practices related to transfusion. To address these issues, we recommend implementing guidelines and providing tailored training for the staff, aiming to rectify these deficiencies and enhance overall practices.展开更多
Introduction: Like healthcare workers, medical students are also exposed to a risk of accidental contamination during their hospital internships. However, they do not benefit from prevention services in the same way a...Introduction: Like healthcare workers, medical students are also exposed to a risk of accidental contamination during their hospital internships. However, they do not benefit from prevention services in the same way as workers in this sector, although they actively participate in the routine care provided to patients in the various hospital departments. The objective of our study is to determine the incidence of these accidents and their medical and administrative management among these victims (medical students) not classified in the category of workers. Materials and Method: This was a cross-sectional study carried out over three months from January 15 to March 14, 2023. The study population consisted of all medical students at the Faculty of Health Sciences at the University of Bangui. Regularly enrolled students from 2nd to 7th year, on placement in hospitals in the Central African Republic and who gave their informed consent were included. Data were collected through a self-administered questionnaire. Results: A cross-sectional study was carried out among medical students concerning the incidence and management of accidents involving exposure to blood in the Central African Republic. Of the 254 students included, three (9%) had already been correctly vaccinated against the viral hepatitis B virus, 198 (77.9%) reported still having access to personal protective equipment, 133 students (52.4%) reported being victims of OBE in the past 12 months. The main types of OBE were stings (62%), followed by liquid splashes (32%) and cuts (6%). Among the 133 victims, 92.9% carried out immediate hand disinfection or abundant eye washing, 41.9% obtained the serology of the source patient and 37% reported the accident to their supervisor. Conclusion: It is important that students benefit from better prevention and management of these accidents.展开更多
AIM:To present the 1-year results of a prospective cohort study investigating the efficacy,potential mechanism,and safety of orthokeratology(ortho-k)with different back optic zone diameters(BOZD)for myopia control in ...AIM:To present the 1-year results of a prospective cohort study investigating the efficacy,potential mechanism,and safety of orthokeratology(ortho-k)with different back optic zone diameters(BOZD)for myopia control in children.METHODS:This randomized clinical study was performed between Dec.2020 and Dec.2021.Participants were randomly assigned to three groups wearing ortho-k:5 mm BOZD(5-MM group),5.5 mm BOZD(5.5-MM group),and 6 mm BOZD(6-MM group).The 1-year data were recorded,including axial length,relative peripheral refraction(RPR,measured by multispectral refractive topography,MRT),and visual quality.The contrast sensitivity(CS)was evaluated by CSV-1000 instrument with spatial frequencies of 3,6,12,and 18 cycles/degree(c/d);the corneal higher-order aberrations(HOAs)were measured by iTrace aberration analyzer.The one-way ANOVA was performed to assess the differences between the three groups.The correlation between the change in AL and RPR was calculated by Pearson’s correlation coefficient.RESULTS:The 1-year results of 20,21,and 21 subjects in the 5-MM,5.5-MM,and 6-MM groups,respectively,were presented.There were no statistical differences in baseline age,sex,or ocular parameters between the three groups(all P>0.05).At the 1-year visit,the 5-MM group had lower axial elongation than the 6-MM group(0.07±0.09 vs 0.18±0.11 mm,P=0.001).The 5-MM group had more myopic total RPR(TRPR,P=0.014),with RPR in the 15°–30°(RPR 15–30,P=0.015),30°–45°(RPR 30–45,P=0.011),temporal(RPR-T,P=0.008),and nasal area(RPR-N,P<0.001)than the 6-MM group.RPR 15–30 in the 5.5-MM group was more myopic than that in the 6-MM group(P=0.002),and RPR-N in the 5-MM group was more myopic than that in the 5.5-MM group(P<0.001).There were positive correlations between the axial elongation and the change in TRPR(r=0.756,P<0.001),RPR 15–30(r=0.364,P=0.004),RPR 30–45(r=0.306,P=0.016),and RPR-N(r=0.253,P=0.047).The CS decreased at 3 c/d(P<0.001),and the corneal HOAs increased in the 5-MM group(P=0.030).CONCLUSION:Ortho-k with 5 mm BOZD can control myopia progression more effectively.The mechanism may be associated with greater myopic shifts in RPR.展开更多
文摘In the last two decades the study of red blood cell elasticity using optical tweezers has known a rise appearing in the scientific research with regard to the various works carried out. Despite the various work done, no study has been done so far to study the influence of friction on the red blood cell indentation response using optical tweezers. In this study, we have developed a new approach to determine the coefficient of friction as well as the frictional forces of the red blood cell. This approach therefore allowed us to simultaneously carry out the indentation and traction test, which allowed us to extract the interfacial properties of the microbead red blood cell couple, among other things, the friction coefficient. This property would be extremely important to investigate the survival and mechanical features of cells, which will be of great physiological and pathological significance. But taking into account the hypothesis of friction as defined by the isotropic Coulomb law. The experiment performed for this purpose is the Brinell Hardness Test (DB).
基金supported by the National Natural Science Foundation of China(Grant Nos.61935004,62227823 and 61805040)the Beijing Institute of Technology Research Fund Program for Young Scholars(XSQD-202123001).
文摘Photodynamic therapy(PDT)has been increasingly used in the clinical treatment of neoplastic,inflammatory and infectious skin diseases.However,the generation of reactive oxygen species(ROS)may induce undesired side effects in normal tissue surrounding the treatment lesion,which is a big challenge for the clinical application of PDT.To date,(–)-Epigallocatechin gallate(EGCG)has been widely proposed as an antiangiogenic and antitumor agent for the protection of normal tissue from ROS-mediated oxidative damage.This study evaluates the regulation ability of EGCG for photodynamic damage of blood vessels during hematoporphyrin monomethyl ether(Hemoporfin)-mediated PDT.The quenching rate constants of EGCG for the triplet-state Hemoporfin and photosensitized 1O2 generation are determined to be 6.8×10^(8)M^(−1)S^(−1),respectively.The vasoconstriction of blood vessels in the protected region treated with EGCG hydrogel after PDT is lower than that of the control region treated with pure hydrogel,suggesting an efficiently reduced photodamage of Hemoporfin for blood vessels treated with EGCG.This study indicates that EGCG is an efficient quencher for triplet-state Hemoporfin and 1O2,and EGCG could be potentially used to reduce the undesired photodamage of normal tissue in clinical PDT.
基金Supported by National Natural Science Foundation of China,No.81702923,and No.81971503Open Project of State Key Laboratory of Medical Immunology,No.NKLMI2023K03+1 种基金Shanghai Shen Kang Hospital Development Center Clinical Science and Technology Innovation Project,No.SHDC12020104Basic Medical Research Project of Naval Medical University,No.2022QN072.
文摘The tumor microenvironment is a complex network of cells,extracellular matrix,and signaling molecules that plays a critical role in tumor progression and metastasis.Lymphatic and blood vessels are major routes for solid tumor metastasis and essential parts of tumor drainage conduits.However,recent studies have shown that lymphatic endothelial cells(LECs)and blood endothelial cells(BECs)also play multifaceted roles in the tumor microenvironment beyond their structural functions,particularly in hepatocellular carcinoma(HCC).This comprehensive review summarizes the diverse roles played by LECs and BECs in HCC,including their involvement in angiogenesis,immune modulation,lymphangiogenesis,and metastasis.By providing a detailed account of the complex interplay between LECs,BECs,and tumor cells,this review aims to shed light on future research directions regarding the immune regulatory function of LECs and potential therapeutic targets for HCC.
文摘BACKGROUND In China,the prevalence of type 2 diabetes mellitus(T2DM)among diabetic patients is estimated to be between 90%-95%.Additionally,China is among the 22 countries burdened by a high number of tuberculosis cases,with approximately 4.5 million individuals affected by active tuberculosis.Notably,T2DM poses a significant risk factor for the development of tuberculosis,as evidenced by the increased incidence of T2DM coexisting with pulmonary tuberculosis(T2DMPTB),which has risen from 19.3%to 24.1%.It is evident that these two diseases are intricately interconnected and mutually reinforcing in nature.AIM To elucidate the clinical features of individuals diagnosed with both T2DM and tuberculosis(T2DM-PTB),as well as to investigate the potential risk factors associated with active tuberculosis in patients with T2DM.METHODS T2DM-PTB patients who visited our hospital between January 2020 and January 2023 were selected as the observation group,Simple DM patients presenting to our hospital in the same period were the control group,Controls and case groups were matched 1:2 according to the principle of the same sex,age difference(±3)years and disease duration difference(±5)years,patients were investigated for general demographic characteristics,diabetes-related characteristics,body immune status,lifestyle and behavioral habits,univariate and multivariate analysis of the data using conditional logistic regression,calculate the odds ratio(OR)values and 95%CI of OR values.RESULTS A total of 315 study subjects were included in this study,including 105 subjects in the observation group and 210 subjects in the control group.Comparison of the results of both anthropometric and biochemical measures showed that the constitution index,systolic blood pressure,diastolic blood pressure and lymphocyte count were significantly lower in the case group,while fasting blood glucose and high-density lipoprotein cholesterol levels were significantly higher than those in the control group.The results of univariate analysis showed that poor glucose control,hypoproteinemia,lymphopenia,TB contact history,high infection,smoking and alcohol consumption were positively associated with PTB in T2DM patients;married,history of hypertension,treatment of oral hypoglycemic drugs plus insulin,overweight,obesity and regular exercise were negatively associated with PTB in T2DM patients.Results of multivariate stepwise regression analysis found lymphopenia(OR=17.75,95%CI:3.40-92.74),smoking(OR=12.25,95%CI:2.53-59.37),history of TB contact(OR=6.56,95%CI:1.23-35.03)and poor glycemic control(OR=3.37,95%CI:1.11-10.25)was associated with an increased risk of developing PTB in patients with T2DM,While being overweight(OR=0.23,95%CI:0.08-0.72)and obesity(OR=0.11,95%CI:0.02-0.72)was associated with a reduced risk of developing PTB in patients with T2DM.CONCLUSION T2DM-PTB patients are prone to worse glycemic control,higher infection frequency,and a higher proportion of people smoking,drinking alcohol,and lack of exercise.Lymphopenia,smoking,history of TB exposure,poor glycemic control were independent risk factors for T2DM-PTB,and overweight and obesity were associated with reduced risk of concurrent PTB in patients with T2DM.
文摘Background:High blood pressure(BP)is a major contributor to mortality and cardiovascular diseases.Despite the known benefits of exercise for reducing BP,it is crucial to identify the most effective physical activity(PA)intervention.This systematic review and network meta-analysis(NMA)aimed to evaluate the available evidence on the effectiveness of various PA interventions for reducing BP and to determine their hierarchy based on their impact on BP.Methods:A search of PubMed,SPORTDiscus,PsycINFO,Web of Science,CINAHL,Cochrane,and Eric databases was conducted up to December 2022 for this systematic review and NMA.Randomized controlled trials and quasi-experimental studies targeting healthy children and adolescents aged 6-12 years old were included in this study.Only studies that compared controlled and intervention groups using PA or exercise as the major influence were included.We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)guidelines.Three independent investigators performed the literature screening,data extraction,and risk of bias assessment.We used Bayesian arm-based NMA to synthesize the data.The primary outcomes were systolic BP and diastolic BP.We calculated the mean differences(MDs)in systolic BP and diastolic BP before and after treatment.Mean treatment differences were estimated using NMA and random-effect models.Results:We synthesized 27 studies involving 15,220 children and adolescents.PA combined with nutrition and behavior change was the most effective intervention for reducing both systolic BP and diastolic BP(MD=-8.64,95%credible interval(95%CI):-11.44 to-5.84;MD=-6.75,95%CI:-10.44 to-3.11),followed by interventions with multiple components(MD=-1.39,95%CI:-1.94 to-0.84;MD=-2.54,95%CI:-4.89 to-0.29).Conclusion:Our findings suggest that PA interventions incorporating nutrition and behavior change,followed by interventions with multiple components,are most effective for reducing both systolic BP and diastolic BP in children and adolescents.
基金supported by the National Natural Science Foundation of China[82073593]the Scientific Research Projects in Colleges and Universities of Anhui Education Department[KJ2019A0281 and KJ2020A0666]+2 种基金Domestic Visiting and Training Project for Excellent Young Key Teachers of Colleges and Universities[gxgnfx2020115]Research level improvement program of Anhui Medical University[2021xkjT010]2022 Early Exposure to Research Training Program for Clinical Medicine(“5+3”Integration)Students(2022-ZQKY-84)。
文摘Di(2-ethylhexyl)phthalate(DEHP)is a widely used plasticizer known for its reproductive developmental and immune system toxicity,mainly through esophagal,dermal,and respiratory exposure^([1-3]).Maternal exposure to DEHP during pregnancy can lead to adverse birth outcomes in offspring,including impacts on the thyroid system of adolescent offspring^([2-4]).
基金financially supported by the National Key Research and Development Program of China(2022YFE0118400)the National Natural Science Foundation of China(51702038)+1 种基金the Science&Technology Department of Sichuan Province(2020YFG0061)the Recruitment Program for Young Professionals。
文摘Quasi-2D Dion-Jacobson(DJ)tin halide perovskite has attracted much attention due to its elimination of Van der Waals gap and enhanced environmental stability.However,the bulky organic spacers usually form a natural quantum well structure,which brings a large quantum barrier and poor film quality,further limiting the carrier transport and device performance.Here,we designed three organic spacers with different chain lengths(ethylenediamine(EDA),1,3-propanediamine(PDA),and 1,4-butanediamine(BDA))to investigate the quantum barrier dependence.Theoretical and experimental characterizations indicate that EDA with short chain can reduce the lattice distortion and dielectric confinement effect,which is beneficial to the effective dissociation of excitons and the inhibition of trap-free non-radiative relaxation.In addition,EDA cation shows strong interaction with the inorganic octahedron,realizing large aggregates in precursor solution and high-quality films with improved structural stability.Furthermore,femtosecond transient absorption proves that EDA cations can also weaken the formation of small n-phases with large quantum barrier to achieve effective carrier transport between different nphases.Finally,the quasi-2D DJ(EDA)FA_(9)Sn_(10)I_(31)solar cells achieves a 7.07%power conversion efficiency with good environment stability.Therefore,this work sheds light on the regulation of the quantum barrier and carrier transport through the chain length of organic spacer for qua si-2D DJ lead-free perovskites.
文摘Context/Objective: High blood pressure (HBP) currently represents the most widespread chronic non-communicable disease in Cameroon. The increase in its prevalence in the country is the result of multiple factors including economic stress imposed by precariousness, poor living conditions, sources of anxiety, anguish, depression and other behavioral disorders. Economic stress is a globalizing concept that integrates into a purely hermeneutic approach, a particular functioning of the nervous system of an individual who faces employment problems and precarious remuneration conditions. The non-satisfaction by an individual of his basic needs due to insufficient financial means can cause him to become irritable, aggressive, and socially and symbolically isolated, thereby increasing the desire to resort to morbid life models such as excessive consumption of narcotics and other psychoactive substances often associated with high blood pressure. The fight against the emergence of BPH is a complex, multifaceted and multifactorial reality that requires taking into account economic stress. The main objective of this survey is to describe the situation of economic stress within the Cameroonian population, which imposes precariousness and life models at risk of high blood pressure. Specifically, we determined the level of household income and the sources of income. Methods: A cross-sectional survey with a descriptive aim among five hundred households in the Central Region of Cameroon was conducted. A probabilistic technique called simple randomness was used. The number of households to be surveyed was determined indirectly using the Cochrane formula. Data collection in face-to-face mode using a physical questionnaire took place from July 1 to August 31, 2023, after obtaining ethical clearance from the Regional Health Research Ethics Committee, Human from the Center and an administrative authorization for data collection. Regarding their processing, the data was grouped during processing in Excel sheets. Normality and reliability tests of the collected data were carried out. For this, the Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value. Descriptive analysis was possible using R software version 3.2, SPSS version 25.0, XLSTAT 2016, PAST and EXCEL programs from Microsoft Office 2013. Results: The main results highlight economic stress, with 45.60% of households surveyed earning less than US$154 per month;55% of household heads were women in single-parent families;14% of household heads were unemployed, 22% worked in the private sector and 19% were self-employed. This general economic situation leads to precarious living conditions, thereby increasing the risk of high blood pressure among the Cameroonian population.
文摘BACKGROUND For compensated advanced chronic liver disease(cACLD)patients,the first decompensation represents a dramatically worsening prognostic event.Based on the first decompensation event(DE),the transition to decompensated advanced chronic liver disease(dACLD)can occur through two modalities referred to as acute decompensation(AD)and non-AD(NAD),respectively.Clinically Significant Portal Hypertension(CSPH)is considered the strongest predictor of decompensation in these patients.However,due to its invasiveness and costs,CSPH is almost never evaluated in clinical practice.Therefore,recognizing noninvasively predicting tools still have more appeal across healthcare systems.The red cell distribution width to platelet ratio(RPR)has been reported to be an indicator of hepatic fibrosis in Metabolic Dysfunction-Associated Steatotic Liver Disease(MASLD).However,its predictive role for the decompensation has never been explored.AIM In this observational study,we investigated the clinical usage of RPR in predicting DEs in MASLD-related cACLD patients.METHODS Fourty controls and 150 MASLD-cACLD patients were consecutively enrolled and followed up(FUP)semiannually for 3 years.At baseline,biochemical,clinical,and Liver Stiffness Measurement(LSM),Child-Pugh(CP),Model for End-Stage Liver Disease(MELD),aspartate aminotransferase/platelet count ratio index(APRI),Fibrosis-4(FIB-4),Albumin-Bilirubin(ALBI),ALBI-FIB-4,and RPR were collected.During FUP,DEs(timing and modaities)were recorded.CSPH was assessed at the baseline and on DE occurrence according to the available Clinical Practice Guidelines.RESULTS Of 150 MASLD-related cACLD patients,43(28.6%)progressed to dACLD at a median time of 28.9 months(29 NAD and 14 AD).Baseline RPR values were significantly higher in cACLD in comparison to controls,as well as MELD,CP,APRI,FIB-4,ALBI,ALBI-FIB-4,and LSM in dACLD-progressing compared to cACLD individuals[all P<0.0001,except for FIB-4(P:0.007)and ALBI(P:0.011)].Receiving operator curve analysis revealed RPR>0.472 and>0.894 as the best cut-offs in the prediction respectively of 3-year first DE,as well as its superiority compared to the other non-invasive tools examined.RPR(P:0.02)and the presence of baseline-CSPH(P:0.04)were significantly and independently associated with the DE.Patients presenting baseline-CSPH and RPR>0.472 showed higher risk of decompensation(P:0.0023).CONCLUSION Altogether these findings suggest the RPR as a valid and potentially applicable non-invasive tool in the prediction of timing and modalities of decompensation in MASLD-related cACLD patients.
文摘We report the case of a 20-year-old female patient presenting with a totally occluded coarctation of the aorta. The patient was admitted for the evaluation of resistant grade III high blood pressure. The physical examination revealed a blood pressure gradient between the upper and lower limbs, absent femoral pulses, a diffuse continuous murmur over the chest, and hyperpulsatility of the carotid arteries and sternal notch. A transthoracic echocardiography outlined a narrowing in the caliber of the isthmic aorta without acceleration of flow or gradient. Thoracic CT angiography revealed a complete aortic coarctation with interruption of continuity between segment 3 and the descending aorta.
文摘Objective: The association hypertension and diabetes is important. The two pathologies may influence each other. The aim was to study the correlation between glycemic control and blood pressure control and to determine the factors associated with blood pressure control. Methodology: This was a descriptive cross-sectional study with an analytical focus over 7 months. Patients were recruited as outpatients and all underwent ambulatory blood pressure measure, glycated hemoglobin and creatinine measurements, and assessment of compliance with treatment. Results: During this period 116 patients were collected. The predominance was female 69%. The mean age of the patients was 62 ± 7 years with a peak between 60 and 70 years. The average age of hypertension was 12 years and that of diabetes 6 1/2 years. The most frequently associated cardiovascular risk factor was a sedentary lifestyle (71.5%) after age. 57.8% of patients were not controlled at the office, with a predominance of systolic hypertension (58.2%). 61.6% of patients were controlled by ambulatory blood pressure measure, a rate of 47.8% of white coat hypertension. Glycemic control was observed in 42.2% of cases and 87% of patients had good renal function (glomerular filter rate ≥ 60 ml/mn). Therapeutic compliance was good in 53.4% of cases and dual therapy was the most used therapeutic modality 44.8% (52 patients) followed by triple therapy. The factors associated with poor blood pressure control were glycemic imbalance, non-compliance and monotherapy. Dual therapy had a protective effect. Conclusion: The association of hypertension and type 2 diabetes is frequent. The risk of occurrence increases with age. Ambulatory blood pressure measure is the best method to assess blood pressure control. Optimization of blood pressure control should also include optimization of glycemic control.
基金funded by the National Natural Science Foundation of China(Grant/Award Numbers 62075135 and 61975126)the Science and Technology Innovation Commission of Shenzhen(Grant/Award Numbers JCYJ20190808174819083 and JCYJ20190808175201640)Shenzhen Science and Technology Planning Project(ZDSYS 20210623092006020).
文摘Measurement of bloodflow velocity is key to understanding physiology and pathology in vivo.While most measurements are performed at the middle of the blood vessel,little research has been done on characterizing the instantaneous bloodflow velocity distribution.This is mainly due to the lack of measurement technology with high spatial and temporal resolution.Here,we tackle this problem with our recently developed dual-wavelength line-scan third-harmonic generation(THG)imaging technology.Simultaneous acquisition of dual-wavelength THG line-scanning signals enables measurement of bloodflow velocities at two radially symmetric positions in both venules and arterioles in mouse brain in vivo.Our results clearly show that the instantaneous bloodflow velocity is not symmetric under general conditions.
文摘Context/objectives: The fight against Chronic Non-Communicable Diseases (NCDs) is a long-term undertaking, which requires available, motivated and well-managed human resources (HR). The administrative management of skills on both qualitative and quantitative levels is one of the essential functions of a health system. To better implement policies of fight against High Blood Pressure (HBP) and other chronic diseases, it is important to establish strategies to retain health personnel. This loyalty requires favorable working conditions and consideration of the contribution-reward couple. Good working conditions are likely to reduce the phenomenon of medical nomadism;conversely, poor HR management can contribute to their exodus towards exotic “green pastures”, thus leading to an additional crisis in the Cameroonian health system. The fight against HBP is a complex, multifaceted and multifactorial reality that requires appropriate management model for all types of resources mainly HR. The main objective of this research is to show the impact of poor management of human resources in Cameroon health system on medical nomadism and the ineffectiveness of the fight against High Blood Pressure. Method: A cross-sectional descriptive survey among five hundred (500) health facilities in the center region of Cameroon has been conducted. A stratified probabilistic technique has been used, and the number of health facilities to be surveyed has been determined using the “sample size estimation table” of Depelteau. The physical questionnaires have been printed and then distributed to data collectors. After data collection, the latter were grouped during processing in Excel sheets. The Chi-square test was used for data with a qualitative value and that of Kolmogorov-Sminorf for data with a quantitative value to assess the normality and reliability of data. The Crochach’s Alpha reliability test allowed us to have a summary of the means and variances and then to search for intragroup correlations between variables. Descriptive analysis was possible with the XLSTAT 2016 software. Results: 43.60% of Health Facilities (HF) managers were unqualified. 82.20% of HF managers have staff in a situation of professional insecurity. They are mainly contractual (49.00), decision-making agents (24.40%), casual agents (08.80). The proportion of unstable personnel is average of 22.00% and very unstable, 12.00%.
文摘Objective: To develop and internally validate a nomogram to predict recurrence-free survival (RFS) including the time to radical cystectomy (RC) and perioperative blood transfusion (PBT) as potential predictors.Methods: Patients who underwent open RC and ileal conduit between January 1996 to December 2016 were split into developing (n=948) and validating (n=237) cohorts. The time to radical cystectomy (TTC) was defined as the interval between the onset of symptoms and RC. The regression coefficients of the independent predictors obtained by Cox regression were used to construct the nomogram. Discrimination, validation, and clinical usefulness in the validation cohort were assessed by the area under the curve, the calibration plot, and decision curve analysis.Results: In the developing dataset, the 1-, 5-, and 10-year RFS were 83.0%, 47.2%, and 44.4%, respectively. On multivariate analysis, independent predictors were TTC (hazards ratio [HR] 1.07, 95% confidence interval [CI] 1.05-1.08, p<0.001), PBT (one unit: HR 1.40, 95% CI 1.03-1.90, p=0.03;two or more units: HR 1.72, 95% CI 1.29-2.29, p<0.001), bilateral hydronephrosis (HR 1.54, 95% CI 1.21-1.97, p<0.001), squamous cell carcinoma (HR 0.60, 95% CI 0.45-0.81, p=0.001), pT3-T4 (HR 1.77, 95% CI 1.41-2.22, p<0.001), lymph node status (HR 1.53, 95% CI 1.21-1.95, p<0.001), and lymphovascular invasion (HR 1.28, 95% CI 1.01-1.62, p=0.044). The areas under the curve in the validation dataset were 79.3%, 69.6%, and 76.2%, for 1-, 5-, and 10-year RFS, respectively. Calibration plots showed considerable correspondence between predicted and actual survival probabilities. The decision curve analysis revealed a better net benefit of the nomogram.Conclusion: A nomogram with good discrimination, validation, and clinical utility was constructed utilizing TTC and PBT in addition to standard pathological criteria.
文摘The breakdown of the Heisenberg Uncertainty Principle occurs when energies approach the Planck scale, and the corresponding Schwarzschild radius becomes similar to the Compton wavelength. Both of these quantities are approximately equal to the Planck length. In this context, we have introduced a model that utilizes a combination of Schwarzschild’s radius and Compton length to quantify the gravitational length of an object. This model has provided a novel perspective in generalizing the uncertainty principle. Furthermore, it has elucidated the significance of the deforming linear parameter β and its range of variation from unity to its maximum value.
基金This study was supported by grants from the Key Project of the Chinese Ministry of Science and Technology(2017ZX102022022)National Key Research and Development Program of China(2021YFC2301801).
文摘Background: Glycine dehydrogenase(GLDC) plays an important role in the initiation and proliferation of several human cancers. In this study, we aimed to detect the methylation status of GLDC promoter and its diagnostic value for hepatitis B virus-associated hepatocellular carcinoma(HBV-HCC). Methods: We enrolled 197 patients, 111 with HBV-HCC, 51 with chronic hepatitis B(CHB), and 35 healthy controls(HCs). The methylation status of GLDC promoter in peripheral mononuclear cells(PBMCs) was identified by methylation specific polymerase chain reaction(MSP). The mRNA expression was examined using real-time quantitative polymerase chain reaction(q PCR). Results: The methylation frequency of the GLDC promoter was significantly lower in HBV-HCC patients(27.0%) compared to that in CHB patients(68.6%) and HCs(74.3%)( P < 0.001). The methylated group had lower alanine aminotransferase level( P = 0.035) and lower rates of tumor node metastasis(TNM) Ⅲ/Ⅳ( P = 0.043) and T3/T4( P = 0.026). TNM stage was identified to be an independent factor for GLDC promoter methylation. GLDC mRNA levels in CHB patients and HCs were significantly lower than those in HBV-HCC patients( P = 0.022 and P < 0.001, respectively). GLDC mRNA levels were significantly higher in HBV-HCC patients with unmethylated GLDC promoters than those with methylated GLDC promoters( P = 0.003). The diagnostic accuracy of alpha-fetoprotein(AFP) combined with GLDC promoter methylation for HBV-HCC was improved compared with that of AFP alone(AUC: 0.782 vs. 0.630, P < 0.001). In addition, GLDC promoter methylation was an independent predictor for overall survival of HBV-HCC patients( P = 0.038). Conclusions: The methylation frequency of GLDC promoter was lower in PBMCs from HBV-HCC patients than that from patients with CHB and HCs. The combination of AFP and GLDC promoter hypomethylation significantly improved the diagnostic accuracy of HBV-HCC.
文摘In this letter,we discuss the topic of necessity of routine laboratory monitoring during isotretinoin treatment for acne.According to Park and colleagues,it is advisable to monitor the levels of triglycerides,alanine aminotransferase,and aspartate aminotransferase every 5 to 6 months.Additionally,the levels of total cholesterol and low-density lipoprotein should be checked within the first two months of treatment.Isotretinoin is a commonly prescribed agent mainly used to treat acne.Despite its high effectiveness,it necessitates regular monitoring of laboratory parameters due to its side effect profile.Currently,there remains a lack of consensus on the appropriate frequency for monitoring these parameters during treatment with isotretinoin.This letter will provide insight into this complex and controversial topic.Based on existing literature,we concluded that the incidence of changes in lipid and liver aminotransferase levels during isotretinoin treatment for acne was low and likely clinically insignificant.For generally healthy people,we recommend testing lipid and liver profiles once at baseline and a second time at the peak dosage.However,frequent testing might still be beneficial in certain populations of patients.
文摘Blood transfusion is a complex activity, involving many actors. As a high-risk activity, it necessitates the implementation of specific methods for effective control. The safety of blood transfusion is significantly influenced by the beliefs of healthcare workers and organizational factors, constituting two major considerations. We conducted a cross-sectional, descriptive, and analytical survey to examine the knowledge and practices related to transfusion among the medical and paramedical staff at the Pediatric Department (Mother-Child) of CHU Mohammed VI from September 1, 2022, to December 31, 2022. Among the 135 staff members interviewed, only 41% had received training in blood transfusion. A majority (65.2%) of the staff noted that a mismatch in cross-matching led to transfusion complications. Two-thirds (66.7%) identified chills as the primary clinical sign of potential accidents. Regarding elements to monitor during a reaction, hemolysis (78.5%) and temperature (76.3%) were most commonly mentioned. Surprisingly, more than half (53.3%) of the personnel interviewed did not conduct post-transfusion monitoring. This survey highlighted significant deficiencies in knowledge and practices related to transfusion. To address these issues, we recommend implementing guidelines and providing tailored training for the staff, aiming to rectify these deficiencies and enhance overall practices.
文摘Introduction: Like healthcare workers, medical students are also exposed to a risk of accidental contamination during their hospital internships. However, they do not benefit from prevention services in the same way as workers in this sector, although they actively participate in the routine care provided to patients in the various hospital departments. The objective of our study is to determine the incidence of these accidents and their medical and administrative management among these victims (medical students) not classified in the category of workers. Materials and Method: This was a cross-sectional study carried out over three months from January 15 to March 14, 2023. The study population consisted of all medical students at the Faculty of Health Sciences at the University of Bangui. Regularly enrolled students from 2nd to 7th year, on placement in hospitals in the Central African Republic and who gave their informed consent were included. Data were collected through a self-administered questionnaire. Results: A cross-sectional study was carried out among medical students concerning the incidence and management of accidents involving exposure to blood in the Central African Republic. Of the 254 students included, three (9%) had already been correctly vaccinated against the viral hepatitis B virus, 198 (77.9%) reported still having access to personal protective equipment, 133 students (52.4%) reported being victims of OBE in the past 12 months. The main types of OBE were stings (62%), followed by liquid splashes (32%) and cuts (6%). Among the 133 victims, 92.9% carried out immediate hand disinfection or abundant eye washing, 41.9% obtained the serology of the source patient and 37% reported the accident to their supervisor. Conclusion: It is important that students benefit from better prevention and management of these accidents.
基金Supported by Education Department Foundation of Sichuan Province(No.15ZA0262).
文摘AIM:To present the 1-year results of a prospective cohort study investigating the efficacy,potential mechanism,and safety of orthokeratology(ortho-k)with different back optic zone diameters(BOZD)for myopia control in children.METHODS:This randomized clinical study was performed between Dec.2020 and Dec.2021.Participants were randomly assigned to three groups wearing ortho-k:5 mm BOZD(5-MM group),5.5 mm BOZD(5.5-MM group),and 6 mm BOZD(6-MM group).The 1-year data were recorded,including axial length,relative peripheral refraction(RPR,measured by multispectral refractive topography,MRT),and visual quality.The contrast sensitivity(CS)was evaluated by CSV-1000 instrument with spatial frequencies of 3,6,12,and 18 cycles/degree(c/d);the corneal higher-order aberrations(HOAs)were measured by iTrace aberration analyzer.The one-way ANOVA was performed to assess the differences between the three groups.The correlation between the change in AL and RPR was calculated by Pearson’s correlation coefficient.RESULTS:The 1-year results of 20,21,and 21 subjects in the 5-MM,5.5-MM,and 6-MM groups,respectively,were presented.There were no statistical differences in baseline age,sex,or ocular parameters between the three groups(all P>0.05).At the 1-year visit,the 5-MM group had lower axial elongation than the 6-MM group(0.07±0.09 vs 0.18±0.11 mm,P=0.001).The 5-MM group had more myopic total RPR(TRPR,P=0.014),with RPR in the 15°–30°(RPR 15–30,P=0.015),30°–45°(RPR 30–45,P=0.011),temporal(RPR-T,P=0.008),and nasal area(RPR-N,P<0.001)than the 6-MM group.RPR 15–30 in the 5.5-MM group was more myopic than that in the 6-MM group(P=0.002),and RPR-N in the 5-MM group was more myopic than that in the 5.5-MM group(P<0.001).There were positive correlations between the axial elongation and the change in TRPR(r=0.756,P<0.001),RPR 15–30(r=0.364,P=0.004),RPR 30–45(r=0.306,P=0.016),and RPR-N(r=0.253,P=0.047).The CS decreased at 3 c/d(P<0.001),and the corneal HOAs increased in the 5-MM group(P=0.030).CONCLUSION:Ortho-k with 5 mm BOZD can control myopia progression more effectively.The mechanism may be associated with greater myopic shifts in RPR.