This paper provides an overview of conventional geothermal systems and unconventional geothermal developments as a common reference is needed for discussions between energy professionals. Conventional geothermal syste...This paper provides an overview of conventional geothermal systems and unconventional geothermal developments as a common reference is needed for discussions between energy professionals. Conventional geothermal systems have the heat, permeability and fluid, requiring only drilling down to °C, normal heat flow or decaying radiogenic granite as heat sources, and used in district heating. Medium-temperature (MT) 100°C - 190°C, and high-temperature (HT) 190°C - 374°C resources are mostly at plate boundaries, with volcanic intrusive heat source, used mostly for electricity generation. Single well capacities are °C - 500°C) and a range of depths (1 m to 20 Km), but lack permeability or fluid, thus requiring stimulations for heat extraction by conduction. HVAC is 1 - 2 m deep and shallow geothermal down to 500 m in wells, both capturing °C, with °C are either advanced by geothermal developers at <7 Km depth (Enhanced Geothermal Systems (EGS), drilling below brittle-ductile transition zones and under geothermal fields), or by the Oil & Gas industry (Advanced Geothermal Systems, heat recovery from hydrocarbon wells or reservoirs, Superhot Rock Geothermal, and millimeter-wave drilling down to 20 Km). Their primary aim is electricity generation, relying on closed-loops, but EGS uses fractures for heat exchange with earthquake risks during fracking. Unconventional approaches could be everywhere, with shallow geothermal already functional. The deeper and hotter unconventional alternatives are still experimental, overcoming costs and technological challenges to become fully commercial. Meanwhile, the conventional geothermal resources remain the most proven opportunities for investments and development.展开更多
Introduction: Osteosarcoma is the most common primary malignant bone tumor in children. It is highly aggressive and has a poor prognosis. A late presentation modifies and makes difficult the management affecting the s...Introduction: Osteosarcoma is the most common primary malignant bone tumor in children. It is highly aggressive and has a poor prognosis. A late presentation modifies and makes difficult the management affecting the survival of children. We report the case of a large conventional osteosarcoma in a 13-year-old girl. Case Presentation: Adolescent girl admitted for painful swelling of the left shoulder with absolute functional impotence of the thoracic limb and severe anemia. The painful swelling was thought to have been caused by a minor trauma that had occurred six months previously. The patient’s general condition was poor, and she presented with a large, shiny, painful mass over the shoulder and upper 2/3 of the left arm, measuring 28 cm long by 28 cm wide and 57 cm in circumference, and a large fistulous axillary adenopathy. CT scan showed a tumour lesion of the left humerus with liver and lung metastases, raising suspicion of osteogenic osteosarcoma. The tumor was classified according to TNM staging: T2N1M1(a + b). Management was modified when uncontrolled bleeding developed. It consisted of an extended amputation of the left thoracic limb. Pathological analysis showed a high-grade conventional osteosarcoma. Quality improvement was obtained for thirty days, followed by the onset of dyspnea. The evolution was towards death at forty days post-operatively. Conclusion: Osteosarcoma is a highly aggressive cancer. Delayed treatment leads to a fatal outcome. Early diagnosis is one of the challenges to be met in order to improve survival.展开更多
Objective: Postoperative pain (POP) following abdominal surgery can vary from a few hours to several days. This acute, unrelieved pain can become chronic, requiring patients to take analgesics on an almost daily basis...Objective: Postoperative pain (POP) following abdominal surgery can vary from a few hours to several days. This acute, unrelieved pain can become chronic, requiring patients to take analgesics on an almost daily basis for comfort. Analgesia using general opioids has many side effects and intrathecal morphine is a good alternative. This study was conducted to evaluate the efficacy of intrathecal morphine (ITM) versus conventional analgesia in the management of postoperative pain in colectomy performed by laparoscopic surgery. Methods: Cohort study conducted at the Hôpital Nord in Marseille, from 01 January to 31 July 2021 in patients aged at least 18 years undergoing anaesthesia for scheduled colectomy by laparoscopic surgery. The primary endpoint was postoperative pain intensity and the secondary endpoints were morphine consumption, treatment side effects and length of hospital stay. Statistical analysis was performed using XLSTAT software. Results: We included 193 patients: 131 in the control group (conventional analgesia) and 62 in the ITM group. We observed: a significant decrease in pain (assessed by numerical scale) in favour of the ITM group in the post-anaesthetic care room, i.e. 3 (±4) vs 1 (±2), p 0 and H2: 2 (±2) vs. 1 (±2);p Conclusion: These results suggest that intrathecal morphine (ITM) in laparoscopic colectomy provides effective postoperative analgesia with low morphine consumption, and a reduction in morphine side-effects compared with conventional analgesia.展开更多
Natural gas hydrate(NGH)is generally produced and accumulated together with the underlying conventional gas.Therefore,optimizing the production technology of these two gases should be seen as a relevant way to effecti...Natural gas hydrate(NGH)is generally produced and accumulated together with the underlying conventional gas.Therefore,optimizing the production technology of these two gases should be seen as a relevant way to effectively reduce the exploitation cost of the gas hydrate.In this study,three types of models accounting for the coexistence of these gases are considered.Type A considers the upper hydrate-bearing layer(HBL)adjacent to the lower conventional gas layer(CGL);with the Type B a permeable interlayer exists between the upper HBL and the lower CGL;with the type C there is an impermeable interlayer between the upper HBL and the lower CGL.The production performances associated with the above three models are calculated under different conditions,including only a depressurized HBL(only HBL DP);only a depressurized CGL(only CGL DP);and both the HBL and the CGL being depressurized(HBL+CGL DP).The results show that for Type A and Type B coexistence accumulation models,when only HBL or CGL is depressurized,the gas from the other layer will flow into the production layer due to the pressure difference between the two layers.In the coexistence accumulation model of type C,the cumulative gas production is much lower than that of Type A and Type B,regardless of whether only HBL DP,only CGL DP,or HBL+CGL DP are considered.This indicates that the impermeable interlayer restricts the cross-flow of gas between HBL and CGL.For three different coexistence accumulation models,CGL DP has the largest gas-to-water ratio.展开更多
China’s unconventional gas fields have a large number of low-productivity and low-efficiency wells, many of whichare located in remote and environmentally harsh mountainous areas. To address the long-term stable prod...China’s unconventional gas fields have a large number of low-productivity and low-efficiency wells, many of whichare located in remote and environmentally harsh mountainous areas. To address the long-term stable productionof these gas wells, plunger-lift technology plays an important role. In order to fully understand and accurately graspthe drainage and gas production mechanisms of plunger-lift, a mechanical model of plunger-liquid column uplift inthe plunger-lift process was established, focusing on conventional plunger-lift systems and representative wellboreconfigurations in the Linxing region. The operating casing pressure of the plunger-lift process and the calculationmethod for the maximum daily fluid production rate based on the work regime with the highest fluid recovery ratewere determined. For the first time, the critical flow rate method was proposed as a constraint for the maximumliquid-carrying capacity of the plunger-lift, and liquid-carrying capacity charts for conventional plunger-lift withdifferent casing sizes were developed. The results showed that for 23/8 casing plunger-lift, with a well depth ofshallower than 808 m, the maximum drainage rate was 33 m3/d;for 27/8 casing plunger-lift, with a well depth ofshallower than 742 m, the maximum drainage rate was 50.15 m3/d;for 31/2 casing plunger-lift, with a well depthof shallower than 560 m, the maximum drainage rate was 75.14 m3/d. This research provides a foundation for thescientific selection of plunger-lift technology and serves as a decision-making reference for developing reasonableplunger-lift work regimes.展开更多
Objective:To explore the clinical effect of a non-invasive ventilator combined with conventional therapy in the treatment of patients with chronic obstructive pulmonary disease(COPD)combined with respiratory failure.M...Objective:To explore the clinical effect of a non-invasive ventilator combined with conventional therapy in the treatment of patients with chronic obstructive pulmonary disease(COPD)combined with respiratory failure.Methods:68 patients with COPD combined with respiratory failure treated in our hospital from September 2021 to October 2023 were selected as the research subjects.Using the random number table method,they were divided into a control group and an experimental group of 34 cases each.The control group received conventional symptomatic treatment,and the experimental group received non-invasive ventilator treatment based on the control group.The clinical effects,blood gas indicators(partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2)),arterial oxygen saturation(SaO_(2))),lung function(forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),6 min walking distance),complications,and inflammatory factor levels(c-reactive protein(CRP),interleukin-6(IL-6),neutrophil-to-lymphocyte ratio(NLR))of the two groups of patients were observed.Results:(1)The clinical efficacy of the patients in the experimental group(33/97.06%)was more significant as compared with the control group(25/73.53%)(P<0.05);(2)After treatment,the clinical efficacy of the two groups of patients in terms of FEV1,FEV1/FVC,6-minute walking distance,PaO_(2)and SaO_(2)all increased in the experimental group as compared to that of the control group(P<0.05);(3)After treatment,the PaCO_(2),CRP,IL-6,and NLR of the two groups of patients decreased,and the decrease in the experimental group was higher than that of the control group(P<0.05);(4)The patients’complication rate in the experimental group(2/5.88%)was lower as compared to that of the control group(9/26.46%)(P<0.05).Conclusion:Non-invasive ventilators combined with conventional therapy achieved good clinical results in treating patients with COPD and respiratory failure.展开更多
Objective:To study the effect of repetitive peripheral magnetic stimulation(rPMS)combined with conventional rehabilitation measures on shoulder dysfunction in early stroke.Methods:60 patients with shoulder dysfunction...Objective:To study the effect of repetitive peripheral magnetic stimulation(rPMS)combined with conventional rehabilitation measures on shoulder dysfunction in early stroke.Methods:60 patients with shoulder dysfunction in early stroke were selected,and all of them were admitted to our hospital from August 2021 to August 2023.The patients were randomly grouped into a control group(conventional rehabilitation measures intervention,30 cases)and an intervention group(rPMS and conventional rehabilitation measures intervention,30 cases)according to the lottery method.The pain scores,shoulder mobility,and motor function scores of the two groups were compared.Results:The pain score was lower in the intervention group,and the shoulder mobility and motor function scores were higher in the intervention group(P<0.05)as compared to that of the control group.Conclusion:The effect of combining rPMS and conventional rehabilitation measures in treating shoulder dysfunction in early stroke was remarkable and should be popularized.展开更多
The classical source-to-trap petroleum system concept only considers the migration and accumulation of conventional oil and gas in traps driven dominantly by buoyance in a basin,although revised and improved,even some...The classical source-to-trap petroleum system concept only considers the migration and accumulation of conventional oil and gas in traps driven dominantly by buoyance in a basin,although revised and improved,even some new concepts as composite petroleum system,total petroleum system,total composite petroleum system,were proposed,but they do not account for the vast unconventional oil and gas reservoirs within the system,which is not formed and distributed in traps dominantly by buoyancedriven.Therefore,the petroleum system concept is no longer adequate in dealing with all the oil and gas accumulations in a basin where significant amount of the unconventional oil and gas resources are present in addition to the conventional oil and gas accumulations.This paper looked into and analyzed the distribution characteristics of conventional and unconventional oil/gas reservoirs and their differences and correlations in petroliferous basins in China and North America,and then proposed whole petroleum system(WPS)concept,the WPS is defined as a natural system that encompasses all the conventional and unconventional oil and gas,reservoirs and resources originated from organic matter in source rocks,the geological elements and processes involving the formation,evolution,and distribution of these oil and gas,reservoirs and resources.It is found in the WPS that there are three kinds of hydrocarbons dynamic fields,three kinds of original hydrocarbons,three kinds of reservoir rocks,and the coupling of these three essential elements lead to the basic ordered distribution model of shale oil/gas reservoirs contacting or interbeded with tight oil/gas reservoirs and separated conventional oil/gas reservoirs from source rocks upward,which is expressed as“S\T-C”.Abnormal conditions lead to other three special ordered distribution models:The first is that with shale oil/gas reservoirs separated from tight oil/gas reservoirs.The second is that with two direction ordered distributions from source upward and downward.The third is with lateral distribution from source outside.展开更多
BACKGROUND Gastric cancer is one of the most common cancers worldwide, with a 5-year survival rate of only 20%. The age of onset of gastric cancer is in line with the general rule of cancer. Most of them occur after m...BACKGROUND Gastric cancer is one of the most common cancers worldwide, with a 5-year survival rate of only 20%. The age of onset of gastric cancer is in line with the general rule of cancer. Most of them occur after middle age, mostly between 40and 60 years old, with an average age of about 50 years old, and only 5% of patients are under 30 years old. The incidence of male is higher than that of female.AIM To investigate the short-term efficacy and influencing factors of chemotherapy combined with irinotecan in patients with advanced gastric cancer.METHODS Eighty patients with advanced gastric cancer who were treated in our hospital from January 2019 to January 2022 were selected. The patients were divided into an observation group(n = 40) and control group(n = 40) by the envelope method.The control group was given preoperative routine chemotherapy. The observation group was treated with irinotecan in addition to the chemotherapy given to the control group. The short-term efficacy of treatment in the two groups, as well as tumor marker levels and quality of life before and after treatment were evaluated.RESULTS The short-term treatment effect in the observation group was better than that in the control group(P < 0.05), and the total effective rate was 57.50%. The age and proportion of tumor node metastasis(TNM) stage IV patients with ineffective chemotherapy in the observation group were(65.12 ± 5.71) years and 52.94%,respectively, which were notably higher than those of patients with effective chemotherapy(P < 0.05), while the Karnofsky Performance Scale score was(67.70± 3.83) points, which was apparently lower than that of patients with effective chemotherapy(P <0.05). After 3 mo of treatment, the SF-36 scale scores of physiological function, energy, emotional function, and mental health in the observation group were 65.12 ± 8.14, 54.76 ± 6.70, 47.58 ± 7.22,and 66.16 ± 8.11 points, respectively, which were considerably higher than those in the control group(P < 0.05). The incidence rates of grade Ⅲ-Ⅳ diarrhea and grade Ⅲ-Ⅳ thrombocytopenia in the observation group were 32.50% and 25.00%, respectively, which were markedly higher than those in the control group(P < 0.05).CONCLUSION Chemotherapy combined with irinotecan in patients with advanced gastric cancer has a good short-term efficacy and can significantly reduce serum tumor markers and improve the quality of life of patients. The efficacy may be affected by the age and TNM stage of the patients, and its long-term efficacy needs further study.展开更多
At present,the large-scale access to electric vehicles(EVs)is exerting considerable pressure on the distribution network.Hence,it is particularly important to analyze the capacity of the distribution network to accomm...At present,the large-scale access to electric vehicles(EVs)is exerting considerable pressure on the distribution network.Hence,it is particularly important to analyze the capacity of the distribution network to accommodate EVs.To this end,we propose a method for analyzing the EV capacity of the distribution network by considering the composition of the conventional load.First,the analysis and pretreatment methods for the distribution network architecture and conventional load are proposed.Second,the charging behavior of an EVis simulated by combining the Monte Carlo method and the trip chain theory.After obtaining the temporal and spatial distribution of the EV charging load,themethod of distribution according to the proportion of the same type of conventional load among the nodes is adopted to integrate the EV charging load with the conventional load of the distribution network.By adjusting the EV ownership,the EV capacity in the distribution network is analyzed and solved on the basis of the following indices:node voltage,branch current,and transformer capacity.Finally,by considering the 10-kV distribution network in some areas of an actual city as an example,we show that the proposed analysis method can obtain a more reasonable number of EVs to be accommodated in the distribution network.展开更多
Introduction: Nasopharyngeal carcinomas are the most radiation-sensitive tumours, and radiotherapy alone provides better local control. Objectives: To evaluate the clinical efficacy and acute and late toxicities of tw...Introduction: Nasopharyngeal carcinomas are the most radiation-sensitive tumours, and radiotherapy alone provides better local control. Objectives: To evaluate the clinical efficacy and acute and late toxicities of two different treatment regimens for locally advanced nasopharyngeal carcinoma. Methods: From 2014 to 2017, 150 cases of stage III and 68 cases of stage IVA nasopharyngeal carcinoma were treated. Of these, 137 received conventional radiotherapy plus chemotherapy, and 81 received intensity-modulated radiotherapy plus chemotherapy. Chemotherapy was given either as induction, concurrent or adjuvant therapy. Survival rates were calculated according to Kaplan Meier and compared with the Log-rank test. The RTOG or EORTC criteria were used to assess acute and late toxicities. Results: The median follow-up time was 21.5 months, and the 2-year locoregional relapse-free survival, distant metastases-free survival, and overall survival rates in the conventional radiotherapy plus chemotherapy group were 76%, 71% and 77%, respectively;in the intensity-modulated radiotherapy plus chemotherapy group, they were 97%, 84%, and 100%, respectively. The difference in survival between the two groups was significant (χ<sup>2</sup> = 5.06, P = 0.028). The incidence of grade 2 and 3 xerostomia one year after radiotherapy was 45.1% and 30.9% versus 33.3% and 0%. Conclusion: Compared with conventional radiotherapy plus chemotherapy, intensity-modulated radiotherapy plus chemotherapy offers better locoregional relapse-free survival and overall survival in patients with stage III and IVA nasopharyngeal carcinoma, and may significantly reduce the occurrence of radiation-induced xerostomia.展开更多
BACKGROUND This was an observational, descriptive, and retrospective study from 2011 to 2020 from the Department of Informatics of the Brazilian Healthcare System database.AIM To describe the intestinal complications(...BACKGROUND This was an observational, descriptive, and retrospective study from 2011 to 2020 from the Department of Informatics of the Brazilian Healthcare System database.AIM To describe the intestinal complications(IC) of patients with ulcerative colitis(UC) who started conventional therapies in Brazil’s public Healthcare system.METHODS Patients ≥ 18 years of age who had at least one claim related to UC 10th revision of the International Statistical Classification of Diseases and Related Health Problems(ICD-10) code and at least 2 claims for conventional therapies were included. IC was defined as at least one claim of: UC-related hospitalization, procedures code for rectum or intestinal surgeries, and/or associated disease defined by ICD-10 codes(malignant neoplasia of colon, stenosis, hemorrhage, ulcer and other rectum or anus disease, megacolon, functional diarrhea volvulus, intussusception and erythema nodosum). Descriptive statistics, annual incidence, and incidence rate(IR) [per 100 patient-years(PY)] over the available follow-up period were calculated.RESULTS In total, 41229 UC patients were included(median age, 48 years;65% women) and the median(interquartile range) follow-up period was 3.3(1.8-5.3) years. Conventional therapy used during follow-up period included: mesalazine(87%), sulfasalazine(15%), azathioprine(16%) or methotrexate(1%) with a median duration of 1.9(0.8-4.0) years. Overall IR of IC was 3.2 cases per 100 PY. Among the IC claims, 54% were related to associated diseases, 20% to procedures and 26% to hospitalizations. The overall annual incidence of IC was 2.9%, 2.6% and 2.5% in the first, second and third year after the first claim for therapy(index date), respectively. Over the first 3 years, the annual IR of UC-related hospitalizations ranged from 0.8% to 1.1%;associated diseases from 0.9% to 1.2%-in which anus or rectum disease, and malignant neoplasia of colon were the most frequently reported;and procedure events from 0.6% to 0.7%, being intestinal resection and polyp removal the most frequent ones.CONCLUSION Study shows that UC patients under conventional therapy seem to present progression of disease developing some IC, which may have a negative impact on patients and the burden on the health system.展开更多
The efficient separation of amphoteric organic compounds from dilute solutions is of great importance in the industrial field. In the present work, the reactive extractions of 4-hydroxypyridine(4-HP) with tributyl pho...The efficient separation of amphoteric organic compounds from dilute solutions is of great importance in the industrial field. In the present work, the reactive extractions of 4-hydroxypyridine(4-HP) with tributyl phosphate(TBP), di(2-ethylhexyl) phosphoric acid(D2EHPA) and TBP + D2EHPA dissolved in 1-octanol were investigated, respectively. The influences of the initial concentrations of TBP, D2EHPA and TBP + D2EHPA on distribution ratio(D) were discussed, as well as the reactive extraction mechanism were proposed. The obvious intensification effect was observed when the mixture of TBP and D2EHPA was used as extractant. The best extraction conditions were found to be of the molar ratio of D2EHPA and TBP at 2:1 and the equilibrium aqueous pH at 3.50-4.50. D values increased with the increase of the total concentration of TBP and D2EHPA in 1-octanol. Especially, the analysis on the extraction mechanisms clearly indicate(i) TBP in 1-octanol shows negligible reactive extraction toward 4-HP,(ii) D2EHPA in 1-octanol exhibits moderate extraction effect by forming 4-HP:D2EHPA(1:1) and 4-HP:2D2EHPA(1:2) type complexes, while(iii) D2EHPA in TBP/1-octanol demonstrates the maximum distribution ratio with the 4-HP:D2EHPA(1:1) type complex domination. The discussion provides new insights on the mechanism and opens a new way for the intensified extraction of amphoteric organic compounds by using the mixture of multiple extractants in the diluent.展开更多
BACKGROUND The frequency and content of follow-up strategies remain controversial for colorectal cancer(CRC),and scheduled follow-ups have limited value.AIM To compare intensive and conventional follow-up strategies f...BACKGROUND The frequency and content of follow-up strategies remain controversial for colorectal cancer(CRC),and scheduled follow-ups have limited value.AIM To compare intensive and conventional follow-up strategies for the prognosis of non-metastatic CRC treated with curative intent using a meta-analysis.METHODS PubMed,Embase,and the Cochrane Library databases were systematically searched for potentially eligible randomized controlled trials(RCTs)from inception until April 2023.The Cochrane risk of bias was used to assess the methodological quality of the included studies.The hazard ratio,relative risk,and 95%confidence interval were used to calculate survival and categorical data,and pooled analyses were performed using the random-effects model.Additional exploratory analyses were performed for sensitivity,subgroups,and publication bias.RESULTS Eighteen RCTs involving 8533 patients with CRC were selected for the final analysis.Intensive follow-up may be superior to conventional follow-up in improving overall survival,but this difference was not statistically significant.Moreover,intensive follow-up was associated with an increased incidence of salvage surgery compared to conventional follow-up.In addition,there was no significant difference in the risk of recurrence between intensive and conventional follow-up strategies,whereas intensive follow-up was associated with a reduced risk of interval recurrence compared to conventional follow-up.Finally,the effects of intensive and conventional follow-up strategies differed when stratified by tumor location and follow-up duration.CONCLUSION Intensive follow-up may have a beneficial effect on the overall survival of patients with non-metastatic CRC treated with curative intent.展开更多
BACKGROUND Varicosis is a common venous condition,which is typically treated surgically.However,selection of the optimal surgical approach can be challenging.Previous studies comparing endovenous laser treatment(EVLT)...BACKGROUND Varicosis is a common venous condition,which is typically treated surgically.However,selection of the optimal surgical approach can be challenging.Previous studies comparing endovenous laser treatment(EVLT)and conventional surgery were retrospective and observational in nature and the results may therefore have been influenced by selection bias and the presence of other confounding factors.In this study,we used propensity score matching to reduce selection bias when comparing EVLT and conventional surgery for the treatment of varicose great saphenous veins.METHODS We retrospectively reviewed the records of 1063 patients treated for primary varicosis of the great saphenous vein at the Second Affiliated Hospital of Xuzhou Medical University between January 2009 and December 2019.Among them,56 patients were excluded owing to additional small saphenous varicose vein involvement,81 owing to recurring varicose veins,83 owing to complicated varicose veins(CEAP clinical classification C5-C6),and 6 owing to perioperative phlebitis.Finally,772 patients were enrolled in this study.Standard demographic and clinicopathological data were collected from the medical records of the patients.For propensity score matching,522 patients(261 who underwent EVLT and 261 who underwent conventional surgery)were randomly matched 1:1 by age,sex,onset time,smoking status,presence of diabetes,family history,stress therapy,C class,and the affected leg.RESULTS Of the 772 patients included in the study,467 underwent EVLT and 305 underwent conventional surgery.There were significant differences in age,onset time,smoking and diabetes status,and family history between the two groups.Following propensity score matching,no significant differences in patients’characteristics remained between the two groups.ELVT was associated with a shorter operation time and hospital stay than conventional surgery,both before and after propensity score matching.There were no differences in complications between the two groups after propensity score matching.Patients who underwent EVLT had a higher recurrence rate during the two-year follow-up period than those who underwent conventional surgery(33.33%vs 21.46%,χ^(2)=11.506,P=0.001),and a greater percentage of patients who underwent EVLT experienced pain one week after the procedure(39.85%vs 19.54%,P=0.000).CONCLUSION EVLT may not always be the best option for the treatment of great saphenous vein varicosis.展开更多
BACKGROUND Primary breast diffuse large B-cell lymphoma(PB-DLBCL)is a rare subtype of non-Hodgkin lymphoma that accounts for<3%of extranodal lymphomas and 1%of breast tumors.Its diagnosis and management are challen...BACKGROUND Primary breast diffuse large B-cell lymphoma(PB-DLBCL)is a rare subtype of non-Hodgkin lymphoma that accounts for<3%of extranodal lymphomas and 1%of breast tumors.Its diagnosis and management are challenging because of its rarity,heterogeneity,and aggressive behavior.Conventional ultrasound(US)is the first-line imaging modality for breast lesions;however,it has limited specificity and accuracy for PB-DLBCL.Shear wave elastography(SWE)is a novel US technique that measures tissue stiffness and may reflect the histological characteristics and biological behavior of breast lesions.AIM To compare the conventional US and SWE features of PB-DLBCL and evaluate their diagnostic performance and prognostic value.METHODS We retrospectively reviewed the clinical data and US images of 32 patients with pathologically confirmed PB-DLBCL who underwent conventional US and SWE before treatment.We analyzed conventional US features(shape,margin,orientation,echo,posterior acoustic features,calcification,and vascularity)and SWE features(mean elasticity value,standard deviation,minimum elasticity value,maximum elasticity value,and lesion-to-fat ratio)of the PB-DLBCL lesions.Using receiver operating characteristic curve analysis,we determined the optimal cutoff values and diagnostic performance of conventional US and SWE features.We also performed a survival analysis to assess the prognostic value of conventional US and SWE features.RESULTS The results showed that the PB-DLBCL lesions were mostly irregular in shape(84.4%),microlobulated or spiculated in margins(75%),parallel in orientation(65.6%),hypoechoic in echo(87.5%),and had posterior acoustic enhancement(65.6%).Calcification was rare(6.3%)and vascularity was variable(31.3%avascular,37.5%hypovascular,and 31.3%hypervascular).The mean elasticity value of PB-DLBCL lesions was significantly higher than that of benign breast lesions(113.4±46.9 kPa vs 27.8±16.4 kPa,P<0.001).The optimal cutoff value of the mean elasticity for distinguishing PB-DLBCL from benign breast lesions was 54.5 kPa,with a sensitivity of 93.8%,specificity of 92.9%,positive predictive value of 93.8%,negative predictive value of 92.9%,and accuracy of 93.3%.The mean elasticity value was also significantly correlated with Ki-67 expression level(r=0.612,P<0.001),which is a marker of tumor proliferation and aggressiveness.Survival analysis showed that patients with higher mean elasticity values(>54.5 kPa)had worse overall survival(OS)and progression-free survival(PFS)than those with lower mean elasticity values(<54.5 kPa)(P=0.038 for OS and P=0.027 for PFS).CONCLUSION Conventional US and SWE provide useful information for diagnosing and forecasting PB-DLBCL.SWE excels in distinguishing PB-DLBCL from benign breast lesions,reflects tumor proliferation and aggressiveness,and improves disease management.展开更多
BACKGROUND Itraconazole is a broad-spectrum triazole antifungal inhibiting fungal growth by inhibiting ergosterol synthesis and exhibits a nonlinear pharmacokinetic profile.Erratic absorption pattern with wide fluctua...BACKGROUND Itraconazole is a broad-spectrum triazole antifungal inhibiting fungal growth by inhibiting ergosterol synthesis and exhibits a nonlinear pharmacokinetic profile.Erratic absorption pattern with wide fluctuations in blood levels causes inconsistent and unpredictable clinical behaviour of this drug despite its low minimum inhibitory concentration(MIC)as compared to other antifungal agents.AIM To compare the oral bioavailability and bioequivalence of Fixtral SB(supra bioavailable itraconazole)with reference product R2(supra bioavailable 2×50 mg itraconazole).METHODS The study population consisted of 54 healthy volunteers,aged between 18-45 years and randomized to receive a single oral dose of either test[T;Fixtral SB(supra bioavailable itraconazole)100 mg]or reference product(R1;Sporanox 100 mg×2 capsules and R2;Lozanoc capsules 50 mg×2 capsules).Blood samples were taken pre-dose and post-dose up to 96 h.The study evaluated bioequivalence by comparing the oral bioavailability of the test product with reference product R2.The pharmacodynamic characteristics of the drug were evaluated by comparing the test product with reference product R1.Pharmacokinetics(PK)-PD comparative analysis[area under the concentration-time curve(AUC)/minimum inhibitory concentration(MIC)>25]was performed for conventional itraconazole 100 mg and supra bioavailable itraconazole 50 mg.Adverse events(AEs)assessments were performed in each study period and post-study evaluation.RESULTS Statistical analysis of primary PK variables revealed bioequivalence,with confidence intervals being completely inside the acceptance criteria of 80%-125%.The peak concentration levels of itraconazole were achieved at 10 h(T)and 8.5 h(R2),respectively.Pharmacodynamic parameter assessment showed that AUC/MIC for R1 are comparable to Fixtral SB 100mg for MIC levels up to 16mcg/mL(P>0.05 and observed P=0.3196).Six AEs were observed that were mild to moderate in severity and resolved.No severe AE was reported.CONCLUSION Test product itraconazole Capsule 100 mg is bioequivalent with the reference product(R2)at 100 mg dose(2 capsules of Lozanoc®50 mg)under fed conditions.Pharmacodynamics activity in terms of AUC/MIC is comparable between the test product at 100 mg dose and marketed itraconazole 200 mg.Fixtral SB is expected to have therapeutically similar efficacy at half the equivalent dose.Tested formulations were found to be safe and well tolerated.展开更多
BACKGROUND Erythrocyte alloantibodies are mainly produced after immune stimulation,such as blood transfusion,pregnancy,and transplantation,and are the leading causes of severe hemolytic transfusion reactions and diffi...BACKGROUND Erythrocyte alloantibodies are mainly produced after immune stimulation,such as blood transfusion,pregnancy,and transplantation,and are the leading causes of severe hemolytic transfusion reactions and difficulty in blood grouping and matching.Therefore,antibody screening is critical to prevent and improve red cell alloantibodies.Routine tube assay is the primary detection method of antibody screening.Recently,erythrocyte-magnetized technology(EMT)has been increasingly used in clinical practice.This study intends to probe the application and efficacy of the conventional tube and EMT in red blood cell alloantibody titration to provide a reference for clinical blood transfusion.AIM To investigate the application value of conventional tube and EMT in red blood cell alloantibody titration and enhance the safety of blood transfusion practice.METHODS A total of 1298 blood samples were harvested from blood donors at the Department of Blood Transfusion of our hospital from March 2021 to December 2022.A 5 mL blood sample was collected in tubing,which was then cut,and the whole blood was put into a test tube for centrifugation to separate the serum.Different red blood cell blood group antibody titers were simultaneously detected using the tube polybrene test,tube antiglobulin test(AGT),and EMT screening irregular antibody methods to determine the best test method.RESULTS Simultaneous detection was performed through the tube polybrene test,tube AGT and EMT screening irregular antibodies.It was discovered that the EMT screening irregular antibody method could detect all immunoglobulin G(IgG)and immunoglobulin M(IgM)irregular antibodies,and the results of manual tube AGT were satisfactory,but the operation time was lengthy,and the equipment had a large footprint.The EMT screening irregular antibody assay was also conducted to determine its activity against type O Rh(D)red blood cells,and the outcomes were satisfactory.Furthermore,compared to the conventional tube method,the EMT screening irregular antibody method was more cost-effective and had significantly higher detection efficiency.CONCLUSION With a higher detection rate,the EMT screening irregular antibody method can detect both IgG and IgM irregular antibodies faster and more effectively than the conventional tube method.展开更多
As a non-destructive testing technology,neutron imaging plays an important role in various fields,including material science,nuclear engineering,and fundamental science.An imaging detector with a neutron-sensitive ima...As a non-destructive testing technology,neutron imaging plays an important role in various fields,including material science,nuclear engineering,and fundamental science.An imaging detector with a neutron-sensitive image intensifier has been developed and demonstrated to achieve good spatial resolution and timing resolution.However,the influence of the working voltage on the performance of the neutron-sensitive imaging intensifier has not been studied.To optimize the performance of the neutron-sensitive image intensifier at different voltages,experiments have been performed at the China Spallation Neutron Source(CSNS)neutron beamline.The change in the light yield and imaging quality with different voltages has been acquired.It is shown that the image quality benefits from the high gain of the microchannel plate(MCP)and the high accelerating electric field between the MCP and the screen.Increasing the accelerating electric field is more effective than increasing the gain of MCPs for the improvement of the imaging quality.Increasing the total gain of the MCP stack can be realized more effectively by improving the gain of the standard MCP than that of the n MCP.These results offer a development direction for image intensifiers in the future.展开更多
Objective:To explore the diagnostic value of conventional ultrasonography combined with contrast-enhanced ultrasonography in thyroid nodules.Methods:From June 2021 to July 2022,163 patients with thyroid nodules enroll...Objective:To explore the diagnostic value of conventional ultrasonography combined with contrast-enhanced ultrasonography in thyroid nodules.Methods:From June 2021 to July 2022,163 patients with thyroid nodules enrolled in our hospital were selected as research subjects.After pathological diagnosis,24 cases were malignant thyroid nodules,and 139 cases were benign thyroid nodules.The diagnosis rate of malignant and benign thyroid nodules was observed and analyzed,with 95%CI.Results:Among them,the malignant and benign detection rates of routine ultrasound were 88.63%and 75.00%,respectively,and the malignant and benign detection rates of contrast-enhanced ultrasound were 81.82%and 81.25%,respectively.The malignant and benign detection rates of conventional ultrasound combined with contrast-enhanced ultrasound were 93.18%and 87.50%,respectively,and the 95%CI was greater than 0.7.Conclusion:Conventional ultrasound combined with contrast-enhanced ultrasound can help improve the diagnostic accuracy of benign and malignant thyroid nodules and reduce the misdiagnosis rate.展开更多
文摘This paper provides an overview of conventional geothermal systems and unconventional geothermal developments as a common reference is needed for discussions between energy professionals. Conventional geothermal systems have the heat, permeability and fluid, requiring only drilling down to °C, normal heat flow or decaying radiogenic granite as heat sources, and used in district heating. Medium-temperature (MT) 100°C - 190°C, and high-temperature (HT) 190°C - 374°C resources are mostly at plate boundaries, with volcanic intrusive heat source, used mostly for electricity generation. Single well capacities are °C - 500°C) and a range of depths (1 m to 20 Km), but lack permeability or fluid, thus requiring stimulations for heat extraction by conduction. HVAC is 1 - 2 m deep and shallow geothermal down to 500 m in wells, both capturing °C, with °C are either advanced by geothermal developers at <7 Km depth (Enhanced Geothermal Systems (EGS), drilling below brittle-ductile transition zones and under geothermal fields), or by the Oil & Gas industry (Advanced Geothermal Systems, heat recovery from hydrocarbon wells or reservoirs, Superhot Rock Geothermal, and millimeter-wave drilling down to 20 Km). Their primary aim is electricity generation, relying on closed-loops, but EGS uses fractures for heat exchange with earthquake risks during fracking. Unconventional approaches could be everywhere, with shallow geothermal already functional. The deeper and hotter unconventional alternatives are still experimental, overcoming costs and technological challenges to become fully commercial. Meanwhile, the conventional geothermal resources remain the most proven opportunities for investments and development.
文摘Introduction: Osteosarcoma is the most common primary malignant bone tumor in children. It is highly aggressive and has a poor prognosis. A late presentation modifies and makes difficult the management affecting the survival of children. We report the case of a large conventional osteosarcoma in a 13-year-old girl. Case Presentation: Adolescent girl admitted for painful swelling of the left shoulder with absolute functional impotence of the thoracic limb and severe anemia. The painful swelling was thought to have been caused by a minor trauma that had occurred six months previously. The patient’s general condition was poor, and she presented with a large, shiny, painful mass over the shoulder and upper 2/3 of the left arm, measuring 28 cm long by 28 cm wide and 57 cm in circumference, and a large fistulous axillary adenopathy. CT scan showed a tumour lesion of the left humerus with liver and lung metastases, raising suspicion of osteogenic osteosarcoma. The tumor was classified according to TNM staging: T2N1M1(a + b). Management was modified when uncontrolled bleeding developed. It consisted of an extended amputation of the left thoracic limb. Pathological analysis showed a high-grade conventional osteosarcoma. Quality improvement was obtained for thirty days, followed by the onset of dyspnea. The evolution was towards death at forty days post-operatively. Conclusion: Osteosarcoma is a highly aggressive cancer. Delayed treatment leads to a fatal outcome. Early diagnosis is one of the challenges to be met in order to improve survival.
文摘Objective: Postoperative pain (POP) following abdominal surgery can vary from a few hours to several days. This acute, unrelieved pain can become chronic, requiring patients to take analgesics on an almost daily basis for comfort. Analgesia using general opioids has many side effects and intrathecal morphine is a good alternative. This study was conducted to evaluate the efficacy of intrathecal morphine (ITM) versus conventional analgesia in the management of postoperative pain in colectomy performed by laparoscopic surgery. Methods: Cohort study conducted at the Hôpital Nord in Marseille, from 01 January to 31 July 2021 in patients aged at least 18 years undergoing anaesthesia for scheduled colectomy by laparoscopic surgery. The primary endpoint was postoperative pain intensity and the secondary endpoints were morphine consumption, treatment side effects and length of hospital stay. Statistical analysis was performed using XLSTAT software. Results: We included 193 patients: 131 in the control group (conventional analgesia) and 62 in the ITM group. We observed: a significant decrease in pain (assessed by numerical scale) in favour of the ITM group in the post-anaesthetic care room, i.e. 3 (±4) vs 1 (±2), p 0 and H2: 2 (±2) vs. 1 (±2);p Conclusion: These results suggest that intrathecal morphine (ITM) in laparoscopic colectomy provides effective postoperative analgesia with low morphine consumption, and a reduction in morphine side-effects compared with conventional analgesia.
基金supported by the National Natural Science Foundation of China (Nos.52074334,51991365)the National Key R&D Program of China (2021YFC2800903),which are gratefully acknowledged.
文摘Natural gas hydrate(NGH)is generally produced and accumulated together with the underlying conventional gas.Therefore,optimizing the production technology of these two gases should be seen as a relevant way to effectively reduce the exploitation cost of the gas hydrate.In this study,three types of models accounting for the coexistence of these gases are considered.Type A considers the upper hydrate-bearing layer(HBL)adjacent to the lower conventional gas layer(CGL);with the Type B a permeable interlayer exists between the upper HBL and the lower CGL;with the type C there is an impermeable interlayer between the upper HBL and the lower CGL.The production performances associated with the above three models are calculated under different conditions,including only a depressurized HBL(only HBL DP);only a depressurized CGL(only CGL DP);and both the HBL and the CGL being depressurized(HBL+CGL DP).The results show that for Type A and Type B coexistence accumulation models,when only HBL or CGL is depressurized,the gas from the other layer will flow into the production layer due to the pressure difference between the two layers.In the coexistence accumulation model of type C,the cumulative gas production is much lower than that of Type A and Type B,regardless of whether only HBL DP,only CGL DP,or HBL+CGL DP are considered.This indicates that the impermeable interlayer restricts the cross-flow of gas between HBL and CGL.For three different coexistence accumulation models,CGL DP has the largest gas-to-water ratio.
基金the Fundamental Research Funds for the Central Universities of China(No.20CX02308A)CNOOC Project(No.ZX2022ZCCYF3835).
文摘China’s unconventional gas fields have a large number of low-productivity and low-efficiency wells, many of whichare located in remote and environmentally harsh mountainous areas. To address the long-term stable productionof these gas wells, plunger-lift technology plays an important role. In order to fully understand and accurately graspthe drainage and gas production mechanisms of plunger-lift, a mechanical model of plunger-liquid column uplift inthe plunger-lift process was established, focusing on conventional plunger-lift systems and representative wellboreconfigurations in the Linxing region. The operating casing pressure of the plunger-lift process and the calculationmethod for the maximum daily fluid production rate based on the work regime with the highest fluid recovery ratewere determined. For the first time, the critical flow rate method was proposed as a constraint for the maximumliquid-carrying capacity of the plunger-lift, and liquid-carrying capacity charts for conventional plunger-lift withdifferent casing sizes were developed. The results showed that for 23/8 casing plunger-lift, with a well depth ofshallower than 808 m, the maximum drainage rate was 33 m3/d;for 27/8 casing plunger-lift, with a well depth ofshallower than 742 m, the maximum drainage rate was 50.15 m3/d;for 31/2 casing plunger-lift, with a well depthof shallower than 560 m, the maximum drainage rate was 75.14 m3/d. This research provides a foundation for thescientific selection of plunger-lift technology and serves as a decision-making reference for developing reasonableplunger-lift work regimes.
文摘Objective:To explore the clinical effect of a non-invasive ventilator combined with conventional therapy in the treatment of patients with chronic obstructive pulmonary disease(COPD)combined with respiratory failure.Methods:68 patients with COPD combined with respiratory failure treated in our hospital from September 2021 to October 2023 were selected as the research subjects.Using the random number table method,they were divided into a control group and an experimental group of 34 cases each.The control group received conventional symptomatic treatment,and the experimental group received non-invasive ventilator treatment based on the control group.The clinical effects,blood gas indicators(partial pressure of carbon dioxide(PaCO_(2)),partial pressure of oxygen(PaO_(2)),arterial oxygen saturation(SaO_(2))),lung function(forced expiratory volume in 1 second(FEV1),forced vital capacity(FVC),6 min walking distance),complications,and inflammatory factor levels(c-reactive protein(CRP),interleukin-6(IL-6),neutrophil-to-lymphocyte ratio(NLR))of the two groups of patients were observed.Results:(1)The clinical efficacy of the patients in the experimental group(33/97.06%)was more significant as compared with the control group(25/73.53%)(P<0.05);(2)After treatment,the clinical efficacy of the two groups of patients in terms of FEV1,FEV1/FVC,6-minute walking distance,PaO_(2)and SaO_(2)all increased in the experimental group as compared to that of the control group(P<0.05);(3)After treatment,the PaCO_(2),CRP,IL-6,and NLR of the two groups of patients decreased,and the decrease in the experimental group was higher than that of the control group(P<0.05);(4)The patients’complication rate in the experimental group(2/5.88%)was lower as compared to that of the control group(9/26.46%)(P<0.05).Conclusion:Non-invasive ventilators combined with conventional therapy achieved good clinical results in treating patients with COPD and respiratory failure.
文摘Objective:To study the effect of repetitive peripheral magnetic stimulation(rPMS)combined with conventional rehabilitation measures on shoulder dysfunction in early stroke.Methods:60 patients with shoulder dysfunction in early stroke were selected,and all of them were admitted to our hospital from August 2021 to August 2023.The patients were randomly grouped into a control group(conventional rehabilitation measures intervention,30 cases)and an intervention group(rPMS and conventional rehabilitation measures intervention,30 cases)according to the lottery method.The pain scores,shoulder mobility,and motor function scores of the two groups were compared.Results:The pain score was lower in the intervention group,and the shoulder mobility and motor function scores were higher in the intervention group(P<0.05)as compared to that of the control group.Conclusion:The effect of combining rPMS and conventional rehabilitation measures in treating shoulder dysfunction in early stroke was remarkable and should be popularized.
基金This work was supported by the major science and technology projects of CNPC during the“14th five-year plan”(Grant number 2021DJ0101)。
文摘The classical source-to-trap petroleum system concept only considers the migration and accumulation of conventional oil and gas in traps driven dominantly by buoyance in a basin,although revised and improved,even some new concepts as composite petroleum system,total petroleum system,total composite petroleum system,were proposed,but they do not account for the vast unconventional oil and gas reservoirs within the system,which is not formed and distributed in traps dominantly by buoyancedriven.Therefore,the petroleum system concept is no longer adequate in dealing with all the oil and gas accumulations in a basin where significant amount of the unconventional oil and gas resources are present in addition to the conventional oil and gas accumulations.This paper looked into and analyzed the distribution characteristics of conventional and unconventional oil/gas reservoirs and their differences and correlations in petroliferous basins in China and North America,and then proposed whole petroleum system(WPS)concept,the WPS is defined as a natural system that encompasses all the conventional and unconventional oil and gas,reservoirs and resources originated from organic matter in source rocks,the geological elements and processes involving the formation,evolution,and distribution of these oil and gas,reservoirs and resources.It is found in the WPS that there are three kinds of hydrocarbons dynamic fields,three kinds of original hydrocarbons,three kinds of reservoir rocks,and the coupling of these three essential elements lead to the basic ordered distribution model of shale oil/gas reservoirs contacting or interbeded with tight oil/gas reservoirs and separated conventional oil/gas reservoirs from source rocks upward,which is expressed as“S\T-C”.Abnormal conditions lead to other three special ordered distribution models:The first is that with shale oil/gas reservoirs separated from tight oil/gas reservoirs.The second is that with two direction ordered distributions from source upward and downward.The third is with lateral distribution from source outside.
文摘BACKGROUND Gastric cancer is one of the most common cancers worldwide, with a 5-year survival rate of only 20%. The age of onset of gastric cancer is in line with the general rule of cancer. Most of them occur after middle age, mostly between 40and 60 years old, with an average age of about 50 years old, and only 5% of patients are under 30 years old. The incidence of male is higher than that of female.AIM To investigate the short-term efficacy and influencing factors of chemotherapy combined with irinotecan in patients with advanced gastric cancer.METHODS Eighty patients with advanced gastric cancer who were treated in our hospital from January 2019 to January 2022 were selected. The patients were divided into an observation group(n = 40) and control group(n = 40) by the envelope method.The control group was given preoperative routine chemotherapy. The observation group was treated with irinotecan in addition to the chemotherapy given to the control group. The short-term efficacy of treatment in the two groups, as well as tumor marker levels and quality of life before and after treatment were evaluated.RESULTS The short-term treatment effect in the observation group was better than that in the control group(P < 0.05), and the total effective rate was 57.50%. The age and proportion of tumor node metastasis(TNM) stage IV patients with ineffective chemotherapy in the observation group were(65.12 ± 5.71) years and 52.94%,respectively, which were notably higher than those of patients with effective chemotherapy(P < 0.05), while the Karnofsky Performance Scale score was(67.70± 3.83) points, which was apparently lower than that of patients with effective chemotherapy(P <0.05). After 3 mo of treatment, the SF-36 scale scores of physiological function, energy, emotional function, and mental health in the observation group were 65.12 ± 8.14, 54.76 ± 6.70, 47.58 ± 7.22,and 66.16 ± 8.11 points, respectively, which were considerably higher than those in the control group(P < 0.05). The incidence rates of grade Ⅲ-Ⅳ diarrhea and grade Ⅲ-Ⅳ thrombocytopenia in the observation group were 32.50% and 25.00%, respectively, which were markedly higher than those in the control group(P < 0.05).CONCLUSION Chemotherapy combined with irinotecan in patients with advanced gastric cancer has a good short-term efficacy and can significantly reduce serum tumor markers and improve the quality of life of patients. The efficacy may be affected by the age and TNM stage of the patients, and its long-term efficacy needs further study.
基金supported by the Science and Technology Project of Zhangjiakou Power Supply Company of State Grid Jibei Co.,Ltd.(SGJBZJ00YJJS2001096).
文摘At present,the large-scale access to electric vehicles(EVs)is exerting considerable pressure on the distribution network.Hence,it is particularly important to analyze the capacity of the distribution network to accommodate EVs.To this end,we propose a method for analyzing the EV capacity of the distribution network by considering the composition of the conventional load.First,the analysis and pretreatment methods for the distribution network architecture and conventional load are proposed.Second,the charging behavior of an EVis simulated by combining the Monte Carlo method and the trip chain theory.After obtaining the temporal and spatial distribution of the EV charging load,themethod of distribution according to the proportion of the same type of conventional load among the nodes is adopted to integrate the EV charging load with the conventional load of the distribution network.By adjusting the EV ownership,the EV capacity in the distribution network is analyzed and solved on the basis of the following indices:node voltage,branch current,and transformer capacity.Finally,by considering the 10-kV distribution network in some areas of an actual city as an example,we show that the proposed analysis method can obtain a more reasonable number of EVs to be accommodated in the distribution network.
文摘Introduction: Nasopharyngeal carcinomas are the most radiation-sensitive tumours, and radiotherapy alone provides better local control. Objectives: To evaluate the clinical efficacy and acute and late toxicities of two different treatment regimens for locally advanced nasopharyngeal carcinoma. Methods: From 2014 to 2017, 150 cases of stage III and 68 cases of stage IVA nasopharyngeal carcinoma were treated. Of these, 137 received conventional radiotherapy plus chemotherapy, and 81 received intensity-modulated radiotherapy plus chemotherapy. Chemotherapy was given either as induction, concurrent or adjuvant therapy. Survival rates were calculated according to Kaplan Meier and compared with the Log-rank test. The RTOG or EORTC criteria were used to assess acute and late toxicities. Results: The median follow-up time was 21.5 months, and the 2-year locoregional relapse-free survival, distant metastases-free survival, and overall survival rates in the conventional radiotherapy plus chemotherapy group were 76%, 71% and 77%, respectively;in the intensity-modulated radiotherapy plus chemotherapy group, they were 97%, 84%, and 100%, respectively. The difference in survival between the two groups was significant (χ<sup>2</sup> = 5.06, P = 0.028). The incidence of grade 2 and 3 xerostomia one year after radiotherapy was 45.1% and 30.9% versus 33.3% and 0%. Conclusion: Compared with conventional radiotherapy plus chemotherapy, intensity-modulated radiotherapy plus chemotherapy offers better locoregional relapse-free survival and overall survival in patients with stage III and IVA nasopharyngeal carcinoma, and may significantly reduce the occurrence of radiation-induced xerostomia.
文摘BACKGROUND This was an observational, descriptive, and retrospective study from 2011 to 2020 from the Department of Informatics of the Brazilian Healthcare System database.AIM To describe the intestinal complications(IC) of patients with ulcerative colitis(UC) who started conventional therapies in Brazil’s public Healthcare system.METHODS Patients ≥ 18 years of age who had at least one claim related to UC 10th revision of the International Statistical Classification of Diseases and Related Health Problems(ICD-10) code and at least 2 claims for conventional therapies were included. IC was defined as at least one claim of: UC-related hospitalization, procedures code for rectum or intestinal surgeries, and/or associated disease defined by ICD-10 codes(malignant neoplasia of colon, stenosis, hemorrhage, ulcer and other rectum or anus disease, megacolon, functional diarrhea volvulus, intussusception and erythema nodosum). Descriptive statistics, annual incidence, and incidence rate(IR) [per 100 patient-years(PY)] over the available follow-up period were calculated.RESULTS In total, 41229 UC patients were included(median age, 48 years;65% women) and the median(interquartile range) follow-up period was 3.3(1.8-5.3) years. Conventional therapy used during follow-up period included: mesalazine(87%), sulfasalazine(15%), azathioprine(16%) or methotrexate(1%) with a median duration of 1.9(0.8-4.0) years. Overall IR of IC was 3.2 cases per 100 PY. Among the IC claims, 54% were related to associated diseases, 20% to procedures and 26% to hospitalizations. The overall annual incidence of IC was 2.9%, 2.6% and 2.5% in the first, second and third year after the first claim for therapy(index date), respectively. Over the first 3 years, the annual IR of UC-related hospitalizations ranged from 0.8% to 1.1%;associated diseases from 0.9% to 1.2%-in which anus or rectum disease, and malignant neoplasia of colon were the most frequently reported;and procedure events from 0.6% to 0.7%, being intestinal resection and polyp removal the most frequent ones.CONCLUSION Study shows that UC patients under conventional therapy seem to present progression of disease developing some IC, which may have a negative impact on patients and the burden on the health system.
基金supported by the Science and Technology Research Project of Henan Province (192102310490 and 212102310505)。
文摘The efficient separation of amphoteric organic compounds from dilute solutions is of great importance in the industrial field. In the present work, the reactive extractions of 4-hydroxypyridine(4-HP) with tributyl phosphate(TBP), di(2-ethylhexyl) phosphoric acid(D2EHPA) and TBP + D2EHPA dissolved in 1-octanol were investigated, respectively. The influences of the initial concentrations of TBP, D2EHPA and TBP + D2EHPA on distribution ratio(D) were discussed, as well as the reactive extraction mechanism were proposed. The obvious intensification effect was observed when the mixture of TBP and D2EHPA was used as extractant. The best extraction conditions were found to be of the molar ratio of D2EHPA and TBP at 2:1 and the equilibrium aqueous pH at 3.50-4.50. D values increased with the increase of the total concentration of TBP and D2EHPA in 1-octanol. Especially, the analysis on the extraction mechanisms clearly indicate(i) TBP in 1-octanol shows negligible reactive extraction toward 4-HP,(ii) D2EHPA in 1-octanol exhibits moderate extraction effect by forming 4-HP:D2EHPA(1:1) and 4-HP:2D2EHPA(1:2) type complexes, while(iii) D2EHPA in TBP/1-octanol demonstrates the maximum distribution ratio with the 4-HP:D2EHPA(1:1) type complex domination. The discussion provides new insights on the mechanism and opens a new way for the intensified extraction of amphoteric organic compounds by using the mixture of multiple extractants in the diluent.
文摘BACKGROUND The frequency and content of follow-up strategies remain controversial for colorectal cancer(CRC),and scheduled follow-ups have limited value.AIM To compare intensive and conventional follow-up strategies for the prognosis of non-metastatic CRC treated with curative intent using a meta-analysis.METHODS PubMed,Embase,and the Cochrane Library databases were systematically searched for potentially eligible randomized controlled trials(RCTs)from inception until April 2023.The Cochrane risk of bias was used to assess the methodological quality of the included studies.The hazard ratio,relative risk,and 95%confidence interval were used to calculate survival and categorical data,and pooled analyses were performed using the random-effects model.Additional exploratory analyses were performed for sensitivity,subgroups,and publication bias.RESULTS Eighteen RCTs involving 8533 patients with CRC were selected for the final analysis.Intensive follow-up may be superior to conventional follow-up in improving overall survival,but this difference was not statistically significant.Moreover,intensive follow-up was associated with an increased incidence of salvage surgery compared to conventional follow-up.In addition,there was no significant difference in the risk of recurrence between intensive and conventional follow-up strategies,whereas intensive follow-up was associated with a reduced risk of interval recurrence compared to conventional follow-up.Finally,the effects of intensive and conventional follow-up strategies differed when stratified by tumor location and follow-up duration.CONCLUSION Intensive follow-up may have a beneficial effect on the overall survival of patients with non-metastatic CRC treated with curative intent.
基金the Excellent Talents Fund Project of Xuzhou Medical University,No.XYFY2021019.
文摘BACKGROUND Varicosis is a common venous condition,which is typically treated surgically.However,selection of the optimal surgical approach can be challenging.Previous studies comparing endovenous laser treatment(EVLT)and conventional surgery were retrospective and observational in nature and the results may therefore have been influenced by selection bias and the presence of other confounding factors.In this study,we used propensity score matching to reduce selection bias when comparing EVLT and conventional surgery for the treatment of varicose great saphenous veins.METHODS We retrospectively reviewed the records of 1063 patients treated for primary varicosis of the great saphenous vein at the Second Affiliated Hospital of Xuzhou Medical University between January 2009 and December 2019.Among them,56 patients were excluded owing to additional small saphenous varicose vein involvement,81 owing to recurring varicose veins,83 owing to complicated varicose veins(CEAP clinical classification C5-C6),and 6 owing to perioperative phlebitis.Finally,772 patients were enrolled in this study.Standard demographic and clinicopathological data were collected from the medical records of the patients.For propensity score matching,522 patients(261 who underwent EVLT and 261 who underwent conventional surgery)were randomly matched 1:1 by age,sex,onset time,smoking status,presence of diabetes,family history,stress therapy,C class,and the affected leg.RESULTS Of the 772 patients included in the study,467 underwent EVLT and 305 underwent conventional surgery.There were significant differences in age,onset time,smoking and diabetes status,and family history between the two groups.Following propensity score matching,no significant differences in patients’characteristics remained between the two groups.ELVT was associated with a shorter operation time and hospital stay than conventional surgery,both before and after propensity score matching.There were no differences in complications between the two groups after propensity score matching.Patients who underwent EVLT had a higher recurrence rate during the two-year follow-up period than those who underwent conventional surgery(33.33%vs 21.46%,χ^(2)=11.506,P=0.001),and a greater percentage of patients who underwent EVLT experienced pain one week after the procedure(39.85%vs 19.54%,P=0.000).CONCLUSION EVLT may not always be the best option for the treatment of great saphenous vein varicosis.
基金This study was reviewed and approved by the Ethics Committee of the Affiliated Hospital of Guizhou Medical University.
文摘BACKGROUND Primary breast diffuse large B-cell lymphoma(PB-DLBCL)is a rare subtype of non-Hodgkin lymphoma that accounts for<3%of extranodal lymphomas and 1%of breast tumors.Its diagnosis and management are challenging because of its rarity,heterogeneity,and aggressive behavior.Conventional ultrasound(US)is the first-line imaging modality for breast lesions;however,it has limited specificity and accuracy for PB-DLBCL.Shear wave elastography(SWE)is a novel US technique that measures tissue stiffness and may reflect the histological characteristics and biological behavior of breast lesions.AIM To compare the conventional US and SWE features of PB-DLBCL and evaluate their diagnostic performance and prognostic value.METHODS We retrospectively reviewed the clinical data and US images of 32 patients with pathologically confirmed PB-DLBCL who underwent conventional US and SWE before treatment.We analyzed conventional US features(shape,margin,orientation,echo,posterior acoustic features,calcification,and vascularity)and SWE features(mean elasticity value,standard deviation,minimum elasticity value,maximum elasticity value,and lesion-to-fat ratio)of the PB-DLBCL lesions.Using receiver operating characteristic curve analysis,we determined the optimal cutoff values and diagnostic performance of conventional US and SWE features.We also performed a survival analysis to assess the prognostic value of conventional US and SWE features.RESULTS The results showed that the PB-DLBCL lesions were mostly irregular in shape(84.4%),microlobulated or spiculated in margins(75%),parallel in orientation(65.6%),hypoechoic in echo(87.5%),and had posterior acoustic enhancement(65.6%).Calcification was rare(6.3%)and vascularity was variable(31.3%avascular,37.5%hypovascular,and 31.3%hypervascular).The mean elasticity value of PB-DLBCL lesions was significantly higher than that of benign breast lesions(113.4±46.9 kPa vs 27.8±16.4 kPa,P<0.001).The optimal cutoff value of the mean elasticity for distinguishing PB-DLBCL from benign breast lesions was 54.5 kPa,with a sensitivity of 93.8%,specificity of 92.9%,positive predictive value of 93.8%,negative predictive value of 92.9%,and accuracy of 93.3%.The mean elasticity value was also significantly correlated with Ki-67 expression level(r=0.612,P<0.001),which is a marker of tumor proliferation and aggressiveness.Survival analysis showed that patients with higher mean elasticity values(>54.5 kPa)had worse overall survival(OS)and progression-free survival(PFS)than those with lower mean elasticity values(<54.5 kPa)(P=0.038 for OS and P=0.027 for PFS).CONCLUSION Conventional US and SWE provide useful information for diagnosing and forecasting PB-DLBCL.SWE excels in distinguishing PB-DLBCL from benign breast lesions,reflects tumor proliferation and aggressiveness,and improves disease management.
文摘BACKGROUND Itraconazole is a broad-spectrum triazole antifungal inhibiting fungal growth by inhibiting ergosterol synthesis and exhibits a nonlinear pharmacokinetic profile.Erratic absorption pattern with wide fluctuations in blood levels causes inconsistent and unpredictable clinical behaviour of this drug despite its low minimum inhibitory concentration(MIC)as compared to other antifungal agents.AIM To compare the oral bioavailability and bioequivalence of Fixtral SB(supra bioavailable itraconazole)with reference product R2(supra bioavailable 2×50 mg itraconazole).METHODS The study population consisted of 54 healthy volunteers,aged between 18-45 years and randomized to receive a single oral dose of either test[T;Fixtral SB(supra bioavailable itraconazole)100 mg]or reference product(R1;Sporanox 100 mg×2 capsules and R2;Lozanoc capsules 50 mg×2 capsules).Blood samples were taken pre-dose and post-dose up to 96 h.The study evaluated bioequivalence by comparing the oral bioavailability of the test product with reference product R2.The pharmacodynamic characteristics of the drug were evaluated by comparing the test product with reference product R1.Pharmacokinetics(PK)-PD comparative analysis[area under the concentration-time curve(AUC)/minimum inhibitory concentration(MIC)>25]was performed for conventional itraconazole 100 mg and supra bioavailable itraconazole 50 mg.Adverse events(AEs)assessments were performed in each study period and post-study evaluation.RESULTS Statistical analysis of primary PK variables revealed bioequivalence,with confidence intervals being completely inside the acceptance criteria of 80%-125%.The peak concentration levels of itraconazole were achieved at 10 h(T)and 8.5 h(R2),respectively.Pharmacodynamic parameter assessment showed that AUC/MIC for R1 are comparable to Fixtral SB 100mg for MIC levels up to 16mcg/mL(P>0.05 and observed P=0.3196).Six AEs were observed that were mild to moderate in severity and resolved.No severe AE was reported.CONCLUSION Test product itraconazole Capsule 100 mg is bioequivalent with the reference product(R2)at 100 mg dose(2 capsules of Lozanoc®50 mg)under fed conditions.Pharmacodynamics activity in terms of AUC/MIC is comparable between the test product at 100 mg dose and marketed itraconazole 200 mg.Fixtral SB is expected to have therapeutically similar efficacy at half the equivalent dose.Tested formulations were found to be safe and well tolerated.
基金Supported by Project of Shanxi Provincial Health Commission,No.2021144.
文摘BACKGROUND Erythrocyte alloantibodies are mainly produced after immune stimulation,such as blood transfusion,pregnancy,and transplantation,and are the leading causes of severe hemolytic transfusion reactions and difficulty in blood grouping and matching.Therefore,antibody screening is critical to prevent and improve red cell alloantibodies.Routine tube assay is the primary detection method of antibody screening.Recently,erythrocyte-magnetized technology(EMT)has been increasingly used in clinical practice.This study intends to probe the application and efficacy of the conventional tube and EMT in red blood cell alloantibody titration to provide a reference for clinical blood transfusion.AIM To investigate the application value of conventional tube and EMT in red blood cell alloantibody titration and enhance the safety of blood transfusion practice.METHODS A total of 1298 blood samples were harvested from blood donors at the Department of Blood Transfusion of our hospital from March 2021 to December 2022.A 5 mL blood sample was collected in tubing,which was then cut,and the whole blood was put into a test tube for centrifugation to separate the serum.Different red blood cell blood group antibody titers were simultaneously detected using the tube polybrene test,tube antiglobulin test(AGT),and EMT screening irregular antibody methods to determine the best test method.RESULTS Simultaneous detection was performed through the tube polybrene test,tube AGT and EMT screening irregular antibodies.It was discovered that the EMT screening irregular antibody method could detect all immunoglobulin G(IgG)and immunoglobulin M(IgM)irregular antibodies,and the results of manual tube AGT were satisfactory,but the operation time was lengthy,and the equipment had a large footprint.The EMT screening irregular antibody assay was also conducted to determine its activity against type O Rh(D)red blood cells,and the outcomes were satisfactory.Furthermore,compared to the conventional tube method,the EMT screening irregular antibody method was more cost-effective and had significantly higher detection efficiency.CONCLUSION With a higher detection rate,the EMT screening irregular antibody method can detect both IgG and IgM irregular antibodies faster and more effectively than the conventional tube method.
基金Project supported by the National Key R&D Program of China (Grant Nos.2023YFC2206502 and 2021YFA1600703)the National Natural Science Foundation of China (Grant Nos.12175254 and 12227810)the Guangdong–Hong Kong–Macao Joint Laboratory for Neutron Scattering Science and Technology。
文摘As a non-destructive testing technology,neutron imaging plays an important role in various fields,including material science,nuclear engineering,and fundamental science.An imaging detector with a neutron-sensitive image intensifier has been developed and demonstrated to achieve good spatial resolution and timing resolution.However,the influence of the working voltage on the performance of the neutron-sensitive imaging intensifier has not been studied.To optimize the performance of the neutron-sensitive image intensifier at different voltages,experiments have been performed at the China Spallation Neutron Source(CSNS)neutron beamline.The change in the light yield and imaging quality with different voltages has been acquired.It is shown that the image quality benefits from the high gain of the microchannel plate(MCP)and the high accelerating electric field between the MCP and the screen.Increasing the accelerating electric field is more effective than increasing the gain of MCPs for the improvement of the imaging quality.Increasing the total gain of the MCP stack can be realized more effectively by improving the gain of the standard MCP than that of the n MCP.These results offer a development direction for image intensifiers in the future.
文摘Objective:To explore the diagnostic value of conventional ultrasonography combined with contrast-enhanced ultrasonography in thyroid nodules.Methods:From June 2021 to July 2022,163 patients with thyroid nodules enrolled in our hospital were selected as research subjects.After pathological diagnosis,24 cases were malignant thyroid nodules,and 139 cases were benign thyroid nodules.The diagnosis rate of malignant and benign thyroid nodules was observed and analyzed,with 95%CI.Results:Among them,the malignant and benign detection rates of routine ultrasound were 88.63%and 75.00%,respectively,and the malignant and benign detection rates of contrast-enhanced ultrasound were 81.82%and 81.25%,respectively.The malignant and benign detection rates of conventional ultrasound combined with contrast-enhanced ultrasound were 93.18%and 87.50%,respectively,and the 95%CI was greater than 0.7.Conclusion:Conventional ultrasound combined with contrast-enhanced ultrasound can help improve the diagnostic accuracy of benign and malignant thyroid nodules and reduce the misdiagnosis rate.