AIM:To evaluate the effect of pantoprazole with a somatostatin adjunct in patients with acute non-variceal upper gastrointestinal bleeding(NVUGIB).METHODS:We performed a retrospective analysis of a prospective databas...AIM:To evaluate the effect of pantoprazole with a somatostatin adjunct in patients with acute non-variceal upper gastrointestinal bleeding(NVUGIB).METHODS:We performed a retrospective analysis of a prospective database in a tertiary care university hospital.From October 2006 to October 2008,we enrolled 101 patients with NVUGIB that had a high-risk stigma on endoscopy.Within 24 h of hospital admission,all patients underwent endoscopic therapy.After successful endoscopic hemostasis,all patients received an 80-mg bolus of pantoprazole followed by continuous intravenous infusion(8 mg/h for 72 h).The somatostatin adjunct group(n=49)also received a 250-μg bolus of somatostatin,followed by continuous infusion (250μg/h for 72 h).Early rebleeding rates,disappearance of endoscopic stigma and risk factors associated with early rebleeding were examined.RESULTS:Early rebleeding rates were not significantly different between treatment groups(12.2%vs 14.3%,P=0.766).Disappearance of endoscopic stigma on the second endoscopy was not significantly different between treatment groups(94.2%vs 95.9%,P=0.696).Multivariate analysis showed that the complete Rockall score was a significant risk factor for early rebleeding(P =0.044,OR:9.080,95%CI:1.062-77.595).CONCLUSION:The adjunctive use of somatostatin was not superior to pantoprazole monotherapy after successful endoscopic hemostasis in patients with NVUGIB.展开更多
AIM:To investigate the prognostic factors of T4 gastric cancer patients without distant metastasis who could undergo potentially curative resection. METHODS:We retrospectively analyzed the clinical data of 71 consecut...AIM:To investigate the prognostic factors of T4 gastric cancer patients without distant metastasis who could undergo potentially curative resection. METHODS:We retrospectively analyzed the clinical data of 71 consecutive patients diagnosed with T4 gastric cancer and who underwent curative gastrectomy at our institutions.The clinicopathological factors that could be associated with overall survival were evaluated.The cumulative survival was determined by the Kaplan-Meier method,and univariate comparisons between the groups were performed using the log-rank test.Multivariate analysis was performed using the Cox proportional hazard model and a step-wise procedure. RESULTS:The study patients comprised 53 men (74.6%)and 18 women(25.4%)aged 39-89 years (mean,68.9 years).Nineteen patients(26.8%)had postoperative morbidity:pancreatic fistula developed in 6 patients(8.5%)and was the most frequent complication,followed by anastomosis stricture in 5 patients (7.0%).During the follow-up period,28 patients(39.4%)died because of gastric cancer recurrence,and 3(4.2%) died because of another disease or accident.For all patients,the estimated overall survival was 34.1%at 5 years.Univariate analyses identified the following statistically significant prognostic factors in T4 gastric cancer patients who underwent potentially curative resection: peritoneal washing cytology(P<0.01),number of metastatic lymph nodes(P<0.05),and venous invasion(P <0.05).In multivariate analyses,only peritoneal washing cytology was identified as an independent prognostic factor(HR=3.62,95%CI=1.37-9.57)for longterm survival. CONCLUSION:Positive peritoneal washing cytology was the only independent poor prognostic factor for T4 gastric cancer patients who could be treated with potentially curative resection.展开更多
AIM:To investigate the patterns and decisive prognostic factors for local recurrence of rectal cancer treated with a multidisciplinary team(MDT) modality.METHODS:Ninety patients with local recurrence were studied,out ...AIM:To investigate the patterns and decisive prognostic factors for local recurrence of rectal cancer treated with a multidisciplinary team(MDT) modality.METHODS:Ninety patients with local recurrence were studied,out of 1079 consecutive rectal cancer patients who underwent curative surgery from 1999 to 2007.For each patient,the recurrence pattern was assessed by specialist radiologists from the MDT using imaging,and the treatment strategy was decided after discussion by the MDT.The associations between clinicopathological factors and long-term outcomes were evaluated using both univariate and multivariate analysis.RESULTS:The recurrence pattern was classified as follows:Twenty-seven(30%) recurrent tumors were evaluated as axial type,21(23.3%) were anterior type,8(8.9%) were posterior type,and 13(25.6%) were lateral type.Forty-one patients had tumors that were evaluated as resectable by the MDT and ultimately received surgery,and R0 resection was achieved in 36(87.8%) of these patients.The recurrence pattern was closely associated with resectability and R0 resection rate(P < 0.001).The recurrence pattern,interval to recurrence,and R0 resection were significantly associated with 5-year survival rate in univariate analysis.Multivariate analysis showed that the R0 resection was the unique independent factor affecting long-term survival.CONCLUSION:The MDT modality improves patient selection for surgery by enabling accurate classification of the recurrence pattern;R0 resection is the most significant factor affecting long-term survival.展开更多
AIM:To identify factors related to serious postoperative bacterial and fungal infections in the first 3 mo after living donor liver transplantation(LDLT).METHODS:In the present study,the data of 207 patients from 2004...AIM:To identify factors related to serious postoperative bacterial and fungal infections in the first 3 mo after living donor liver transplantation(LDLT).METHODS:In the present study,the data of 207 patients from 2004 to 2011 were reviewed.The pre-,intra-and post-operative factors were statistically analyzed.All transplantations were approved by the ethics committee of West China Hospital,Sichuan University.Patients with definitely preoperative infections and infections within 48 h after transplantation were excluded from current study.All potential risk factors were analyzed using univariate analyses.Factors significant at a P < 0.10 in the univariate analyses were involved in the multivariate analyses.The diagnostic accuracy of the identified risk factors was evaluated using receiver operating curve.RESULTS:The serious bacterial and fungal infection rates were 14.01% and 4.35% respectively.Enterococcus faecium was the predominant bacterial pathogen,whereas Candida albicans was the most common fungal pathogen.Lung was the most common infection site for both bacterial and fungal infections.Recipient age older than 45 years,preoperative hyponatremia,intensive care unit stay longer than 9 d,postoperative bile leak and severe hyperglycemia were independent risk factors for postoperative bacterial infection.Massive red blood cells transfusion and postoperative bacterial infection may be related to postoperative fungal infection.CONCLUSION:Predictive risk factors for bacterial and fungal infections were indentified in current study.Pre-,intra-and post-operative factors can cause postoperative bacterial and fungal infections after LDLT.展开更多
Objective To explore the efficacy of hepatic resection(HR) in a relatively unselected group of patients with ovarian cancer liver metastases(OCLM). Methods A study was conducted between September 2000 and September 20...Objective To explore the efficacy of hepatic resection(HR) in a relatively unselected group of patients with ovarian cancer liver metastases(OCLM). Methods A study was conducted between September 2000 and September 2011 on 60 ovarian cancer patients with hepatic metastases(24 solitary and 36 multiple),40 of whom had extrahepatic metastases.HR was done in all patients provided that curative hepatic resection was feasible,and extrahepatic disease was controlled with medical and/or surgical therapy. Results Most patients(n=54;90.0% ) had a negative hepatic margin(R0),whereas 6 patients(10.0% ) had microscopic disease at the margin(R1).The prognostic value of each study variable was assessed using log rank tests for univariate analysis and Cox proportional hazard models for multivariate analysis.The result was a median survival of 39 months and 5-year overall survival rate of 30% .Univariate analysis showed that surgery result(P=0.001),disease free interval(P=0.018) and the number of hepatic lesions (P=0.018) were significantly related to survival.Furthermore,the surgery result(P=0.004) remained significant for prognosis in multivariate analysis. Conclusions For patients with OCLM,HR is safe and may provide a significant survival benefit compared with medical therapy alone.A long interval time,the number of hepatic lesions,and surgery results are key prognostic factors.Favorable outcomes can be achieved even in patients with medically controlled or surgically resectable extrahepatic disease,indicating that surgery should be considered more frequently in the multidisciplinary care of patients with OCLM.展开更多
AIM: To evaluate the presence of extracapsular invasion (ECI) in positive nodes as a predictor of disease recurrence disease in colorectal cancer. METHODS: Two hundred and twenty-eight consecutive patients who underwe...AIM: To evaluate the presence of extracapsular invasion (ECI) in positive nodes as a predictor of disease recurrence disease in colorectal cancer. METHODS: Two hundred and twenty-eight consecutive patients who underwent colorectal resection were identified for inclusion in this study, of which 46 had positive lymph nodes. Among 46 cases with stage Ⅲcolorectal cancer, 16 had ECI at positive nodes and 8 had disease recurrence. The clinical and pathological features of these cases were reviewed. RESULTS: In the univariate analysis, the number of positive lymph nodes and depth of tumor invasion were significantly associated with the presence of ECI at positive nodes. Multivariate analysis demonstrated that only ECI was a predictor of recurrence. The recurrence-free interval differed significantly among patients with ECI at positive nodes.CONCLUSION: Our results suggest that ECI at metastatic nodes can identify which cases are at high risk of short-term disease recurrence in colorectal cancer.展开更多
Glucose homeostasis deficiency leads to a chronic increase in blood glucose concentration. In contrast to physiological glucose concentration, chronic super-physiological glucose concentration negatively affects a lar...Glucose homeostasis deficiency leads to a chronic increase in blood glucose concentration. In contrast to physiological glucose concentration, chronic super-physiological glucose concentration negatively affects a large number of organs and tissues. Glucose toxicity means a decrease in insulin secretion and an increase in insulin resistance due to chronic hyperglycemia. It is now generally accepted that glucose toxicity is involved in the worsening of diabetes by affecting the secretion of B-cells. Several mechanisms have been proposed to explain the adverse effects of hyperglycemia. It was found that persistent hyperglycemia caused the functional decline of neutrophils. Infection is thus the main problem resulting from glucose toxicity in the acute phase. In other words, continued hyperglycemia is a life-threatening risk factor, not only in the chronic but also the acute phase, and it becomes a risk factor for infection, particularly in the perioperative period.展开更多
Colorectal cancers (CRC) account for frequent and serious cancers which result from the interaction between individual genetic factors and environmental factors, and in particular widely studied nutritional ones. Th...Colorectal cancers (CRC) account for frequent and serious cancers which result from the interaction between individual genetic factors and environmental factors, and in particular widely studied nutritional ones. The role of other occupational factors remains a controversial subject. The objective of this study is to evaluate the possible impact of occupational factors on the risk of developing CRC. Materials and Methods: This is a retrospective case-control study. The cases and the control group were enlisted in the general surgical ward of Farhat Hached Teaching Hospital of Sousse (Tunisia) during the period extending from 2004 to 2008, and they were age and gender-matched. The data were analyzed using SPSS 11.0 software with a signification threshold fixed at 5%. A univariate analysis was carried out as well as a multiple binary logistical regression. Results: During the period of the study, 40 cases of colorectal cancers have been colligated including 28 men and 12 women with a sex ratio of 0.43. The average age of the cases was 61.55 ± 13.3 years and 60.40 ± 12.84 years for the control group, with a non significant difference (P = 0.69). The univariate analysis has objectivized significant associations between colorectal cancer and the housing conditions, the neoplastic and digestive family history, the occupational activity sector, exposure to pesticides, and lack of periodic medical supervision. After logistical regression, the occurrence risk of CRC was significantly associated with: alcohol and smoking (ORa = 3.43; Pa = 0.05), meat consumption (ORa = 3.34; Pa = 0.03), exposure to pesticides (ORa = 20.44; Pa = 0.012) and lack of periodic medical supervision (OR = 7.45; P = 0.004). Conclusion: The occupational risk factors might play a role in the etiopathogenesis of colorectal cancers. With regard to our study, pesticides seem to be most implicated and necessitate suitable preventive measures. Nevertheless, it seems useful to multiply the studies to a much larger scale in order to further explore such relationship and to further reinforce the prevention of such serious disease.展开更多
AIM: To examine the relationships between pre-diag- nostic biomarkers and colorectal cancer risk and assess their relevance in predictive models.METHODS: A nested case-control study was designed to include all first...AIM: To examine the relationships between pre-diag- nostic biomarkers and colorectal cancer risk and assess their relevance in predictive models.METHODS: A nested case-control study was designed to include all first primary incident colorectal cancer cases diagnosed between inclusion in the SUpplemen- tation en VItamines et Min^raux AntioXydants cohort in 1994 and the end of follow-up in 2007. Cases (n = 50) were matched with two randomly selected con- trols (n = 100). Conditional logistic regression models were used to investigate the associations between pre- diagnostic levels of hs-CRP, adiponectin, leptin, soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-I, E-selectin, monocyte chemoattractant protein-1 and colorectal cancer risk. Area under the receiver operating curves (AUC) and relative integrated discrimination improvement (RIDI) statistics were used to assess the discriminatory poten- tial of the models. RESULTS: Plasma adiponectin level was associated with decreased colorectal cancer risk (P for linear trend -- 0.03). Quartiles of sVCAM-1 were associated with increased colorectal cancer risk (P for linear trend = 0.02). No association was observed with any of the other biomarkers. Compared to standard models with known risk factors, those including both adiponectin and sVCAM-1 had substantially improved performance for colorectal cancer risk prediction (P for AUC improve- ment = 0.01, RIDI = 26.5%). CONCLUSION: These results suggest that pre-diag- nostic plasma adiponectin and sVCAM-1 levels are as- sociated with decreased and increased colorectal cancer risk, respectively. These relationships must be confirmed in large validation studies.展开更多
Topographic shielding of cosmic radiation flux is a key parameter in using cosmogenic nuclides to determine surface exposure ages or erosion rates. Traditionally, this parameter is measured in the field and uncertaint...Topographic shielding of cosmic radiation flux is a key parameter in using cosmogenic nuclides to determine surface exposure ages or erosion rates. Traditionally, this parameter is measured in the field and uncertainty and/or inconsistency may exist among different investigators. This paper provides an ArcGIS python code to determine topographic shielding factors using digital elevation models (DEMs). This code can be imported into ArcGIS as a geoprocessing tool with a user-friendly graphical interface. The DEM-derived parameters using this method were validated with field measurements in central Tian Shan. Results indicate that DEM-derived shielding factors are consistent with field-measured values. It provides a valuable tool to save fieldwork efforts and has the potential to provide consistent results for different regions in the world to facilitate the comparison of cosmogenie nuclide results.展开更多
OBJECTIVE To discuss the effects of clinico-pathological features on lymph node metastasis (LNM) in undifferentiated EGC (early gastric cancer), as well as identify the appropriate medical management. METHODS From...OBJECTIVE To discuss the effects of clinico-pathological features on lymph node metastasis (LNM) in undifferentiated EGC (early gastric cancer), as well as identify the appropriate medical management. METHODS From January 1999 to June 2011, 352 patients were treated for undifferentiated EGC in our hospital. All patients had undergone gastrectomy with regional lymphadenectomy. We used univariate and multivariate associated with lymph node entiated EGC. analyses to determine the features metastasis in patients with undiffer- RESULTS Signet ring cell carcinoma (SRC) was more common in patients with undifferentiated EGC than other undifferentiated carcinoma (UDC). SRC had a tendency to be confined to the mucosa, with a smaller size than other UDC. The incidence of LNM for SRC was lower than that for other UDC. Multivariate analysis showed that LNM was associated with the sex, tumor size, depth of invasion, lymphovascular invasion, and histological type. CONCLUSION Complete endoscopic resection is suitable for SRC- type intramucosal EGC, which is less than 2 cm in diameter without lymphovascular invasion in the postoperative histological examination.展开更多
Ab Objective: We evaluated the prognostic factors of patients with stage IV gastric cancer. Methods: In the current retrospective study, 138 patients of stage I gastric cancer treated with platinum-based chemotherap...Ab Objective: We evaluated the prognostic factors of patients with stage IV gastric cancer. Methods: In the current retrospective study, 138 patients of stage I gastric cancer treated with platinum-based chemotherapy were analyzed. Survival rate was estimated by using Kaplan-Meier method. The prognostic factors were analyzed using univariate (Log rank) and multivariate (Cox model) analysis methods. Results: Univariate analysis showed and multivariate analysis showed that poor performance status (P = 0.001), weight loss (P = 0.001), depth of invasion (P = 0.000), presence of peritoneal metastasis (P = 0.005), more than 1 metastatic site (P = 0.029) and elevated total bilirubin (P = 0.018) were confirmed as independent prognostic factors. According to the outcomes of the Cox model analysis, a formula of the prognostic index was developed. According to the values of PI, 16 patients were categorized as the good risk group, 28 patients were categorized as the moderate risk group and 8 patients were categorized as the poor risk group, respectively. The survival ratios of 6 months, 12 months and 24 months of the good risk group were 75.00%, 50.00%, 25.00%, respectively. The survival ratios of 6 month, 1-year and 2-year of the moderate risk group were 71.79%, 28.57%, 7.14%, respectively. While the survival ratios of 6 month, 12 months and 24 months of the poor risk group were 50%, 0, 0, respectively. The overall survival ratios of the 3 groups were compared in pairs. Conclusion: Poor performance status, depth of invasion, elevated total bilirubin, more than 1 metastatic site, presence of peritoneal metastasis ,weight loss were the independent prognostic factors. A formula of the prognostic index was developed, and it could help clinicians and patients in clinical decision-making and treatment tailoring based on the estimated prognosis.展开更多
Objective: Survival and treatment of patients with microinvasive breast cancer(MIBC) remain controversial. In this paper, we evaluated whether adjuvant chemotherapy is necessary for patients with MIBC to identify risk...Objective: Survival and treatment of patients with microinvasive breast cancer(MIBC) remain controversial. In this paper, we evaluated whether adjuvant chemotherapy is necessary for patients with MIBC to identify risk factors influencing its prognosis and decide the indication for adjuvant chemotherapy.Methods: In this retrospective study, 108 patients with MIBC were recruited according to seventh edition of the staging manual of the American Joint Committee on Cancer(AJCC). The subjects were divided into chemotherapy and non-chemotherapy groups.We compared the 5-year disease-free survival(DFS) and overall survival(OS) rates between groups. Furthermore, we analyzed the factors related to prognosis for patients with MIBC using univariate and multivariate analyses. We also evaluated the impact of adjuvant chemotherapy on the prognostic factors by subgroup analysis after median follow-up time of 33 months(13-104months).Results: The 5-year DFS and OS rates for the chemotherapy group were 93.7% and 97.5%, whereas those for the nonchemotherapy group were 89.7% and 100%. Results indicate that 5-year DFS was superior, but OS was inferior, in the former group compared with the latter group. However, no statistical significance was observed in the 5-year DFS(P=0.223) or OS(P=0.530) rate of the two groups. Most relevant poor-prognostic factors were Ki-67 overexpression and negative hormonal receptors. Cumulative survival was 98.2% vs. 86.5% between low Ki-67(≤20%) and high Ki-67(>20%). The hazard ratio of patients with high Ki-67 was 16.585 [95% confidence interval(CI), 1.969-139.724; P=0.010]. Meanwhile, ER(-)/PR(-) patients with MIBC had cumulative survival of 79.3% compared with 97.5% for ER(+) or PR(+) patients with MIBC. The hazard ratio for ER(-)/PR(-) patients with MIBC was 19.149(95% CI, 3.702-99.057; P<0.001). Subgroup analysis showed that chemotherapy could improve the outcomes of ER(-)/PR(-) patients(P=0.014), but not those who overexpress Ki-67(P=0.105).Conclusions: Patients with MIBC who overexpress Ki-67 and with negative hormonal receptors have relatively substantial risk of relapse within the first five years after surgery. However, adjuvant chemotherapy can only improve the outcomes of ER(-)/PR(-)patients, but not those who overexpress Ki-67. Further studies with prolonged follow-up of large cohorts are recommended to assess the prognostic significance and treatment of this lesion.展开更多
Consuming a cyanogenic plant is an etiological factor to the persistence of iodine deficiency in the post salt iodization phase. Ghana, notably the Northern belt, still reports of iodine deficiency after 14 years of m...Consuming a cyanogenic plant is an etiological factor to the persistence of iodine deficiency in the post salt iodization phase. Ghana, notably the Northern belt, still reports of iodine deficiency after 14 years of mandatory consumption of iodized salt by an Act of Parliament. The study aimed at determining the cyanide contents of leaves of commonly consumed cassava varieties in Ghana and investigating the effects of some environmental factors on cyanide content. Three communities each from Southern, Middle and Northern Ghana served as the study sites from where young, non-diseased and fully-spread cassava leaves were sampled from plants of commonly consumed cassava varieties. Cyanide was analyzed by the standard color^metric method based on the chloramine-T/pyridine-barbituric acid protocol (4500-CN E). Cassava leaves from Northern Ghana had significantly higher mean cyanide content (177.22 ± 20.82 ppm) than those from Middle (130.83± 33.00 ppm) and Southern Ghana (127.24 ± 37.54 ppm) (P 〈 0.001). Two-factor ANOVA showed significantly higher adverse environmental effects on cyanide contents of leaves of unimproved cassava varieties than improved ones (R2 = 0.627, P = 0.023). From multiple regression analysis, temperature was the most significant environmental factor explaining 33% of the variability in cyanide content (R2 = 0.331, P = 0.002), followed by altitude (R2 = 0.106, P = 0.049) and rainfall (R2 = 0.084, P = 0.062). The high cyanide contents of cassava leaves from Northern Ghana, due principally to the high atmospheric temperature, may be a contributory factor to the high prevalence of goiter and the persistence of iodine deficiency in that geographic region.展开更多
The nutritive quality in plant organs is related to the different partitioning patterns of nutrient resources among the organs under various environmental conditions.This study examined the relationship between the nu...The nutritive quality in plant organs is related to the different partitioning patterns of nutrient resources among the organs under various environmental conditions.This study examined the relationship between the nutritive quality of pods and seeds in Zanthoxylum and environmental factors, such as temperature and preciptation by using numerous samples collected from Southwest China to the East China of Shandong peninsula. The increasing accumulations of N, P and C in seeds implied that the nutritive quality in seeds was higher at the regions with relative higher mean annual temperature(MAT) and mean annual precipitation(MAP), while that in pods was on the contrary. By contrast, pod nutritive content was relatively high, but seed nutritive content was relatively low at the regions with relative high MAT and MAP. In addition, C:N ratio in pods was significantly and negatively correlated with MAT and MAP, while that in seed was significantly and positively correlated with MAT and MAP. The partitioning patterns of N-compounds between pods and seeds reflected different nitrogen translocations in the plant organs under various climate condition. The N:P ratios were negatively correlated with MAP, implying a higher proportional allocation of P to seeds than that of N in the areas with a relative high MAP. Therefore, the strategies to assess pod nutritional quality should be taken into accountfor nutritive translocation under various environmental conditions.展开更多
The fresh snow density was observed with snow analyzer (Snow Fork) at Tianshan Station for Snowcover and Avalanche Research, Chinese Academy of Sciences from February 21 to March 5, 2009. Results show that fresh snow ...The fresh snow density was observed with snow analyzer (Snow Fork) at Tianshan Station for Snowcover and Avalanche Research, Chinese Academy of Sciences from February 21 to March 5, 2009. Results show that fresh snow density increases from the 5th h to the 291st h after the snowfall, with an average rate of increase of 4.0×10-4 g/(cm3·h) (R2 = 0.943). Analysis shows that fresh snow density is negatively correlated with the compac-tion rate of fresh snow (R2 = -0.960). Inversely, it is positively correlated with fresh snow viscosity (R2 = 0.896). In relation to meteorological factors, ground temperature rising at a depth of 40 cm is the major driving factor of snow density increase. The temperature increase in fresh snow layer and the decrease in depth hoar layer have the most prominent impacts on the snow density increase in the afternoon. Principal component analysis shows that the de-terminant factors of fresh snow density change can be grouped into 3 types as follows: 1) dynamic factor contributes about 69.71% to fresh snow density change, with a significant effect from the 5th h to the 106th h after the snowfall; 2) exogenous energy factor contributes about 20.91% to it, with a significant effect at the 130th h; and c) endoge-nous energy factor contributes about 9.38% to it, with a significant effect at the 130th h and the 195th h.展开更多
With the continuous increase of social and economic competitiveness, the position of advertising becomes more and more important. For attracting people's attention to the advertising, merchants should not only rely o...With the continuous increase of social and economic competitiveness, the position of advertising becomes more and more important. For attracting people's attention to the advertising, merchants should not only rely on novel advertising creativity and also add some sentiment elements in advertising design under the background of today's advertising all over the world. Sentiments are the most capable of touching human nerves so as to leave a deep impression in the minds of people, so the quality of advertising can be well improved if appropriate sentiment elements are added in advertising design. In this paper, the application of emotional elements to advertising design is specifically discussed from emotional elements classification, main application methods, and matters needing attention.展开更多
The paper firstly represents two kind statements of China money multipliers and theoretically analyzes the relationship between each structure factor and China money multiplier. Secondly, it summarizes the several fea...The paper firstly represents two kind statements of China money multipliers and theoretically analyzes the relationship between each structure factor and China money multiplier. Secondly, it summarizes the several features and the move trends of China narrow and broad money multipliers and their structure factors. Thirdly, the paper empirically analyzes how and what degree the each structure factor affects China narrow and broad money multipliers holding everything else constant. At last two important conclusions are got, that is, the required reserve ratio is the most associated with China money multipliers and the saving deposit ratio is more associated with that, the required reserve ratio and the interest rates can be used as the ways of affecting money aggregate by the People's Bank of China.展开更多
基金Supported by A grant of the Korea Healthcare technology R&D Project,Ministry for Health,Welfare&Family Affairs,Republic of Korea NO.A091047 Medical Research Institute Grant (2009-1),Pusan National University
文摘AIM:To evaluate the effect of pantoprazole with a somatostatin adjunct in patients with acute non-variceal upper gastrointestinal bleeding(NVUGIB).METHODS:We performed a retrospective analysis of a prospective database in a tertiary care university hospital.From October 2006 to October 2008,we enrolled 101 patients with NVUGIB that had a high-risk stigma on endoscopy.Within 24 h of hospital admission,all patients underwent endoscopic therapy.After successful endoscopic hemostasis,all patients received an 80-mg bolus of pantoprazole followed by continuous intravenous infusion(8 mg/h for 72 h).The somatostatin adjunct group(n=49)also received a 250-μg bolus of somatostatin,followed by continuous infusion (250μg/h for 72 h).Early rebleeding rates,disappearance of endoscopic stigma and risk factors associated with early rebleeding were examined.RESULTS:Early rebleeding rates were not significantly different between treatment groups(12.2%vs 14.3%,P=0.766).Disappearance of endoscopic stigma on the second endoscopy was not significantly different between treatment groups(94.2%vs 95.9%,P=0.696).Multivariate analysis showed that the complete Rockall score was a significant risk factor for early rebleeding(P =0.044,OR:9.080,95%CI:1.062-77.595).CONCLUSION:The adjunctive use of somatostatin was not superior to pantoprazole monotherapy after successful endoscopic hemostasis in patients with NVUGIB.
文摘AIM:To investigate the prognostic factors of T4 gastric cancer patients without distant metastasis who could undergo potentially curative resection. METHODS:We retrospectively analyzed the clinical data of 71 consecutive patients diagnosed with T4 gastric cancer and who underwent curative gastrectomy at our institutions.The clinicopathological factors that could be associated with overall survival were evaluated.The cumulative survival was determined by the Kaplan-Meier method,and univariate comparisons between the groups were performed using the log-rank test.Multivariate analysis was performed using the Cox proportional hazard model and a step-wise procedure. RESULTS:The study patients comprised 53 men (74.6%)and 18 women(25.4%)aged 39-89 years (mean,68.9 years).Nineteen patients(26.8%)had postoperative morbidity:pancreatic fistula developed in 6 patients(8.5%)and was the most frequent complication,followed by anastomosis stricture in 5 patients (7.0%).During the follow-up period,28 patients(39.4%)died because of gastric cancer recurrence,and 3(4.2%) died because of another disease or accident.For all patients,the estimated overall survival was 34.1%at 5 years.Univariate analyses identified the following statistically significant prognostic factors in T4 gastric cancer patients who underwent potentially curative resection: peritoneal washing cytology(P<0.01),number of metastatic lymph nodes(P<0.05),and venous invasion(P <0.05).In multivariate analyses,only peritoneal washing cytology was identified as an independent prognostic factor(HR=3.62,95%CI=1.37-9.57)for longterm survival. CONCLUSION:Positive peritoneal washing cytology was the only independent poor prognostic factor for T4 gastric cancer patients who could be treated with potentially curative resection.
文摘AIM:To investigate the patterns and decisive prognostic factors for local recurrence of rectal cancer treated with a multidisciplinary team(MDT) modality.METHODS:Ninety patients with local recurrence were studied,out of 1079 consecutive rectal cancer patients who underwent curative surgery from 1999 to 2007.For each patient,the recurrence pattern was assessed by specialist radiologists from the MDT using imaging,and the treatment strategy was decided after discussion by the MDT.The associations between clinicopathological factors and long-term outcomes were evaluated using both univariate and multivariate analysis.RESULTS:The recurrence pattern was classified as follows:Twenty-seven(30%) recurrent tumors were evaluated as axial type,21(23.3%) were anterior type,8(8.9%) were posterior type,and 13(25.6%) were lateral type.Forty-one patients had tumors that were evaluated as resectable by the MDT and ultimately received surgery,and R0 resection was achieved in 36(87.8%) of these patients.The recurrence pattern was closely associated with resectability and R0 resection rate(P < 0.001).The recurrence pattern,interval to recurrence,and R0 resection were significantly associated with 5-year survival rate in univariate analysis.Multivariate analysis showed that the R0 resection was the unique independent factor affecting long-term survival.CONCLUSION:The MDT modality improves patient selection for surgery by enabling accurate classification of the recurrence pattern;R0 resection is the most significant factor affecting long-term survival.
基金Supported by The National Science and Technology Major Project of China,No.2012ZX10002-016 and 2012ZX10002017-006
文摘AIM:To identify factors related to serious postoperative bacterial and fungal infections in the first 3 mo after living donor liver transplantation(LDLT).METHODS:In the present study,the data of 207 patients from 2004 to 2011 were reviewed.The pre-,intra-and post-operative factors were statistically analyzed.All transplantations were approved by the ethics committee of West China Hospital,Sichuan University.Patients with definitely preoperative infections and infections within 48 h after transplantation were excluded from current study.All potential risk factors were analyzed using univariate analyses.Factors significant at a P < 0.10 in the univariate analyses were involved in the multivariate analyses.The diagnostic accuracy of the identified risk factors was evaluated using receiver operating curve.RESULTS:The serious bacterial and fungal infection rates were 14.01% and 4.35% respectively.Enterococcus faecium was the predominant bacterial pathogen,whereas Candida albicans was the most common fungal pathogen.Lung was the most common infection site for both bacterial and fungal infections.Recipient age older than 45 years,preoperative hyponatremia,intensive care unit stay longer than 9 d,postoperative bile leak and severe hyperglycemia were independent risk factors for postoperative bacterial infection.Massive red blood cells transfusion and postoperative bacterial infection may be related to postoperative fungal infection.CONCLUSION:Predictive risk factors for bacterial and fungal infections were indentified in current study.Pre-,intra-and post-operative factors can cause postoperative bacterial and fungal infections after LDLT.
文摘Objective To explore the efficacy of hepatic resection(HR) in a relatively unselected group of patients with ovarian cancer liver metastases(OCLM). Methods A study was conducted between September 2000 and September 2011 on 60 ovarian cancer patients with hepatic metastases(24 solitary and 36 multiple),40 of whom had extrahepatic metastases.HR was done in all patients provided that curative hepatic resection was feasible,and extrahepatic disease was controlled with medical and/or surgical therapy. Results Most patients(n=54;90.0% ) had a negative hepatic margin(R0),whereas 6 patients(10.0% ) had microscopic disease at the margin(R1).The prognostic value of each study variable was assessed using log rank tests for univariate analysis and Cox proportional hazard models for multivariate analysis.The result was a median survival of 39 months and 5-year overall survival rate of 30% .Univariate analysis showed that surgery result(P=0.001),disease free interval(P=0.018) and the number of hepatic lesions (P=0.018) were significantly related to survival.Furthermore,the surgery result(P=0.004) remained significant for prognosis in multivariate analysis. Conclusions For patients with OCLM,HR is safe and may provide a significant survival benefit compared with medical therapy alone.A long interval time,the number of hepatic lesions,and surgery results are key prognostic factors.Favorable outcomes can be achieved even in patients with medically controlled or surgically resectable extrahepatic disease,indicating that surgery should be considered more frequently in the multidisciplinary care of patients with OCLM.
基金Supported by Grants-in-Aid from the Japanese Ministry of Education, Culture, Sports, Science, and Technology
文摘AIM: To evaluate the presence of extracapsular invasion (ECI) in positive nodes as a predictor of disease recurrence disease in colorectal cancer. METHODS: Two hundred and twenty-eight consecutive patients who underwent colorectal resection were identified for inclusion in this study, of which 46 had positive lymph nodes. Among 46 cases with stage Ⅲcolorectal cancer, 16 had ECI at positive nodes and 8 had disease recurrence. The clinical and pathological features of these cases were reviewed. RESULTS: In the univariate analysis, the number of positive lymph nodes and depth of tumor invasion were significantly associated with the presence of ECI at positive nodes. Multivariate analysis demonstrated that only ECI was a predictor of recurrence. The recurrence-free interval differed significantly among patients with ECI at positive nodes.CONCLUSION: Our results suggest that ECI at metastatic nodes can identify which cases are at high risk of short-term disease recurrence in colorectal cancer.
文摘Glucose homeostasis deficiency leads to a chronic increase in blood glucose concentration. In contrast to physiological glucose concentration, chronic super-physiological glucose concentration negatively affects a large number of organs and tissues. Glucose toxicity means a decrease in insulin secretion and an increase in insulin resistance due to chronic hyperglycemia. It is now generally accepted that glucose toxicity is involved in the worsening of diabetes by affecting the secretion of B-cells. Several mechanisms have been proposed to explain the adverse effects of hyperglycemia. It was found that persistent hyperglycemia caused the functional decline of neutrophils. Infection is thus the main problem resulting from glucose toxicity in the acute phase. In other words, continued hyperglycemia is a life-threatening risk factor, not only in the chronic but also the acute phase, and it becomes a risk factor for infection, particularly in the perioperative period.
文摘Colorectal cancers (CRC) account for frequent and serious cancers which result from the interaction between individual genetic factors and environmental factors, and in particular widely studied nutritional ones. The role of other occupational factors remains a controversial subject. The objective of this study is to evaluate the possible impact of occupational factors on the risk of developing CRC. Materials and Methods: This is a retrospective case-control study. The cases and the control group were enlisted in the general surgical ward of Farhat Hached Teaching Hospital of Sousse (Tunisia) during the period extending from 2004 to 2008, and they were age and gender-matched. The data were analyzed using SPSS 11.0 software with a signification threshold fixed at 5%. A univariate analysis was carried out as well as a multiple binary logistical regression. Results: During the period of the study, 40 cases of colorectal cancers have been colligated including 28 men and 12 women with a sex ratio of 0.43. The average age of the cases was 61.55 ± 13.3 years and 60.40 ± 12.84 years for the control group, with a non significant difference (P = 0.69). The univariate analysis has objectivized significant associations between colorectal cancer and the housing conditions, the neoplastic and digestive family history, the occupational activity sector, exposure to pesticides, and lack of periodic medical supervision. After logistical regression, the occurrence risk of CRC was significantly associated with: alcohol and smoking (ORa = 3.43; Pa = 0.05), meat consumption (ORa = 3.34; Pa = 0.03), exposure to pesticides (ORa = 20.44; Pa = 0.012) and lack of periodic medical supervision (OR = 7.45; P = 0.004). Conclusion: The occupational risk factors might play a role in the etiopathogenesis of colorectal cancers. With regard to our study, pesticides seem to be most implicated and necessitate suitable preventive measures. Nevertheless, it seems useful to multiply the studies to a much larger scale in order to further explore such relationship and to further reinforce the prevention of such serious disease.
基金Supported by A grant from the French National Cancer Institute (Institut National du Cancer), No. INCa 2007-1-SPC-3
文摘AIM: To examine the relationships between pre-diag- nostic biomarkers and colorectal cancer risk and assess their relevance in predictive models.METHODS: A nested case-control study was designed to include all first primary incident colorectal cancer cases diagnosed between inclusion in the SUpplemen- tation en VItamines et Min^raux AntioXydants cohort in 1994 and the end of follow-up in 2007. Cases (n = 50) were matched with two randomly selected con- trols (n = 100). Conditional logistic regression models were used to investigate the associations between pre- diagnostic levels of hs-CRP, adiponectin, leptin, soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-I, E-selectin, monocyte chemoattractant protein-1 and colorectal cancer risk. Area under the receiver operating curves (AUC) and relative integrated discrimination improvement (RIDI) statistics were used to assess the discriminatory poten- tial of the models. RESULTS: Plasma adiponectin level was associated with decreased colorectal cancer risk (P for linear trend -- 0.03). Quartiles of sVCAM-1 were associated with increased colorectal cancer risk (P for linear trend = 0.02). No association was observed with any of the other biomarkers. Compared to standard models with known risk factors, those including both adiponectin and sVCAM-1 had substantially improved performance for colorectal cancer risk prediction (P for AUC improve- ment = 0.01, RIDI = 26.5%). CONCLUSION: These results suggest that pre-diag- nostic plasma adiponectin and sVCAM-1 levels are as- sociated with decreased and increased colorectal cancer risk, respectively. These relationships must be confirmed in large validation studies.
基金supported by the Professional Development Award of the University of Tennessee
文摘Topographic shielding of cosmic radiation flux is a key parameter in using cosmogenic nuclides to determine surface exposure ages or erosion rates. Traditionally, this parameter is measured in the field and uncertainty and/or inconsistency may exist among different investigators. This paper provides an ArcGIS python code to determine topographic shielding factors using digital elevation models (DEMs). This code can be imported into ArcGIS as a geoprocessing tool with a user-friendly graphical interface. The DEM-derived parameters using this method were validated with field measurements in central Tian Shan. Results indicate that DEM-derived shielding factors are consistent with field-measured values. It provides a valuable tool to save fieldwork efforts and has the potential to provide consistent results for different regions in the world to facilitate the comparison of cosmogenie nuclide results.
文摘OBJECTIVE To discuss the effects of clinico-pathological features on lymph node metastasis (LNM) in undifferentiated EGC (early gastric cancer), as well as identify the appropriate medical management. METHODS From January 1999 to June 2011, 352 patients were treated for undifferentiated EGC in our hospital. All patients had undergone gastrectomy with regional lymphadenectomy. We used univariate and multivariate associated with lymph node entiated EGC. analyses to determine the features metastasis in patients with undiffer- RESULTS Signet ring cell carcinoma (SRC) was more common in patients with undifferentiated EGC than other undifferentiated carcinoma (UDC). SRC had a tendency to be confined to the mucosa, with a smaller size than other UDC. The incidence of LNM for SRC was lower than that for other UDC. Multivariate analysis showed that LNM was associated with the sex, tumor size, depth of invasion, lymphovascular invasion, and histological type. CONCLUSION Complete endoscopic resection is suitable for SRC- type intramucosal EGC, which is less than 2 cm in diameter without lymphovascular invasion in the postoperative histological examination.
文摘Ab Objective: We evaluated the prognostic factors of patients with stage IV gastric cancer. Methods: In the current retrospective study, 138 patients of stage I gastric cancer treated with platinum-based chemotherapy were analyzed. Survival rate was estimated by using Kaplan-Meier method. The prognostic factors were analyzed using univariate (Log rank) and multivariate (Cox model) analysis methods. Results: Univariate analysis showed and multivariate analysis showed that poor performance status (P = 0.001), weight loss (P = 0.001), depth of invasion (P = 0.000), presence of peritoneal metastasis (P = 0.005), more than 1 metastatic site (P = 0.029) and elevated total bilirubin (P = 0.018) were confirmed as independent prognostic factors. According to the outcomes of the Cox model analysis, a formula of the prognostic index was developed. According to the values of PI, 16 patients were categorized as the good risk group, 28 patients were categorized as the moderate risk group and 8 patients were categorized as the poor risk group, respectively. The survival ratios of 6 months, 12 months and 24 months of the good risk group were 75.00%, 50.00%, 25.00%, respectively. The survival ratios of 6 month, 1-year and 2-year of the moderate risk group were 71.79%, 28.57%, 7.14%, respectively. While the survival ratios of 6 month, 12 months and 24 months of the poor risk group were 50%, 0, 0, respectively. The overall survival ratios of the 3 groups were compared in pairs. Conclusion: Poor performance status, depth of invasion, elevated total bilirubin, more than 1 metastatic site, presence of peritoneal metastasis ,weight loss were the independent prognostic factors. A formula of the prognostic index was developed, and it could help clinicians and patients in clinical decision-making and treatment tailoring based on the estimated prognosis.
文摘Objective: Survival and treatment of patients with microinvasive breast cancer(MIBC) remain controversial. In this paper, we evaluated whether adjuvant chemotherapy is necessary for patients with MIBC to identify risk factors influencing its prognosis and decide the indication for adjuvant chemotherapy.Methods: In this retrospective study, 108 patients with MIBC were recruited according to seventh edition of the staging manual of the American Joint Committee on Cancer(AJCC). The subjects were divided into chemotherapy and non-chemotherapy groups.We compared the 5-year disease-free survival(DFS) and overall survival(OS) rates between groups. Furthermore, we analyzed the factors related to prognosis for patients with MIBC using univariate and multivariate analyses. We also evaluated the impact of adjuvant chemotherapy on the prognostic factors by subgroup analysis after median follow-up time of 33 months(13-104months).Results: The 5-year DFS and OS rates for the chemotherapy group were 93.7% and 97.5%, whereas those for the nonchemotherapy group were 89.7% and 100%. Results indicate that 5-year DFS was superior, but OS was inferior, in the former group compared with the latter group. However, no statistical significance was observed in the 5-year DFS(P=0.223) or OS(P=0.530) rate of the two groups. Most relevant poor-prognostic factors were Ki-67 overexpression and negative hormonal receptors. Cumulative survival was 98.2% vs. 86.5% between low Ki-67(≤20%) and high Ki-67(>20%). The hazard ratio of patients with high Ki-67 was 16.585 [95% confidence interval(CI), 1.969-139.724; P=0.010]. Meanwhile, ER(-)/PR(-) patients with MIBC had cumulative survival of 79.3% compared with 97.5% for ER(+) or PR(+) patients with MIBC. The hazard ratio for ER(-)/PR(-) patients with MIBC was 19.149(95% CI, 3.702-99.057; P<0.001). Subgroup analysis showed that chemotherapy could improve the outcomes of ER(-)/PR(-) patients(P=0.014), but not those who overexpress Ki-67(P=0.105).Conclusions: Patients with MIBC who overexpress Ki-67 and with negative hormonal receptors have relatively substantial risk of relapse within the first five years after surgery. However, adjuvant chemotherapy can only improve the outcomes of ER(-)/PR(-)patients, but not those who overexpress Ki-67. Further studies with prolonged follow-up of large cohorts are recommended to assess the prognostic significance and treatment of this lesion.
文摘Consuming a cyanogenic plant is an etiological factor to the persistence of iodine deficiency in the post salt iodization phase. Ghana, notably the Northern belt, still reports of iodine deficiency after 14 years of mandatory consumption of iodized salt by an Act of Parliament. The study aimed at determining the cyanide contents of leaves of commonly consumed cassava varieties in Ghana and investigating the effects of some environmental factors on cyanide content. Three communities each from Southern, Middle and Northern Ghana served as the study sites from where young, non-diseased and fully-spread cassava leaves were sampled from plants of commonly consumed cassava varieties. Cyanide was analyzed by the standard color^metric method based on the chloramine-T/pyridine-barbituric acid protocol (4500-CN E). Cassava leaves from Northern Ghana had significantly higher mean cyanide content (177.22 ± 20.82 ppm) than those from Middle (130.83± 33.00 ppm) and Southern Ghana (127.24 ± 37.54 ppm) (P 〈 0.001). Two-factor ANOVA showed significantly higher adverse environmental effects on cyanide contents of leaves of unimproved cassava varieties than improved ones (R2 = 0.627, P = 0.023). From multiple regression analysis, temperature was the most significant environmental factor explaining 33% of the variability in cyanide content (R2 = 0.331, P = 0.002), followed by altitude (R2 = 0.106, P = 0.049) and rainfall (R2 = 0.084, P = 0.062). The high cyanide contents of cassava leaves from Northern Ghana, due principally to the high atmospheric temperature, may be a contributory factor to the high prevalence of goiter and the persistence of iodine deficiency in that geographic region.
基金supported by the National Key R&D Program of China Grant 2016YFA0601002National Natural Science Foundation of China(Grant Nos.41571130072)(S-L Li)
文摘The nutritive quality in plant organs is related to the different partitioning patterns of nutrient resources among the organs under various environmental conditions.This study examined the relationship between the nutritive quality of pods and seeds in Zanthoxylum and environmental factors, such as temperature and preciptation by using numerous samples collected from Southwest China to the East China of Shandong peninsula. The increasing accumulations of N, P and C in seeds implied that the nutritive quality in seeds was higher at the regions with relative higher mean annual temperature(MAT) and mean annual precipitation(MAP), while that in pods was on the contrary. By contrast, pod nutritive content was relatively high, but seed nutritive content was relatively low at the regions with relative high MAT and MAP. In addition, C:N ratio in pods was significantly and negatively correlated with MAT and MAP, while that in seed was significantly and positively correlated with MAT and MAP. The partitioning patterns of N-compounds between pods and seeds reflected different nitrogen translocations in the plant organs under various climate condition. The N:P ratios were negatively correlated with MAP, implying a higher proportional allocation of P to seeds than that of N in the areas with a relative high MAP. Therefore, the strategies to assess pod nutritional quality should be taken into accountfor nutritive translocation under various environmental conditions.
基金Under the auspices of National R & D Project of Social Welfare, Ministry of Science and Technology Development, China (No. GYHY200706008, GYHY200806011)West Light Foundation of Chinese Academy of Sciences (No. RCPY200902)
文摘The fresh snow density was observed with snow analyzer (Snow Fork) at Tianshan Station for Snowcover and Avalanche Research, Chinese Academy of Sciences from February 21 to March 5, 2009. Results show that fresh snow density increases from the 5th h to the 291st h after the snowfall, with an average rate of increase of 4.0×10-4 g/(cm3·h) (R2 = 0.943). Analysis shows that fresh snow density is negatively correlated with the compac-tion rate of fresh snow (R2 = -0.960). Inversely, it is positively correlated with fresh snow viscosity (R2 = 0.896). In relation to meteorological factors, ground temperature rising at a depth of 40 cm is the major driving factor of snow density increase. The temperature increase in fresh snow layer and the decrease in depth hoar layer have the most prominent impacts on the snow density increase in the afternoon. Principal component analysis shows that the de-terminant factors of fresh snow density change can be grouped into 3 types as follows: 1) dynamic factor contributes about 69.71% to fresh snow density change, with a significant effect from the 5th h to the 106th h after the snowfall; 2) exogenous energy factor contributes about 20.91% to it, with a significant effect at the 130th h; and c) endoge-nous energy factor contributes about 9.38% to it, with a significant effect at the 130th h and the 195th h.
文摘With the continuous increase of social and economic competitiveness, the position of advertising becomes more and more important. For attracting people's attention to the advertising, merchants should not only rely on novel advertising creativity and also add some sentiment elements in advertising design under the background of today's advertising all over the world. Sentiments are the most capable of touching human nerves so as to leave a deep impression in the minds of people, so the quality of advertising can be well improved if appropriate sentiment elements are added in advertising design. In this paper, the application of emotional elements to advertising design is specifically discussed from emotional elements classification, main application methods, and matters needing attention.
文摘The paper firstly represents two kind statements of China money multipliers and theoretically analyzes the relationship between each structure factor and China money multiplier. Secondly, it summarizes the several features and the move trends of China narrow and broad money multipliers and their structure factors. Thirdly, the paper empirically analyzes how and what degree the each structure factor affects China narrow and broad money multipliers holding everything else constant. At last two important conclusions are got, that is, the required reserve ratio is the most associated with China money multipliers and the saving deposit ratio is more associated with that, the required reserve ratio and the interest rates can be used as the ways of affecting money aggregate by the People's Bank of China.