Safety Evaluation of Irradiated Foods in China: A Condensed Report

Eight trials, with 439 human volunteers who consumed irradiated foods including rice, potatoes, mushrooms, peanuts, and Chinese sausages, as well as diets composed of multiple irradiated foods (irradiated at dosages of 0.2 to 8 kGy) that accounted for 60-66％ of the entire diet, were carried out for 2-3 months according to a unified protocol. No adverse effects on body weight, blood pressure, ECG, hematology, blood enzyme activities, serum lipids, or blood or urine 17-hydroxycortisol contents and no chromosomal aberration of peripheral blood lymphocytes were found. It is especially worthwhile to note that there was no change in the polyploidy after consumption of irradiated diets. On the basis of these results and a comprehensive analysis of the physical and chemical characteristics of irradiated foods, temporary hygienic standards for irradiated rice, potatoes, onions, garlic, Chinese sausages, peanuts, and mushrooms were promulgated by the Chinese Ministry of Public Health. 1989 Academic Press, Inc.

Acute ischemic Stroke combined with Stanford type A aortic dissection:A case report and literature review

BACKGROUND Acute aortic dissection(AAD)is a high mortality disease that can lead to acute ischemic strokes(AIS).Some of the patients with AAD combined with AIS initially present with neurological symptoms,which can easily lead to missed or delayed AAD diagnosis.This is attributed to the lack of physician awareness or the urgency of patient thrombolysis.Intravenous administration of thrombolytic therapy(IVT)for AAD is associated with poor prognostic outcomes.We report a patient with AIS combined with AAD who developed a massive cerebral infarction after receiving IVT for a missed AAD diagnosis.CASE SUMMARY A 49-year-old man was admitted to a local hospital with an acute onset of leftsided limb weakness accompanied by slurred speech.The patient had a history of hypertension that was not regularly treated with medication.Physical examination revealed incomplete mixed aphasia and left limb hemiparesis.Cranial computed tomography(CT)scan showed bilateral basal ganglia and lateral ventricular paraventricular infarct lesions.The patient was diagnosed with AIS and was administered with IVT.After IVT,patient’s muscle strength and consciousness deteriorated.From the local hospital,he was referred to our hospital for further treatment.Emergency head and neck CT angiography(CTA)scans were performed.Results showed multiple cerebral infarctions,and aortic dissection in the ascending aorta,innominate artery,as well as in the right common carotid artery.Then,the CTA of thoracoabdominal aorta was performed,which revealed a Stanford type A aortic dissection and aortic dissection extending from the aortic root to the left external iliac artery.Laceration was located in the lesser curvature of the aortic arch.AAD complicated with AIS was considered,and the patient was immediately subjected to cardiovascular surgery for treatment.The next day,the patient underwent aortic arch and ascending aortic replacement and aortic valvuloplasty.CONCLUSION Clinical manifestations for AAD combined with AIS are diverse.Some patients may not exhibit typical chest or back pains.Therefore,patients should be carefully evaluated to exclude AAD before administering IVT in order to avoid adverse consequences.

Pathological humerus fracture due to anti-interferon-gamma autoantibodies:A case report

BACKGROUND Various etiologies contribute to pathological fractures,including bone infections.Recently,non-tuberculosis Mycobacterium-related bone infections among patients with anti-interferon-gamma autoantibody-induced adult-onset immunodeficiency has raised concerns in Southeast Asia,with the common presentations including osteomyelitis.However,it also rarely manifests as traumatic fractures,as reported in this case.CASE SUMMARY A diabetic female fractured her humerus after a traumatic accident and received fixation surgery.Abnormal necrotic bone tissue and abscess formation were noted,and she was diagnosed with a pathological fracture due to nontuberculosis Mycobacterium infection.Multiple bone involvement was also revealed in a bone scan.Anti-interferon-gamma autoantibodies were then checked due to an unexplained immunocompromised status and found to be positive.Her humerus fracture and multiple bone infections healed after steroid and anti-non-tuberculosis Mycobacterium medication treatment following fixation surgery.CONCLUSION Comprehensive preoperative evaluations may help identify pathological fractures and guide the treatment course.

Lenvatinib for large hepatocellular carcinomas with portal trunk invasion:Two case reports

BACKGROUND In a phase III trial of lenvatinib as first-line treatment for advanced unresectable hepatocellular carcinoma(uHCC),the drug proved non-inferior to sorafenib in terms of the overall survival,but offered better progression-free survival.However,the effects of lenvatinib in uHCC patients with a tumor thrombus in the main portal vein and/or a high tumor burden(tumor occupancy more than 50%of the total liver volume),remain unclear,because these were set as exclusion criteria in the aforementioned trial.CASE SUMMARY A 53-year-old man(case 1)and 66-year-old woman(case 2)with uHCC presented to us with a tumor thrombus in both the main portal vein and inferior vena cava,a high tumor burden accompanied by a tumor diameter greater than>100 mm,and distant metastasis,with the residual liver function classified as grade 2A according to the modified Albumin–Bilirubin grading.We started both patients on lenvatinib.The therapeutic effect,as evaluated by the modified Response Evaluation Criteria in Solid Tumors,was rated as partial response in both case 1 and case 2(at 8 wk and 4 wk after the start of lenvatinib administration,respectively).The therapeutic effect was sustained for 6 mo in case 1 and 20 mo in case 2.Fever occurred as an adverse event in both case 1 and 2,and hyperthyroidism and thrombocytopenia in only case 2,neither of which,however,necessitated treatment discontinuation.CONCLUSION Even in hepatocellular carcinoma patients with poor prognostic factors,if the liver function is well-preserved,lenvatinib is effective and safe.

Rehabilitative training effects of severe mixed-type cerebral palsy in children One case report

It has often been thought that severe spastic and athetoid cerebral palsy children respond poorly to rehabilitative training effects and have a poor prognosis after school age. The present study included a nine-year-old severe spastic and athetoid cerebral palsy boy, who received 2 years of physical therapy, supplemented with drugs and orthotic devices and who acquired good therapeutic effects. The beneficial rehabilitative effects were as follows： After discharge, primitive reflex disappeared, and both vertical reflex and parachute reflex were found; In the establishment of balance reflex, sitting position was rated as level III, and standing position was rated as level II. The boy could independently walk for 30-50 meters. In the assessment of muscle tone, the level was rated according to the Modified Ashworth Scale and was decreased from three, four to one, two, and the level rated according to the Clonus Scale decreased from V to II. Motor function was noticeably improved. The level was rated according to the Gross Motor Function Classification System and was decreased from V to II. The total score of 88 items of the Gross Motor Function Measure was increased from 6.1% to 72.2%. The Berg Balance Scale score increased from 0 to 42. The Holden Walking Functional Classification level increased from 0 to 3. The score of activities of daily living increased from 9.5 to 70. The symptoms of dysarthria were alleviated from severe to moderate, and those of salivation were alleviated from level V to level I. These results demonstrated that after systemic and scientific treatment and training, the spastic and athetoid cerebral palsy boy had the ability to walk independently and to care for himself.

Castleman disease in the hepatic-gastric space: A case report

BACKGROUND Castleman disease, also known as giant lymph node hyperplasia, was first reported in 1956. It is a rare benign proliferative pathological change of the lymph nodes.CASE SUMMARY The patient, a 33-year-old woman, had epigastric distension for half a year.Examinations were performed in a local hospital. Computed tomography scan showed round soft tissue nodules, about 5.45 cm in diameter, in the hepaticgastric space. Endoscopic ultrasound and endoscopic ultrasound guided fine needle aspiration was performed on the patient. Rapid on-site evaluation,hematoxylin eosin staining and histopathology of the puncture smear was performed. According to the Diff-Quik staining and hematoxylin eosin staining results of preoperative endoscopic ultrasound guided fine needle aspiration puncture smears as well as the immunohistochemistry results, Castleman disease was highly suspected. A sufficient preoperative evaluation was made, and a precise surgical plan was developed. Postoperative pathology confirmed Castleman disease.CONCLUSION Endoscopic ultrasound guided fine needle aspiration can extract internal tissues of the tumor for histological and cytological examinations and provide accurate diagnosis as much as possible. Therefore, a sufficient preoperative evaluation can be made, and a precise surgical plan can be developed.

Technological developments enable measuring and using patientreported outcomes data in orthopaedic clinical practice

Patient-reported outcomes measures form the backbone of outcomes evaluation in orthopaedics,with most of the literature now relying on these scoring tools to measure change in patient health status.This patient-reported information is increasingly collected routinely by orthopaedic providers but use of the data is typically restricted to academic research.Developments in electronic data capture and the outcome tools themselves now allow use of this data as part of the clinical consultation.This review evaluates the role of patient reported outcomes data as a tool to enhance daily orthopaedic clinical practice,and documents how developments in electronic outcome measures,computer-adaptive questionnaire design and instant graphical display of questionnaire can facilitate enhanced patientclinician shared decision making.

A Conceptually-Based Empirical Analysis on Quality Differences Between UK Annual Reports and US 10-K Reports

The International Accounting Standards Board （IASB） and the Financial Accounting Standards Board （FASB） stress the importance of high-quality ＇financial reports. From a scientific point of view, however, major methodological drawbacks can arise when trying to arrive at a comprehensive assessment and evaluation of the decision usefulness of financial reports. In this conceptually-based exploratory study, the authors construct a 33-item index aimed at operationalizing decision usefulness in terms of the fundamental and enhancing qualitative characteristics laid out in the conceptual framework （CF） of the IASB （2010）. Using a matched-pairs sample design, which includes 70 UK annual reports and 70 US 10-K reports for 2010, the results of test-retest and inter-rater reliability tests show that these multiple items, which were based on items used in previous research, can be measured in a reliable manner. At the same time, the results of an exploratory factor analysis indicate that the IASB qualitative characteristics cannot be measured separately when the 33-item index is applied. At an aggregate level, the results of paired-sample t-tests reveal that UK reports score on average higher than US 10-K reports, which suggests that the overall quality of UK reports is better. The findings of this study add to the existing literature on the empirical evaluation of the effects of international accounting standards, showing that, as compared with 10-K reports, UK annual reports provide more information on topics such as corporate social responsibility （CSR）, corporate governance, and annual bonus schemes. On the other hand, US reports outperform UK reports with respect to the content of fair value information, cash flow statements, off-balance financing, and audit reporting.

颈淋巴结清扫术后颈肩功能障碍患者报告结局测量工具的研究进展

对国内外颈淋巴结清扫术后颈肩功能障碍患者报告结局测量工具进行综述,旨在为我国临床护理人员选择和开发颈淋巴结清扫术后颈肩功能障碍患者报告结局测量工具提供参考。

竞技运动中的认知负荷评估

科学评估训练负荷是优化运动表现、预防运动伤害的关键。目前的研究主要关注的是机械和生理方面,对认知方面的关注明显不足。认知负荷在调节运动表现中的作用已得到广泛认可,但有关认知负荷的评估目前还存在诸多困难和障碍,缺乏适当的评估方法是造成这一现象的主因。笔者运用文献资料法、专家访谈法和逻辑分析法,对竞技运动中的认知负荷评估进行了探讨。研究结果显示:竞技运动中的认知负荷评估可以借助自我报告方法、行为测量方法和生理测量方法进行,但要提高评估的有效性,通常需要整合运用多种主观和客观的方法和技术。

轨道车辆动力学性能评价软件开发研究

针对目前车辆仿真/测试数据量大,人工分析、处理容易出现错误等问题,开发了基于MATLAB的车辆动力学性能评价的软件。软件可以调用Simpack自动完成车辆建模与仿真,再根据GB/T 5599—2019自动化完成数据分析与评价,生成车辆性能评价报告。最后通过某动车组数据对软件功能进行了验证,实现了快速建模、自动仿真及快速生成分析评价报告,证明了该软件的高效性。

基于滑动窗口的协作频谱感知对抗拜占庭攻击

认知无线电技术允许从用户动态地接入主要用户被授权的频谱,提高频谱利用率。协作频谱感知是认知无线电技术的一个重要组成部分,通过空间分集检测主用户信号。然而,由于认知无线网络的开放性,协作频谱感知过程可能会受到拜占庭攻击,恶意用户伪造有关主用户信号的状态信息,然后对主用户的通信造成干扰或自私地占用频谱资源,此外,协作频谱感知因多个从用户协作而需要更多的时间来检测主用户信号,因而将导致协作频谱感知的性能和效率进一步降低。针对上述问题,提出了基于滑动窗口的协作频谱感知方案,以减轻拜占庭攻击的负面影响,提高协作效率。在深入分析融合中心盲的问题的基础上,从恶意用户的角度出发,建立了一个随机拜占庭攻击模型来描述恶意行为。为了解决感知样本融合过程中的盲的问题,提出了一种交付评估机制,为基于滑动窗口的协作频谱感知奠定了坚实的基础,并在一个滑动窗口内进一步评估信誉值,以提高报告阶段的协作效率。仿真结果表明,无论恶意比例如何,基于滑动窗口的协作频谱感知在始终攻击的情况下只需要6个平均样本数就可以提供100%的检测准确率,而在恶意比例超过50%的随机攻击的情况下依然能够展现出显著的性能优势。

结构化晨间报告在肾内科住院医师规范化培训中的探索

目的探究结构化晨间报告在肾内科住院医师规范化培训(简称住培)教学中的应用效果。方法选取2022年在首都医科大学宣武医院肾内科住培的住院医师为观察组,采用结构化晨间报告教学;2021年未接受结构化晨间报告教学的肾内科住院医师为对照组。对比两组的出科考核成绩,并采用匿名问卷形式调查观察组对结构化晨间报告教学的满意度。结果接受结构化晨间报告的观察组住院医师出科考核成绩为(94.43±4.77)分,高于对照组(91.85±2.83)分,差异有统计学意义(t=-2.092,P=0.043);教学满意度调查结果提示,住院医师对结构化晨间报告的开展形式、具体内容满意度达90%以上。结论结构化晨间报告教学方法有助于提高住院医师考试成绩和临床思维能力,并得到住院医师认可。

基于半结构化访谈的中医外风证患者口述症状特征研究

目的总结外风证患者口述症状,结合外风证诊断标准对比分析,归纳其对患者日常生活等方面的影响,为优化临床问诊及建立中医外风证疗效评价量表提供数据基础。方法参照《中医临床诊疗术语》及《中医诊断学》中外风证诊断标准内容制定访谈提纲,采用目的抽样法收集病例,运用访谈法提取患者口述症状。结果共访谈患者33例,预访谈7例,正式访谈26例,其中男5例,女28例,结合外风证诊断标准列举出频次较多的口述症状,其中包含恶风33例、关节疼痛21例、头痛20例、喷嚏20例、水肿20例、咳嗽18例、流鼻涕18例等。结论外风证患者的症状表现复杂多样,且与基础疾病息息相关,这些不适症状对患者的生活、休息、情绪、出行等方面都具有不同程度的影响,可结合国标,为问诊及量表构建提供参考。

基于自评价报告的国家重点研发计划项目实施成效与机制研究

2016年启动的国家重点研发计划,是我国中央财政科技计划布局架构改革的重大战略举措,肩负着为其他四类计划优化整合“架桥铺路”的重要使命。经过约5年项目执行期,近年来部分项目已完成结题验收。以国家重点研发计划“战略性先进电子材料”重点专项中2022年结题验收的43个项目为调查对象,以各项目综合绩效自评价报告为调查素材,综合国家重点研发计划的组织管理创新以及自评价报告的内容结构特点,制定针对性的结题项目实施成效统计方案,从中归纳国家重点研发计划的实施成效特征与作用机制,为专业机构进一步提升国家重点研发计划管理服务水平提出建议参考。

患者报告结局在前列腺癌病人中应用的研究进展

对国内外开发的前列腺癌患者报告结局评估工具及其临床应用情况进行综述,以期为前列腺癌患者报告结局评估工具的应用、开发及临床实践提供借鉴和参考。

Standardizing Individualized Efficacy Evaluation to Optimize Evidence-Using Pattern in Traditional Chinese Medicine-Preliminarily Establishing Traditional Chinese Medicine Evidence-based Case Reporting System

Individualized treatment is a basic feature of Traditional Chinese Medicine(TCM), and individualized efficacy evaluation is also emphasized in TCM clinical practice. Individualized evaluation is in favor of improving intervention continuously, and optimizing the TCM evidenceusing pattern gradually. Traditional case reports can better demonstrate the efficacy of individual, but lack of standardized design, making such evidence show a lower quality. Meanings, objectives and design elements of TCM individualized evaluation were discussed in this paper.Then based on the original work, design ideas and framework of TCM evidence-based case reporting system were established preliminarily.This work will improve the methodology of TCM individualized evaluation to realize the goal of optimizing TCM clinical evidence-using pattern.

胃肠道手术ERAS指南/共识质量评价及内容分析

目的 通过评价和分析胃肠道手术加速术后康复(ERAS)指南/共识,遴选推荐使用的高质量指南/共识,为ERAS临床实践提供决策依据。方法 计算机检索PubMed、Embase、万方、中国知识基础设施工程等数据库及指南相关网站,纳入自数据库建库至2023年7月的胃肠道手术ERAS指南/共识。应用指南研究与评估系统Ⅱ和国际实践指南报告规范对纳入研究的指南/共识进行质量评价。分析整理推荐使用的高质量指南,汇总推荐意见。结果 最终纳入8部指南、13部共识。基于应用指南研究与评估系统Ⅱ,各领域平均标准化得分:范围和目的 64.22%±14.47%、参与人员29.68%±15.43%、制定的严谨性30.26%±18.76%、表达的明晰性73.68%±19.06%、应用性10.05%±11.39%、编辑独立性54.46%±36.58%,其中3部指南推荐使用。基于国际实践指南报告规范,指南背景、证据和推荐意见领域存在严重报告缺失(报告率<10%)。基于3部推荐使用的指南,汇总提出术前、术中和术后三部分24条推荐意见。结论 胃肠道手术ERAS指南/共识质量参差不齐,3部推荐使用。

基于自上而下构建方法的壮医医生报告结局概念框架

医生报告结局(CROs),是医生对患者健康状态疗效评价的报告,是从医生的角度考察干预措施有效性、安全性和医生自身的满意度。根据壮医相关文献,借鉴西医患者报告结局(PROs)和中医CROs的研究方法,以“自上而下”的方法,壮医CROs作为核心,将临床有效性、安全性和医生满意度各领域与壮医特色指标相结合初步构成逻辑完备的框架,为建立有壮医特色的临床疗效评价体系提供了可能,有利于壮医疗效评价的客观化和现代化。

Quality Evaluation and Reporting Specification for Real-World Studies of Traditional Chinese Medicine

In recent years,the real-world studies(RWS)have attracted extensive attention,and the realworld evidence(RwE)has been acceptedto support the drug development in Chinaand abroad.However,there is stll a lack of standards for the evaluation of the quality of RWE.It is necessary to formulate a quality evaluation and reporting specification for RWE especially in traditional Chinese medicine(TCM).To this end,under the guidance of China Association of Chinese Medicine,the Quality Evaluation and Reporting Specification for Real-World Evidence of Traditional Chinese Medicine(QUERST)Group,including 24 experts(clinical epidemiologists,clinicians,pharmacologists,ethical reviewerand statisticians),was established to develop the specification.This specification contains the listing of classification of RWS design and RWE,the general principles and methods of RWE quality evaluation(26 tools or scales),25 types of bias in RWS,the special considerations in evaluating the quality of RWE of TCM,and the 19 reporting standards of RWE.This specification aims to propose the quality evaluation principles and key points of RWE,and provide guidance for the proper use of RWE in the development of TCM new drugs.