BACKGROUND Although chronic erosive gastritis(CEG)is common,its clinical characteristics have not been fully elucidated.The lack of consensus regarding its treatment has resulted in varied treatment regimens.AIM To ex...BACKGROUND Although chronic erosive gastritis(CEG)is common,its clinical characteristics have not been fully elucidated.The lack of consensus regarding its treatment has resulted in varied treatment regimens.AIM To explore the clinical characteristics,treatment patterns,and short-term outcomes in CEG patients in China.METHODS We recruited patients with chronic non-atrophic or mild-to-moderate atrophic gastritis with erosion based on endoscopy and pathology.Patients and treating physicians completed a questionnaire regarding history,endoscopic findings,and treatment plans as well as a follow-up questionnaire to investigate changes in symptoms after 4 wk of treatment.RESULTS Three thousand five hundred sixty-three patients from 42 centers across 24 cities in China were included.Epigastric pain(68.0%),abdominal distension(62.6%),and postprandial fullness(47.5%)were the most common presenting symptoms.Gastritis was classified as chronic non-atrophic in 69.9%of patients.Among those with erosive lesions,72.1%of patients had lesions in the antrum,51.0%had multiple lesions,and 67.3%had superficial flat lesions.In patients with epigastric pain,the combination of a mucosal protective agent(MPA)and proton pump inhibitor was more effective.For those with postprandial fullness,acid regurgitation,early satiety,or nausea,a MPA appeared more promising.CONCLUSION CEG is a multifactorial disease which is common in Asian patients and has non-specific symptoms.Gastroscopy may play a major role in its detection and diagnosis.Treatment should be individualized based on symptom profile.展开更多
Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death.China has the largest population of patients with traumatic spinal cord injury.Previous studies of traumatic ...Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death.China has the largest population of patients with traumatic spinal cord injury.Previous studies of traumatic spinal cord injury in China have mostly been regional in scope;national-level studies have been rare.To the best of our knowledge,no national-level study of treatment status and economic burden has been performed.This retrospective study aimed to examine the epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China at the national level.We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China.Patient epidemiological and clinical features,treatment status,and total and daily costs were recorded.Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program.The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall(annual percentage change,-0.5%and 2.1%,respectively).A total of 10,053(74.7%)patients underwent surgery.Only 2.8%of patients who underwent surgery did so within 24 hours of injury.A total of 2005(14.9%)patients were treated with high-dose(≥500 mg)methylprednisolone sodium succinate/methylprednisolone(MPSS/MP);615(4.6%)received it within 8 hours.The total cost for acute traumatic spinal cord injury decreased over the study period(-4.7%),while daily cost did not significantly change(1.0%increase).Our findings indicate that public health initiatives should aim at improving hospitals’ability to complete early surgery within 24 hours,which is associated with improved sensorimotor recovery,increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.展开更多
Magnesium(Mg)alloys are considered to be a new generation of revolutionary medical metals.Laser-beam powder bed fusion(PBF-LB)is suitable for fabricating metal implants withpersonalized and complicated structures.Howe...Magnesium(Mg)alloys are considered to be a new generation of revolutionary medical metals.Laser-beam powder bed fusion(PBF-LB)is suitable for fabricating metal implants withpersonalized and complicated structures.However,the as-built part usually exhibits undesirable microstructure and unsatisfactory performance.In this work,WE43 parts were firstly fabricated by PBF-LB and then subjected to heat treatment.Although a high densification rate of 99.91%was achieved using suitable processes,the as-built parts exhibited anisotropic and layeredmicrostructure with heterogeneously precipitated Nd-rich intermetallic.After heat treatment,fine and nano-scaled Mg24Y5particles were precipitated.Meanwhile,theα-Mg grainsunderwent recrystallization and turned coarsened slightly,which effectively weakened thetexture intensity and reduced the anisotropy.As a consequence,the yield strength and ultimate tensile strength were significantly improved to(250.2±3.5)MPa and(312±3.7)MPa,respectively,while the elongation was still maintained at a high level of 15.2%.Furthermore,the homogenized microstructure reduced the tendency of localized corrosion and favoredthe development of uniform passivation film.Thus,the degradation rate of WE43 parts was decreased by an order of magnitude.Besides,in-vitro cell experiments proved their favorable biocompatibility.展开更多
Context/Objectives: Tuberculosis (TB) and HIV co-infection is a serious health problem in Cameroon. The problems associated with poor adherence to treatment are on the increase worldwide. This problem can be observed ...Context/Objectives: Tuberculosis (TB) and HIV co-infection is a serious health problem in Cameroon. The problems associated with poor adherence to treatment are on the increase worldwide. This problem can be observed in all situations where patients are required to administer their own medication, whatever the type of illness. The general objective of this study was to assess the factors affecting adherence to treatment among HIV-TB co-infected patients in health facilities in the East Region in the COVID context. Method: A retrospective cohort study before and during COVID-19 was conducted in HIV care units in 13 health districts in the East Region of Cameroon. Data were collected using a questionnaire recorded in the Kobo Collect android application, analyzed using SPSS version 25 software and plotted using Excel. Results: The pre-COVID-19 cohort compared to the during-COVID-19 cohort had a 1.90 risk of not adhering to treatment (OR: 1.90, CI {1.90 - 3.37}) and the difference was statistically significant at the 5% level (p-value = 0.029). Frequency of adherence was 65.4% (140/214). Adherence before COVID-19 was 56.9% whereas during COVID-19, it was 74.3%. Conclusion: The implementation of targeted interventions in the COVID-19 context, using evidence-based data and integrating the individual needs of HIV-TB co-infected patients, improved adherence to concurrent anti-tuberculosis treatment and antiretroviral therapy during the COVID-19 Era.展开更多
To the editor:In the USA alone,there were 1.7 million suicide attempts in 2021.1 Although the majority of suicide attempts are not fatal,immediate medical attention is often necessary,especially when violent methods a...To the editor:In the USA alone,there were 1.7 million suicide attempts in 2021.1 Although the majority of suicide attempts are not fatal,immediate medical attention is often necessary,especially when violent methods are used.2 These methods include jumping from heights,using a firearm,crashing a motor vehicle,and lying down or jumping in front of a moving object.展开更多
Extracorporeal membrane oxygenation(ECMO)is a technology that can temporarily take over the functions of the heart and lungs.Acute kidney injury is a common issue in patients receiving ECMO treatment,with reported inc...Extracorporeal membrane oxygenation(ECMO)is a technology that can temporarily take over the functions of the heart and lungs.Acute kidney injury is a common issue in patients receiving ECMO treatment,with reported incidence rates ranging from 70%to 85%.[1]To maintain the balance of fluids and electrolytes in patients,continuous renal replacement therapy(CRRT)is frequently employed.展开更多
To the Editor:SARS-CoV-2,the pathogen responsible for the pandemic of coronavirus disease 2019(COVID-19),has had profound impacts on human health,and its antagonist Paxlovid is a commonly used treatment option[1].Howe...To the Editor:SARS-CoV-2,the pathogen responsible for the pandemic of coronavirus disease 2019(COVID-19),has had profound impacts on human health,and its antagonist Paxlovid is a commonly used treatment option[1].However,treatment selection for immunosuppressed patients,such as liver recipients,remains uncertain due to potential drug interactions and the risk of immunosuppressant dosage adjustment,which can cause liver injury[2].展开更多
The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.This is the third section of the report with a specific focus on community-based prevention a...The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.This is the third section of the report with a specific focus on community-based prevention and treatment of cardiovascular diseases(CVD).This section of the report underscores the importance of initiatives outlined in the"Healthy China 2030 Plan,"emphasizing the comprehensive prevention and control strategy for chronic diseases.A key aspect of this plan involves the establishment of national demonstration areas aimed at comprehensive prevention and control of chronic diseases.By 2020,488 such areas had been set up across China,surpassing the initial target and covering a significant proportion of counties and districts.The report highlights the successful implementation of these strategies in Lishan district,Anshan city,where demonstration areas for comprehensive prevention and control of chronic diseases were launched in 2013.Over the course of seven years,the number of healthy units increased substantially,leading to improvements in managing risk factors for CVD among residents.Significant reductions in prevalence rates of overweight,obesity,smoking,passive smoking,and drinking were observed,along with the development of healthier behaviors among residents.Similarly,Qiaokou district in Wuhan City,designated as a national demonstration area in 2014,implemented comprehensive public health promotion initiatives.Notably,special clinics for hypertension intervention were established,contributing to an increase in self-reported rates of hypertension,a slight decrease in prevalence,and a remarkable improvement in the control rate among treated patients.Overall,these efforts underscore the effectiveness of community-based approaches in driving positive health outcomes and advancing the comprehensive prevention and control of chronic diseases,particularly cardiovascular diseases,in China.展开更多
Introduction: Medical treatment for POAG is continuous and lifelong treatment. The aim of this study was to evaluate the relationship between the cost of this treatment and patients’ income and the impact of this rel...Introduction: Medical treatment for POAG is continuous and lifelong treatment. The aim of this study was to evaluate the relationship between the cost of this treatment and patients’ income and the impact of this relationship on treatment compliance. Materials and Methods: Prospective cross-sectional study with a descriptive aim covering sociodemographic data, average incomes, and direct and indirect costs of treatment of 57 patients followed for POAG during the period from January 1, 2012, to December 31, 2016 (5 years). Results: The patients were aged 25 to 77 years (mean = 54.4 years) with a male predominance (sex ratio = 1.5). Retirees were the most represented (26.32%), followed by workers in the informal sector (14.04%) and housewives (12.28%). Patients who had an annual income less than or equal to 900,000 CFA francs (€1370.83) per year represented 56.14% and those who did not have health coverage represented 57.89%. The treatment was monotherapy (64.91%), dual therapy (31.58%) or triple therapy (3.05%) and the average ratio of “annual cost of treatment to annual income” was 0.56 with for maximum 2.23 and 0.02 as minimum. Patients who considered the cost of treatment unbearable for their income represented 78.95%. Conclusion: Prevention of blindness due to glaucoma requires early detection but also the establishment of health coverage mechanisms to improve compliance with medical treatment. In addition, consideration should be given to the development of glaucoma surgery in our country, the indication of which could be the first intention in certain patients, considering for those patients, the geographical and financial accessibility of medical treatment. .展开更多
Background Structural imaging holds great potential for precise targeting and stimulation for deep brain stimulation(DBS).The anatomical information it provides may serve as potential biomarkers for predicting the eff...Background Structural imaging holds great potential for precise targeting and stimulation for deep brain stimulation(DBS).The anatomical information it provides may serve as potential biomarkers for predicting the efficacy of DBS in treatment-resistant depression(TRD).Aims The primary aim is to identify preoperative imaging biomarkers that correlate with the efficacy of DBS in patients with TRD.Methods Preoperative imaging parameters were estimated and correlated with the 6-month clinical outcome of patients with TRD receiving combined bed nucleus of the stria terminalis(BNST)-nucleus accumbens(NAc)DBS.White matter(WM)properties were extracted and compared between the response/non-response and remission/non-remission groups.Structural connectome was constructed and analysed using graph theory.Distances of the volume of activated tissue(VAT)to the main modulating tracts were also estimated to evaluate the correlations.Results Differences in fibre bundle properties of tracts,including superior thalamic radiation and reticulospinal tract,were observed between the remission and nonremission groups.Distance of the centre of the VAT to tracts connecting the ventral tegmental area and the anterior limb of internal capsule on the left side varied between the remission and non-remission groups(p=0.010,t=3.07).The normalised clustering coefficient(γ)and the small-world property(σ)in graph analysis correlated with the symptom improvement after the correction of age.Conclusions Presurgical structural alterations in WM tracts connecting the frontal area with subcortical regions,as well as the distance of the VAT to the modulating tracts,may influence the clinical outcome of BNST-NAc DBS.These findings provide potential imaging biomarkers for the DBS treatment for patients with TRD.展开更多
Background The presence of mental health conditions is pervasive in patients who experienced acute myocardial infarction(AMI),significantly disrupting their recovery.Providing timely and easily accessible psychologica...Background The presence of mental health conditions is pervasive in patients who experienced acute myocardial infarction(AMI),significantly disrupting their recovery.Providing timely and easily accessible psychological interventions using virtual reality-based cognitive-behavioural therapy(VR-CBT)could potentially improve both acute and long-term symptoms affecting their mental health.Aims We aim to examine the effectiveness of VR-CBT on anxiety symptoms in patients with AMI who were admitted to the intensive care unit(ICU)during the acute stage of their illness.Methods In this single-blind randomised clinical trial,participants with anxiety symptoms who were admitted to the ICU due to AMI were continuously recruited from December 2022 to February 2023.Patients who were Han Chinese aged 18-75 years were randomly assigned(1:1)via block randomisation to either the VR-CBT group to receive VR-CBT in addition to standard mental health support,or the control group to receive standard mental health support only.VR-CBT consisted of four modules and was delivered at the bedside over a 1-week period.Assessments were done at baseline,immediately after treatment and at 3-month follow-up.The intention-to-treat analysis began in June 2023.The primary outcome measure was the changes in anxiety symptoms as assessed by the Hamilton Anxiety Rating Scale(HAM-A).Results Among 148 randomised participants,70 were assigned to the VR-CBT group and 78 to the control group.The 1-week VR-CBT intervention plus standard mental health support significantly reduced the anxiety symptoms compared with standard mental health support alone in terms of HAM-A scores at both post intervention(Cohen’s d=−1.27(95%confidence interval(CI):−1.64 to−0.90,p<0.001)and 3-month follow-up(Cohen’s d=−0.37(95%CI:−0.72 to−0.01,p=0.024).Of the 70 participants who received VR-CBT,62(88.6%)completed the entire intervention.Cybersickness was the main reported adverse event(n=5).Conclusions Our results indicate that VR-CBT can significantly reduce post-AMI anxiety at the acute stage of the illness;the improvement was maintained at the 3-month follow-up.Trial registration number The trial was registered at www.chictr.org.cn with the identifier:ChiCTR2200066435.展开更多
In recent years,ultra-wide bandgap β-Ga_(2)O_(3) has emerged as a fascinating semiconductor material due to its great potential in power and photoelectric devices.In semiconductor industrial,thermal treatment has bee...In recent years,ultra-wide bandgap β-Ga_(2)O_(3) has emerged as a fascinating semiconductor material due to its great potential in power and photoelectric devices.In semiconductor industrial,thermal treatment has been widely utilized as a convenient and effective approach for substrate property modulation and device fabrication.Thus,a thorough summary of β-Ga_(2)O_(3) substrates and devices behaviors after high-temperature treatment should be significant.In this review,we present the recent advances in modulating properties of β-Ga_(2)O_(3) substrates by thermal treatment,which include three major applications:(ⅰ)tuning surface electrical properties,(ⅱ)modifying surface morphology,and(ⅲ)oxidating films.Meanwhile,regulating electrical contacts and handling with radiation damage and ion implantation have also been discussed in device fabrication.In each category,universal annealing conditions were speculated to figure out the corresponding problems,and some unsolved questions were proposed clearly.This review could construct a systematic thermal treatment strategy for various purposes and applications of β-Ga_(2)O_(3).展开更多
The purpose of this paper is to examine the effect of processing parameters and subsequent heat treatments on the microstructures and bonding strengths of Ti-6Al-4V/AA1050 laminations formed via a non-equal channel la...The purpose of this paper is to examine the effect of processing parameters and subsequent heat treatments on the microstructures and bonding strengths of Ti-6Al-4V/AA1050 laminations formed via a non-equal channel lateral co-extrusion process.The microstructural evolution and growth mechanism in the diffusion layer were discussed further to optimize the bonding quality by appropriately adjusting process parameters.Scanning electron microscopes(SEM),energy dispersive spectrometer(EDS),and X-ray diffraction(XRD)were used to characterize interfacial diffusion layers.The shear test was used to determine the mechanical properties of the interfacial diffusion layer.The experimental results indicate that it is possible to co-extrusion Ti-6Al-4V/AA1050 compound profiles using non-equal channel lateral co-extrusion.Different heat treatment processes affect the thickness of the diffusion layer.When the temperature and time of heat treatment increase,the thickness of the reaction layers increases dramatically.Additionally,the shear strength of the Ti-6Al-4V/AA1050 composite interface is proportional to the diffusion layer thickness.It is observed that a medium interface thickness results in superior mechanical performance when compared to neither a greater nor a lesser interface thickness.Microstructural characterization of all heat treatments reveals that the only intermetallic compound observed in the diffusion layers is TiAl_(3).Due to the inter-diffusion of Ti and Al atoms,the TiAl_(3) layer grows primarily at AA1050/TiAl_(3) interfaces.展开更多
This review describes the mechanisms of natural coagulants.It provides a good understanding of the two key processes of coagulation-flocculation:adsorption and charge neutralization,as well as adsorption and bridging....This review describes the mechanisms of natural coagulants.It provides a good understanding of the two key processes of coagulation-flocculation:adsorption and charge neutralization,as well as adsorption and bridging.Various factors have influence the coagulation/flocculation process,including the effect of pH,coagulant dosage,coagulant type,temperature,initial turbidity,coagulation speed,flocculation speed,coagulation and flocculation time,settling time,colloidal particles,zeta potential,the effects of humic acids,and extraction density are explained.The bio-coagulants derived from plants are outlined.The impact of organic coagulants on water quality,focusing on their effects on the physicochemical parameters of water,heavy metals removal,and bacteriological water quality,is examined.The methods of extraction and purification of plant-based coagulants,highlighting techniques such as solvent extraction and ultrasonic extraction,are discussed.It also examines the parameters that influence these processes.The methods and principles of purification of coagulating agents,including dialysis,freeze-drying,ion exchange,electrophoresis,filtration,and centrifugation,are listed.Finally,it evaluates the sustainability of natural coagulants,focusing on the environmental,technical,and economic aspects of their use.At the end of this review,the readers should have a comprehensive understanding of the mechanisms,selection,extraction,purification,and sustainability of plant-based natural coagulants in water treatment.展开更多
Phytobezoars is a rare disease and less common in Western countries.The stomach is the primary site for these formations,and endoscopic treatment involving fragmentation and extraction has traditionally been the most ...Phytobezoars is a rare disease and less common in Western countries.The stomach is the primary site for these formations,and endoscopic treatment involving fragmentation and extraction has traditionally been the most effective approach.However,medical treatments using enzymatic and chemical agents,such as cellulase and Coca-Cola,aimed at dissolving the bezoars,have also been utilized,showing varying degrees of resolution success.Notably,the oral dissolution treatment with Coca-Cola has emerged as a promising,simpler,and more costeffective method.The study by Liu et al represents an important step in clinical research on this topic,despite some limitations that need addressing for a more comprehensive understanding of its findings.Key considerations for future research include sample size calculation,endoscopic procedure details,outpatient vs.inpatient treatment,and detailed cost calculations.The study's exclusions,such as patients with upper gastric surgery,phytobezoars older than 14 d,and cases of gastroparesis,limit its applicability to broader populations,especially in Western countries.Given the promising outcomes of the Coca-Cola treatment,it's advocated as a first-line therapy for phytobezoars.Nonetheless,further research is essential to overcome these limitations.However special situations such as perforation or small bowel obstruction will require surgical treatment.展开更多
BACKGROUND The incidence of patients with early-onset pancreatic cancer(EOPC;age≤50 years at diagnosis)is on the rise,placing a heavy burden on individuals,families,and society.The role of combination therapy includi...BACKGROUND The incidence of patients with early-onset pancreatic cancer(EOPC;age≤50 years at diagnosis)is on the rise,placing a heavy burden on individuals,families,and society.The role of combination therapy including surgery,radiotherapy,and chemotherapy in non-metastatic EOPC is not well-defined.AIM To investigate the treatment patterns and survival outcomes in patients with non-metastatic EOPC.METHODS A total of 277 patients with non-metastatic EOPC who were treated at our institution between 2017 and 2021 were investigated retrospectively.Overall survival(OS),disease-free survival,and progression-free survival were estimated using the Kaplan-Meier method.Univariate and multivariate analyses with the Cox proportional hazards model were used to identify prognostic factors.RESULTS With a median follow-up time of 34.6 months,the 1-year,2-year,and 3-year OS rates for the entire cohort were 84.3%,51.5%,and 27.6%,respectively.The median OS of patients with localized disease who received surgery alone and adjuvant therapy(AT)were 21.2 months and 28.8 months,respectively(P=0.007).The median OS of patients with locally advanced disease who received radiotherapy-based combination therapy(RCT),surgery after neoadjuvant therapy(NAT),and chemotherapy were 28.5 months,25.6 months,and 14.0 months,respectively(P=0.002).The median OS after regional recurrence were 16.0 months,13.4 months,and 8.9 months in the RCT,chemotherapy,and supportive therapy groups,respectively(P=0.035).Multivariate analysis demonstrated that carbohydrate antigen 19-9 level,pathological grade,T-stage,N-stage,and resection were independent prognostic factors for non-metastatic EOPC.CONCLUSION AT improves postoperative survival in localized patients.Surgery after NAT and RCT are the preferred therapeutic options for patients with locally advanced EOPC.展开更多
AIM:To demonstrate the outcomes of translacrimal canalicular drainage using a lacrimal probe and intranasal drainage by D-silicone intubation for acute dacryocystitis(AD).METHODS:This retrospective study included 23 p...AIM:To demonstrate the outcomes of translacrimal canalicular drainage using a lacrimal probe and intranasal drainage by D-silicone intubation for acute dacryocystitis(AD).METHODS:This retrospective study included 23 patients with AD and had undergone abscess decompression with the use of lacrimal probe and intranasal drainage by D-silicone intubation between January 2019 and December 2022.Patients received abscess decompression and systemic antibiotic-corticosteroid from the time of diagnosis.D-silicone tube was inserted within 10d after diagnosis and removed 3-6mo after intubation.The procedure and outcomes of this method were evaluated.RESULTS:All patients showed improvement of signs and symptoms of AD within 72h.No intraoperative and postoperative complications were observed.No recurrence of lacrimal sac abscesses occurred after D-silicone tube removed.CONCLUSION:Lacrimal probe and D-silicone intubation appear to be a feasible,minimally invasive,safe,and effective method,which could be a reasonable choice in the treatment of AD.展开更多
The basal texture of traditional magnesium alloy AZ31 is easy to form and exhibits poor plasticity at room temperature.To address these problems,a multi-micro-alloyed high-plasticity Mg-1.8Zn-0.8Gd-0.1Ca-0.2Mn(wt%)all...The basal texture of traditional magnesium alloy AZ31 is easy to form and exhibits poor plasticity at room temperature.To address these problems,a multi-micro-alloyed high-plasticity Mg-1.8Zn-0.8Gd-0.1Ca-0.2Mn(wt%)alloy was developed using the unique role of rare earth and Ca solute atoms.In addition,the influence of the annealing process on the grain size,second phase,texture,and mechanical properties of the warm-rolled sheet at room temperature was analyzed with the goal of developing high-plasticity mag-nesium alloy sheets and obtaining optimal thermal-mechanical treatment parameters.The results show that the annealing temperature has a significant effect on the microstructure and properties due to the low alloying content:there are small amounts of larger-sized block and long string phases along the rolling direction(RD),as well as several spherical and rodlike particle phases inside the grains.With increas-ing annealing temperature,the grain size decreases and then increases,and the morphology,number,and size of the second phase also change correspondingly.The particle phase within the grains vanishes at 450℃,and the grain size increases sharply.In the full recrystal-lization stage at 300-350℃,the optimum strength-plasticity comprehensive mechanical properties are presented,with yield strengths of 182.1 and 176.9 MPa,tensile strengths of 271.1 and 275.8 MPa in the RD and transverse direction(TD),and elongation values of 27.4%and 32.3%,respectively.Moreover,there are still some larger-sized phases in the alloy that influence its mechanical properties,which offers room for improvement.展开更多
Gastric cancer ranks as the sixth most prevalent cancer worldwide.In recent research within the realm of gastric cancer treatment,the identification and application of immune-related genetic features have emerged as g...Gastric cancer ranks as the sixth most prevalent cancer worldwide.In recent research within the realm of gastric cancer treatment,the identification and application of immune-related genetic features have emerged as groundbreaking advancements.The study by Ma et al,which developed a prognostic model based on 10 genes,categorizes patients into high and low-risk groups to predict their responsiveness to immune checkpoint inhibitor therapy.This research underscores the potential of immune-related genes as biomarkers for personalized treatment,offering insights into tumor mutation burden and immune phenotype scores.We advocate for further validation,understanding of biological mechanisms,and integration of diverse datasets to enhance the model's predictive accuracy and clinical application,marking a significant step towards personalized and precise treatment for gastric cancer.展开更多
Background: Treatment non-adherence poses significant risks to health outcomes and impedes the health system’s efficiency, hence curtailing progress towards the end Tuberculosis (TB) strategy under SDG 3.3. Despite i...Background: Treatment non-adherence poses significant risks to health outcomes and impedes the health system’s efficiency, hence curtailing progress towards the end Tuberculosis (TB) strategy under SDG 3.3. Despite interventions to address TB treatment non-adherence, Kenya still reports high TB treatment non-adherence rates of 35% and consequently poor treatment outcome rates. Health Care Workers (HCWs) play a critical role in linking the population to health services, yet little is known of their influence on patients’ TB treatment non-adherence in Kenya. Objective: To analyze HCW-related factors associated with TB treatment non-adherence among patients in Kisumu East Sub-County. Methods: Health facility-based analytical cross-sectional mixed-method study. A Semi-structured questionnaire on treatment adherence and patients’ perceptions of HCWs during the clinic visit was administered to 102 consenting adult (out of a total census of 107 adults) drug-susceptible TB patients. 12 purposively selected HCWs by rank from 6 health facilities participated in Key Informant Interview sessions. Medication adherence was measured using the Morisky Medication Adherence Scale and then expressed as a dichotomous variable. Quantitative analysis utilized STATA version 15.1 while qualitative deductive thematic analysis was done using NVIVO version 14. Results: TB treatment non-adherence rate of 26% (CI: 18% - 36%) was recorded. Overall, patients who felt supported in dealing with the illness were 8 times more likely to adhere to treatment compared to those who were not (aOR = 7.947, 95% CI: 2.214 - 28.527, p = 0.001). Key HCW related factors influencing adherence to treatment included: friendliness (cOR = 4.31, 95% CI: 1.514 - 12.284, p = 0.006), respect (cOR = 6.679, 95% CI: 2.239 - 19.923, p = 0.001) and non-discriminatory service (cOR = 0.1478, 95% CI: 0.047 - 0.464, p = 0.001), communication [adequacy of consultation time (cOR = 6.563, 95% CI: 2.467 - 17.458, p = 0.001) and patients’ involvement in their health decisions (cOR = 3.02 95% CI: 1.061 - 8.592, p = 0.038)] and education and counselling (cOR = 4.371, 95% CI: 1.725 - 11.075, p = 0.002). Conclusion: The study results underline importance of patient-centered consultation for TB patients and targeted education and counselling for improved treatment adherence.展开更多
基金the National Key Clinical Specialty Construction Project,No.ZK108000CAMS Innovation Fund for Medical Sciences,No.2021-I2M-C&T-A-001 and No.2022-I2M-C&T-B-012.
文摘BACKGROUND Although chronic erosive gastritis(CEG)is common,its clinical characteristics have not been fully elucidated.The lack of consensus regarding its treatment has resulted in varied treatment regimens.AIM To explore the clinical characteristics,treatment patterns,and short-term outcomes in CEG patients in China.METHODS We recruited patients with chronic non-atrophic or mild-to-moderate atrophic gastritis with erosion based on endoscopy and pathology.Patients and treating physicians completed a questionnaire regarding history,endoscopic findings,and treatment plans as well as a follow-up questionnaire to investigate changes in symptoms after 4 wk of treatment.RESULTS Three thousand five hundred sixty-three patients from 42 centers across 24 cities in China were included.Epigastric pain(68.0%),abdominal distension(62.6%),and postprandial fullness(47.5%)were the most common presenting symptoms.Gastritis was classified as chronic non-atrophic in 69.9%of patients.Among those with erosive lesions,72.1%of patients had lesions in the antrum,51.0%had multiple lesions,and 67.3%had superficial flat lesions.In patients with epigastric pain,the combination of a mucosal protective agent(MPA)and proton pump inhibitor was more effective.For those with postprandial fullness,acid regurgitation,early satiety,or nausea,a MPA appeared more promising.CONCLUSION CEG is a multifactorial disease which is common in Asian patients and has non-specific symptoms.Gastroscopy may play a major role in its detection and diagnosis.Treatment should be individualized based on symptom profile.
基金supported by the National Key Research and Development Project,No.2019YFA0112100(to SF).
文摘Traumatic spinal cord injury is potentially catastrophic and can lead to permanent disability or even death.China has the largest population of patients with traumatic spinal cord injury.Previous studies of traumatic spinal cord injury in China have mostly been regional in scope;national-level studies have been rare.To the best of our knowledge,no national-level study of treatment status and economic burden has been performed.This retrospective study aimed to examine the epidemiological and clinical features,treatment status,and economic burden of traumatic spinal cord injury in China at the national level.We included 13,465 traumatic spinal cord injury patients who were injured between January 2013 and December 2018 and treated in 30 hospitals in 11 provinces/municipalities representing all geographical divisions of China.Patient epidemiological and clinical features,treatment status,and total and daily costs were recorded.Trends in the percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department and cost of care were assessed by annual percentage change using the Joinpoint Regression Program.The percentage of traumatic spinal cord injuries among all hospitalized patients and among patients hospitalized in the orthopedic department did not significantly change overall(annual percentage change,-0.5%and 2.1%,respectively).A total of 10,053(74.7%)patients underwent surgery.Only 2.8%of patients who underwent surgery did so within 24 hours of injury.A total of 2005(14.9%)patients were treated with high-dose(≥500 mg)methylprednisolone sodium succinate/methylprednisolone(MPSS/MP);615(4.6%)received it within 8 hours.The total cost for acute traumatic spinal cord injury decreased over the study period(-4.7%),while daily cost did not significantly change(1.0%increase).Our findings indicate that public health initiatives should aim at improving hospitals’ability to complete early surgery within 24 hours,which is associated with improved sensorimotor recovery,increasing the awareness rate of clinical guidelines related to high-dose MPSS/MP to reduce the use of the treatment with insufficient evidence.
基金supported by the following funds:National Natural Science Foundation of China(51935014,52165043)Jiangxi Provincial Cultivation Program for Academic and Technical Leaders of Major Subjects(20225BCJ23008)+1 种基金Jiangxi Provincial Natural Science Foundation(20224ACB204013,20224ACB214008)Scientific Research Project of Anhui Universities(KJ2021A1106)。
文摘Magnesium(Mg)alloys are considered to be a new generation of revolutionary medical metals.Laser-beam powder bed fusion(PBF-LB)is suitable for fabricating metal implants withpersonalized and complicated structures.However,the as-built part usually exhibits undesirable microstructure and unsatisfactory performance.In this work,WE43 parts were firstly fabricated by PBF-LB and then subjected to heat treatment.Although a high densification rate of 99.91%was achieved using suitable processes,the as-built parts exhibited anisotropic and layeredmicrostructure with heterogeneously precipitated Nd-rich intermetallic.After heat treatment,fine and nano-scaled Mg24Y5particles were precipitated.Meanwhile,theα-Mg grainsunderwent recrystallization and turned coarsened slightly,which effectively weakened thetexture intensity and reduced the anisotropy.As a consequence,the yield strength and ultimate tensile strength were significantly improved to(250.2±3.5)MPa and(312±3.7)MPa,respectively,while the elongation was still maintained at a high level of 15.2%.Furthermore,the homogenized microstructure reduced the tendency of localized corrosion and favoredthe development of uniform passivation film.Thus,the degradation rate of WE43 parts was decreased by an order of magnitude.Besides,in-vitro cell experiments proved their favorable biocompatibility.
文摘Context/Objectives: Tuberculosis (TB) and HIV co-infection is a serious health problem in Cameroon. The problems associated with poor adherence to treatment are on the increase worldwide. This problem can be observed in all situations where patients are required to administer their own medication, whatever the type of illness. The general objective of this study was to assess the factors affecting adherence to treatment among HIV-TB co-infected patients in health facilities in the East Region in the COVID context. Method: A retrospective cohort study before and during COVID-19 was conducted in HIV care units in 13 health districts in the East Region of Cameroon. Data were collected using a questionnaire recorded in the Kobo Collect android application, analyzed using SPSS version 25 software and plotted using Excel. Results: The pre-COVID-19 cohort compared to the during-COVID-19 cohort had a 1.90 risk of not adhering to treatment (OR: 1.90, CI {1.90 - 3.37}) and the difference was statistically significant at the 5% level (p-value = 0.029). Frequency of adherence was 65.4% (140/214). Adherence before COVID-19 was 56.9% whereas during COVID-19, it was 74.3%. Conclusion: The implementation of targeted interventions in the COVID-19 context, using evidence-based data and integrating the individual needs of HIV-TB co-infected patients, improved adherence to concurrent anti-tuberculosis treatment and antiretroviral therapy during the COVID-19 Era.
文摘To the editor:In the USA alone,there were 1.7 million suicide attempts in 2021.1 Although the majority of suicide attempts are not fatal,immediate medical attention is often necessary,especially when violent methods are used.2 These methods include jumping from heights,using a firearm,crashing a motor vehicle,and lying down or jumping in front of a moving object.
文摘Extracorporeal membrane oxygenation(ECMO)is a technology that can temporarily take over the functions of the heart and lungs.Acute kidney injury is a common issue in patients receiving ECMO treatment,with reported incidence rates ranging from 70%to 85%.[1]To maintain the balance of fluids and electrolytes in patients,continuous renal replacement therapy(CRRT)is frequently employed.
基金The study was supported by grants from the National Natural Science Foundation of China(81871259,81971495,82070675,81530048,82200731 and 81570562)the Foundation of Jiangsu Collaborative Innovation Center of Biomedical Functional Materials,and the Priority Academic Program Development of Jiangsu Higher Education Institutions.
文摘To the Editor:SARS-CoV-2,the pathogen responsible for the pandemic of coronavirus disease 2019(COVID-19),has had profound impacts on human health,and its antagonist Paxlovid is a commonly used treatment option[1].However,treatment selection for immunosuppressed patients,such as liver recipients,remains uncertain due to potential drug interactions and the risk of immunosuppressant dosage adjustment,which can cause liver injury[2].
文摘The Annual Report on Cardiovascular Health and Diseases in China(2022)intricate landscape of cardiovascular health in China.This is the third section of the report with a specific focus on community-based prevention and treatment of cardiovascular diseases(CVD).This section of the report underscores the importance of initiatives outlined in the"Healthy China 2030 Plan,"emphasizing the comprehensive prevention and control strategy for chronic diseases.A key aspect of this plan involves the establishment of national demonstration areas aimed at comprehensive prevention and control of chronic diseases.By 2020,488 such areas had been set up across China,surpassing the initial target and covering a significant proportion of counties and districts.The report highlights the successful implementation of these strategies in Lishan district,Anshan city,where demonstration areas for comprehensive prevention and control of chronic diseases were launched in 2013.Over the course of seven years,the number of healthy units increased substantially,leading to improvements in managing risk factors for CVD among residents.Significant reductions in prevalence rates of overweight,obesity,smoking,passive smoking,and drinking were observed,along with the development of healthier behaviors among residents.Similarly,Qiaokou district in Wuhan City,designated as a national demonstration area in 2014,implemented comprehensive public health promotion initiatives.Notably,special clinics for hypertension intervention were established,contributing to an increase in self-reported rates of hypertension,a slight decrease in prevalence,and a remarkable improvement in the control rate among treated patients.Overall,these efforts underscore the effectiveness of community-based approaches in driving positive health outcomes and advancing the comprehensive prevention and control of chronic diseases,particularly cardiovascular diseases,in China.
文摘Introduction: Medical treatment for POAG is continuous and lifelong treatment. The aim of this study was to evaluate the relationship between the cost of this treatment and patients’ income and the impact of this relationship on treatment compliance. Materials and Methods: Prospective cross-sectional study with a descriptive aim covering sociodemographic data, average incomes, and direct and indirect costs of treatment of 57 patients followed for POAG during the period from January 1, 2012, to December 31, 2016 (5 years). Results: The patients were aged 25 to 77 years (mean = 54.4 years) with a male predominance (sex ratio = 1.5). Retirees were the most represented (26.32%), followed by workers in the informal sector (14.04%) and housewives (12.28%). Patients who had an annual income less than or equal to 900,000 CFA francs (€1370.83) per year represented 56.14% and those who did not have health coverage represented 57.89%. The treatment was monotherapy (64.91%), dual therapy (31.58%) or triple therapy (3.05%) and the average ratio of “annual cost of treatment to annual income” was 0.56 with for maximum 2.23 and 0.02 as minimum. Patients who considered the cost of treatment unbearable for their income represented 78.95%. Conclusion: Prevention of blindness due to glaucoma requires early detection but also the establishment of health coverage mechanisms to improve compliance with medical treatment. In addition, consideration should be given to the development of glaucoma surgery in our country, the indication of which could be the first intention in certain patients, considering for those patients, the geographical and financial accessibility of medical treatment. .
基金supported by an unrestricted,investigator-initiated research grant by Scenery(BS),which provided the devices used.The project was sponsored by SJTU Trans-med Awards Research(2019015 to BS)Shanghai Clinical Research Centre for Mental Health(19MC191100 to BS)+3 种基金sponsored by the National Natural Science Foundation of China(81771482)supported by the Guangci Professorship Programme of Ruijin Hospital(N/A)and a Medical Research Council Senior Clinical Fellowship(MR/P008747/1)sponsored by the National Natural Science Foundation of China(82101546)the Shanghai Sailing Program(21YF1426700).The funding sources were not involved in the design and conduct of the study。
文摘Background Structural imaging holds great potential for precise targeting and stimulation for deep brain stimulation(DBS).The anatomical information it provides may serve as potential biomarkers for predicting the efficacy of DBS in treatment-resistant depression(TRD).Aims The primary aim is to identify preoperative imaging biomarkers that correlate with the efficacy of DBS in patients with TRD.Methods Preoperative imaging parameters were estimated and correlated with the 6-month clinical outcome of patients with TRD receiving combined bed nucleus of the stria terminalis(BNST)-nucleus accumbens(NAc)DBS.White matter(WM)properties were extracted and compared between the response/non-response and remission/non-remission groups.Structural connectome was constructed and analysed using graph theory.Distances of the volume of activated tissue(VAT)to the main modulating tracts were also estimated to evaluate the correlations.Results Differences in fibre bundle properties of tracts,including superior thalamic radiation and reticulospinal tract,were observed between the remission and nonremission groups.Distance of the centre of the VAT to tracts connecting the ventral tegmental area and the anterior limb of internal capsule on the left side varied between the remission and non-remission groups(p=0.010,t=3.07).The normalised clustering coefficient(γ)and the small-world property(σ)in graph analysis correlated with the symptom improvement after the correction of age.Conclusions Presurgical structural alterations in WM tracts connecting the frontal area with subcortical regions,as well as the distance of the VAT to the modulating tracts,may influence the clinical outcome of BNST-NAc DBS.These findings provide potential imaging biomarkers for the DBS treatment for patients with TRD.
基金The study was supported by the Transverse Project of Zhongshan Hospital and Hangzhou Xinjing Science and Technology(XH,H2022-009)National Key Research and Development Program of China(XH,2023YFC2506200)Shanghai Clinical Research Center for Interventional Medicine(JBG,19MC1910300).
文摘Background The presence of mental health conditions is pervasive in patients who experienced acute myocardial infarction(AMI),significantly disrupting their recovery.Providing timely and easily accessible psychological interventions using virtual reality-based cognitive-behavioural therapy(VR-CBT)could potentially improve both acute and long-term symptoms affecting their mental health.Aims We aim to examine the effectiveness of VR-CBT on anxiety symptoms in patients with AMI who were admitted to the intensive care unit(ICU)during the acute stage of their illness.Methods In this single-blind randomised clinical trial,participants with anxiety symptoms who were admitted to the ICU due to AMI were continuously recruited from December 2022 to February 2023.Patients who were Han Chinese aged 18-75 years were randomly assigned(1:1)via block randomisation to either the VR-CBT group to receive VR-CBT in addition to standard mental health support,or the control group to receive standard mental health support only.VR-CBT consisted of four modules and was delivered at the bedside over a 1-week period.Assessments were done at baseline,immediately after treatment and at 3-month follow-up.The intention-to-treat analysis began in June 2023.The primary outcome measure was the changes in anxiety symptoms as assessed by the Hamilton Anxiety Rating Scale(HAM-A).Results Among 148 randomised participants,70 were assigned to the VR-CBT group and 78 to the control group.The 1-week VR-CBT intervention plus standard mental health support significantly reduced the anxiety symptoms compared with standard mental health support alone in terms of HAM-A scores at both post intervention(Cohen’s d=−1.27(95%confidence interval(CI):−1.64 to−0.90,p<0.001)and 3-month follow-up(Cohen’s d=−0.37(95%CI:−0.72 to−0.01,p=0.024).Of the 70 participants who received VR-CBT,62(88.6%)completed the entire intervention.Cybersickness was the main reported adverse event(n=5).Conclusions Our results indicate that VR-CBT can significantly reduce post-AMI anxiety at the acute stage of the illness;the improvement was maintained at the 3-month follow-up.Trial registration number The trial was registered at www.chictr.org.cn with the identifier:ChiCTR2200066435.
基金the‘Pioneer’and‘Leading Goose’R&D Program of Zhejiang,China(No.2023C01193)the National Natural Science Foundation of China(Nos.52202150 and 22205203)+2 种基金the Foundation for Innovative Research Groups of the National Natural Science Foundation of China(No.61721005)the Fundamental Research Funds for the Central Universities(Nos.226-2022-00200 and 226-2022-00250)the National Program for Support of Topnotch Young Professionals。
文摘In recent years,ultra-wide bandgap β-Ga_(2)O_(3) has emerged as a fascinating semiconductor material due to its great potential in power and photoelectric devices.In semiconductor industrial,thermal treatment has been widely utilized as a convenient and effective approach for substrate property modulation and device fabrication.Thus,a thorough summary of β-Ga_(2)O_(3) substrates and devices behaviors after high-temperature treatment should be significant.In this review,we present the recent advances in modulating properties of β-Ga_(2)O_(3) substrates by thermal treatment,which include three major applications:(ⅰ)tuning surface electrical properties,(ⅱ)modifying surface morphology,and(ⅲ)oxidating films.Meanwhile,regulating electrical contacts and handling with radiation damage and ion implantation have also been discussed in device fabrication.In each category,universal annealing conditions were speculated to figure out the corresponding problems,and some unsolved questions were proposed clearly.This review could construct a systematic thermal treatment strategy for various purposes and applications of β-Ga_(2)O_(3).
基金the financial support by the National Natural Science Foundation of China(No.12272094,51805087 and 51705080)the Natural Science Foundation of Fujian Province of China(No.2022J01541)。
文摘The purpose of this paper is to examine the effect of processing parameters and subsequent heat treatments on the microstructures and bonding strengths of Ti-6Al-4V/AA1050 laminations formed via a non-equal channel lateral co-extrusion process.The microstructural evolution and growth mechanism in the diffusion layer were discussed further to optimize the bonding quality by appropriately adjusting process parameters.Scanning electron microscopes(SEM),energy dispersive spectrometer(EDS),and X-ray diffraction(XRD)were used to characterize interfacial diffusion layers.The shear test was used to determine the mechanical properties of the interfacial diffusion layer.The experimental results indicate that it is possible to co-extrusion Ti-6Al-4V/AA1050 compound profiles using non-equal channel lateral co-extrusion.Different heat treatment processes affect the thickness of the diffusion layer.When the temperature and time of heat treatment increase,the thickness of the reaction layers increases dramatically.Additionally,the shear strength of the Ti-6Al-4V/AA1050 composite interface is proportional to the diffusion layer thickness.It is observed that a medium interface thickness results in superior mechanical performance when compared to neither a greater nor a lesser interface thickness.Microstructural characterization of all heat treatments reveals that the only intermetallic compound observed in the diffusion layers is TiAl_(3).Due to the inter-diffusion of Ti and Al atoms,the TiAl_(3) layer grows primarily at AA1050/TiAl_(3) interfaces.
文摘This review describes the mechanisms of natural coagulants.It provides a good understanding of the two key processes of coagulation-flocculation:adsorption and charge neutralization,as well as adsorption and bridging.Various factors have influence the coagulation/flocculation process,including the effect of pH,coagulant dosage,coagulant type,temperature,initial turbidity,coagulation speed,flocculation speed,coagulation and flocculation time,settling time,colloidal particles,zeta potential,the effects of humic acids,and extraction density are explained.The bio-coagulants derived from plants are outlined.The impact of organic coagulants on water quality,focusing on their effects on the physicochemical parameters of water,heavy metals removal,and bacteriological water quality,is examined.The methods of extraction and purification of plant-based coagulants,highlighting techniques such as solvent extraction and ultrasonic extraction,are discussed.It also examines the parameters that influence these processes.The methods and principles of purification of coagulating agents,including dialysis,freeze-drying,ion exchange,electrophoresis,filtration,and centrifugation,are listed.Finally,it evaluates the sustainability of natural coagulants,focusing on the environmental,technical,and economic aspects of their use.At the end of this review,the readers should have a comprehensive understanding of the mechanisms,selection,extraction,purification,and sustainability of plant-based natural coagulants in water treatment.
文摘Phytobezoars is a rare disease and less common in Western countries.The stomach is the primary site for these formations,and endoscopic treatment involving fragmentation and extraction has traditionally been the most effective approach.However,medical treatments using enzymatic and chemical agents,such as cellulase and Coca-Cola,aimed at dissolving the bezoars,have also been utilized,showing varying degrees of resolution success.Notably,the oral dissolution treatment with Coca-Cola has emerged as a promising,simpler,and more costeffective method.The study by Liu et al represents an important step in clinical research on this topic,despite some limitations that need addressing for a more comprehensive understanding of its findings.Key considerations for future research include sample size calculation,endoscopic procedure details,outpatient vs.inpatient treatment,and detailed cost calculations.The study's exclusions,such as patients with upper gastric surgery,phytobezoars older than 14 d,and cases of gastroparesis,limit its applicability to broader populations,especially in Western countries.Given the promising outcomes of the Coca-Cola treatment,it's advocated as a first-line therapy for phytobezoars.Nonetheless,further research is essential to overcome these limitations.However special situations such as perforation or small bowel obstruction will require surgical treatment.
文摘BACKGROUND The incidence of patients with early-onset pancreatic cancer(EOPC;age≤50 years at diagnosis)is on the rise,placing a heavy burden on individuals,families,and society.The role of combination therapy including surgery,radiotherapy,and chemotherapy in non-metastatic EOPC is not well-defined.AIM To investigate the treatment patterns and survival outcomes in patients with non-metastatic EOPC.METHODS A total of 277 patients with non-metastatic EOPC who were treated at our institution between 2017 and 2021 were investigated retrospectively.Overall survival(OS),disease-free survival,and progression-free survival were estimated using the Kaplan-Meier method.Univariate and multivariate analyses with the Cox proportional hazards model were used to identify prognostic factors.RESULTS With a median follow-up time of 34.6 months,the 1-year,2-year,and 3-year OS rates for the entire cohort were 84.3%,51.5%,and 27.6%,respectively.The median OS of patients with localized disease who received surgery alone and adjuvant therapy(AT)were 21.2 months and 28.8 months,respectively(P=0.007).The median OS of patients with locally advanced disease who received radiotherapy-based combination therapy(RCT),surgery after neoadjuvant therapy(NAT),and chemotherapy were 28.5 months,25.6 months,and 14.0 months,respectively(P=0.002).The median OS after regional recurrence were 16.0 months,13.4 months,and 8.9 months in the RCT,chemotherapy,and supportive therapy groups,respectively(P=0.035).Multivariate analysis demonstrated that carbohydrate antigen 19-9 level,pathological grade,T-stage,N-stage,and resection were independent prognostic factors for non-metastatic EOPC.CONCLUSION AT improves postoperative survival in localized patients.Surgery after NAT and RCT are the preferred therapeutic options for patients with locally advanced EOPC.
基金Supported by Natural Science Foundation of Zhejiang Province(No.LQ18E020002)Traditional Chinese Medicine of Zhejiang Provincial Scientific Research Foundation(No.2020ZA005).
文摘AIM:To demonstrate the outcomes of translacrimal canalicular drainage using a lacrimal probe and intranasal drainage by D-silicone intubation for acute dacryocystitis(AD).METHODS:This retrospective study included 23 patients with AD and had undergone abscess decompression with the use of lacrimal probe and intranasal drainage by D-silicone intubation between January 2019 and December 2022.Patients received abscess decompression and systemic antibiotic-corticosteroid from the time of diagnosis.D-silicone tube was inserted within 10d after diagnosis and removed 3-6mo after intubation.The procedure and outcomes of this method were evaluated.RESULTS:All patients showed improvement of signs and symptoms of AD within 72h.No intraoperative and postoperative complications were observed.No recurrence of lacrimal sac abscesses occurred after D-silicone tube removed.CONCLUSION:Lacrimal probe and D-silicone intubation appear to be a feasible,minimally invasive,safe,and effective method,which could be a reasonable choice in the treatment of AD.
基金supported by the National Natural Science Foundation of China(Nos.52271107 and 52205392)the Natural Science Foundation of Shandong Province(No.ZR2021ME241)the Bintech-IMR R&D Program(No.GYY-JSBU-2022-012).
文摘The basal texture of traditional magnesium alloy AZ31 is easy to form and exhibits poor plasticity at room temperature.To address these problems,a multi-micro-alloyed high-plasticity Mg-1.8Zn-0.8Gd-0.1Ca-0.2Mn(wt%)alloy was developed using the unique role of rare earth and Ca solute atoms.In addition,the influence of the annealing process on the grain size,second phase,texture,and mechanical properties of the warm-rolled sheet at room temperature was analyzed with the goal of developing high-plasticity mag-nesium alloy sheets and obtaining optimal thermal-mechanical treatment parameters.The results show that the annealing temperature has a significant effect on the microstructure and properties due to the low alloying content:there are small amounts of larger-sized block and long string phases along the rolling direction(RD),as well as several spherical and rodlike particle phases inside the grains.With increas-ing annealing temperature,the grain size decreases and then increases,and the morphology,number,and size of the second phase also change correspondingly.The particle phase within the grains vanishes at 450℃,and the grain size increases sharply.In the full recrystal-lization stage at 300-350℃,the optimum strength-plasticity comprehensive mechanical properties are presented,with yield strengths of 182.1 and 176.9 MPa,tensile strengths of 271.1 and 275.8 MPa in the RD and transverse direction(TD),and elongation values of 27.4%and 32.3%,respectively.Moreover,there are still some larger-sized phases in the alloy that influence its mechanical properties,which offers room for improvement.
文摘Gastric cancer ranks as the sixth most prevalent cancer worldwide.In recent research within the realm of gastric cancer treatment,the identification and application of immune-related genetic features have emerged as groundbreaking advancements.The study by Ma et al,which developed a prognostic model based on 10 genes,categorizes patients into high and low-risk groups to predict their responsiveness to immune checkpoint inhibitor therapy.This research underscores the potential of immune-related genes as biomarkers for personalized treatment,offering insights into tumor mutation burden and immune phenotype scores.We advocate for further validation,understanding of biological mechanisms,and integration of diverse datasets to enhance the model's predictive accuracy and clinical application,marking a significant step towards personalized and precise treatment for gastric cancer.
文摘Background: Treatment non-adherence poses significant risks to health outcomes and impedes the health system’s efficiency, hence curtailing progress towards the end Tuberculosis (TB) strategy under SDG 3.3. Despite interventions to address TB treatment non-adherence, Kenya still reports high TB treatment non-adherence rates of 35% and consequently poor treatment outcome rates. Health Care Workers (HCWs) play a critical role in linking the population to health services, yet little is known of their influence on patients’ TB treatment non-adherence in Kenya. Objective: To analyze HCW-related factors associated with TB treatment non-adherence among patients in Kisumu East Sub-County. Methods: Health facility-based analytical cross-sectional mixed-method study. A Semi-structured questionnaire on treatment adherence and patients’ perceptions of HCWs during the clinic visit was administered to 102 consenting adult (out of a total census of 107 adults) drug-susceptible TB patients. 12 purposively selected HCWs by rank from 6 health facilities participated in Key Informant Interview sessions. Medication adherence was measured using the Morisky Medication Adherence Scale and then expressed as a dichotomous variable. Quantitative analysis utilized STATA version 15.1 while qualitative deductive thematic analysis was done using NVIVO version 14. Results: TB treatment non-adherence rate of 26% (CI: 18% - 36%) was recorded. Overall, patients who felt supported in dealing with the illness were 8 times more likely to adhere to treatment compared to those who were not (aOR = 7.947, 95% CI: 2.214 - 28.527, p = 0.001). Key HCW related factors influencing adherence to treatment included: friendliness (cOR = 4.31, 95% CI: 1.514 - 12.284, p = 0.006), respect (cOR = 6.679, 95% CI: 2.239 - 19.923, p = 0.001) and non-discriminatory service (cOR = 0.1478, 95% CI: 0.047 - 0.464, p = 0.001), communication [adequacy of consultation time (cOR = 6.563, 95% CI: 2.467 - 17.458, p = 0.001) and patients’ involvement in their health decisions (cOR = 3.02 95% CI: 1.061 - 8.592, p = 0.038)] and education and counselling (cOR = 4.371, 95% CI: 1.725 - 11.075, p = 0.002). Conclusion: The study results underline importance of patient-centered consultation for TB patients and targeted education and counselling for improved treatment adherence.