Cohort study on the treatment of BRAF V600E mutant metastatic colorectal cancer with integrated Chinese and western medicine

BACKGROUND Patients with BRAF V600E mutant metastatic colorectal cancer(mCRC)have a low incidence rate,poor biological activity,suboptimal response to conventional treatments,and a poor prognosis.In the previous cohort study on mCRC conducted by our team,it was observed that integrated Chinese and Western medicine treatment could significantly prolong the overall survival(OS)of patients with colorectal cancer.Therefore,we further explored the survival benefits in the population with BRAF V600E mutant mCRC.AIM To evaluate the efficacy of integrated Chinese and Western medicine in the treatment of BRAF V600E mutant metastatic colorectal cancer.METHODS A cohort study was conducted on patients with BRAF V600E mutant metastatic colorectal cancer admitted to Xiyuan Hospital of China Academy of Chinese Medical Sciences and Traditional Chinese Medicine Hospital of Xinjiang Uygur Autonomous Region from January 2016 to December 2022.The patients were divided into two cohorts.RESULTS A total of 34 cases were included,with 23 in Chinese-Western medicine cohort(cohort A)and 11 in Western medicine cohort(cohort B).The median overall survival was 19.9 months in cohort A and 14.2 months in cohort B,with a statistically significant difference(P=0.038,hazard ratio=0.46).The 1-3-year survival rates were 95.65%(22/23),39.13%(9/23),and 26.09%(6/23)in cohort A,and 63.64%(7/11),18.18%(2/11),and 9.09%(1/11)in cohort B,respectively.Subgroup analysis showed statistically significant differences in median OS between the two cohorts in the right colon,liver metastasis,chemotherapy,and first-line treatment subgroups(P<0.05).CONCLUSION Integrated Chinese and Western medicine can prolong the survival and reduce the risk of death in patients with BRAF V600E mutant metastatic colorectal cancer,with more pronounced benefits observed in patients with right colon involvement,liver metastasis,combined chemotherapy,and first-line treatment.

Formulation of Work-Study Combined and Result-Oriented Integrated Curriculum Standards

According to the Annex Technical Regulations for Integrated Curriculum Development(Trial)in Document No.30 of the General Office of the Ministry of Human Resources and Social Security(2012),this paper studies the formulation of the curriculum standards for the integration of Chinese medicinal materials production.We focus on the formulation ideas of the curriculum standards for the integration of Chinese medicinal materials production,the formulation process of the curriculum standards for the integration of Chinese medicinal materials production,including the description of typical work tasks,the determination of curriculum objectives,the analysis of study content,the description of referential study tasks,teaching implementation suggestions,assessment and evaluation suggestions,which can provide a reference for the development and research of other related integrated courses.

A Study on Integrated Construction of Luzhou Comprehensive Transportation Hub

The target of integrated construction of comprehensive transportation hub is to integrate the traffic resources,achieve butt joint of pan-regional transportation mode,and finally realize the"seamless connection"of the goods and"zero transfer"of the passenger traffic.Relying on the particularity of the geographical location and the convenience of the Yangtze River channel,Luzhou puts forth effort to build a comprehensive transport hub in Southern Sichuan and has made great efforts in traffic infrastructure construction.However,there are still some problems.Combining practice of Luzhou,using the advanced experience of foreign and domestic cities for reference,the paper pointed out that for the sake of constructing a comprehensive transportation hub,we need to build the traffic integration on the basis of the efficiency.Besides,the paper proposed the strategies for construction.

Reflection on the Integrated Development of Marine Fisheries and Tourism Based on the Transformation of Fishery Facilities: A Case Study of Ningde City of Fujian Province, China

Based on the analysis on the current situation of marine fishery resources and development in Ningde City,this paper plans a spatial pattern for the integration of marine fishery and tourism of the“one belt,three zones,and multiple points”,designs key projects,analyzes the existing problems in the integrated development of fishery and tourism,and proposes relevant countermeasures and suggestions.

Study on Si-SiGe Three-Dimensional CMOS Integrated Circuits

Based on the physical characteristics of SiGe material,a new three-dimensional （3D） CMOS IC structure is proposed,in which the first device layer is made of Si material for nMOS devices and the second device layer is made of Six Ge1- x material for pMOS. The intrinsic performance of ICs with the new structure is then limited by Si nMOS.The electrical characteristics of a Si-SiGe 3D CMOS device and inverter are all simulated and analyzed by MEDICI. The simulation results indicate that the Si-SiGe 3D CMOS ICs are faster than the Si-Si 3D CMOS ICs. The delay time of the 3D Si-SiGe CMOS inverter is 2-3ps,which is shorter than that of the 3D Si-Si CMOS inverter.

Study on Integrated Control against Oriental Fruit Fly[Bactrocera dorsalis(Hendel)] in Guava Orchard

[ Objective ] The paper was to explore the damage, occurrence pattern and integrated control methods of oriental fruit fly [ Bactrocera dorsalis （ Hen- del） ] in Nanning region of Guangxi Province. [ Method ] Using fixed system survey method, with fruit fly attractants as the materials, the occurrence dynamic of oriental fruit fly adult in guava orchard was investigated. The control effects of the methods such as fruit fly attractants, fruit bagging, cleaning park to pick up fallen fruit and timely spraying pesticide against the pest were also studied. [ Result] Oriental fruit fly had two damage peak periods in Nanning region of Guangxi Prov- ince （May to June, August to September）. Through the integrated control measures of trapping agent for male flies, timely spraying, fruit bagging and cleaning park to pick up fallen fruit, the population density in guava orchard dropped significantly. The fruit damage rates of guava in research base were only 6.67% -7.33% during the peak period of oriental fruit fly in June 2008, while they were 90.53% -98.00% in control area, obtaining good control effect against the pest. [ Con- dttalon ] The method used in the study preliminarily restored the yield losses of guava, which also provided basis for the preparation of overall strategy against orien- tal fruit fly in the region.

Study on the Modes and Strategies of Integrated Urban-Rural Construction

The connotation of urban-rural integration,its construction courses,construction modes in China and abroad are introduced in this study,the problems emerging from the urban-rural integration practices are analyzed,and strategies for the urban-rural integration in China are proposed.

Compilation Mode for the Integrated Planning of Lake Scenic Areas——A Case Study of the Longhu Lake Scenic Area in the Taihang Mountains

In view of lake scenic areas with abundant tourist resources but less-developed economy,contradictions between the urgency of its tourist resource development and complexity of urban-rural planning compilation were analyzed,and also limitations summarized as insufficient time and fund.Statutory planning contents included in the integrated compilation system were elaborated,and compilation of the integrated planning for the Longhe Lake Scenic Area in the Taihang Mountains was taken for example to introduce planning concepts of the compilation technical system.Considering characteristics of the study area,"regionality" was stressed as the foundation of planning compilation,concise,convenient and practical planning compilation contents were advocated and further explained from the perspectives of compiling by layer and category.In view of this,it is necessary to apply integrated compilation mode under certain circumstances,so as to provide a new approach for the planning compilation of other regions in China and enhance economic and social development of local areas.

Integrated Evaluation of Ecological Security at Different Scales Using Remote Sensing: A Case Study of Zhongxian County, the Three Gorges Area, China

Based on related literature and this research, an ecological security evaluation from the pixel scale to the small watershed or county scale was presented using remote sensing data and related models. With the driver-pressure, state and exposure to pollution-response （DPSER） model as a basis, a conceptual framework of regional ecological evaluation and an index system were established. The extraction and standardization of evaluation indices were carried out with GIS techniques, an information extraction model and a data standardization model. The conversion of regional ecological security results from the pixel scale to a small watershed or county scale was obtained with an evaluation model and a scaling model. Two conceptual scale conversion models of regional ecological security from the pixel scale to the county scale were proposed： 1） scale conversion of ecological security regime results from plxel to small watershed; and 2） scale conversion from pixel to county. These research results could provide useful ideas for regional ecological security evaluation as well as ecological and environmental management.

Study on integrated development and hybrid operation mode of nuclear power plant and pumped-storage power station

The nuclear power plant is suitable for base-load operation, while the pumped-storage unit mainly gives play to capacity benefit in the electric power system;hence, the integrated development and hybrid operation mode of the two can better meet the needs of the electric power system. This article first presents an analysis of the necessity and superiority of such mode, then explains its meaning and analyzes the working routes. Finally, it proposes the business modes as follows: low price pumping water electricity plus nuclear power in the near term;nuclear power shifted to pumped storage power participating in market competition in the middle term;and, in the long term, nuclear power shifted to pumped storage power as primary and serving as an electric power system when needed.

Experimental Study of Integrated Ebullated-bed and Fixed-bed for Hydrotreating Mid-Low Temperature Coal Tar to Clean Fuel

A new hydrotreating technology integrating the ebullated-bed(EB) and the fixed-bed(FB) hydrogenation was proposed to investigate the efficiency for hydrotreating mid- low-temperature coal tar to clean fuel, and multiple tests at the bench scale were carried out. The results showed that the distillates obtained from EB reactors were greatly upgraded and could meet the requirements of FB unit without discarding any tail oil. The naphtha produced from FB reactors could be fed to the catalytic reforming unit, while a high quality diesel was also obtained. The unconverted oil(UCO) could be further hydrocracked to clean fuel. It is found that the removal of impurities from the coal tar oil is related with the molecular aggregation structure and composition of the coal tar. Application of the integrated hydrotreating technology to the hightemperature coal tar processing demonstrated that more than half of heavy components could be effectively upgraded.

Effects of Integrated Case Payment on Medical Expenditure and Readmission of Inpatients with Chronic Obstructive Pulmonary Disease： A Nonrandomized, Comparative Study in Xi County, China

In the past few decades, Chinese government attempted to reduce the economic burden of chronic diseases and lower family financial risk of patients by establishing a nationwide coverage of Social Health Insurance system. However, the payment mode of Social Health Insurance varies across Chinese healthcare settings, and the effectiveness of each mode differs. This study aimed to evaluate the effects of integrated case payment on medical expenditure and readmission of inpatients with chronic obstructive pulmonary disease （COPD）, a complex, multicomponent, chronic condition. A nonrandomized, comparative method was used in this study. Inpatients with COPD before （n=1569） and after the integrated case payment reform （n=4764） were selected from the inpatient information database of the New Cooperative Medical Scheme Agency of Xi County. The integrated case payment comprises the case payment （including price-cap case payment and fixed-reimbursement case payment） and clinical pathway （including clinical pathway A, clinical pathway B and clinical pathway C）. Effects of integrated case payment were evaluated with indicators of per capita total medical expense and readmission within 30 days. A multivariate linear regression and a binary logistic regression were used to conduct statistical analysis. The results showed that case payment, comprising price-cap case payment （β=2382.988, P〈0.001） and fixed-reimbursement case payment β=2613.564, P〈0.001）, and clinical pathway C （β=1996.467, P〈0.001） were risk factors of per capita total medical expenses. Clinical pathway A （β=-1443.409, P〈0.001） and clinical pathway B （β=-1583.791, P〈0.001） were protective factors. The interactive effects of case payment with hospital level （β=0.710, P〈0.001） lowered the readmission rate within 30 days. Meanwhile, clinical pathways A （β=18.949, P〈0.001）, B （β=-19.752, P〈0.001） and C （β=-1.882, P〈0.1） were associated with the rate increase. The findings revealed that integrated case payment ensured the quality of care for inpatients with COPD to some extent. However, this payment mode increased the per capita total medical expense. Further, policy-makers should set reasonable reimbursement standards of case payment, unify the type of case payment, and strengthen the supervision of the reform to enhance its function on medical cost control.

Spatial Distribution of Integrated Impact Index of Mega-event——A Case Study of Expo '99 Kunming

Taking the affinity between events and media as a conceptualization base, a total of 1032 related news re-ports of Expo '99 Kunming, gathered from the internet data bank of China INFOBANK from 1992 to 2003, are used as data sources. After classifying them with a communication research method-the content analysis, a data bank for SPSS is set up, and a mathematic model called the Integrated Impact Index of Expo '99 Kunming is constituted. With the model, the spatial distribution of the total integrated impacts of Expo '99 Kunming on the regions or cities with different regional scales is analysed quantitatively. The conclusions are: 1) the Expo '99 Kunming made obvious integrated impacts on the regions or cities of every scale, especially in the venue city and the region-Kunming City and Yunnan Province; 2) it had corresponding impacts on other provinces; 3) the spatial distribution of Integrated Impact Index had a disaggregation with both plane extension and spotted decentralization; and 4) there was a distance decay law in all three scales of regions (Kunming City, Yunnan Province and the whole China), which incarnated the spatial extension law of the integrated impact of a special mega-event.

Numerical study of attack angle characteristics for integrated hypersonic vehicle

The two-dimensional coupled implicit Navier-Stokes equations and standard k-ε viscous models are used to simulate the angle of attack characteristics of an inte- grated hypersonic vehicle with a hark head configuration under three kinds of working conditions： inlet cut-off, engine through-flow, and engine ignition. Influence of each com- ponent on aero-propulsive performance of the vehicle is discussed. It is concluded that the longitudinal static stability of the vehicle is good, and there is enough lift-to-drag ratio to satisfy the flying requirement of the vehicle. At the same time, it is important to change configurations of engine and upper surface of airframe to improve aero-propulsive ~erformance of the vehicle.

Exploration and Development of Urban Integrated Traffic System Planning: A Case Study of Ganzhou City

Based on combing of urban integrated traffic planning report in Ganzhou City and its contrastive study with revised traffic model of general planning,it is found that there is great difference between integrated traffic planning and its actual development in medium-sized cities.Combining new process of reform and opening-up in the past 40 years,the development of urban integrated planning is looked ahead and explored.

A MULTIDISCIPLINARY AND INTEGRATED STUDY OF RICE PRECISION FARMING

In terms of demands of rice farming in the southern China, the information processing system and the yield measurement system that is installed in combine harvester, are designed and completed. Now the systems have been used in demonstration site in the Experiment Base of Shanghai Precision Agriculture. Based on the idea of spatial-oriented, object-oriented, user-oriented, the Farm Geographic Information System for precision farming of rice was developed, which is characterized by intelligence and visualized. The Decision-making Management System is integrated with rice growth model, expert model for rice cultivation. The DGPS, RS, GIS and intelligence sensors and computer technique were adopted in building the artificial intelligence system for measuring grain yield that is installed in combine harvester, so the combine harvester could provide the grain yield distribution map real-timely. The environmental and economic assessment shows that the precision rice farming applied in the demonstration site will benefit the society, economy and ecology greatly.

Study on Lightning Protection Integrated Service Management Platform in Yantai City

Via database technology, a perfect lightning protection integrated service work platform is established, thereby realizing paperless data management of routine business.

Integrated Development of Rural Tourism and Rural Poverty Alleviation in the Context of Rural Revitalization:A Case Study of Enshi Prefecture,Hubei Province

As a good mode of getting rid of poverty,poverty alleviation through tourism can transform the advantages of local resources into industrial advantages,mobilize the local economic vitality,and effectively improve the income of farmers.Through the investigation and study of rural poverty alleviation through tourism in Enshi Prefecture,Hubei Province,this paper analyzes the model of poverty alleviation through tourism formed in Enshi Prefecture,and puts forward the corresponding recommendations according to the problems encountered in the process of poverty alleviation through tourism.

Study on an Integrated Sintered Metal Screen Moving Granular Bed Filter

A new gas clean-up process called 'integrated sintered metal screen moving granular bed' (ISMSMGB) for the integrated gasification combined cycle (IGCC) and pressured fluidized bed combustion (PFBC) was developed on the basis of a sintered metal candle filter and a cross-flow moving granular bed filter. This is a combination of the surface and deep bed filtering processes. A set of facilities was established and a series of cold model tests were carried out. The dust removal efficiency and the pressure drop of the filter were measured and analyzed. The results show that this process features the advantages of the moving bed for high capacity as well as high inlet dust load and the surface filter for high efficiency. Meanwhile, the granules moving downward cleans the cake on the screen surface, so that the system is operated at steady state.

Numerical study on forming complex fitting body on end of integrated stainless steel pipe without welds

It is necessary to use the integrated stainless steel pipe having two fitting bodies without welds while train travelling at high speed. In order to form this type of integrated stainless steel pipe, the method of preforming combined finish forming process is developed. The preforming process is characterized by flaring combined upsetting for left fitting body which is like a flange, and is characterized by tube axial compressive process under die constraint for right fitting body which is like a double-wall pipe. The finite element simulations of the processes are carried out by software package DEFORM, and the results indicate that: 1) left or right fitting body can be formed by a two-step forming process without folding and under-filling defects; 2) by using two-step forming, strain and stress in left fitting body are larger than those in right fitting body, and deformation in right fitting body is more homogenous than the deformation in left fitting body; 3) two or more preforming steps may be needed for left fitting body considering the distributions of strain and stress.