微粒体谷胱甘肽S-转移酶1(microsomal glutathione S-transferase 1,MGST1)是谷胱甘肽S-转移酶(glutathione S-transferase,GST)超家族和花生四烯酸与谷胱甘肽代谢中的膜相关蛋白(membrane-associated proteins in eicosanoid and gluta...微粒体谷胱甘肽S-转移酶1(microsomal glutathione S-transferase 1,MGST1)是谷胱甘肽S-转移酶(glutathione S-transferase,GST)超家族和花生四烯酸与谷胱甘肽代谢中的膜相关蛋白(membrane-associated proteins in eicosanoid and glutathione metabolism,MAPEG)超家族的共同成员,它通过催化外源性物质的II相解毒过程,从而保护细胞膜免受氧化应激的损伤。众多研究发现MGST1与恶性肿瘤的发生发展密切相关,有望成为癌症治疗的新型分子靶点。本文就MGST1在恶性肿瘤中的研究进展予以综述。展开更多
This paper has identified two models of intra-product international division of labor:the model of passive inclusion and the model of proactive participation.Their difference is essentially whether participation in in...This paper has identified two models of intra-product international division of labor:the model of passive inclusion and the model of proactive participation.Their difference is essentially whether participation in international division of labor is dominated by multinational firms or by local firms.At the level of representative sectors,some characteristic variables of participation in international division of labor demonstrate significant industry differences.Models of division of labor affect technology progress.According to the empirical analysis result at the micro-level of four sectors,no matter for export or the contribution of learning by doing to corporate technology progress,the model of proactive participation is superior to the model of passive inclusion;under the model of passive inclusion,the technology spillover effect of import is smaller than "learning by doing " effect;under the model of proactive participation,technology spillover effect is over two times the "learning by doing" effect.展开更多
目的:了解近10年护理硕士研究生教育领域在全球的研究热点、研究现状和发展趋势。方法:通过Web of Science检索2013年1月1日—2023年3月1日护理硕士研究生教育领域的英文文献,对收集到英文文献的年度发文量、国家发文量、作者发文量、...目的:了解近10年护理硕士研究生教育领域在全球的研究热点、研究现状和发展趋势。方法:通过Web of Science检索2013年1月1日—2023年3月1日护理硕士研究生教育领域的英文文献,对收集到英文文献的年度发文量、国家发文量、作者发文量、机构发文量、关键词聚类共现的数据进行可视化处理,分析其研究热点。CiteSpace软件用于检测关键字突现。结果:护理硕士研究生教育领域全球年度发文量呈整体逐步上升趋势;关键词共现聚类分析结果显示,研究热点主题集中在多领域服务实践、心理支持策略、跨专业教育课程、研究生教育模式。结论:近10年护理硕士研究生教育处于迅速发展阶段,护理硕士研究生模拟训练策略、临床思维能力、社会适应能力、跨学科模式等可能是未来该领域研究的热点和方向。未来发展跨学科研究生教育模式,充分发挥护理硕士研究生优势,提高其社会适应能力水平。展开更多
The 1990s is a key historical decade in the process of China’s on-going modernization drive.When reviewing the overall picture of the socio-economic trend and S&T development around the world during the last two ...The 1990s is a key historical decade in the process of China’s on-going modernization drive.When reviewing the overall picture of the socio-economic trend and S&T development around the world during the last two decades,we may reach the conclusion that a new technological revolution is taking shape.For both the developed and the developing countries,challenges and opportunities are close at hand.In the Decision to Speed up China’s S&T Progress Jointly Issued by the CPC Central Committee and the State Council.a developmen-展开更多
The Proposal for the Twelfth Five-Year Plan for China's Economic and Social Development (2011-2015)(herein after referred to as the "Proposed Plan" for short) provides a complete range of guidelines for China'...The Proposal for the Twelfth Five-Year Plan for China's Economic and Social Development (2011-2015)(herein after referred to as the "Proposed Plan" for short) provides a complete range of guidelines for China's im-mediate and long-term development.展开更多
Under the leadership of the Communist Party of China,the human rights cause in China has developed and progressed through the period of democratic revolution,the early founding of the People’s Republic of China,the n...Under the leadership of the Communist Party of China,the human rights cause in China has developed and progressed through the period of democratic revolution,the early founding of the People’s Republic of China,the new period of reform and openingup,and the new era of socialism with Chinese characteristics.all previous national Congresses of the Communist Party of China have made illustrations and arrangements on human rights issues,and the successive Party leaders have made important expositions on human rights issues.The Party and the state have enacted a series of policies,laws,and regulations to protect human rights in various periods.China has made historic and great achievements in human rights practice and created a human rights development path suited to China’s national conditions.China’s human rights development over the past century has fully proved that the CPC has always been,and it remains,the firm core of leadership for China’s human rights development and progress.展开更多
John Bunyan's The Pilgrim's Progress has been written to preach the Christian doctrines of salvation.Therefore its allegorical protagonists have gradually gone through four stages of development on the path to...John Bunyan's The Pilgrim's Progress has been written to preach the Christian doctrines of salvation.Therefore its allegorical protagonists have gradually gone through four stages of development on the path to salvation.This paper is focused on the earlier two stages,that is,the repentance of sins and the temptations after conversion.展开更多
Through a comparative analysis of The Pilgrim's Progress and The Journey to the West, the paper aims to reveal what common ground is shared by the two novels and what light is thrown on the theme of spiritual salv...Through a comparative analysis of The Pilgrim's Progress and The Journey to the West, the paper aims to reveal what common ground is shared by the two novels and what light is thrown on the theme of spiritual salvation. The fruit of the study leads to a conclusion that both novels have employed religious doctrines and social criticisms to make the theme of spiritual salvation more palatable for their readers.展开更多
Barrett's esophagus (BE) confers a significant increased risk for development of esophageal adenocarcinoma (EAC), with the pathogenesis appearing to progress through a "metaplasia-dysplasia-carcinoma" (M...Barrett's esophagus (BE) confers a significant increased risk for development of esophageal adenocarcinoma (EAC), with the pathogenesis appearing to progress through a "metaplasia-dysplasia-carcinoma" (MDC) sequence. Many of the genetic insults driving this MDC sequence have recently been characterized, providing targets for candidate biomarkers with potential clinical utility to stratify risk in individual patients. Many clinical risk factors have been investigated, and associations with a variety of genetic, specific gastrointestinal and other modifiable factors have been proposed in the literature. This review summarizes the current understanding of the mechanisms involved in neoplastic progression of BE to EAC and critically appraises the relative roles and contributions of these putative risk factors from the published evidence currently available.展开更多
Alzheimer's disease (AD), a fatal, progressive, neurodegener- ative disorder, is the most common cause of old-age demen- tia, accounting for 50-75% of dementia patients. Early stages of AD are marked by vocabulary ...Alzheimer's disease (AD), a fatal, progressive, neurodegener- ative disorder, is the most common cause of old-age demen- tia, accounting for 50-75% of dementia patients. Early stages of AD are marked by vocabulary shrinkage, spatial disori- entation, depression, apraxia, and deterioration of recent forms of declarative memory. In course of time, the patients require close supervision due to the loss of cognitive and functional abilities, and at the terminal stages of the disease, all forms of memory are severely impaired with the patients needing nursing home care (World Alzheimer Report, 2013).展开更多
Since 2015, the China Geological Survey has implemented a major program of "Geology Survey of Land Energy Mineral Resources". Till now, a total of billions of RMB have been invested and seven engineering projects ha...Since 2015, the China Geological Survey has implemented a major program of "Geology Survey of Land Energy Mineral Resources". Till now, a total of billions of RMB have been invested and seven engineering projects have been established, all of which has greatly enhanced the geological survey and exploration of China's continental shale gas in an attempt to overcome the oil and gas shortage.展开更多
The Pilgrim’s Progress in Mandarin translated by the British missionary William Chalmers Burns in the 1860s is regarded as one of the typical representatives of the early Europeanized vernacular texts.Compared with t...The Pilgrim’s Progress in Mandarin translated by the British missionary William Chalmers Burns in the 1860s is regarded as one of the typical representatives of the early Europeanized vernacular texts.Compared with the ancient vernacular,the frequency of the inclusive usage of“wǒmen”has increased significantly,which is directly influenced by the plural usage of first-person pronoun in English.Tracking back the origin of Chinese Europeanized grammar is an important part of the study of modern Chinese grammar,which not only is helpful to have a clear understanding of the characteristic of Europeanized grammar in the pre-development stage of modern Chinese,but also can lay a certain foundation for the comparative study of Europeanized grammar in different periods.In addition,this study can also provide linguistic basis for investigating the influence of western missionaries’Chinese translation on the formation of new literature.展开更多
Huntington’s disease(HD)is an autosomal dominant,monogenic,progressive,neurodegenerative and rare disease with a frequency of10 per 100,000 in the Caucasian population and occurring more rarely in other races(Squi...Huntington’s disease(HD)is an autosomal dominant,monogenic,progressive,neurodegenerative and rare disease with a frequency of10 per 100,000 in the Caucasian population and occurring more rarely in other races(Squitieri et al.,1994).HD is,nevertheless,one of the most frequently and extensively studied diseases of those caused by a dynamic mutation.The HD mutation is located on the short arm of the 4th chromosome within the HTT gene.展开更多
A myriad of medicinal effects has been attributed to Thymoquinone (TQ), the major biological-active component of Nigella sativa. TQ has been shown to exhibit potent anti-tumor activities. The present work was undertak...A myriad of medicinal effects has been attributed to Thymoquinone (TQ), the major biological-active component of Nigella sativa. TQ has been shown to exhibit potent anti-tumor activities. The present work was undertaken to further explore TQ’s chemopreventive efficacy against 1, 2-dimethylhydrazine (DMH)-induced colon carcinogenesis in the rat model through a two-phase study (initiation and post-initiation) and to evaluate its potential impact on tumor progression and invasion in vivo. TQ treatment in the initiation phase significantly reduced tumor incidence, multiplicity and mean tumor volume. However, although mean tumor volume and multiplicity were decreased upon TQ treatment in the post-initiation phase, TQ did not reduce incidence significantly. Cellular proliferation, as assessed by expression of colonic PCNA, was shown to be inhibited in consequence to TQ treatment in both phases, with a more pronounced reduction in the initiation phase. In addition, our results demonstrated an appreciable negative impact of TQ on vascular endothelial growth factor (VEGF) production in tumor-bearing rats. Furthermore, we provided evidence that TQ-treatment, in both phases, tended to considerably suppress tumor progression and invasion. Taken together, the present study demonstrated that TQ, at an orally daily dose of 10 mg/kg, has a chemopreventive effect in the initiation phase, and has the potential to attenuate tumor burden, suppress progression of pre-neoplastic lesions and to inhibit tumor growth in the post-initiation phase of DMH-induced colon carcinogenesis, We surmise that such effects of TQ may be due to suppression of cellular proliferation and inhibition of VEGF production. The results could provide an effective chemopreventive approach in the primary prevention of colon cancer in humans in the next future, and illuminate a promising horizon to combat progression of benign colonic pre-neoplastic lesions into malignant metastatic tumors and to manage colon cancer.展开更多
Liquid propellant rocket engines for a launch vehicle are an essential aerospace technology, representing the advanced level of hi-tech in a country. In recent years, China’s aerospace industry has made remarkable ac...Liquid propellant rocket engines for a launch vehicle are an essential aerospace technology, representing the advanced level of hi-tech in a country. In recent years, China’s aerospace industry has made remarkable achievements, and liquid rocket engine technology has also been effectively developed. In this article, the development processes of China’s liquid rocket engines are discussed. Then, the performance features of China’s new generation liquid rocket engines as well as the flight tests of the new-generation launch vehicles are introduced. Finally, the development direction and the most recent progress of the next generation large-thrust liquid rocket engine is presented.展开更多
In 2002, PetroChina have made obvious progress since it began to carry forward integrated exploration and development, in the first half year, exploration and development have gained a series of achievements through o...In 2002, PetroChina have made obvious progress since it began to carry forward integrated exploration and development, in the first half year, exploration and development have gained a series of achievements through optimizing deployment,deepening geological research, strengthening technological innovation, organizing elaborately and arranging carefully.展开更多
since the establishment of the People’s Republic of China,the central leader-groups from generation to generation have been continuously exploring and innovating Marxist political party theory in terms of its value t...since the establishment of the People’s Republic of China,the central leader-groups from generation to generation have been continuously exploring and innovating Marxist political party theory in terms of its value target,ideological construction,working style,and organization developments.This process can be categorized into five stages:the founding stage in Mao Zedong’s era,the development stage in Deng Xiaoping’s ear,the promotion stage in Jiang Zemin’s times,the deepening stage under Hu Jintao’s leadership,and the stage of further innovation by Xi Jinping in the new era,with the characteristics of inheritance,development as well as scientificity and valuation.展开更多
The National Road RN 91 has been threatened for about twenty-five years by a huge landslide, located 25 km south-east to the town of Grenoble (France). If several million cubic meters of rock fall down, the debris wil...The National Road RN 91 has been threatened for about twenty-five years by a huge landslide, located 25 km south-east to the town of Grenoble (France). If several million cubic meters of rock fall down, the debris will dam the valley. Then the failure of the dam by overtopping and rapid erosion might result in a catastrophic flood and dramatic consequences for human life, environment and economy throughout the valley. The paper presents the hazard assessment based on geological and hydrological surveys, including small scale hydraulic tests, as well as the risk evaluation that has been performed. The risk management relies first upon a high level monitoring and an emergency plan; various mitigation strategies have been considered.展开更多
To study Barrett’s esophagus (BE) in cirrhosis and assess progression to esophageal adenocarcinoma (EAC) compared to non-cirrhotic BE controls.METHODSCirrhotic patients who were found to have endoscopic evidence of B...To study Barrett’s esophagus (BE) in cirrhosis and assess progression to esophageal adenocarcinoma (EAC) compared to non-cirrhotic BE controls.METHODSCirrhotic patients who were found to have endoscopic evidence of BE confirmed by the presence of intestinal metaplasia on histology from 1/1/2000 to 12/1/2015 at Cleveland Clinic were included. Cirrhotic patients were matched 1:4 to BE controls without cirrhosis. Age, gender, race, BE length, hiatal hernia size, Child-Pugh (CP) class and histological findings were recorded. Cases and controls without high-grade dysplasia (HGD)/EAC and who had follow-up endoscopies were studied for incidence of dysplasia/EAC and to assess progression rates. Univariable conditional logistic regression was done to assess differences in baseline characteristics between the two groups.RESULTSA total of 57 patients with cirrhosis and BE were matched with 228 controls (BE without cirrhosis). The prevalence of dysplasia in cirrhosis and controls were similar with 8.8% vs 12% with low grade dysplasia (LGD) and 12.3 % vs 19.7% with HGD or EAC (P = 0.1). In the incidence cohort of 44 patients with median follow-up time of 2.7 years [interquartile range 1.0, 4.8], there were 7 cases of LGD, 2 cases of HGD, and 2 cases of EAC. There were no differences in incidence rates of HGD/EAC in nondysplastic BE between cirrhotic cases and noncirrhotic controls (1.4 vs 1.1 per 100 person- years, P = 0.8). In LGD, cirrhotic patients were found to have higher rates of progression to HGD/EAC compared to control group though this did not reach statistical significance (13.7 vs 8.1 per 100 person- years, P = 0.51). A significant association was found between a higher CP class and neoplastic progression of BE in cirrhotic patients (HR =7.9, 95%CI: 2.0-30.9, P = 0.003).CONCLUSIONCirrhotics with worsening liver function are at increased risk of progression of BE. More frequent endoscopic surveillance might be warranted in such patients.展开更多
文摘This paper has identified two models of intra-product international division of labor:the model of passive inclusion and the model of proactive participation.Their difference is essentially whether participation in international division of labor is dominated by multinational firms or by local firms.At the level of representative sectors,some characteristic variables of participation in international division of labor demonstrate significant industry differences.Models of division of labor affect technology progress.According to the empirical analysis result at the micro-level of four sectors,no matter for export or the contribution of learning by doing to corporate technology progress,the model of proactive participation is superior to the model of passive inclusion;under the model of passive inclusion,the technology spillover effect of import is smaller than "learning by doing " effect;under the model of proactive participation,technology spillover effect is over two times the "learning by doing" effect.
文摘目的:了解近10年护理硕士研究生教育领域在全球的研究热点、研究现状和发展趋势。方法:通过Web of Science检索2013年1月1日—2023年3月1日护理硕士研究生教育领域的英文文献,对收集到英文文献的年度发文量、国家发文量、作者发文量、机构发文量、关键词聚类共现的数据进行可视化处理,分析其研究热点。CiteSpace软件用于检测关键字突现。结果:护理硕士研究生教育领域全球年度发文量呈整体逐步上升趋势;关键词共现聚类分析结果显示,研究热点主题集中在多领域服务实践、心理支持策略、跨专业教育课程、研究生教育模式。结论:近10年护理硕士研究生教育处于迅速发展阶段,护理硕士研究生模拟训练策略、临床思维能力、社会适应能力、跨学科模式等可能是未来该领域研究的热点和方向。未来发展跨学科研究生教育模式,充分发挥护理硕士研究生优势,提高其社会适应能力水平。
文摘The 1990s is a key historical decade in the process of China’s on-going modernization drive.When reviewing the overall picture of the socio-economic trend and S&T development around the world during the last two decades,we may reach the conclusion that a new technological revolution is taking shape.For both the developed and the developing countries,challenges and opportunities are close at hand.In the Decision to Speed up China’s S&T Progress Jointly Issued by the CPC Central Committee and the State Council.a developmen-
文摘The Proposal for the Twelfth Five-Year Plan for China's Economic and Social Development (2011-2015)(herein after referred to as the "Proposed Plan" for short) provides a complete range of guidelines for China's im-mediate and long-term development.
文摘Under the leadership of the Communist Party of China,the human rights cause in China has developed and progressed through the period of democratic revolution,the early founding of the People’s Republic of China,the new period of reform and openingup,and the new era of socialism with Chinese characteristics.all previous national Congresses of the Communist Party of China have made illustrations and arrangements on human rights issues,and the successive Party leaders have made important expositions on human rights issues.The Party and the state have enacted a series of policies,laws,and regulations to protect human rights in various periods.China has made historic and great achievements in human rights practice and created a human rights development path suited to China’s national conditions.China’s human rights development over the past century has fully proved that the CPC has always been,and it remains,the firm core of leadership for China’s human rights development and progress.
文摘John Bunyan's The Pilgrim's Progress has been written to preach the Christian doctrines of salvation.Therefore its allegorical protagonists have gradually gone through four stages of development on the path to salvation.This paper is focused on the earlier two stages,that is,the repentance of sins and the temptations after conversion.
文摘Through a comparative analysis of The Pilgrim's Progress and The Journey to the West, the paper aims to reveal what common ground is shared by the two novels and what light is thrown on the theme of spiritual salvation. The fruit of the study leads to a conclusion that both novels have employed religious doctrines and social criticisms to make the theme of spiritual salvation more palatable for their readers.
文摘Barrett's esophagus (BE) confers a significant increased risk for development of esophageal adenocarcinoma (EAC), with the pathogenesis appearing to progress through a "metaplasia-dysplasia-carcinoma" (MDC) sequence. Many of the genetic insults driving this MDC sequence have recently been characterized, providing targets for candidate biomarkers with potential clinical utility to stratify risk in individual patients. Many clinical risk factors have been investigated, and associations with a variety of genetic, specific gastrointestinal and other modifiable factors have been proposed in the literature. This review summarizes the current understanding of the mechanisms involved in neoplastic progression of BE to EAC and critically appraises the relative roles and contributions of these putative risk factors from the published evidence currently available.
基金in part supported by the German Ministry for Education and Research (BMBF) special network program KMU-Innovativ-2
文摘Alzheimer's disease (AD), a fatal, progressive, neurodegener- ative disorder, is the most common cause of old-age demen- tia, accounting for 50-75% of dementia patients. Early stages of AD are marked by vocabulary shrinkage, spatial disori- entation, depression, apraxia, and deterioration of recent forms of declarative memory. In course of time, the patients require close supervision due to the loss of cognitive and functional abilities, and at the terminal stages of the disease, all forms of memory are severely impaired with the patients needing nursing home care (World Alzheimer Report, 2013).
文摘Since 2015, the China Geological Survey has implemented a major program of "Geology Survey of Land Energy Mineral Resources". Till now, a total of billions of RMB have been invested and seven engineering projects have been established, all of which has greatly enhanced the geological survey and exploration of China's continental shale gas in an attempt to overcome the oil and gas shortage.
文摘The Pilgrim’s Progress in Mandarin translated by the British missionary William Chalmers Burns in the 1860s is regarded as one of the typical representatives of the early Europeanized vernacular texts.Compared with the ancient vernacular,the frequency of the inclusive usage of“wǒmen”has increased significantly,which is directly influenced by the plural usage of first-person pronoun in English.Tracking back the origin of Chinese Europeanized grammar is an important part of the study of modern Chinese grammar,which not only is helpful to have a clear understanding of the characteristic of Europeanized grammar in the pre-development stage of modern Chinese,but also can lay a certain foundation for the comparative study of Europeanized grammar in different periods.In addition,this study can also provide linguistic basis for investigating the influence of western missionaries’Chinese translation on the formation of new literature.
文摘Huntington’s disease(HD)is an autosomal dominant,monogenic,progressive,neurodegenerative and rare disease with a frequency of10 per 100,000 in the Caucasian population and occurring more rarely in other races(Squitieri et al.,1994).HD is,nevertheless,one of the most frequently and extensively studied diseases of those caused by a dynamic mutation.The HD mutation is located on the short arm of the 4th chromosome within the HTT gene.
文摘A myriad of medicinal effects has been attributed to Thymoquinone (TQ), the major biological-active component of Nigella sativa. TQ has been shown to exhibit potent anti-tumor activities. The present work was undertaken to further explore TQ’s chemopreventive efficacy against 1, 2-dimethylhydrazine (DMH)-induced colon carcinogenesis in the rat model through a two-phase study (initiation and post-initiation) and to evaluate its potential impact on tumor progression and invasion in vivo. TQ treatment in the initiation phase significantly reduced tumor incidence, multiplicity and mean tumor volume. However, although mean tumor volume and multiplicity were decreased upon TQ treatment in the post-initiation phase, TQ did not reduce incidence significantly. Cellular proliferation, as assessed by expression of colonic PCNA, was shown to be inhibited in consequence to TQ treatment in both phases, with a more pronounced reduction in the initiation phase. In addition, our results demonstrated an appreciable negative impact of TQ on vascular endothelial growth factor (VEGF) production in tumor-bearing rats. Furthermore, we provided evidence that TQ-treatment, in both phases, tended to considerably suppress tumor progression and invasion. Taken together, the present study demonstrated that TQ, at an orally daily dose of 10 mg/kg, has a chemopreventive effect in the initiation phase, and has the potential to attenuate tumor burden, suppress progression of pre-neoplastic lesions and to inhibit tumor growth in the post-initiation phase of DMH-induced colon carcinogenesis, We surmise that such effects of TQ may be due to suppression of cellular proliferation and inhibition of VEGF production. The results could provide an effective chemopreventive approach in the primary prevention of colon cancer in humans in the next future, and illuminate a promising horizon to combat progression of benign colonic pre-neoplastic lesions into malignant metastatic tumors and to manage colon cancer.
文摘Liquid propellant rocket engines for a launch vehicle are an essential aerospace technology, representing the advanced level of hi-tech in a country. In recent years, China’s aerospace industry has made remarkable achievements, and liquid rocket engine technology has also been effectively developed. In this article, the development processes of China’s liquid rocket engines are discussed. Then, the performance features of China’s new generation liquid rocket engines as well as the flight tests of the new-generation launch vehicles are introduced. Finally, the development direction and the most recent progress of the next generation large-thrust liquid rocket engine is presented.
文摘In 2002, PetroChina have made obvious progress since it began to carry forward integrated exploration and development, in the first half year, exploration and development have gained a series of achievements through optimizing deployment,deepening geological research, strengthening technological innovation, organizing elaborately and arranging carefully.
文摘since the establishment of the People’s Republic of China,the central leader-groups from generation to generation have been continuously exploring and innovating Marxist political party theory in terms of its value target,ideological construction,working style,and organization developments.This process can be categorized into five stages:the founding stage in Mao Zedong’s era,the development stage in Deng Xiaoping’s ear,the promotion stage in Jiang Zemin’s times,the deepening stage under Hu Jintao’s leadership,and the stage of further innovation by Xi Jinping in the new era,with the characteristics of inheritance,development as well as scientificity and valuation.
文摘The National Road RN 91 has been threatened for about twenty-five years by a huge landslide, located 25 km south-east to the town of Grenoble (France). If several million cubic meters of rock fall down, the debris will dam the valley. Then the failure of the dam by overtopping and rapid erosion might result in a catastrophic flood and dramatic consequences for human life, environment and economy throughout the valley. The paper presents the hazard assessment based on geological and hydrological surveys, including small scale hydraulic tests, as well as the risk evaluation that has been performed. The risk management relies first upon a high level monitoring and an emergency plan; various mitigation strategies have been considered.
文摘To study Barrett’s esophagus (BE) in cirrhosis and assess progression to esophageal adenocarcinoma (EAC) compared to non-cirrhotic BE controls.METHODSCirrhotic patients who were found to have endoscopic evidence of BE confirmed by the presence of intestinal metaplasia on histology from 1/1/2000 to 12/1/2015 at Cleveland Clinic were included. Cirrhotic patients were matched 1:4 to BE controls without cirrhosis. Age, gender, race, BE length, hiatal hernia size, Child-Pugh (CP) class and histological findings were recorded. Cases and controls without high-grade dysplasia (HGD)/EAC and who had follow-up endoscopies were studied for incidence of dysplasia/EAC and to assess progression rates. Univariable conditional logistic regression was done to assess differences in baseline characteristics between the two groups.RESULTSA total of 57 patients with cirrhosis and BE were matched with 228 controls (BE without cirrhosis). The prevalence of dysplasia in cirrhosis and controls were similar with 8.8% vs 12% with low grade dysplasia (LGD) and 12.3 % vs 19.7% with HGD or EAC (P = 0.1). In the incidence cohort of 44 patients with median follow-up time of 2.7 years [interquartile range 1.0, 4.8], there were 7 cases of LGD, 2 cases of HGD, and 2 cases of EAC. There were no differences in incidence rates of HGD/EAC in nondysplastic BE between cirrhotic cases and noncirrhotic controls (1.4 vs 1.1 per 100 person- years, P = 0.8). In LGD, cirrhotic patients were found to have higher rates of progression to HGD/EAC compared to control group though this did not reach statistical significance (13.7 vs 8.1 per 100 person- years, P = 0.51). A significant association was found between a higher CP class and neoplastic progression of BE in cirrhotic patients (HR =7.9, 95%CI: 2.0-30.9, P = 0.003).CONCLUSIONCirrhotics with worsening liver function are at increased risk of progression of BE. More frequent endoscopic surveillance might be warranted in such patients.