Natural history,a discipline of ecological significance,is regaining popularity in China,especially after 2010,thanks to the promotion of academics in the history of science and technology.A series of natural history ...Natural history,a discipline of ecological significance,is regaining popularity in China,especially after 2010,thanks to the promotion of academics in the history of science and technology.A series of natural history books have been published,creating a publishing boom.Natural history books in China are experiencing growth in numbers and genre with more accurate segmentation in themes,indicating that the natural history publication trade is going to mature.By genre,most natural history books are primary,focusing on basic knowledge about birds,animals,and plants,while the secondary books focusing on the historical and theoretical study of natural history make up only a small portion.In the early 20th century,natural history books saw a boom driven by peoples’enthusiastic pursuit of science.Today,natural history books follow the tides of building an ecological civilization,reaching out to the domain of“natural history and the public.”There will be broad prospects for books featuring“natural history+,”such as“natural history+painting,”“natural history+literature,”“natural history+food,”and“natural history+tourism.”展开更多
Cutaneous nerve injury is the most common complication following foot and ankle surgery. However, clinical studies including long-term follow-up data after cutaneous nerve injury of the foot and ankle are lacking. In ...Cutaneous nerve injury is the most common complication following foot and ankle surgery. However, clinical studies including long-term follow-up data after cutaneous nerve injury of the foot and ankle are lacking. In the current retrospective study, we analyzed the clinical data of 279 patients who underwent foot and ankle surgery. Subjects who suffered from apparent paresthesia in the cutaneous sensory nerve area after surgery were included in the study. Pa- tients received oral vitamin B^2 and methylcobalamin. We examined final follow-up data of 17 patients, including seven with sural nerve injury, five with superficial peroneal nerve injury, and five with plantar medial cutaneous nerve injury. We assessed nerve sensory function using the Medical Research Council Scale. Follow-up immediately, at 6 weeks, 3, 6 and 9 months, and 1 year after surgery demonstrated that sensory function was gradually restored in most patients within 6 months. However, recovery was slow at 9 months. There was no significant difference in sensory function between 9 months and 1 year after surgery. Painful neuromas occurred in four patients at 9 months to 1 year. The results demonstrated that the recovery of sensory func- tion in patients with various cutaneous nerve injuries after foot and ankle surgery required at least 6 months.展开更多
OBJECTIVE: To clarify the natural history, of chronic hepatitis B so as to evaluate its long-term therapeutic outcome of the patients and the efficacy of antiviral drugs. METHODS: A cohort of 183 biopsy-proven chronic...OBJECTIVE: To clarify the natural history, of chronic hepatitis B so as to evaluate its long-term therapeutic outcome of the patients and the efficacy of antiviral drugs. METHODS: A cohort of 183 biopsy-proven chronic hepatitis B patients (mean age of 31.75±8.03 years, male/female ratio: 152:31) and 247 controls were followed up retrospectively for 11.81±4.08 years. This study was focused on long-term clinical outcome including the rates of liver cirrhosis, hepatocellular carcinoma and death, apart from the long-term effect of antiviral drugs and prognostic factors. RESULTS: In the 183 chronic hepatitis B patients, 22 (12.02%) developed liver cirrhosis, 12 (6.56%) developed hepatocellular carcinoma, and 20 (10.93%) died. The 5-, 10- and 15-year survival rates were 97. 27%, 91.62%, and 84.47%, respectively. The 5-, 10- and 15-year incidence rates of HCC were O, 3.19%, and 11.56%, respectively. In the 247 controls, 6 (2.43%) died; none of them developed cirrhosis or HCC. The rates of death, liver cirrhosis, and HCC in the hepatitis B patients were markedly different (P<0. 005) compared with the controls. The overall mortality of hepatitis B patients was 4.5-fold higher than the general population. Cox multiple regression analysis showed that old age, severe histological injury, and positive HBeAg were closely related to liver cirrhosis; old age, severe histological injury, and male were major factors leading to death. The independent variable of predicted HCC was not found. CONCLUSION: The long-term outcome of hepatitis B patients is poor and the efficacy of antiviral drugs needs further study.展开更多
Barrett's esophagus(BE)is the precursor to esophageal adenocarcinoma(EAC).Progression to cancer typically occurs in a stepwise fashion through worsening dysplasia and ultimately,invasive neoplasia.Established EAC ...Barrett's esophagus(BE)is the precursor to esophageal adenocarcinoma(EAC).Progression to cancer typically occurs in a stepwise fashion through worsening dysplasia and ultimately,invasive neoplasia.Established EAC with deep involvement of the esophageal wall and/or metastatic disease is invariably associated with poor long-term survival rates.This guides the rationale of surveillance of Barrett’s in an attempt to treat lesions at an earlier,and potentially curative stage.The last two decades have seen a paradigm shift in management of Barrett’s with rapid expansion in the role of endoscopic eradication therapy(EET)for management of dysplastic and early neoplastic BE,and there have been substantial changes to international consensus guidelines for management of early BE based on evolving evidence.This review aims to assist the physician in the therapeutic decision-making process with patients by comprehensive review and summary of literature surrounding natural history of Barrett’s by histological stage,and the effectiveness of interventions in attenuating the risk posed by its natural history.Key findings were as follows.Non-dysplastic Barrett’s is associated with extremely low risk of progression,and interventions cannot be justified.The annual risk of cancer progression in low grade dysplasia is between 1%-3%;EET can be offered though evidence for its benefit remains confined to highly select settings.High-grade dysplasia progresses to cancer in 5%-10%per year;EET is similarly effective to and less morbid than surgery and should be routinely performed for this indication.Risk of nodal metastases in intramucosal cancer is 2%-4%,which is comparable to operative mortality rate,so EET is usually preferred.Submucosal cancer is associated with nodal metastases in 14%-41%hence surgery remains standard of care,except for select situations.展开更多
BACKGROUND Ischemic colitis with inferior mesenteric arteriovenous malformation(AVM)is a rare disease.Although a few reports have been published,no report has described the natural history of idiopathic mesenteric AVM...BACKGROUND Ischemic colitis with inferior mesenteric arteriovenous malformation(AVM)is a rare disease.Although a few reports have been published,no report has described the natural history of idiopathic mesenteric AVM.CASE SUMMARY A 50-year-old male was admitted to our hospital due to abdominal pain that had persisted for 3 mo and bloody diarrhea.He had no history of trauma or abdominal surgery.He had undergone two colonoscopies 6 mo and 2 years ago,and they showed only a polyp.He was diagnosed with ischemic colitis with inferior mesenteric AVM following contrast-enhanced abdominal computed tomography(CT)and underwent rectal low anterior resection.He has not had a recurrence of symptoms for 3 years.His history showed that he had undergone non-enhanced abdominal CT 2,5,and 8 years ago when he had attacks of urinary stones.Retrospectively,dilation of blood vessels around the rectosigmoid colon could have been detected 5 years ago,and these findings gradually became more evident.CONCLUSION This is the first report of the natural history of inferior mesenteric AVM.展开更多
The Kunming Natural History Museum of Zoology is located in the campus of Kunming Institute of Zoology (KIZ), the Chinese Academy of Sciences (CAS). The museum occupies 7 350 square meters, including a research sp...The Kunming Natural History Museum of Zoology is located in the campus of Kunming Institute of Zoology (KIZ), the Chinese Academy of Sciences (CAS). The museum occupies 7 350 square meters, including a research specimen library, a science awareness hall and a multi-functional reference room. The museum is currently housing the most substantial collections of zoological specimens in southwest China.展开更多
To study the natural history of dry type of age-related macular degeneration (AMD) and search for a sensitive method for detecting the development of the disease, the fundus fluorescein angiography, visual acuity, ele...To study the natural history of dry type of age-related macular degeneration (AMD) and search for a sensitive method for detecting the development of the disease, the fundus fluorescein angiography, visual acuity, electroretinogram and FM 100-hue test were used to examine 75 eyes, 147 eyes, 73 eyes, and 94 eyes respectively. These examinations were taken at least twice during the follow-up periods. The average age was 63.2 years (50-80 years ). The average follow-up was 29.8 months with a range of 3-74 ...展开更多
THE Beijing Natural History Museum was the first natural science museum established after the founding of the People’s Republic. It encompasses specimen collection, preservation,
Chronic hepatitis B(CHB)is a condition of globalprevalence and its sequelae include cirrhosis and hepatocellular carcinoma.The natural history of CHB isa complex interplay of virological,environmental andhost factors....Chronic hepatitis B(CHB)is a condition of globalprevalence and its sequelae include cirrhosis and hepatocellular carcinoma.The natural history of CHB isa complex interplay of virological,environmental andhost factors.The dynamic relationship between thevirus and host evolves over the duration of the infection and different phases of the disease have been observed and described.These have been conceptualizedin terms of the state of balance between the host immune system and the hepatitis B virus and have beengiven the labels immune tolerant,immune clearance,immune control and immune escape although othernomenclature is also used.Host factors,such as age atinfection,determine progression to chronicity.Virological factors including hepatitis B viral load,mutationsand genotype also have an impact on the adverseoutcomes of the infection,as do hepatotoxic cofactorssuch as alcohol.Our understanding of the natural history of CHB has evolved significantly over the past fewdecades and characterizing the phase of disease ofCHB remains an integral part of managing this virus in the clinic.展开更多
Crohn’s disease is a chronic inflammatory disease process involving different sites in the gastrointestinal tract.Occasionally,so-called metastatic disease occurs in extra-intestinal sites.Granulomatous inflammation ...Crohn’s disease is a chronic inflammatory disease process involving different sites in the gastrointestinal tract.Occasionally,so-called metastatic disease occurs in extra-intestinal sites.Granulomatous inflammation may be detected in endoscopic biopsies or resected tissues.Genetic,epigenetic and environmental factors appear to play a role.Multiple susceptibility genes have been described in both familial and non-familial forms while the disease is phenotypically heterogeneous with a female predominance.The disorder occurs over a broad age spectrum,from early childhood to late adulthood.More than 80%are diagnosed before age 40 years usually with terminal ileal and colonic involvement.Pediatric-onset disease is more severe and more extensive,usually with a higher chance of upper gastrointestinal tract disease,compared to adult-onset disease.Long-term studies have shown that the disorder may evolve with time into more complex disease with stricture formation and penetrating disease complications(i.e.,fistula,abscess).Although prolonged remission may occur,discrete periods of symptomatic disease may re-appear over many decades suggesting recurrence or re-activation of this inflammatory process.Eventual development of a cure will likely depend on identification of an etiologic cause and a fundamental understanding of its pathogenesis.Until now,treatment has focused on removing risk factors,particularly cigarette smoking,and improving symptoms.In clinical trials,clinical remission is largely defined as improved numerical and endoscopic indices for"mucosal healing"."Deep remission"is a conceptual,more"extended"goal that may or may not alter the long-term natural history of the disease in selected patients,albeit at a significant risk for treatment complications,including serious and unusual opportunistic infections.展开更多
BACKGROUND Chronic hepatitis B is a highly heterogeneous disease that can be divided into four phases: Immune tolerant(IT), immune active(IA), inactive carrier(IC) and hepatitis B envelope antigen(HBeAg)-negative hepa...BACKGROUND Chronic hepatitis B is a highly heterogeneous disease that can be divided into four phases: Immune tolerant(IT), immune active(IA), inactive carrier(IC) and hepatitis B envelope antigen(HBeAg)-negative hepatitis(ENEG).AIM To investigate the immune status of natural killer(NK) and T cells in different phases of chronic hepatitis B.METHODS The frequency, phenotype and function of circulating NK cells, as well as nonantigen-specific and hepatitis B virus(HBV)-specific T cell responses were detected by flow cytometry in healthy and HBV-infected subjects.RESULTS The ability of NK cells to produce IFN-γ was markedly attenuated in HBVinfected patients overall but was less compromised in IC patients. Patients in the IT and IA phases also displayed significantly lower TNF-α production compared to healthy subjects. NK cells were phenotypically activated in the IA and ENEGphases, as evidenced by the upregulation of NKp44 in CD56^(bright) NK cells and CD69 in CD56^(dim) NK cells. Furthermore, global T-cells from the ENEG phase displayed a proinflammatory cytokine profile with upregulated IFN-γ and TNF-αexpression, while this profile was suppressed in IT and IA patients. Finally, core and S antigen-specific T cell responses were significantly stronger after in vitro expansion in the IC phase compared to other phases.CONCLUSION Our findings demonstrate the changes in immune response pattern during the natural history of HBV infection. Both NK and T cells are functionally impaired in the IT and IA phases. With the spontaneous clearance of HBeAg and hepatitis B surface antigen decline, NK cell cytokine production and HBV-specific T responses are partially restored in IC phase, and the ENEG phase is dominated by nonantigen-specific T cell responses.展开更多
Intracranial atherosclerotic disease (ICAD) contributes to a significant number of ischemic strokes. There is debate in the recent literature concerning the impact of the location of stenosis in ICAD on outcome. Some ...Intracranial atherosclerotic disease (ICAD) contributes to a significant number of ischemic strokes. There is debate in the recent literature concerning the impact of the location of stenosis in ICAD on outcome. Some reports have suggested that disease processes and outcomes vary by vessel location, potentially altering the natural history and indications for intervention. Here we have performed a comprehensive, critical review of the natural history of ICAD by vessel in an attempt to assess the differences in disease specific to each of the vascular territories. Our assessment concludes that only minor differences exist between patients with different vessels affected in vessel-specific ICAD. We have found that middle cerebral artery disease confers a lower mortality than vessel-specific ICAD in other intracranial vessels, asymptomatic disease follows a more benign course than symptomatic disease, andthat plaque progression or the detection of microemboli on transcranial Doppler may predict poor outcome. Given the expanding indications for treatment of ICAD and rapidly developing endovascular techniques to confront this disease, a thorough understanding of the natural history of ICAD aids the interventional neuroradiologist in determining when to treat and how to predict outcome in this patient population.展开更多
Crohn’s disease(CD)is a multifactorial potentially debilitating disease.It has a variable disease course,but the majority of patients eventually develop penetrating or stricturing complications leading to repeated su...Crohn’s disease(CD)is a multifactorial potentially debilitating disease.It has a variable disease course,but the majority of patients eventually develop penetrating or stricturing complications leading to repeated surgeries and disability.Studies on the natural history of CD provide invaluable data on its course and clinical predictors,and may help to identify patient subsets based on clinical phenotype.Most data are available from referral centers,however these outcomes may be different from those in population-based cohorts.New data suggest the possibility of a change in the natural history in Crohn’s disease,with an increasing percentage of patients diagnosed with inflammatory disease behavior.Hospitalization rates remain high,while surgery rates seem to have decreased in the last decade.In addition,mortality rates still exceed that of the general population.The impact of changes in treatment strategy,including increased,earlier use of immunosuppressives,biological therapy,and patient monitoring on the natural history of the disease are still conflictive.In this review article,the authors summarize the available evidence on the natural history,current trends,and predictive factors for evaluating the disease course of CD.展开更多
Sphenomorphus incognitus is recorded for the first time outside of China. The new locality record is from the Tay Yen Tu Nature Reserve in Bac Giang Province, northeastern Vietnam at elevations between 200–450 m. Bas...Sphenomorphus incognitus is recorded for the first time outside of China. The new locality record is from the Tay Yen Tu Nature Reserve in Bac Giang Province, northeastern Vietnam at elevations between 200–450 m. Based on the newly collected specimens, we present an expanded description and provide data on the natural history of this species in northern Vietnam.展开更多
Background: The natural history of meniscal tears is unclear. Studies have tried to clarify many aspects. Association with chondral injuries are of main relevance to the long-term status of the knee but evidence is li...Background: The natural history of meniscal tears is unclear. Studies have tried to clarify many aspects. Association with chondral injuries are of main relevance to the long-term status of the knee but evidence is limited. Objective: The aim of this study is to describe the intraarticular state of the knee focused on chondral injury in patients with persistent symptomatic meniscal tears that were untreated for a minimum period of 4 years. Methods: A total of 47 patients with symptomatic meniscal tears in whom surgery was indicated but was delayed mainly for administrative reasons, were recruited between January 1st, 2004 and April 30th, 2010 in a regional hospital. Follow up ended until circumstances allowed surgical resolution through arthroscopy. Only patients with meniscal tear in which diagnosis was confirmed and remained symptomatic were included. Patients with initial grade IV Kellgren-Lawrence osteo-arthritis were excluded. Statistical chi-square and logistic regression analysis were used. Results: Mean follow up period was 5.8 years (range: 4.3 - 10.2 years). 57 meniscal injuries were found in 47 patients. 25 were lateral and 32 medial meniscal tears. Overall, 29 patients had articular cartilage damage (51%). Chondral injuries were found in 15 of 25 lateral meniscal lesions (60%) and 14 of 32 medial lesions (44%). Patients with lateral compartment meniscal injury had a relative risk (RR) of 2.5 of developing chondral injury (p-value 0.05). Compared to 51% of patients with associated chondral and meniscal damage (n = 29), only 12% of patients with healthy meniscus (n = 7) had chondral injury (p-value 0.05). Conclusion: Persistent symptomatic meniscal tears after medium to long term (4 to 10 years) are associated with chondral damage in 51% of patients. Chondral damage associated with meniscal tears is usually deep and involves femur and tibial sides. Lateral menisci injury is significantly associated with articular cartilage damage in the ipsilateral compartment. This study demonstrates a significant association between meniscal injury and chondral damage.展开更多
The present ecological imbalance is due to human beings' unrestrained desires and their actions of developing multifarious strong forces in order to conquer nature. Present science and technology and institutional...The present ecological imbalance is due to human beings' unrestrained desires and their actions of developing multifarious strong forces in order to conquer nature. Present science and technology and institutional arrangement still follow the old-fashioned premises. According to Tao Te Ching, nature and the natural process are sacred. The concept of Anthropocene and the idea of unpredictability from complexity science remind us that it is necessary to revive the old tradition of natural history, which is interesting enough and helps to maintain the ecological balance.展开更多
While diverticular disease is extremely common, the natural history(NH) of its most frequent presentation(i.e., sigmoid diverticulitis) is poorly investigated. Relevant information is mostly restricted to populationba...While diverticular disease is extremely common, the natural history(NH) of its most frequent presentation(i.e., sigmoid diverticulitis) is poorly investigated. Relevant information is mostly restricted to populationbased or retrospective studies. This comprehensive review aimed to evaluate the NH of simple sigmoid diverticulitis. While there is a clear lack of uniformity in terminology, which results in difficulties interpreting and comparing findings between studies, this review demonstrates the benign nature of simple sigmoid diverticulitis. The overall recurrence rate is relatively low, ranging from 13% to 47%, depending on the definition used by the authors. Among different risk factors for recurrence, patients with C-reactive protein > 240 mg/L are three times more likely to recur. Other risk factors include: Young age, a history of several episodes of acute diverticulitis, medical vs surgical management, male patients, radiological signs of complicated first episode, higher comorbidity index, family history of diverticulitis, and length of involved colon > 5 cm. The risk of developing a complicated second episode(and its corollary to require an emergency operation) is less than 2%-5%. In fact, the old rationale for elective surgery as a preventive treatment, based mainly on concerns that recurrence would result in a progressively increased risk of sepsis or the need for a colostomy, is not upheld by the current evidence.展开更多
John Clare is widely known as a nature poet in British romantic literature.Critics often focus quite exclusively on his poetic works therefore,most of his natural prose writings have been constantly neglected.In fact,...John Clare is widely known as a nature poet in British romantic literature.Critics often focus quite exclusively on his poetic works therefore,most of his natural prose writings have been constantly neglected.In fact,in addition to presenting the artistic values,Clare' s poems and prose also jointly contribute to the scientific values from the aspect of natural history studies.Through comparative studies with the contemporary nature writers,one can grasp Clare' s contribution concerning botanical and zoological aspects respectively,This paper aims at demonstrating the linking role between scientific studies and homeland protection in the typical "Clarean" nature writing.展开更多
Background and Importance: Lipomatous medulloblastoma (cerebellar liponeurocytoma) is a rare cerebellar tumor, with only twenty-nine cases reported, considered a distinct variant of medulloblastoma. The few cases desc...Background and Importance: Lipomatous medulloblastoma (cerebellar liponeurocytoma) is a rare cerebellar tumor, with only twenty-nine cases reported, considered a distinct variant of medulloblastoma. The few cases described support an indolent nature for this tumor. We aim at defining the optimum treatment strategy and long-term behavior for this tumor entity. Clinical presentation: A 74 years old male presented on September 2010 complaining of mild dizziness and headache slowly progressing over a few months. This gentleman was operated on at our department some 18 years ago for a right cerebellar hemispheral lesion, defined as a liponeurocytoma. This patient received no adjuvant treatment. Current magnetic resonance imaging (MRI) studies disclosed a right hemispheral cerebellar mass, locally recurrent in the original surgical tumor bed. Gross total resection of the tumor was accomplished through a suboccipital craniotomy, with complete resection of the lesion. The histopathological diagnosis was defined as cerebellar liponeurocytoma. No adjuvant therapy was given as initially, after the first operation. Currently, the patient is alive, fully alert with minimal neurological deficits, Barthel index 90, Kernofsky performance status of 90 and with no evidence of disease on neuroimaging. Conclusion: This patient portrays this tumor’s natural history after surgical intervention with no adjuvant treatment, being the longest reported follow-up and recurrence. This distinct variant of medulloblastoma appears to have a uniquely favorable prognosis, even without adjuvant therapy. A complete surgical resection with close follow-up seems both sufficient and prudent.展开更多
Dural arteriovenous fistulas (dAVFs) of an anterior cranial fossa are rare. Because of the high risk of intracranial hemorrhage and relatively easy access for direct surgery, aggressive treatment has been recommended....Dural arteriovenous fistulas (dAVFs) of an anterior cranial fossa are rare. Because of the high risk of intracranial hemorrhage and relatively easy access for direct surgery, aggressive treatment has been recommended. The natural history of anterior cranial fossa dAVFs (ACF dAVFs) is unclear in spite of many reports for the natural history of general dAVFs. To treat ACF dAVFs, direct surgery has traditionally been performed and endovascular surgery has recently been introduced. A 74-year-old man was transferred with severe consciousness disturbance and presented with devastating intracerebral hemorrhage on the CT scan. Digital subtraction angiography revealed the ACF dAVFs with a large venous pouch. The patient received direct surgery, nevertheless he became vegetative state. Later on, a smaller venous pouch was recognized on the CT scan when he had suffered from the thalamic hemorrhage sixteen months before. There are twelve cases including our case which was treated for a certain period and documented in detail. Eleven of twelve cases were asymptomatic. Three of the six cases with a venous pouch had some events possibly related to the disease, though none of the six cases without a venous pouch had any events during observation. In conclusion, an ACF dAVF with a venous pouch should be treated by direct surgery or endovascular surgery even if it is incidentally found. By contrast, careful observation might be a possible therapeutic option for an ACF dAVF without a venous pouch if there is mild reflux flow.展开更多
基金a phased achievement of the National Social Science Fund Project entitled Research on Natural History Writing of Chinese Ecological Literature in the New Century (19XZW026)
文摘Natural history,a discipline of ecological significance,is regaining popularity in China,especially after 2010,thanks to the promotion of academics in the history of science and technology.A series of natural history books have been published,creating a publishing boom.Natural history books in China are experiencing growth in numbers and genre with more accurate segmentation in themes,indicating that the natural history publication trade is going to mature.By genre,most natural history books are primary,focusing on basic knowledge about birds,animals,and plants,while the secondary books focusing on the historical and theoretical study of natural history make up only a small portion.In the early 20th century,natural history books saw a boom driven by peoples’enthusiastic pursuit of science.Today,natural history books follow the tides of building an ecological civilization,reaching out to the domain of“natural history and the public.”There will be broad prospects for books featuring“natural history+,”such as“natural history+painting,”“natural history+literature,”“natural history+food,”and“natural history+tourism.”
文摘Cutaneous nerve injury is the most common complication following foot and ankle surgery. However, clinical studies including long-term follow-up data after cutaneous nerve injury of the foot and ankle are lacking. In the current retrospective study, we analyzed the clinical data of 279 patients who underwent foot and ankle surgery. Subjects who suffered from apparent paresthesia in the cutaneous sensory nerve area after surgery were included in the study. Pa- tients received oral vitamin B^2 and methylcobalamin. We examined final follow-up data of 17 patients, including seven with sural nerve injury, five with superficial peroneal nerve injury, and five with plantar medial cutaneous nerve injury. We assessed nerve sensory function using the Medical Research Council Scale. Follow-up immediately, at 6 weeks, 3, 6 and 9 months, and 1 year after surgery demonstrated that sensory function was gradually restored in most patients within 6 months. However, recovery was slow at 9 months. There was no significant difference in sensory function between 9 months and 1 year after surgery. Painful neuromas occurred in four patients at 9 months to 1 year. The results demonstrated that the recovery of sensory func- tion in patients with various cutaneous nerve injuries after foot and ankle surgery required at least 6 months.
基金The project was supported by the fund for young hepatologists,Chongqing,China(Chinese Medical Association 1998).
文摘OBJECTIVE: To clarify the natural history, of chronic hepatitis B so as to evaluate its long-term therapeutic outcome of the patients and the efficacy of antiviral drugs. METHODS: A cohort of 183 biopsy-proven chronic hepatitis B patients (mean age of 31.75±8.03 years, male/female ratio: 152:31) and 247 controls were followed up retrospectively for 11.81±4.08 years. This study was focused on long-term clinical outcome including the rates of liver cirrhosis, hepatocellular carcinoma and death, apart from the long-term effect of antiviral drugs and prognostic factors. RESULTS: In the 183 chronic hepatitis B patients, 22 (12.02%) developed liver cirrhosis, 12 (6.56%) developed hepatocellular carcinoma, and 20 (10.93%) died. The 5-, 10- and 15-year survival rates were 97. 27%, 91.62%, and 84.47%, respectively. The 5-, 10- and 15-year incidence rates of HCC were O, 3.19%, and 11.56%, respectively. In the 247 controls, 6 (2.43%) died; none of them developed cirrhosis or HCC. The rates of death, liver cirrhosis, and HCC in the hepatitis B patients were markedly different (P<0. 005) compared with the controls. The overall mortality of hepatitis B patients was 4.5-fold higher than the general population. Cox multiple regression analysis showed that old age, severe histological injury, and positive HBeAg were closely related to liver cirrhosis; old age, severe histological injury, and male were major factors leading to death. The independent variable of predicted HCC was not found. CONCLUSION: The long-term outcome of hepatitis B patients is poor and the efficacy of antiviral drugs needs further study.
文摘Barrett's esophagus(BE)is the precursor to esophageal adenocarcinoma(EAC).Progression to cancer typically occurs in a stepwise fashion through worsening dysplasia and ultimately,invasive neoplasia.Established EAC with deep involvement of the esophageal wall and/or metastatic disease is invariably associated with poor long-term survival rates.This guides the rationale of surveillance of Barrett’s in an attempt to treat lesions at an earlier,and potentially curative stage.The last two decades have seen a paradigm shift in management of Barrett’s with rapid expansion in the role of endoscopic eradication therapy(EET)for management of dysplastic and early neoplastic BE,and there have been substantial changes to international consensus guidelines for management of early BE based on evolving evidence.This review aims to assist the physician in the therapeutic decision-making process with patients by comprehensive review and summary of literature surrounding natural history of Barrett’s by histological stage,and the effectiveness of interventions in attenuating the risk posed by its natural history.Key findings were as follows.Non-dysplastic Barrett’s is associated with extremely low risk of progression,and interventions cannot be justified.The annual risk of cancer progression in low grade dysplasia is between 1%-3%;EET can be offered though evidence for its benefit remains confined to highly select settings.High-grade dysplasia progresses to cancer in 5%-10%per year;EET is similarly effective to and less morbid than surgery and should be routinely performed for this indication.Risk of nodal metastases in intramucosal cancer is 2%-4%,which is comparable to operative mortality rate,so EET is usually preferred.Submucosal cancer is associated with nodal metastases in 14%-41%hence surgery remains standard of care,except for select situations.
文摘BACKGROUND Ischemic colitis with inferior mesenteric arteriovenous malformation(AVM)is a rare disease.Although a few reports have been published,no report has described the natural history of idiopathic mesenteric AVM.CASE SUMMARY A 50-year-old male was admitted to our hospital due to abdominal pain that had persisted for 3 mo and bloody diarrhea.He had no history of trauma or abdominal surgery.He had undergone two colonoscopies 6 mo and 2 years ago,and they showed only a polyp.He was diagnosed with ischemic colitis with inferior mesenteric AVM following contrast-enhanced abdominal computed tomography(CT)and underwent rectal low anterior resection.He has not had a recurrence of symptoms for 3 years.His history showed that he had undergone non-enhanced abdominal CT 2,5,and 8 years ago when he had attacks of urinary stones.Retrospectively,dilation of blood vessels around the rectosigmoid colon could have been detected 5 years ago,and these findings gradually became more evident.CONCLUSION This is the first report of the natural history of inferior mesenteric AVM.
文摘The Kunming Natural History Museum of Zoology is located in the campus of Kunming Institute of Zoology (KIZ), the Chinese Academy of Sciences (CAS). The museum occupies 7 350 square meters, including a research specimen library, a science awareness hall and a multi-functional reference room. The museum is currently housing the most substantial collections of zoological specimens in southwest China.
文摘To study the natural history of dry type of age-related macular degeneration (AMD) and search for a sensitive method for detecting the development of the disease, the fundus fluorescein angiography, visual acuity, electroretinogram and FM 100-hue test were used to examine 75 eyes, 147 eyes, 73 eyes, and 94 eyes respectively. These examinations were taken at least twice during the follow-up periods. The average age was 63.2 years (50-80 years ). The average follow-up was 29.8 months with a range of 3-74 ...
文摘THE Beijing Natural History Museum was the first natural science museum established after the founding of the People’s Republic. It encompasses specimen collection, preservation,
文摘Chronic hepatitis B(CHB)is a condition of globalprevalence and its sequelae include cirrhosis and hepatocellular carcinoma.The natural history of CHB isa complex interplay of virological,environmental andhost factors.The dynamic relationship between thevirus and host evolves over the duration of the infection and different phases of the disease have been observed and described.These have been conceptualizedin terms of the state of balance between the host immune system and the hepatitis B virus and have beengiven the labels immune tolerant,immune clearance,immune control and immune escape although othernomenclature is also used.Host factors,such as age atinfection,determine progression to chronicity.Virological factors including hepatitis B viral load,mutationsand genotype also have an impact on the adverseoutcomes of the infection,as do hepatotoxic cofactorssuch as alcohol.Our understanding of the natural history of CHB has evolved significantly over the past fewdecades and characterizing the phase of disease ofCHB remains an integral part of managing this virus in the clinic.
文摘Crohn’s disease is a chronic inflammatory disease process involving different sites in the gastrointestinal tract.Occasionally,so-called metastatic disease occurs in extra-intestinal sites.Granulomatous inflammation may be detected in endoscopic biopsies or resected tissues.Genetic,epigenetic and environmental factors appear to play a role.Multiple susceptibility genes have been described in both familial and non-familial forms while the disease is phenotypically heterogeneous with a female predominance.The disorder occurs over a broad age spectrum,from early childhood to late adulthood.More than 80%are diagnosed before age 40 years usually with terminal ileal and colonic involvement.Pediatric-onset disease is more severe and more extensive,usually with a higher chance of upper gastrointestinal tract disease,compared to adult-onset disease.Long-term studies have shown that the disorder may evolve with time into more complex disease with stricture formation and penetrating disease complications(i.e.,fistula,abscess).Although prolonged remission may occur,discrete periods of symptomatic disease may re-appear over many decades suggesting recurrence or re-activation of this inflammatory process.Eventual development of a cure will likely depend on identification of an etiologic cause and a fundamental understanding of its pathogenesis.Until now,treatment has focused on removing risk factors,particularly cigarette smoking,and improving symptoms.In clinical trials,clinical remission is largely defined as improved numerical and endoscopic indices for"mucosal healing"."Deep remission"is a conceptual,more"extended"goal that may or may not alter the long-term natural history of the disease in selected patients,albeit at a significant risk for treatment complications,including serious and unusual opportunistic infections.
基金Supported by National Science Fund of China(NSFC)No.30771911National Science and Technology Major Project No.2012ZX10002007-003
文摘BACKGROUND Chronic hepatitis B is a highly heterogeneous disease that can be divided into four phases: Immune tolerant(IT), immune active(IA), inactive carrier(IC) and hepatitis B envelope antigen(HBeAg)-negative hepatitis(ENEG).AIM To investigate the immune status of natural killer(NK) and T cells in different phases of chronic hepatitis B.METHODS The frequency, phenotype and function of circulating NK cells, as well as nonantigen-specific and hepatitis B virus(HBV)-specific T cell responses were detected by flow cytometry in healthy and HBV-infected subjects.RESULTS The ability of NK cells to produce IFN-γ was markedly attenuated in HBVinfected patients overall but was less compromised in IC patients. Patients in the IT and IA phases also displayed significantly lower TNF-α production compared to healthy subjects. NK cells were phenotypically activated in the IA and ENEGphases, as evidenced by the upregulation of NKp44 in CD56^(bright) NK cells and CD69 in CD56^(dim) NK cells. Furthermore, global T-cells from the ENEG phase displayed a proinflammatory cytokine profile with upregulated IFN-γ and TNF-αexpression, while this profile was suppressed in IT and IA patients. Finally, core and S antigen-specific T cell responses were significantly stronger after in vitro expansion in the IC phase compared to other phases.CONCLUSION Our findings demonstrate the changes in immune response pattern during the natural history of HBV infection. Both NK and T cells are functionally impaired in the IT and IA phases. With the spontaneous clearance of HBeAg and hepatitis B surface antigen decline, NK cell cytokine production and HBV-specific T responses are partially restored in IC phase, and the ENEG phase is dominated by nonantigen-specific T cell responses.
文摘Intracranial atherosclerotic disease (ICAD) contributes to a significant number of ischemic strokes. There is debate in the recent literature concerning the impact of the location of stenosis in ICAD on outcome. Some reports have suggested that disease processes and outcomes vary by vessel location, potentially altering the natural history and indications for intervention. Here we have performed a comprehensive, critical review of the natural history of ICAD by vessel in an attempt to assess the differences in disease specific to each of the vascular territories. Our assessment concludes that only minor differences exist between patients with different vessels affected in vessel-specific ICAD. We have found that middle cerebral artery disease confers a lower mortality than vessel-specific ICAD in other intracranial vessels, asymptomatic disease follows a more benign course than symptomatic disease, andthat plaque progression or the detection of microemboli on transcranial Doppler may predict poor outcome. Given the expanding indications for treatment of ICAD and rapidly developing endovascular techniques to confront this disease, a thorough understanding of the natural history of ICAD aids the interventional neuroradiologist in determining when to treat and how to predict outcome in this patient population.
文摘Crohn’s disease(CD)is a multifactorial potentially debilitating disease.It has a variable disease course,but the majority of patients eventually develop penetrating or stricturing complications leading to repeated surgeries and disability.Studies on the natural history of CD provide invaluable data on its course and clinical predictors,and may help to identify patient subsets based on clinical phenotype.Most data are available from referral centers,however these outcomes may be different from those in population-based cohorts.New data suggest the possibility of a change in the natural history in Crohn’s disease,with an increasing percentage of patients diagnosed with inflammatory disease behavior.Hospitalization rates remain high,while surgery rates seem to have decreased in the last decade.In addition,mortality rates still exceed that of the general population.The impact of changes in treatment strategy,including increased,earlier use of immunosuppressives,biological therapy,and patient monitoring on the natural history of the disease are still conflictive.In this review article,the authors summarize the available evidence on the natural history,current trends,and predictive factors for evaluating the disease course of CD.
基金Vietnam was partially funded by IEBR(Vietnam)+4 种基金the Nagao Natural Environment Foundation(Japan)the German Academic Exchange Service(DAAD)Research of T.Q.Nguyen in Germany is funded by the Alexander von Humboldt Foundation(VIE 1143441 STP)
文摘Sphenomorphus incognitus is recorded for the first time outside of China. The new locality record is from the Tay Yen Tu Nature Reserve in Bac Giang Province, northeastern Vietnam at elevations between 200–450 m. Based on the newly collected specimens, we present an expanded description and provide data on the natural history of this species in northern Vietnam.
文摘Background: The natural history of meniscal tears is unclear. Studies have tried to clarify many aspects. Association with chondral injuries are of main relevance to the long-term status of the knee but evidence is limited. Objective: The aim of this study is to describe the intraarticular state of the knee focused on chondral injury in patients with persistent symptomatic meniscal tears that were untreated for a minimum period of 4 years. Methods: A total of 47 patients with symptomatic meniscal tears in whom surgery was indicated but was delayed mainly for administrative reasons, were recruited between January 1st, 2004 and April 30th, 2010 in a regional hospital. Follow up ended until circumstances allowed surgical resolution through arthroscopy. Only patients with meniscal tear in which diagnosis was confirmed and remained symptomatic were included. Patients with initial grade IV Kellgren-Lawrence osteo-arthritis were excluded. Statistical chi-square and logistic regression analysis were used. Results: Mean follow up period was 5.8 years (range: 4.3 - 10.2 years). 57 meniscal injuries were found in 47 patients. 25 were lateral and 32 medial meniscal tears. Overall, 29 patients had articular cartilage damage (51%). Chondral injuries were found in 15 of 25 lateral meniscal lesions (60%) and 14 of 32 medial lesions (44%). Patients with lateral compartment meniscal injury had a relative risk (RR) of 2.5 of developing chondral injury (p-value 0.05). Compared to 51% of patients with associated chondral and meniscal damage (n = 29), only 12% of patients with healthy meniscus (n = 7) had chondral injury (p-value 0.05). Conclusion: Persistent symptomatic meniscal tears after medium to long term (4 to 10 years) are associated with chondral damage in 51% of patients. Chondral damage associated with meniscal tears is usually deep and involves femur and tibial sides. Lateral menisci injury is significantly associated with articular cartilage damage in the ipsilateral compartment. This study demonstrates a significant association between meniscal injury and chondral damage.
基金the result of the"Study of Social Structure and Social Stratum Change"(2015MZD054)─a major program of the Marxism Research and Construction Project and the National Social Science Fund
文摘The present ecological imbalance is due to human beings' unrestrained desires and their actions of developing multifarious strong forces in order to conquer nature. Present science and technology and institutional arrangement still follow the old-fashioned premises. According to Tao Te Ching, nature and the natural process are sacred. The concept of Anthropocene and the idea of unpredictability from complexity science remind us that it is necessary to revive the old tradition of natural history, which is interesting enough and helps to maintain the ecological balance.
文摘While diverticular disease is extremely common, the natural history(NH) of its most frequent presentation(i.e., sigmoid diverticulitis) is poorly investigated. Relevant information is mostly restricted to populationbased or retrospective studies. This comprehensive review aimed to evaluate the NH of simple sigmoid diverticulitis. While there is a clear lack of uniformity in terminology, which results in difficulties interpreting and comparing findings between studies, this review demonstrates the benign nature of simple sigmoid diverticulitis. The overall recurrence rate is relatively low, ranging from 13% to 47%, depending on the definition used by the authors. Among different risk factors for recurrence, patients with C-reactive protein > 240 mg/L are three times more likely to recur. Other risk factors include: Young age, a history of several episodes of acute diverticulitis, medical vs surgical management, male patients, radiological signs of complicated first episode, higher comorbidity index, family history of diverticulitis, and length of involved colon > 5 cm. The risk of developing a complicated second episode(and its corollary to require an emergency operation) is less than 2%-5%. In fact, the old rationale for elective surgery as a preventive treatment, based mainly on concerns that recurrence would result in a progressively increased risk of sepsis or the need for a colostomy, is not upheld by the current evidence.
文摘John Clare is widely known as a nature poet in British romantic literature.Critics often focus quite exclusively on his poetic works therefore,most of his natural prose writings have been constantly neglected.In fact,in addition to presenting the artistic values,Clare' s poems and prose also jointly contribute to the scientific values from the aspect of natural history studies.Through comparative studies with the contemporary nature writers,one can grasp Clare' s contribution concerning botanical and zoological aspects respectively,This paper aims at demonstrating the linking role between scientific studies and homeland protection in the typical "Clarean" nature writing.
文摘Background and Importance: Lipomatous medulloblastoma (cerebellar liponeurocytoma) is a rare cerebellar tumor, with only twenty-nine cases reported, considered a distinct variant of medulloblastoma. The few cases described support an indolent nature for this tumor. We aim at defining the optimum treatment strategy and long-term behavior for this tumor entity. Clinical presentation: A 74 years old male presented on September 2010 complaining of mild dizziness and headache slowly progressing over a few months. This gentleman was operated on at our department some 18 years ago for a right cerebellar hemispheral lesion, defined as a liponeurocytoma. This patient received no adjuvant treatment. Current magnetic resonance imaging (MRI) studies disclosed a right hemispheral cerebellar mass, locally recurrent in the original surgical tumor bed. Gross total resection of the tumor was accomplished through a suboccipital craniotomy, with complete resection of the lesion. The histopathological diagnosis was defined as cerebellar liponeurocytoma. No adjuvant therapy was given as initially, after the first operation. Currently, the patient is alive, fully alert with minimal neurological deficits, Barthel index 90, Kernofsky performance status of 90 and with no evidence of disease on neuroimaging. Conclusion: This patient portrays this tumor’s natural history after surgical intervention with no adjuvant treatment, being the longest reported follow-up and recurrence. This distinct variant of medulloblastoma appears to have a uniquely favorable prognosis, even without adjuvant therapy. A complete surgical resection with close follow-up seems both sufficient and prudent.
文摘Dural arteriovenous fistulas (dAVFs) of an anterior cranial fossa are rare. Because of the high risk of intracranial hemorrhage and relatively easy access for direct surgery, aggressive treatment has been recommended. The natural history of anterior cranial fossa dAVFs (ACF dAVFs) is unclear in spite of many reports for the natural history of general dAVFs. To treat ACF dAVFs, direct surgery has traditionally been performed and endovascular surgery has recently been introduced. A 74-year-old man was transferred with severe consciousness disturbance and presented with devastating intracerebral hemorrhage on the CT scan. Digital subtraction angiography revealed the ACF dAVFs with a large venous pouch. The patient received direct surgery, nevertheless he became vegetative state. Later on, a smaller venous pouch was recognized on the CT scan when he had suffered from the thalamic hemorrhage sixteen months before. There are twelve cases including our case which was treated for a certain period and documented in detail. Eleven of twelve cases were asymptomatic. Three of the six cases with a venous pouch had some events possibly related to the disease, though none of the six cases without a venous pouch had any events during observation. In conclusion, an ACF dAVF with a venous pouch should be treated by direct surgery or endovascular surgery even if it is incidentally found. By contrast, careful observation might be a possible therapeutic option for an ACF dAVF without a venous pouch if there is mild reflux flow.