Comparative efficacy and safety between endoscopic submucosal dissection,surgery and definitive chemoradiotherapy in patients with cT1N0M0 esophageal cancer

BACKGROUND Endoscopic submucosal dissection(ESD)and surgical resection are the standard of care for cT1N0M0 esophageal cancer(EC),whereas definitive chemoradiotherapy(d-CRT)is a treatment option.Nevertheless,the comparative efficiency and safety of ESD,surgery and d-CRT for cT1N0M0 EC remain unclear.AIM To compare the efficiency and safety of ESD,surgery and d-CRT for cT1N0M0 EC.METHODS We retrospectively analyzed the hospitalized data of a total of 472 consecutive patients with cT1N0M0 EC treated at Sun Yat-sen University Cancer center between 2017-2019 and followed up until October 30th,2022.We analyzed demographic,medical recorded,histopathologic characteristics,imaging and endoscopic,and follow-up data.The Kaplan-Meier method and Cox proportional hazards modeling were used to analyze the difference of survival outcome by treatments.Inverse probability of treatment weighting(IPTW)was used to minimize potential confounding factors.RESULTS We retrospectively analyzed patients who underwent ESD(n=99)or surgery(n=220)or d-CRT(n=16)at the Sun Yat-sen University Cancer Center from 2017 to 2019.The median follow-up time for the ESD group,the surgery group,and the d-CRT group was 42.0 mo(95%CI:35.0-60.2),45.0 mo(95%CI:34.0-61.75)and 32.5 mo(95%CI:28.3-40.0),respectively.After adjusting for background factors using IPTW,the highest 3-year overall survival(OS)rate and 3-year recurrence-free survival(RFS)rate were observed in the ESD group(3-year OS:99.7% and 94.7% and 79.1%;and 3-year RFS:98.3%,87.4% and 79.1%,in the ESD,surgical,and d-CRT groups,respectively).There was no difference of severe complications occurring between the three groups(P≥0.05).Multivariate analysis showed that treatment method,histology and depth of infiltration were independently associated with OS and RFS.CONCLUSION For cT1N0M0 EC,ESD had better long-term survival and lower hospitalization costs than those who underwent d-CRT and surgery,with a similar rate of severe complications occurring.

The Njiki’s Fundamental Theorem-Definition on Fractions in the Mathematical Set ℚ and by Extension in ℝ and ℂ, for the Purpose of Leading to the Construction of Some Algebraic Structures as Its Theoretical Applications and for the Practical Ones

The purpose of the research in the NJIKI’s fundamental THEOREM-DEFINITION on fractions in the mathematical set ℚand by extension in ℝand ℂand in order to construct some algebraic structures is about the proved EXISTENCE and the DEFINITION by NJIKI of two INNOVATIVE, IMPORTANT and TEACHABLE operations of addition or additive operations, in ℚ, marked ⊕and +α,β, and taken as VECTORIAL, TRIANGULAR, of THREE or PROPORTIONAL operations and in order to make THEM not be different from the RATIONAL ONE, +, but to bring much more and new information on fractions, and, by extension in ℝand ℂ. And the very NJIKI’s fundamental THEOREM-DEFINITION having many APPLICATIONS in the everyday life of the HUMAN BEINGS and without talking about computer sciences, henceforth being supplied with very interesting new ALGORITHMS. And as for the work done in the research, it will be waiting for its extension to be done after publication and along with the research results concerned.

Predictive factors of survival in patients treated with definitive chemoradiotherapy for squamous cell esophageal carcinoma

AIM： The aim of the study was to evaluate the predictive factors of survival in patients with locally advanced squamous cell esophageal carcinoma （LASCOC） treated with definitive chemoradiotherapy （CRT） regimen based on the 5FU/CDDP combination. METHODS： All patients with LASCOC treated with a definitive CRT using the 5FU/CDDP combination between 1994 and 2000 were retrospectively included. Clinical complete response （CCR） to CRT was assessed by esophageal endoscopy and C-F-scan 2 mo after CRT completion. Prognostic factors of survival were assessed using univariate and multivariate analysis by the Cox regression model. RESULTS： A total of 116 patients were included in the study. A CCR to CRT was observed in 86/116 （74.1%）. The median survival was 20 mo （range 2-114） and the 5-year survival was 9.4%. Median survival of responder patients to CRT was 25 mo （range 3-114） as compared to 9 mo （range 2-81） in non-responder patients （P 〈 0.001）. In univariate analysis, survival was associated with CCR （P 〈 0.001）, WHO performance status 〈 2 （P = 0.01）, tumour length 〈 6 cm （P = 0.045） and weight loss 〈 10% was in limit of significance （P = 0.053）. In multivariate analysis, survival was dependant to CCR （P 〈 0.0001）, weight loss 〈 10% （P = 0.034） and WHO performance 〈 2 （P = 0.046）. CONCLUSION： Our results suggest that survival in patients with LASCOC b＇eated with definitive CRT was correlated to CCR, weight loss and WHO performance status.

Survival outcomes of patients with cervical esophageal cancer who received definitive radiotherapy:a retrospective study conducted in a single institution

Objective Cervical esophageal cancer(CEC)is a relatively rare condition,with limited treatment options.The current study aimed to assess the survival outcomes of patients with CEC who received definitive radiotherapy.Methods In total,63 consecutive patients with CEC who received definitive radiotherapy between 2010 and 2018 were included in this study.The survival outcomes were analyzed based on statistics.Results The median progression-free survival(PFS)and overall survival(OS)of the patients were 12 and 19 months,respectively.There were no significant differences in terms of survival outcomes between the groups who received radiation doses≥60 and<60 Gy.Interestingly,in the proximal CEC subgroup,the PFS(P=0.039),OS(P=0.031),and loco-regional failure-free survival(LRFFS)(P=0.005)improved significantly in patients who received a radiation dose≥60 Gy compared with those who received a radiation dose<60 Gy.However,in the distal CEC subgroup,the PFS,OS,and LRFFS did not significantly improve between patients who received radiation doses≥60 and<60 Gy.Definitive radiotherapy was well tolerated,and no significant differences were observed in terms of treatment-related toxicities between the groups who received radiation doses≥60 and<60 Gy.Conclusion The survival outcomes of patients with CEC should be improved.In proximal CEC,a radiation dose≥60 Gy is significantly correlated with better PFS,OS,and LRFFS.However,further research must be performed to validate this finding.

Siemens Definition AS128 CT维修5例

介绍了Siemens Definition AS128 CT的硬件构成,分析并总结了该设备在日常使用中出现的检查床水平移动后机架掉电、图像重建系统(image reconstruction system,IRS)计算机硬盘故障、开机时F1开关脱开、“Exam”按钮灰化等故障产生的原因及维修思路,为临床工程技术人员排除相似故障提供了参考。

Cardiac Tamponade Associated with Blunt Cardiac Injury: Its Definitive Management in the Emergency Department

Cardiac tamponade secondary to blunt cardiac injury is an extremely serious and life-threatening condition that the emergency physician is required to make definitive and appropriate management and resuscitation. Although blunt cardiac injury includes a wide spectrum of pathological conditions, cardiac tamponade due to blunt trauma is rarely seen because most of the patients with cardiac rupture die at the scene or before arrival at the hospital. Definitive surgical repair is commonly necessary following pericardial decompression if the patient is too unstable with impending cardiac arrest. Bringing the patient to definitive surgery as soon as possible is crucial for the chance of survival to the emergency physician. We describe two cases of cardiac tamponade resulting from blunt chest trauma successfully treated with a definitive management and surgical repair.

Combined Single Step Definitive Treatment in Acute Pilonidal Sinus Abscess Running Head: Single Step Treatment of Pilonidal Abscess

Backgrounds: The treatment of choice has been drainage and definitive surgical treatment after an interval for acute pilonidal sinus abscess till now. Because of the high incidence of chronic pilonidal sinus disease following drainage and aiming the cure in one step, synchronous treatment choices to drainage have been attempted recently. We analyzed retrospectively 20 patients with pilonidal sinus abscess on whom we carried out drainage+ marsupialization as singlestep treatment. Methods: Drainage+ synchronous marsupialization results of 20 patients (17 male, 3 female) between 20 to 37 years of age (mean 28) were analyzed retrospectively on the parameters of operation time, recovery period, time to workreturn and recurrence ratios. Results Operation times were between 15 to 25 minutes. Mean recovery period was 45 days (3050 days), the mean period from operation to workreturn was 24 (2230) days. There were full recovery in 18 patients (90%) and recurrence in 2 patients (10%). Silver nitrate ablation treatment achieved cure in recurrences. Conclusion: Drainage+ Marsupialization is an applicable and successful combined choice in the treatment of Pilonidal sinus abscess.

Building a Beautiful China:A Definitive Exploration on Sustainable Economy

FINALLY,the world is witnessing what may well turn out to be the definitive how-to guide on building a sustainable economy that works in complete harmony with the environment:China’s transformation under the banner of an"ecological civilization."It’s been a long time coming.For well over a century,

Hermite Positive Definite Solution of the Quaternion Matrix Equation Xm + B*XB = C

This paper discusses the necessary and sufficient conditions for the existence of Hermite positive definite solutions of the quaternion matrix equation Xm+ B*XB = C (m > 0) and its iterative solution method. According to the characteristics of the coefficient matrix, a corresponding algebraic equation system is ingeniously constructed, and by discussing the equation system’s solvability, the matrix equation’s existence interval is obtained. Based on the characteristics of the coefficient matrix, some necessary and sufficient conditions for the existence of Hermitian positive definite solutions of the matrix equation are derived. Then, the upper and lower bounds of the positive actual solutions are estimated by using matrix inequalities. Four iteration formats are constructed according to the given conditions and existence intervals, and their convergence is proven. The selection method for the initial matrix is also provided. Finally, using the complexification operator of quaternion matrices, an equivalent iteration on the complex field is established to solve the equation in the Matlab environment. Two numerical examples are used to test the effectiveness and feasibility of the given method. .

中国脑小血管病的神经影像学诊断标准及名词标准化定义——来自中国卒中学会的专家共识

脑小血管病(small vessel disease,SVD)是一类以脑内小血管受损为主的临床影像综合征,可能会导致卒中、血管性认知障碍、神经心理疾病与其他功能障碍等。自2013年血管性神经病变的影像报告标准(standards for reporting vascular changes on neuroimaging,STRIVE)发布以来,SVD的神经影像学特征得到了初步的分类与标准化。然而,在临床实践与科学研究中,对SVD影像特征的认识和应用仍存在诸多不一致和不规范之处。随着对SVD病理生理机制的深入探索与影像技术的不断进步,新的SVD影像特征和定量标志物被相继发现,为SVD的诊断和评估提供了更为全面且精准的信息。在此基础上,STRIVE-2应运而生,以期能更全面地揭示SVD对脑功能与结构的影响。为了规范中国SVD的神经影像学评估和诊断,本共识将在STRIVE-2的基础上,结合中国具体国情,对SVD的神经影像学特征进行深入解读,旨在推动SVD影像学诊断术语的标准化,提高临床诊断的准确性,进一步促进相关领域的研究与进步。

基于深度学习文本摘要的科技名词释义生成方法

科技名词是科学技术形成、积累、交流和传播的前提和基础。为科技名词生成百科性释义,对于普通民众和中文学习者掌握科技名词内涵、正确使用术语具有很强的现实意义。文章提出了一种基于深度学习的科技名词百科释义生成方法。通过网络采集百科文本和专家撰写的术语释义文章,构建了科技名词百科释义数据集。基于T5 PEGASUS预训练模型并对模型进行微调,构建了生成式文本摘要模型和建立了科技名词释义生成系统。实验结果显示,本项研究所提出的模型在生成质量、语义连贯性和通用性等方面具有较高的性能。

复杂系统视角下数字领域“smart”概念的国际标准化共识构建及应用

进入数字时代,伴随大数据和人工智能技术快速发展和普遍应用,带有“smart”的指称不断涌现,然而关于“smart”概念的认知尚缺少跨领域和跨国际标准组织的标准化共识构建研究。采用ISO 704:2022的概念构建原则和方法,基于复杂系统论视角,对数字领域国际标准定义中涉及“smart”的概念特征进行了识别。基于跨领域国际标准组织专家的研讨、问卷调查和国际共识构建,提出了适应于复杂系统数字领域“smart”的通用概念,并将其用于指导《智慧城市城市智能服务体系构建指南》国家标准的制定过程。该研究对推进国家标准和国际标准兼容具有重要战略意义。

长持时地震动对建筑结构抗震影响的研究进展

该文综述了长持时地震动作用下建筑结构抗震性能的研究进展。介绍了长持时地震动的定义和特性;梳理了长持时地震动作用下建筑结构数值模拟、试验研究和理论分析的研究进展;详细综述了长持时地震动作用下建筑结构的延性性能、耗能能力、易损性和抗倒塌性能的研究进展。此外,介绍了考虑长持时地震作用影响的建筑结构抗震设计方法,梳理了国内外建筑结构抗震设计规范对长持时地震作用的考虑方法,并对长持时地震动作用下建筑结构抗震性能的研究进行了展望。建议关注长持时地震动作用下建筑结构的抗震性能,进一步研究长持时地震动的定义和特性,改进长持时地震动作用下建筑结构的数值模拟、理论分析和试验研究方法,深入探讨长持时地震动作用下各类建筑结构的地震响应、易损性和抗倒塌性能,为未来结构抗震设计及评估中考虑长持时地震作用的影响和规范修订提供参考。

国际视域下的微证书:概念界定、运行模式与本土化体系构建

微证书是终身学习理念下教育发展的重要趋势,利于帮助学习者搭建终身学习和不断进步的台阶,使其能够有效应对数字化时代就业市场对工作技能的新需求。从微证书的通用定义、设计原则、功能特征和运行模式等维度对相关概念进行界定,分析了世界范围内三个微证书体系的主要特征、模式,即欧洲的纵向发展体系、澳大利亚的横向发展体系以及美国和加拿大的附加增值体系,提出我国微证书体系建设要立足于服务人们终身学习与工作,坚持需求导向、能力本位,具备学习、流动、评价、认可和转换等功能,要突出一个成果、融通两个类型、建立三个机制、兼顾四个方面、把握好五种程度。

试论“谐体”与“本体”的界定区分及其重要意义

汉语学界多年前就开始对谐音结构中的“谐体”和“本体”加以界定和区分。尽管前述概念早已用开,但论及何谓谐体何谓本体始终是各说各话。目前流行的代表性观点主要有三种,而无论着眼于谐音生成的起与讫,还是着眼于形式表现的常与变,还是着眼于语义层次的内与外,均无法保证这三种观点无往不利。文章通过同比喻和借代相关概念的比较,亦即通过同喻体和本体、代体和本体的比较,以及基于术语系统对称性和整齐性的考量,提出将对应于手段还是对应于目的作为区分谐体和本体根据的新观点,并对此作了充分验证。科学界定和正确区分谐体和本体,对谐音构成机理的探究、谐音研究的学术交流、谐音译注的理解领会、语文教学的顺利开展及语文词典的规范编纂,都有着重要的学术价值和实践指导意义。

食品安全法律责任阶梯化的关键问题研究

食品安全法律责任阶梯化是解决食品安全领域法律责任合理化的一种重要途径,可以有效提高食品安全治理水平。当前存在行刑衔接缺失、惩罚性赔偿金额缺乏弹性、刑事责任设置不平等、一味从严设定的法律责任缺乏可操作性等问题。实现食品安全法律责任阶梯化应当遵循法律明确性原则和比例原则。刑事立法应当将危害食品安全犯罪的对象、主体、资格刑与行政法相协调,罚款应当折抵罚金。行政法律应当降低行政处罚的最低限度,实现行政责任梯度清晰化。惩罚性赔偿标准应当增强灵活性,并设置赔偿金额的上限。食品药品监管渎职罪应当增加罪刑阶梯。

宇航元器件需求工程化研究

面向宇航任务的元器件需求规划,为系统解决宇航元器件需求表达不完整、表征不准确的问题,文章提出了宇航元器件需求工程的概念并阐述了其内涵和范围,建立了宇航元器件需求工程的整体技术体系,研究了需求解析、需求建模、产品定义和需求验证等关键技术,阐述了4个关键技术在载人空间站工程中应用直流-直流(DC-DC)电源产品的典型案例。研究形成的技术体系和方法可以为宇航领域元器件需求规划、研制攻关提供参考。

不同类型的一体化编码对青年人和老年人在联结记忆任务中项目再认的影响

使用脑电探究不同的一体化对联结记忆任务中项目再认的影响及其相关的神经机制。两个实验分别使用复合词和定义操作自下而上和自上而下一体化。青年人的行为结果发现两种一体化的联结再认相当,项目再认也无显著差异。脑电结果发现复合词减少了顶区新/旧效应,定义缺失额区新/旧效应,说明青年人依据较少的神经活动达到相当的行为表现,支持“只有收益”观点。老年人的结果发现两种一体化都能提高联结再认,但对项目再认的影响不同。复合词在促进联结再认时也促进了项目再认,脑电结果发现仅在复合词下存在额区新/旧效应,显示复合词促进项目再认可能是源于熟悉性的增加,支持“只有收益”的观点。定义在促进联结再认时损害了项目再认,脑电结果发现定义缺失额区新/旧效应,显示定义对项目再认的损害可能源于熟悉性的缺失,支持“收支平衡”的观点。这些结果表明一体化促进还是损害老年人项目再认取决于自下而上和自上而下的一体化对认知资源的需求情况。