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FibroScan-aspartate transaminase:A superior non-invasive model for diagnosing high-risk metabolic dysfunction-associated steatohepatitis 被引量:1
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作者 Jing-Ya Yin Tian-Yuan Yang +4 位作者 Bing-Qing Yang Chen-Xue Hou Jun-Nan Li Yue Li Qi Wang 《World Journal of Gastroenterology》 SCIE CAS 2024年第18期2440-2453,共14页
BACKGROUND Non-alcoholic fatty liver disease(NAFLD)with hepatic histological NAFLD activity score≥4 and fibrosis stage F≥2 is regarded as“at risk”non-alcoholic steatohepatitis(NASH).Based on an international conse... BACKGROUND Non-alcoholic fatty liver disease(NAFLD)with hepatic histological NAFLD activity score≥4 and fibrosis stage F≥2 is regarded as“at risk”non-alcoholic steatohepatitis(NASH).Based on an international consensus,NAFLD and NASH were renamed as metabolic dysfunction-associated steatotic liver disease(MASLD)and metabolic dysfunction-associated steatohepatitis(MASH),respectively;hence,we introduced the term“high-risk MASH”.Diagnostic values of seven non-invasive models,including FibroScan-aspartate transaminase(FAST),fibrosis-4(FIB-4),aspartate transaminase to platelet ratio index(APRI),etc.for high-risk MASH have rarely been studied and compared in MASLD.AIM To assess the clinical value of seven non-invasive models as alternatives to liver biopsy for diagnosing high-risk MASH.METHODS A retrospective analysis was conducted on 309 patients diagnosed with NAFLD via liver biopsy at Beijing Ditan Hospital,between January 2012 and December 2020.After screening for MASLD and the exclusion criteria,279 patients wereincluded and categorized into high-risk and non-high-risk MASH groups.Utilizing threshold values of each model,sensitivity,specificity,positive predictive value(PPV),and negative predictive values(NPV),were calculated.Receiver operating characteristic curves were constructed to evaluate their diagnostic efficacy based on the area under the curve(AUROC).RESULTS MASLD diagnostic criteria were met by 99.4%patients with NAFLD.The MASLD population was analyzed in two cohorts:Overall population(279 patients)and the subgroup(117 patients)who underwent liver transient elastography(FibroScan).In the overall population,FIB-4 showed better diagnostic efficacy and higher PPV,with sensitivity,specificity,PPV,NPV,and AUROC of 26.9%,95.2%,73.5%,72.2%,and 0.75.APRI,Forns index,and aspartate transaminase to alanine transaminase ratio(ARR)showed moderate diagnostic efficacy,whereas S index and gamma-glutamyl transpeptidase to platelet ratio(GPR)were relatively weaker.In the subgroup,FAST had the highest diagnostic efficacy,its sensitivity,specificity,PPV,NPV,and AUROC were 44.2%,92.3%,82.1%,67.4%,and 0.82.The FIB-4 AUROC was 0.76.S index and GPR exhibited almost no diagnostic value for high-risk MASH.CONCLUSION FAST and FIB-4 could replace liver biopsy as more effectively diagnostic methods for high-risk MASH compared to APRI,Forns index,ARR,S index,and GPR;FAST is superior to FIB-4. 展开更多
关键词 Metabolic dysfunction-associated steatotic liver disease high-risk metabolic dysfunction-associated steatohepatitis Non-invasive models Liver biopsy Diagnostic value
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Efficacy of mycophenolate mofetil combined with topical 0.05%tacrolimus in high-risk keratoplasty:1-year cohort study
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作者 Jin-Yu Zhang Kang Yu +2 位作者 Xiu-Ying Jiang Jia-Xin Liang Shi-You Zhou 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2024年第12期2229-2235,共7页
AIM:To investigate the efficacy of systemic mycophenolate mofetil(MMF)as an adjunct in combination with topical tacrolimus(FK506)and corticosteroid eyedrops for preventing corneal graft rejection after high-risk kerat... AIM:To investigate the efficacy of systemic mycophenolate mofetil(MMF)as an adjunct in combination with topical tacrolimus(FK506)and corticosteroid eyedrops for preventing corneal graft rejection after high-risk keratoplasty(HRK).METHODS:In this cohort study,55 consecutive patients(55 eyes)from an eye center who met the criteria of HRK were included.The definition for HRK includes large grafts of no less than 9 mm diameter,vascularized cornea of two or more quadrants,regrafting,or eccentric grafts.After penetrating keratoplasty,25 patients treated with systemic MMF in combination with 0.05%FK506 and tapering corticosteroid eyedrops were enrolled in Group 1 from October 2019.Thirty patients receiving postoperative treatment with 0.05%FK506 and tapering corticosteroid eyedrops alone were enrolled in Group 2 from January 2018 to September 2019.All participants were closely monitored after surgery,and episodes of graft rejection and relevant clinical data were collected and assessed over a one-year follow-up period.RESULTS:After a follow-up of 9.6±3.2mo,graft rejection episodes occurred in 4 cases(16%)in Group 1 and 18 cases(60%)in Group 2.One reversible and 3 irreversible graft rejections occurred in Group 1,while 3 reversible and 15 irreversible rejections occurred in Group 2.Kaplan-Meier analysis revealed that 82.5%of grafts in Group 1 and 37.1%in Group 2 did not experience corneal graft rejection(P<0.01,log-rank test).The clear graft survival rate was 83.6%in Group 1 and 36.7%in Group 2(P<0.01,log-rank test)within one year of follow-up.No severe systemic side effects were observed in either group during the follow-up period.CONCLUSION:The triple treatment regimen consisting of MMF,topical FK506,and corticosteroid eyedrops represents a promising strategy for effectively preventing graft rejection and improving graft survival in patients with HRK. 展开更多
关键词 IMMUNOSUPPRESSANTS high-risk keratoplasty mycophenolate mofetil
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Intravitreal conbercept injection with panretinal photocoagulation for high-risk proliferative diabetic retinopathy with vitreous hemorrhage
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作者 Yao Xu Qing Ye Wei Shen 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2024年第6期1066-1072,共7页
AIM:To assess the clinical efficacy and safety of combining panretinal photocoagulation(PRP)with intravitreal conbercept(IVC)injections for patients with high-risk proliferative diabetic retinopathy(HR-PDR)complicated... AIM:To assess the clinical efficacy and safety of combining panretinal photocoagulation(PRP)with intravitreal conbercept(IVC)injections for patients with high-risk proliferative diabetic retinopathy(HR-PDR)complicated by mild or moderate vitreous hemorrhage(VH),with or without diabetic macular edema(DME).METHODS:Patients diagnosed with VH with/without DME secondary to HR-PDR and received PRP combined with IVC injections were recruited in this retrospective study.Upon establishing the patient’s diagnosis,an initial IVC was performed,followed by prompt administration of PRP.In cases who significant bleeding persisted and impeded the laser operation,IVC was sustained before supplementing with PRP.Following the completion of PRP,patients were meticulously monitored for a minimum of six months.Laser therapy and IVC injections were judiciously adjusted based on fundus fluorescein angiography(FFA)results.Therapeutic effect and the incidence of adverse events were observed.RESULTS:Out of 42 patients(74 eyes),29 were male and 13 were female,with a mean age of 59.17±12.74y(33-84y).The diabetic history was between 1wk and 26y,and the interval between the onset of visual symptoms and diagnosis of HR-PDR was 1wk-1y.The affected eye received 2.59±1.87(1-10)IVC injections and underwent 5.5±1.02(4-8)sessions of PRP.Of these,68 eyes received PRP following 1 IVC injection,5 eyes after 2 IVC injections,and 1 eye after 3 IVC injections.Complete absorption of VH was observed in all 74 eyes 5-50wk after initial treatment,with resolution of DME in 51 eyes 3-48wk after initial treatment.A newly developed epiretinal membrane was noted in one eye.Visual acuity significantly improved in 25 eyes.No complications such as glaucoma,retinal detachment,or endophthalmitis were reported.CONCLUSION:The study suggests that the combination of PRP with IVC injections is an effective and safe modality for treating diabetic VH in patients with HR-PDR. 展开更多
关键词 conbercept panretinal photocoagulation high-risk proliferative diabetic retinopathy vitreous hemorrhage
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Prevalence of Precancerous Lesions Based on Digital Cervicography with VIA/VILI among Women Positive for High-Risk Human Papillomavirus Serotypes: A Screening Center-Based Study in Cameroon
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作者 Jeffrey-Lewis Nzang Cliford Ebontane Ebong +8 位作者 Simon Manga Florence Manjuh Félix Essiben Isidore Tompeen Judith Seungue Serge Robert Nyada Jeanne Hortence Fouedjio Ymele Fouelifack Julius Sama Dohbit 《Open Journal of Obstetrics and Gynecology》 2024年第6期967-978,共12页
Background: Since 2021, high-risk Human Papilloma Virus (HR-HPV) testing has been the recommended screening test for cervical cancer for all settings;either used alone in a “test and treat” strategy, or with a triag... Background: Since 2021, high-risk Human Papilloma Virus (HR-HPV) testing has been the recommended screening test for cervical cancer for all settings;either used alone in a “test and treat” strategy, or with a triage test, with or without biopsy, before treatment. Cameroon has rolled out immunization against HPV 16 and 18, but studies show a higher prevalence of non-16/18 HR-HPV types. Objectives: Determine the prevalence of precancerous lesions, in women with HR-HPV infection and evaluate association of digital cervicography (DC) VIA/VILI positivity with HPV serotype, as a measure of their contribution to precancer and cancer incidence. Methodology: The study was cross-sectional, descriptive, and analytic. It took place at the Etoug-Ebe and Ekoudoum Baptist Hospitals in Yaoundé, during the period April-September 2022. We reviewed the records of women screened for cervical cancer between February 2020 and December 2021 and evaluated the prevalence of lesions on digital cervicography (DC) with VIA/VILI for women positive for HR-HPV serotypes. The data were analyzed using SPSS version 20.0 for Windows. P values Results: We identified 315 cases with a positive HR-HPV deoxyribonucleic acid (DNA) test, 224 (71.1%) had a DC VIA/VILI triage test done. Of these, 30 (13.4%) women had a positive DC VIA/VILI, with five women (2.2%) having lesions suggestive of cancer. Out of 11 cases positive for HPV 16 alone, 05 (45.5%) had a positive DC VIA/VILI test. Of the 14 cases positive for HPV 18 alone, 03 (21.4%) had a positive VIA/VILI, meanwhile only 19 (10.7%) of the 177 cases positive for non-16/18 HPV had a positive VIA/VILI test. Conclusion: A high proportion of women (13.4%) with HR HPV had a positive DC VIA/VILI, with a significant proportion (2.2%) having lesions suggestive of invasive cervical cancer HR-HPV serotype was associated with DC VIA/VILI positivity;HPV 16 had the strongest association (45.5%), followed by HPV 18 (21.4%), and non-16/18 HR-HPV (10.7%), suggesting a decreasing order of oncogenicity. 展开更多
关键词 high-risk Human Papillomavirus PRECANCEROUS Digital Cervicography VIA/VILI SEROTYPE
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Effects of Health Education with Problem-Based Learning Approaches on the Knowledge, Attitude, Practice and Coping Skills of Women with High-Risk Pregnancies in Plateau Areas
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作者 Ying Wu Suolang Sezhen +5 位作者 Renqing Yuzhen Hong Wei Zhijuan Zhan Baima Hongying Yuhong Zhang Lihong Liu 《Open Journal of Nursing》 2024年第5期192-199,共8页
Objective: Given the unique cultural background, way of life, and physical environment of the Tibetan Plateau, this study aims to investigate the effects of health education using problem-based learning (PBL) approach... Objective: Given the unique cultural background, way of life, and physical environment of the Tibetan Plateau, this study aims to investigate the effects of health education using problem-based learning (PBL) approaches on the knowledge, attitude, practice, and coping skills of women with high-risk pregnancies in this region. Methods: 76 high-risk pregnancy cases were enrolled at Tibet’s Linzhi People’s Hospital between September 2023 and April 2024. 30 patients admitted between September 2023 and December 2023 were selected as the control group and were performed with regular patient education. 46 patients admitted between January 2024 and April 2024 were selected as the observation group and were performed regular patient education with problem-based learning approaches. Two groups’ performance on their health knowledge, attitude, practice and coping skills before and after interventions were evaluated, and patient satisfaction were measured at the end of the study. Results: There was no statistical significance (P P P Conclusions: Health education with problem-based learning approaches is worth promoting as it can help high-risk pregnant women in plateau areas develop better health knowledge, attitude and practice and healthier coping skills. Also, it can improve patient sanctification. 展开更多
关键词 Plateau Areas Patients with high-risk Pregnancies Problem-Based Learning Health Education Health Knowledge Attitude and Practice Coping Skills
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Experimental models of high-risk bowel anastomosis in rats:A systematic review
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作者 Georgios Ntampakis Manousos-Georgios Pramateftakis +8 位作者 Elissavet Anestiadou Stefanos Bitsianis Orestis Ioannidis Chryssa Bekiari George Koliakos Maria Karakota Anastasia Tsakona Angeliki Cheva Stamatios Angelopoulos Fourth 《World Journal of Experimental Medicine》 2024年第2期114-131,共18页
BACKGROUND Anastomotic leaks remain one of the most dreaded complications in gastrointestinal surgery causing significant morbidity,that negatively affect the patients’quality of life.Experimental studies play an imp... BACKGROUND Anastomotic leaks remain one of the most dreaded complications in gastrointestinal surgery causing significant morbidity,that negatively affect the patients’quality of life.Experimental studies play an important role in understanding the pathophysiological background of anastomotic healing and there are still many fields that require further investigation.Knowledge drawn from these studies can lead to interventions or techniques that can reduce the risk of anastomotic leak in patients with high-risk features.Despite the advances in experimental protocols and techniques,designing a high-quality study is still challenging for the investigators as there is a plethora of different models used.AIM To review current state of the art for experimental protocols in high-risk anastomosis in rats.METHODS This systematic review was performed according to The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.To identify eligible studies,a comprehensive literature search was performed in the electronic databases PubMed(MEDLINE)and Scopus,covering the period from conception until 18 October 2023.RESULTS From our search strategy 102 studies were included and were categorized based on the mechanism used to create a high-risk anastomosis.Methods of assessing anastomotic healing were extracted and were individually appraised.CONCLUSION Anastomotic healing studies have evolved over the last decades,but the findings are yet to be translated into human studies.There is a need for high-quality,well-designed studies that will help to the better understanding of the pathophysiology of anastomotic healing and the effects of various interventions. 展开更多
关键词 high-risk anastomosis RATS Experimental models BOWEL COLON Anastomotic leak Colon resection Inflammatory bowel disease Intra-abdominal sepsis Bursting pressure
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Application Value of NLR,PLR,LMR,HEART score,and POCT in Early Warning and Accurate Graded Diagnosis of High-Risk Chest Pain in Emergency Medicine
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作者 Shaochang Ma Chunhua Lin +2 位作者 Yanmei Li Yan Chen Guohui Zhang 《Journal of Clinical and Nursing Research》 2024年第4期93-98,共6页
Objective: To evaluate the application value of neutrophils/lymphocytes (NLR), platelets/lymphocytes (PLR), lymphocytes/monocytes (LMR), HEART (history, electrocardiogram, age, risk factors, and troponin) score, and p... Objective: To evaluate the application value of neutrophils/lymphocytes (NLR), platelets/lymphocytes (PLR), lymphocytes/monocytes (LMR), HEART (history, electrocardiogram, age, risk factors, and troponin) score, and point-of- care testing (POCT) in the early warning and precise diagnosis of high-risk chest pain in emergency medicine. Methods: A total of 157 patients with acute chest pain who were admitted to the emergency department and chest pain treatment unit of our hospital between August 2022 and September 2023 were selected. Rapid testing of bedside myocardial markers (ultrasensitive troponin (hs-cTnI), myoglobin (MYO), creatine kinase isoenzyme (CK-MB), D-dimer (D-Dimer), and N-terminal B-type natriuretic peptide precursor (NT-proBNP)) was performed on the patients using a POCT device (ThermoKing BioMQ60proB). A HEART score was used to classify the patients into low (n = 53), intermediate (n = 59), and high-risk (n = 45) groups, and the NLR, PLR, and LMR were calculated. The NLR, PLR, and LMR values were compared among the three groups of patients, and the optimal cutoff values as well as sensitivity and specificity were determined based on receiver operating characteristic (ROC) analysis. Results: The HEART scores of patients in the low-risk, intermediate-risk, and high-risk groups were (2.72 ± 0.24), (4.75 ± 0.56), and (5.32 ± 0.73) respectively, and the differences were statistically significant (P < 0.05). Compared with the low-risk group, the intermediate-risk group and high-risk group had a significantly higher NLR and PLR, and a significantly lower LMR;the high-risk group had higher NLR and PLR and lower values of LMR as compared to the other two groups, and the difference was statistically significant (P < 0.05). The ROC curves suggested that the area under the curve, sensitivity, and specificity of the combined diagnosis of NLR, PLR, LMR, HEART score, and POCT were greater than those of LR, PLR, and LMR with HEART score and POCT alone. Conclusion: The combined application of NLR, PLR, LMR, HEART score, and POCT has significant application value in the early warning and precise diagnosis of emergency high-risk chest pain. It provides a more simple, easy-to-access, and efficient assessment index for the clinical prediction and treatment of emergency high- risk chest pain. 展开更多
关键词 NLR PLR LMR POCT myocardial markers HEART score Emergency high-risk chest pain
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Cost-benefit analysis of esophageal cancer endoscopic screening in high-risk areas of China 被引量:33
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作者 Juan Yang wen-Qiang wei +3 位作者 Jin Niu Zhi-Cai Liu Chun-Xia Yang You-Lin Qiao 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第20期2493-2501,共9页
AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer(EC)in high-risk areas of China. METHODS:Markov model-based analyses were conducted to compare the net present values(NPVs)and th... AIM:To estimate the cost-benefit of endoscopic screening strategies of esophageal cancer(EC)in high-risk areas of China. METHODS:Markov model-based analyses were conducted to compare the net present values(NPVs)and the benefit-cost ratios(BCRs)of 12 EC endoscopic screening strategies.Strategies varied according to the targeted screening age,screening frequencies,and follow-up intervals.Model parameters were collected from population-based studies in China,published literatures,and surveillance data. RESULTS:Compared with non-screening outcomes,all strategies with hypothetical 100 000 subjects saved life years.Among five dominant strategies determined by the incremental cost-effectiveness analysis,screening once at age 50 years incurred the lowest NPV(international dollar-I$55 million)and BCR(2.52).Screening six times between 40-70 years at a 5-year interval[i.e., six times(40)f-strategy]yielded the highest NPV(I$99 million)and BCR(3.06).Compared with six times(40)fstrategy,screening thrice between 40-70 years at a 10-year interval resulted in relatively lower NPV,but the same BCR. CONCLUSION:EC endoscopic screening is cost-beneficial in high-risk areas of China.Policy-makers should consider the cost-benefit,population acceptance,and local economic status when choosing suitable screening strategies. 展开更多
关键词 Cost-benefit analysis Esophageal cancer ENDOSCOPY SCREENING high-risk area
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Predictors of rebleeding after initial hemostasis with epinephrine injection in high-risk ulcers 被引量:12
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作者 Ming-Luen Hu King-Wah Chiu +4 位作者 Yi-Chun Chiu Yeh-Pin Chou Tsung-Hui Hu Shue-Shian Chiou Seng-Kee Chuah 《World Journal of Gastroenterology》 SCIE CAS CSCD 2010年第43期5490-5495,共6页
AIM: To identify the predictors of rebleeding after initial hemostasis with epinephrine injection (EI) in patients with high-risk ulcers. METHODS: Recent studies have revealed that endoscopic thermocoagulation, or cli... AIM: To identify the predictors of rebleeding after initial hemostasis with epinephrine injection (EI) in patients with high-risk ulcers. METHODS: Recent studies have revealed that endoscopic thermocoagulation, or clips alone or combined with EI are superior to EI alone to arrest ulcer bleeding. However, the reality is that EI monotherapy is still common in clinical practice. From October 2006 to April 2008, high-risk ulcer patients in whom hemorrhage was stopped after EI monotherapy were studied using clinical, laboratory and endoscopic variables. The patients were divided into 2 groups: sustained hemostasis and rebleeding. RESULTS: A total of 175 patients (144, sustainedhemostasis; 31, rebleeding) were enrolled. Univariate analysis revealed that older age (≥ 60 years), advanced American Society of Anesthesiology (ASA) status (category Ⅲ , Ⅳ and Ⅴ ), shock, severe anemia (hemoglobin < 80 g/L), EI dose ≥ 12 mL and severe bleeding signs (SBS) including hematemesis or hematochezia were the factors which predicted rebleeding. However, only older age, severe anemia, high EI dose and SBS were independent predictors. Among 31 rebleeding patients, 10 (32.2%) underwent surgical hemostasis, 15 (48.4%) suffered from delayed hemostasis causing major complications and 13 (41.9%) died of these complications. CONCLUSION: Endoscopic EI monotherapy in patients with high-risk ulcers should be avoided. Initial hemostasis with thermocoagulation, clips or additional hemostasis after EI is mandatory for such patients to ensure better hemostatic status and to prevent subsequent rebleeding, surgery, morbidity and mortality. 展开更多
关键词 EPINEPHRINE injection high-risk ULCERS Initial HEMOSTASIS PREDICTORS REBLEEDING
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Total N,total P and organic matters content in floodplain soils of Xianghai Nature Reserve 被引量:2
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作者 DENG Wei, ZHAI Jin-liang, HE Yan (Changchun Institute of Geography, CAS, Changchun 130021, China) 《Journal of Geographical Sciences》 SCIE CSCD 2002年第1期58-64,共7页
Soil sediment samples of 10 layers with a spacing of 10 cm each were collected in different floodplain zones adjacent to Huolin River in the Xianghai Nature Reserve, and contents of total N, total P and organic matter... Soil sediment samples of 10 layers with a spacing of 10 cm each were collected in different floodplain zones adjacent to Huolin River in the Xianghai Nature Reserve, and contents of total N, total P and organic matters were analyzed. The results showed that contents of total N, total P and organic matters were generally decreasing with the increase of distance from sample locations to the river channel, and contents of the three items were generally higher in the upper soil layer than that in the lower soil layer. The content variations displayed how flooding functions influenced nutrient matter content variations in floodplain soils since the flood inundation frequencies of the sample locations varied. The correlation analysis displayed that there were remarkable relativities between total N, total P and organic matters within definite spatial distance from the Huolin River channel. 展开更多
关键词 floodplain wetland total N total P organic matter correlation analysis
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Influencing factors of the neurodevelopment of high-risk infants 被引量:8
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作者 Yuan Tian Chuncao Zhang +3 位作者 Guangjun Yu Xiangying Hu Zheng Pu Liyu Ma 《General Psychiatry》 CSCD 2018年第6期140-145,共6页
Background High-risk infants refer to newborns exposed to high-risk factors in the prenatal, natal or postnatal period. High-risk infants are at high risk of developmental retardation, and early identification of deve... Background High-risk infants refer to newborns exposed to high-risk factors in the prenatal, natal or postnatal period. High-risk infants are at high risk of developmental retardation, and early identification of developmental abnormalities plays a vital role in improving high-risk infants' quality of life.Aims To describe the neurodevelopment of high-risk infants aged less than 1 year old, and to analyse the incidences and influencing factors of neurodevelopmental abnormalities in order to provide a basis for neurodevelopment monitoring and management of highrisk infants.Methods High-risk infants born between January 2016 and December 2016 in the maternity and infant health hospitals of three districts in Shanghai were followed up.The Gesell Developmental Scale was used to assess the neurodevelopmental level at the time of recruitment(0-2 months) and at 9 months. Univariate and multivariate analyses of the influencing factors were conducted.Results 484 high-risk infants(male 51 %, female 49%)with an average gestation age of 36.5±2.2 weeks were recruited. At the time of recruitment, the average age was2.1(0.8) months, and the developmental quotient(DQ)scores of full-term high-risk infants in motor(t=3.542,p=0.001), cognitive(t=3.125, p=0.002), language(t=3.189, p=0.002) and social(t=3.316, p=0.001) areas were higher than those of preterm infants. The incidences of developmental abnormalities of full-term high-risk infants in motor(χ~2 =9.452, p=0.002), cognitive(χ~2=6.258, p=0.012), language(χ~2 =12.319, p =0.001) and social(χ~2 =6.811, p=0.009) areas were lower than the preterm infants. At 9 months, there was no difference in the DQ scores and incidences of developmental abnormalities in four areas between full-term and preterm high-risk infants, and the incidence of developmental abnormalities was around 10%.Conclusion The incidence of neurodevelopmental abnormalities in high-risk infants aged less than 1 year old is high. Preterm birth and parental bad habits are significant factors affecting the neurodevelopment.Monitoring and early interventions help to improve highrisk infants' neurodevelopment. 展开更多
关键词 INFANTS high-risk FACTORS ABNORMALITIES DEVELOPMENTAL
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Mechanism of immune tolerance induced by donor derived immature dendritic cells in rat high-risk corneal transplantation 被引量:11
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作者 Xiao-Wei Gao Yan Fu +3 位作者 Wen-Jing Li An-Jie Du Xia Li Xu-Dong Zhao 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2013年第3期269-275,共7页
·AIM: To study the role of immature dendritic cells (imDCs) on immune tolerance in rat penetrating keratoplasty (PKP) in high -risk eyes and to investigate the mechanism of immune hyporesponsiveness induced by do... ·AIM: To study the role of immature dendritic cells (imDCs) on immune tolerance in rat penetrating keratoplasty (PKP) in high -risk eyes and to investigate the mechanism of immune hyporesponsiveness induced by donor-derived imDCs. ·METHODS: Seventy-five SD rats (recipient) and 39 Wistar rats (donor) were randomly divided into 3 groups: control, imDC and mature dendritic cell (mDC) group respectively. Using a model of orthotopic corneal transplantation in which allografts were placed in neovascularized high -risk eyes of recipient rat. Corneal neovascularization was induced by alkaline burn in the central cornea of recipient rat. Recipients in imDC group or mDC group were injected donor bone marrow-derived imDCs or mDCs of 1 ×10 6 respectively 1 week before corneal transplantation tail vein. Control rat received the same volume of PBS. In each group, 16 recipients were kept for determination of survival time and other 9 recipients were executed on day 3, 7 and 14 after transplantation. Cornea was harvested for hematoxylin eosin staining and acute rejection evaluation, Western blot was used to detect the expression level of Foxp3. ·RESULTS: The mean survival time of imDC group was significantly longer than that of control and mDC groups (all 【0.05). The expression level of Foxp3 on CD4 + CD25 + T cells of imDC group (2.24 ±0.18) was significantly higher than that in the control (1.68 ±0.09) and mDC groups (1.46±0.13) (all 【0.05).·CONCLUSION: Donor -derived imDC is an effective treatment in inducing immune hyporesponsiveness in rat PKP. The mechanism of immune tolerance induced by imDC might be inhibit T lymphocytes responsiveness by regulatory T cells. · 展开更多
关键词 immature dendritic cell high-risk keratoplasty regulatory T cells
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Evaluation of greenlight photoselective vaporization of the prostate for the treatment of high-risk patients with benign prostatic hyperplasia 被引量:12
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作者 Wei-Jun Fu Bao-Fa Hong Xiao-Xiong Wang Yong Yang Wei Cai Jiang-Ping Gao Yao-Fu Chen Cui-E Zhang 《Asian Journal of Andrology》 SCIE CAS CSCD 2006年第3期367-371,共5页
Aim: To explore the feasibility and safety of greenlight photoselective vaporization of the prostate (PVP) on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplas... Aim: To explore the feasibility and safety of greenlight photoselective vaporization of the prostate (PVP) on high-risk patients presenting with lower urinary tract symptoms suggestive of benign prostatic hyperplasia (BPH) and to evaluate their clinical and voiding outcome. Methods: A total of 85 high-risk patients with obstructive BPH underwent PVP with an 80 W potassium-titanyl-phosphate laser, which was delivered through a side-deflecting fiber with a 23 Fr continuous flow cystoscope. Operative time, blood loss, indwelling catheterzation, international prostate symptom score (IPSS), quality of life score (QoL), uroflowmetry, postvoid residual urine volume and short-term complication rates were evaluated for all patients. Results: All patients got through the perioperative period safely. The chief advantages of PVP were: short operative time (25.6 ± 7.6 min), little bleeding loss (56.8 ± 14.3 mL) and short indwelling catheterization (1.6 ± 0.8 d). The IPSS and QoL decreased from (29.6 ± 5.4) and (5.4 ± 0.6) to (9.5 ± 2.6) and (1.3 ± 0.6), respectively. The vast majority of patients were satisfied with voiding outcome. The mean maximal urinary flow rate increased to 17.8 mL/s and postvoid residual urine volume decreased to 55.6 mL. These results are significantly different from preoperative data (P 〈 0.05). No patient required blood transfusion or fluid absorption. There were few complications and very high patient satisfaction after operation. Conclusion: PVP has a short operative time and high tolerance, and is safe, effective and minimally invasive for high-risk patients, therefore it might be considered as a good alternative treatment for high-risk patients with obstructive urinary symptoms as a result of BPH. 展开更多
关键词 benign prostatic hyperplasia photoselective vaporization of the prostate high-risk laser surgery PROSTATE
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Prevalence and Determinants of High-risk HPV Infection among 11549 Women from an Opportunistic Screening in Hubei Province 被引量:6
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作者 Quan-fu MA Yu-lin GUO +8 位作者 Han GAO Bin YAN Xuan DAI Meng XU Yu-jing XIONG Qiu-zi PENG Ying WANG Miao ZOU Xu-feng WU 《Current Medical Science》 SCIE CAS 2019年第4期622-630,共9页
High-risk human papillomavirus (hrHPV) infection plays an important role in the development of cervical intraepithelial neoplasia and cervical cancer.A total of 11 549 women were enrolled from the Maternal and Child H... High-risk human papillomavirus (hrHPV) infection plays an important role in the development of cervical intraepithelial neoplasia and cervical cancer.A total of 11 549 women were enrolled from the Maternal and Child Health Hospital of Hubei Province.Each participant accepted hrHPV testing and completed a self^administered questionnaire about basic information and potential risk factors.The univariable and multivariable logistic regression model was used to explore the associations between variants and hrHPV infection.Our results showed that hrHPV prevalence was 16.09% in Hubei Province,among which,hrHPV was more likely to be positive in women aged 51 years or above (OR=1.65,95% CI:1.28-2.14),and in women who had symptoms of bleeding after intercourse (OR=1.32,95% CI:1.17-1.50),had first sexual intercourse at the age of 18 years or below (OR=1.33,95% CI:1.07-1.64),had at least three male sexual partners (OR=2.50,95% CI:2.07-3.03),and who had been diagnosed with sexually transmitted infections (OR=1.50,95% CI:1.12-2.03).Married women (OR=0.66,95% CI:0.55-0.78) and women who frequently used condoms (OR=0.75,95% CI:0.67-0.84) had a relatively lower hrHPV prevalence.This study confirms that hrHPV infection was associated with age,marital status,symptoms of intercourse bleeding,history of sexually transmitted infections,and sex-related behaviors.Above all,this study provides a baseline database prior to obtaining vaccinations for dynamic tracking of the changes in hrHPV prevalence. 展开更多
关键词 high-risk human PAPILLOMAVIRUS CERVICAL cancer PREVALENCE risk FACTORS China
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Non-invasive prediction model for high-risk esophageal varices in the Chinese population 被引量:7
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作者 Long-Bao Yang Jing-Yuan Xu +6 位作者 Xin-Xing Tantai Hong Li Cai-Lan Xiao Cai-Feng Yang Huan Zhang Lei Dong Gang Zhao 《World Journal of Gastroenterology》 SCIE CAS 2020年第21期2839-2851,共13页
BACKGROUND There are two types of esophageal varices(EVs):high-risk EVs(HEVs)and lowrisk EVs,and HEVs pose a greater threat to patient life than low-risk EVs.The diagnosis of EVs is mainly conducted by gastroscopy,whi... BACKGROUND There are two types of esophageal varices(EVs):high-risk EVs(HEVs)and lowrisk EVs,and HEVs pose a greater threat to patient life than low-risk EVs.The diagnosis of EVs is mainly conducted by gastroscopy,which can cause discomfort to patients,or by non-invasive prediction models.A number of noninvasive models for predicting EVs have been reported;however,those that are based on the formula for calculation of liver and spleen volume in HEVs have not been reported.AIM To establish a non-invasive prediction model based on the formula for liver and spleen volume for predicting HEVs in patients with viral cirrhosis.METHODS Data from 86 EV patients with viral cirrhosis were collected.Actual liver and spleen volumes of the patients were determined by computed tomography,and their calculated liver and spleen volumes were calculated by standard formulas.Other imaging and biochemical data were determined.The impact of each parameter on HEVs was analyzed by univariate and multivariate analyses,the data from which were employed to establish a non-invasive prediction model.Then the established prediction model was compared with other previous prediction models.Finally,the discriminating ability,calibration ability,and clinical efficacy of the new model was verified in both the modeling group and the external validation group.RESULTS Data from univariate and multivariate analyses indicated that the liver-spleen volume ratio,spleen volume change rate,and aspartate aminotransferase were correlated with HEVs.These indexes were successfully used to establish the noninvasive prediction model.The comparison of the models showed that the established model could better predict HEVs compared with previous models.The discriminating ability,calibration ability,and clinical efficacy of the new model were affirmed.CONCLUSION The non-invasive prediction model for predicting HEVs in patients with viral cirrhosis was successfully established.The new model is reliable for predicting HEVs and has clinical applicability. 展开更多
关键词 CIRRHOSIS high-risk esophageal varices Non-invasive prediction model Liver volume Spleen volume
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Panretinal photocoagulation versus panretinal photocoagulation plus intravitreal bevacizumab for high-risk proliferative diabetic retinopathy 被引量:14
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作者 Ai-Yi Zhou Chen-Jing Zhou +3 位作者 Jing Yao Yan-Long Quan Bai-Chao Ren Jian-Ming Wang 《International Journal of Ophthalmology(English edition)》 SCIE CAS 2016年第12期1772-1778,共7页
AIM: To evaluate the effects of panretinal photocoagulation (PRP) compared with PRP plus intravitreal bevacizumab (IVB) in patients with high-risk proliferative diabetic retinopathy (PDR) according to the Early... AIM: To evaluate the effects of panretinal photocoagulation (PRP) compared with PRP plus intravitreal bevacizumab (IVB) in patients with high-risk proliferative diabetic retinopathy (PDR) according to the Early Treatment Diabetic Retinopathy Study criteria.METHODS: The data were collected retrospectively from the eyes of high-risk PDR patients, which were divided into two groups. After treated with standard PRP, the eyes were randomly assigned to receive only PRP (PRP group) or PRP plus intravitreal injection of 1.25 mg of bevacizumab (PRP-Plus group). Patients underwent complete ophthalmic evaluation, including best corrected visual acuity (BCVA), intraocular pressure (IOP), and new vessel size in fluorescein angiography (FA) and optical coherence tomography for the assessment of central subfield macular thickness (CSMT) at baseline and at weeks 12 (±2), 16 (±2), 24 (±2) and 48 (±2). Main outcome measures also included vitreous clear-up time and neovascularization on the disc (NVD) regression time. Adverse events associated with intravitreal injection were investigated.RESULTS: Thirty consecutive patients (n=36 eyes) completed the 48-week follow-up. There was no significant difference between the PRP and PRP-Plus groups with respect to age, gender, type or duration of diabetes, area of fluorescein leakage from active neovascularizations (NVs), BCVA or CSMT at baseline. The mean vitreous clear-up time was 12.1±3.4wk after PRP and 8.4±3.5wk after PRP combined with IVB. The mean time interval from treatment to complete NVD regression on FA examination was 15.2±3.5wk in PRP group and 12.5±3.1wk in PRP-Plus group. No significant difference in CSMT was observed between the groups throughout the study period. However, the total area of actively leaking NVs was significantly reduced in the PRP-Plus group compared with the PRP group (P〈0.05). Patients received an average of 1.3 injections (range: 1-2). Ten eyes (27.8%) underwent 2 injections. Two eyes had ocular complication of PDR progression to dense vitreous hemorrhage (VH). No major adverse events were identified.CONCLUSION: The adjunctive use of IVB with PRP is associated with a greater reduction in the area of active leaking NVs than PRP alone in patients with high-risk PDR. Short-term results suggest combined IVB and PRP achieved rapid clearance of VH and regression of retinal NV in the treatment of high-risk PDR. Further studies are needed to determine the effect of repeated intravitreal bevacizumab injections and the proper number of bevacizumab injections as an adjuvant. 展开更多
关键词 panrctinal photocoagulation intravitreal bevacizumab high-risk proliferative diabetic retinopathy neovascularization on the disc
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Improved ecological development model for lower Yellow River floodplain,China 被引量:4
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作者 Jin-liang Zhang Yi-zi Shang +2 位作者 Ji-xiang Liu Jian Fu Meng Cui 《Water Science and Engineering》 EI CAS CSCD 2020年第4期275-285,共11页
In this study,a model for the development of the wide floodplain in the lower Yellow River Basin,in China was developed.This model includes flood control schemes using grading criteria,enables sediment deposition in p... In this study,a model for the development of the wide floodplain in the lower Yellow River Basin,in China was developed.This model includes flood control schemes using grading criteria,enables sediment deposition in partitioned zones,and allows free exchange between channel runoff and sediment.The wide floodplain located between the main channel and levees is divided into three typical regions:the tender,low,and high floodplains.Different ecological models should be applied when these floodplains are constructed.This paper describes the associated research ideas and methodology,and clarifies several key issues,including sediment prediction and regulation,land planning,land use,and a multi-dimensional framework of safeguard measures for industries on the lower Yellow River floodplain.A refined ecological development model is proposed for the lower Yellow River floodplain,and future work on ecological and sustainable development of the lower floodplain is suggested.To establish a comprehensive system integrating runoff and sediment resource regulation in the Yellow River Basin,future work should focus on runoff and sediment exchange mechanisms in the wandering lower reaches.Furthermore,it is necessary to improve theories on floodplain planning and ecological construction,and these theories should be integrated with the research findings on land development across the lower Yellow River floodplain.©2020 Hohai University.Production and hosting by Elsevier B.V.This is an open access article under the CC BY-NC-ND license(http://creativecommons.org/licenses/by-nc-nd/4.0/). 展开更多
关键词 Ecological development Lower Yellow River floodplain SEDIMENT Eco-friendly construction model
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Methods and outcomes of screening for pancreatic adenocarcinoma in high-risk individuals 被引量:3
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作者 Gabriele Capurso Marianna Signoretti +5 位作者 Roberto Valente Urban Arnelo Matthias Lohr Jan-Werner Poley Gianfranco Delle Fave Marco Del Chiaro 《World Journal of Gastrointestinal Endoscopy》 CAS 2015年第9期833-842,共10页
Pancreatic ductal adenocarcinoma(PDAC) is a lethal neoplasia, for which secondary prevention(i.e., screening) is advisable for high-risk individuals with "familiar pancreatic cancer" and with other specific ... Pancreatic ductal adenocarcinoma(PDAC) is a lethal neoplasia, for which secondary prevention(i.e., screening) is advisable for high-risk individuals with "familiar pancreatic cancer" and with other specific genetic syndromes(Peutz-Jeghers, p16, BRCA2, PALB and mismatch repair gene mutation carriers). There is limited evidence regarding the accuracy of screening tests, their acceptability, costs and availability, and agreement on whom to treat. Successful target of screening are small resectable PDAC, intraductal papillary mucinous neoplasms with high-grade dysplasia and advanced pancreatic intraepithelial neoplasia. Both magnetic resonance imaging(MRI) and endoscopic ultrasound(EUS) are employed for screening, and the overall yield for pre-malignant or malignant pancreatic lesions is of about 20% with EUS and 14% with MRI/magnetic resonance colangiopancreatography. EUS performs better for solid and MRI for cystic lesions. However, only 2% of these detected lesions can be considered a successful target, and there are insufficient data demonstrating that resection of benign or low grade lesions improves survival. Many patients in the published studies therefore seemed to have received an overtreatment by undergoing surgery. It is crucial to better stratify the risk of malignancy individually, and to better define optimal screening intervals and methods either with computerized tools or molecular biomarkers, possibly in large multicentre studies. At the moment, screening should be carefully performed within research protocols at experienced centres, offering involved individuals medical and psychological advice. 展开更多
关键词 ENDOSCOPIC ultrasound PANCREATIC cancer SCREENING high-risk individuals Magnetic RESONANCE
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Influence of Floodplain Area on Fish Species Richness in Waterbodies of the Chao Phraya River Basin, Thailand 被引量:1
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作者 Wataru Tanaka Rottapon Wattanasiriserekul +5 位作者 Yuta Tomiyama Tomomi Yamasita Wikit Phinrub Tosapol Chamnivikaipong Apinun Suvarnaraksha Yukihiro Shimatani 《Open Journal of Ecology》 2015年第9期434-451,共18页
River-floodplain ecosystems are in delicate balance and are impacted by even minor changes in water availability. In this study, we surveyed fish assemblages and investigated environmental and landscape parameters in ... River-floodplain ecosystems are in delicate balance and are impacted by even minor changes in water availability. In this study, we surveyed fish assemblages and investigated environmental and landscape parameters in a total of 135 floodplain waterbodies (rivers, diversion canals, ponds, irrigation ditches, paddy fields, and wetlands) in the Chao Phraya River Basin in rainy (September 2014) and dry (March 2015) seasons. Factors affecting fish species richness in each type of waterbody were analyzed using generalized linear mixed models. Floodplain area around each surveyed waterbody was a major factor determining fish species richness in rivers, diversion canals, and ponds in the region. The contribution of floodplain area was equivalent to that of hydrology (current velocity, water depth) and water quality (dissolved oxygen, turbidity) in the waterbodies. The population of juvenile fishes was increased in temporarily connected floodplain waterbodies to main rivers compared with isolated waterbodies, and fluvial and lacustrine fishes were observed in the temporary inundated floodplain waterbodies during the rainy season. The high dependence of fish species richness on floodplain area in the region appeared to be a result of the use of inundated floodplains by fish species to forage and breed. Our results highlight the impact of flood control measures that reduces floodplain area. These measures must be reviewed to ensure the conservation of fish biodiversity in the Chao Phraya River Basin, one of the world’s most threatened floodplain systems. 展开更多
关键词 floodplain FISH Species Richness LATERAL FISH Migration Chao Phraya River BASIN FLOOD Pulse Concept
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Detection of Asymptomatic Carotid Artery Stenosis in High-Risk Individuals of Stroke Using a Machine-Learning Algorithm 被引量:2
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作者 Junxiong Yin Cheng Yu +6 位作者 Lixia Wei Chuanyong Yu Hongxing Liu Mingyang Du Feng Sun Chongjun Wang Xiaoshan Wang 《Chinese Medical Sciences Journal》 CAS CSCD 2020年第4期297-305,共9页
Objective Asymptomatic carotid stenosis(ACS)is closely associated to the incidence of severe cerebrovascular diseases.Early identifying the individuals with ACS and its associated risk factors could be beneficial for ... Objective Asymptomatic carotid stenosis(ACS)is closely associated to the incidence of severe cerebrovascular diseases.Early identifying the individuals with ACS and its associated risk factors could be beneficial for primary prevention of stroke.This study aimed to investigate a machine-learning algorithm for the detection of ACS among high-risk population of stroke based on the associated risk factors.Methods A novel model of machine learning was utilized to screen the associated predictors of ACS based on 30 potential risk factors.The algorithm of this model adopted a random forest pattern based on the training data and then was verified using the testing data.All of the original data were retrieved from the China National Stroke Screening and Prevention Project(CNSSPP),including demographic,clinical and laboratory characteristics.The individuals with high risk of stroke were enrolled and randomly divided into a training group and a testing group at a ratio of 4:1.The identification of carotid stenosis by carotid artery duplex scans was set as the golden standard.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)was used to evaluate the efficacy of the model in detecting ACS.Results Of 2841 high risk individual of stroke enrolled,326(11.6%)were diagnosed as ACS by ultrasonography.The top five risk fectors contributing to ACS in this model were identified as family history of dyslipidemia,high level of lowdensity lipoprotein cholesterol(LDL-c),low level of high-density lipoprotein cholesterol(HDL-c),aging,and low body. 展开更多
关键词 high-risk population STROKE asymptomatic carotid stenosis risk factors machine learning
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