Diabetes,one of the world's top ten diseases,is known for its high mortality and complication rates and low cure rate.Prediabetes precedes the onset of diabetes,during which effective treatment can reduce diabetes...Diabetes,one of the world's top ten diseases,is known for its high mortality and complication rates and low cure rate.Prediabetes precedes the onset of diabetes,during which effective treatment can reduce diabetes risk.Prediabetes risk factors include high-calorie and high-fat diets,sedentary lifestyles,and stress.Consequences may include considerable damage to vital organs,including the retina,liver,and kidneys.Interventions for treating prediabetes include a healthy lifestyle diet and pharmacological treatments.However,while these options are effective in the short term,they may fail due to the difficulty of long-term implementation.Medications may also be used to treat prediabetes.This review examines prediabetic treatments,particularly metformin,glucagon-like peptide-1 receptor agonists,sodium glucose cotransporter 2 inhibitors,vitamin D,and herbal medicines.Given the remarkable impact of prediabetes on the progression of diabetes mellitus,it is crucial to intervene promptly and effectively to regulate prediabetes.However,the current body of research on prediabetes is limited,and there is considerable confusion surrounding clinically relevant medications.This paper aims to provide a comprehensive summary of the pathogenesis of prediabetes mellitus and its associated therapeutic drugs.The ultimate goal is to facilitate the clinical utilization of medications and achieve efficient and timely control of diabetes mellitus.展开更多
BACKGROUND With the development of minimally invasive surgical techniques,the use of laparoscopic D2 radical surgery for the treatment of locally advanced gastric cancer(GC)has gradually increased.However,the effect o...BACKGROUND With the development of minimally invasive surgical techniques,the use of laparoscopic D2 radical surgery for the treatment of locally advanced gastric cancer(GC)has gradually increased.However,the effect of this procedure on survival and prognosis remains controversial.This study evaluated the survival and prognosis of patients receiving laparoscopic D2 radical resection for the treatment of locally advanced GC to provide more reliable clinical evidence,guide clinical decision-making,optimize treatment strategies,and improve the survival rate and quality of life of patients.METHODS A retrospective cohort study was performed.Clinicopathological data from 652 patients with locally advanced GC in our hospitals from December 2013 to December 2023 were collected.There were 442 males and 210 females.The mean age was 57±12 years.All patients underwent a laparoscopic D2 radical operation for distal GC.The patients were followed up in the outpatient department and by telephone to determine their tumor recurrence,metastasis,and survival.The follow-up period ended in December 2023.Normally distributed data are expressed as the mean±SD,and normally distributed data are expressed as M(Q1,Q3)or M(range).Statistical data are expressed as absolute numbers or percentages;theχ^(2) test was used for comparisons between groups,and the Mann-Whitney U nonparametric test was used for comparisons of rank data.The life table method was used to calculate the survival rate,the Kaplan-Meier method was used to construct survival curves,the log rank test was used for survival analysis,and the Cox risk regression model was used for univariate and multifactor analysis.RESULTS The median overall survival(OS)time for the 652 patients was 81 months,with a 10-year OS rate of 46.1%.Patients with TNM stages II and III had 10-year OS rates of 59.6%and 37.5%,respectively,which were significantly different(P<0.05).Univariate analysis indicated that factors such as age,maximum tumor diameter,tumor diffe-rentiation grade(low to undifferentiated),pathological TNM stage,pathological T stage,pathological N stage(N2,N3),and postoperative chemotherapy significantly influenced the 10-year OS rate for patients with locally advanced GC following laparoscopic D2 radical resection for distal stomach cancer[hazard ratio(HR):1.45,1.64,1.45,1.64,1.37,2.05,1.30,1.68,3.08,and 0.56 with confidence intervals(CIs)of 1.15-1.84,1.32-2.03,1.05-1.77,1.62-2.59,1.05-1.61,1.17-2.42,2.15-4.41,and 0.44-0.70,respectively;P<0.05].Multifactor analysis revealed that a tumor diameter greater than 4 cm,low tumor differentiation,and pathological TNM stage III were independent risk factors for the 10-year OS rate in these patients(HR:1.48,1.44,1.81 with a 95%CI:1.19-1.84).Additionally,postoperative chemotherapy emerged as an independent protective factor for the 10-year OS rate(HR:0.57,95%CI:0.45-0.73;P<0.05).CONCLUSION A maximum tumor diameter exceeding 4 cm,low tumor differentiation,and pathological TNM stage III were identified as independent risk factors for the 10-year OS rate in patients with locally advanced GC following laparoscopic D2 radical resection for distal GC.Conversely,postoperative chemotherapy was found to be an independent protective factor for the 10-year OS rate in these patients.展开更多
The Gouméré region is located in the North-East of Côte d’Ivoire and is located in the South-West of the Bui furrow. In order to highlight the geology of the area studied, 14 samples were taken for stu...The Gouméré region is located in the North-East of Côte d’Ivoire and is located in the South-West of the Bui furrow. In order to highlight the geology of the area studied, 14 samples were taken for studies using petrographic, geochemical and metallogenic methods. The study of macroscopic and microscopic petrography made it possible to highlight two major lithological units: 1) a volcano-plutonic unit, formed of gabbros, basalt, volcaniclastics and rhyodacite;2) a sedimentary unit (microconglomerate). From a geochemical point of view, the results obtained indicate that the plutonites are gabbro and gabbro diorite while the volcanics have compositions of basaltic andesites, rhyolite and dacites. The sediments have a litharenitic to sublitharenitic character. The metallogenic study made it possible to highlight hydrothermal alterations and metalliferous paragenesis on the formations studied. Hydrothermal alteration is characterized by the presence of carbonation, silicification, sericitization, sulfidation and to a lesser degree chloritization. Metalliferous paragenesis consists of pyrite, chalcopyrite, hematite and magnetite.展开更多
Climate change is an alarming global challenge, particularly affecting the least developed countries (LDCs) including Liberia. These countries, located in regions prone to unpredictable temperature and precipitation c...Climate change is an alarming global challenge, particularly affecting the least developed countries (LDCs) including Liberia. These countries, located in regions prone to unpredictable temperature and precipitation changes, are facing significant challenges, particularly in climate-sensitive sectors such as mining and agriculture. LDCs need more resilience to adverse climate shocks but have limited capacity for adaptation compared to other developed and developing nations. This paper examines Liberia’s susceptibility to climate change as a least developed country, focusing on its exposure, sensitivity, and adaptive capacity. It provides an overview of LDCs and outlines the global distribution of carbon dioxide emissions. The paper also evaluates specific challenges that amplify Liberia’s vulnerability and constrain sustainable adaptation, providing insight into climate change’s existing and potential effects. The paper emphasizes the urgency of addressing climate impacts on Liberia and calls for concerted local and international efforts for effective and sustainable mitigation efforts. It provides recommendations for policy decisions and calls for further research on climate change mitigation and adaptation.展开更多
基金Supported by National Natural Science Foundation of China,No.31770948,No.31570875,and No.81803547Natural Science Foundation of Fujian Province,No.2021J01204and Fujian Provincial Regional Development Project,No.2021N3005.
文摘Diabetes,one of the world's top ten diseases,is known for its high mortality and complication rates and low cure rate.Prediabetes precedes the onset of diabetes,during which effective treatment can reduce diabetes risk.Prediabetes risk factors include high-calorie and high-fat diets,sedentary lifestyles,and stress.Consequences may include considerable damage to vital organs,including the retina,liver,and kidneys.Interventions for treating prediabetes include a healthy lifestyle diet and pharmacological treatments.However,while these options are effective in the short term,they may fail due to the difficulty of long-term implementation.Medications may also be used to treat prediabetes.This review examines prediabetic treatments,particularly metformin,glucagon-like peptide-1 receptor agonists,sodium glucose cotransporter 2 inhibitors,vitamin D,and herbal medicines.Given the remarkable impact of prediabetes on the progression of diabetes mellitus,it is crucial to intervene promptly and effectively to regulate prediabetes.However,the current body of research on prediabetes is limited,and there is considerable confusion surrounding clinically relevant medications.This paper aims to provide a comprehensive summary of the pathogenesis of prediabetes mellitus and its associated therapeutic drugs.The ultimate goal is to facilitate the clinical utilization of medications and achieve efficient and timely control of diabetes mellitus.
文摘BACKGROUND With the development of minimally invasive surgical techniques,the use of laparoscopic D2 radical surgery for the treatment of locally advanced gastric cancer(GC)has gradually increased.However,the effect of this procedure on survival and prognosis remains controversial.This study evaluated the survival and prognosis of patients receiving laparoscopic D2 radical resection for the treatment of locally advanced GC to provide more reliable clinical evidence,guide clinical decision-making,optimize treatment strategies,and improve the survival rate and quality of life of patients.METHODS A retrospective cohort study was performed.Clinicopathological data from 652 patients with locally advanced GC in our hospitals from December 2013 to December 2023 were collected.There were 442 males and 210 females.The mean age was 57±12 years.All patients underwent a laparoscopic D2 radical operation for distal GC.The patients were followed up in the outpatient department and by telephone to determine their tumor recurrence,metastasis,and survival.The follow-up period ended in December 2023.Normally distributed data are expressed as the mean±SD,and normally distributed data are expressed as M(Q1,Q3)or M(range).Statistical data are expressed as absolute numbers or percentages;theχ^(2) test was used for comparisons between groups,and the Mann-Whitney U nonparametric test was used for comparisons of rank data.The life table method was used to calculate the survival rate,the Kaplan-Meier method was used to construct survival curves,the log rank test was used for survival analysis,and the Cox risk regression model was used for univariate and multifactor analysis.RESULTS The median overall survival(OS)time for the 652 patients was 81 months,with a 10-year OS rate of 46.1%.Patients with TNM stages II and III had 10-year OS rates of 59.6%and 37.5%,respectively,which were significantly different(P<0.05).Univariate analysis indicated that factors such as age,maximum tumor diameter,tumor diffe-rentiation grade(low to undifferentiated),pathological TNM stage,pathological T stage,pathological N stage(N2,N3),and postoperative chemotherapy significantly influenced the 10-year OS rate for patients with locally advanced GC following laparoscopic D2 radical resection for distal stomach cancer[hazard ratio(HR):1.45,1.64,1.45,1.64,1.37,2.05,1.30,1.68,3.08,and 0.56 with confidence intervals(CIs)of 1.15-1.84,1.32-2.03,1.05-1.77,1.62-2.59,1.05-1.61,1.17-2.42,2.15-4.41,and 0.44-0.70,respectively;P<0.05].Multifactor analysis revealed that a tumor diameter greater than 4 cm,low tumor differentiation,and pathological TNM stage III were independent risk factors for the 10-year OS rate in these patients(HR:1.48,1.44,1.81 with a 95%CI:1.19-1.84).Additionally,postoperative chemotherapy emerged as an independent protective factor for the 10-year OS rate(HR:0.57,95%CI:0.45-0.73;P<0.05).CONCLUSION A maximum tumor diameter exceeding 4 cm,low tumor differentiation,and pathological TNM stage III were identified as independent risk factors for the 10-year OS rate in patients with locally advanced GC following laparoscopic D2 radical resection for distal GC.Conversely,postoperative chemotherapy was found to be an independent protective factor for the 10-year OS rate in these patients.
文摘The Gouméré region is located in the North-East of Côte d’Ivoire and is located in the South-West of the Bui furrow. In order to highlight the geology of the area studied, 14 samples were taken for studies using petrographic, geochemical and metallogenic methods. The study of macroscopic and microscopic petrography made it possible to highlight two major lithological units: 1) a volcano-plutonic unit, formed of gabbros, basalt, volcaniclastics and rhyodacite;2) a sedimentary unit (microconglomerate). From a geochemical point of view, the results obtained indicate that the plutonites are gabbro and gabbro diorite while the volcanics have compositions of basaltic andesites, rhyolite and dacites. The sediments have a litharenitic to sublitharenitic character. The metallogenic study made it possible to highlight hydrothermal alterations and metalliferous paragenesis on the formations studied. Hydrothermal alteration is characterized by the presence of carbonation, silicification, sericitization, sulfidation and to a lesser degree chloritization. Metalliferous paragenesis consists of pyrite, chalcopyrite, hematite and magnetite.
文摘Climate change is an alarming global challenge, particularly affecting the least developed countries (LDCs) including Liberia. These countries, located in regions prone to unpredictable temperature and precipitation changes, are facing significant challenges, particularly in climate-sensitive sectors such as mining and agriculture. LDCs need more resilience to adverse climate shocks but have limited capacity for adaptation compared to other developed and developing nations. This paper examines Liberia’s susceptibility to climate change as a least developed country, focusing on its exposure, sensitivity, and adaptive capacity. It provides an overview of LDCs and outlines the global distribution of carbon dioxide emissions. The paper also evaluates specific challenges that amplify Liberia’s vulnerability and constrain sustainable adaptation, providing insight into climate change’s existing and potential effects. The paper emphasizes the urgency of addressing climate impacts on Liberia and calls for concerted local and international efforts for effective and sustainable mitigation efforts. It provides recommendations for policy decisions and calls for further research on climate change mitigation and adaptation.
