Purpose: This study aimed to characterize mood and quality of life and to examine the associations of these areas with subjective cognitive concerns and attitudes toward genetic testing for the Common Hispanic Mutatio...Purpose: This study aimed to characterize mood and quality of life and to examine the associations of these areas with subjective cognitive concerns and attitudes toward genetic testing for the Common Hispanic Mutation, a gene that has been associated with increased risk for CCM1. Method: Fifty-four adults with previous genetic testing for the Common Hispanic Mutation completed a mail survey that included assessments of the above identified areas. Results: Self-reported depressive symptoms and quality of life did not differ between those with positive and negative genetic test results. The negative group expressed a more favorable attitude toward genetic testing (p p = 0.06). Using generalized linear regression, more subjective cognitive concerns were associated with poorer quality of life and more depressive symptoms (p p Conclusions: Subjective cognitive concerns and negative attitudes toward genetic testing may influence emotional well-being after genetic testing for the Common Hispanic Mutation. Additional research is needed that uses objective neuropsychological measures to understand the associations of subjective cognitive concerns, emotional well-being, and cognitive test performance in individuals with CCM1. There is also a need for research that focuses on protective factors and resiliency following genetic testing for CCM1 and the development of mental health interventions to preempt psychosocial difficulties.展开更多
The joint development of teachers and young children is the basis for promoting the development of high-quality preschool education in the new era,and encouraging early childhood teachers to make playthings according ...The joint development of teachers and young children is the basis for promoting the development of high-quality preschool education in the new era,and encouraging early childhood teachers to make playthings according to local conditions is both the fine tradition of China's early childhood education and the direct orientation of China's preschool education policy.Homemade play and teaching aids are some of the methods often used in kindergartens,which skillfully combine young children's daily life objects with toys and early childhood teaching,not only enriching the collective activities of young children but also cultivating children's abilities in various aspects.Kindergarten homemade"play and teaching aids"for early childhood teachers and children have their special educational significance and value,therefore,this paper is based on the children and teachers double subject basis,discussing the homemade"play and teaching aids"for children and teachers of the double subject meanings,and puts forward the realization of the This paper discusses the double-subjective meaning of homemade teaching aids for children and teachers on the basis of the double-subjective foundation of children and teachers,and puts forward specific suggestions for realizing the double-subjectivity of kindergarten homemade teaching aids to enrich the theoretical value and practical significance of homemade teaching aids,to provide theoretical references and support for the relevant staff.展开更多
Introduction: Acute coronary syndrome is often the first event of coronary disease of young subjects. Objective: To study sociodemographic, clinical, paraclinical, therapeutic and evolutionary aspects of acute coronar...Introduction: Acute coronary syndrome is often the first event of coronary disease of young subjects. Objective: To study sociodemographic, clinical, paraclinical, therapeutic and evolutionary aspects of acute coronary syndrome of young subjects. Patients and Methods: Descriptive cross-sectional study with prospective recruitment from October 01, 2020 to March 31, 2022. Were included all patients admitted for acute coronary syndrome whose age was less or equal to 45 years and who had undergone coronary angiography at the Mother-Child University Hospital on Luxembourg from Bamako. Results: During the study period, we collected 60 patient files out of 198. These 60 patient files met our inclusion criteria. Hospital frequency was 30.30%. Average age of patients was 40.43 ± 3.9 years. Sex ratio M/F was 5.3. Main cardiovascular risk factor was smoking tobacco (23.42%), followed by dyslipidemia (13.92%). Functional signs were dominated by angina 62% followed by dyspnea 25.3%. Persistent ST-segment elevation on electrocardiogram was present in 76.4%. Left ventricular systolic dysfunction was present in 26.5%. Time to first medical contact was more than 12 hours in 62.7% of cases. Radial approach was adopted in 94% of cases. Coronary angiography was pathological in 85% (n = 51) of cases. Lesions were single-vessel disease in 47.1% and culprit artery was anterior interventricular in 51% of cases. Dual anti-platelet aggregation was aspirin and ticagrelor in 91.8% of cases. Angioplasty was performed in all patients who had significant abnormalities at coronary angiography. In-hospital mortality was 3.9%. Conclusion: Acute coronary syndromes exist in young Africans with a male predominance. Main cardiovascular risk factor is smoking tobacco. Coronary lesions are single vessel disease in the majority of case. Most of patients meet medical team after 12 hours. Time to first medical contact is a main challenge in our country.展开更多
Genetic improvement of drought resistance is one of the main breeding goals for common bean,so molecular markers must be identified to facilitate drought resistance breeding.In this study,we evaluated the proline,treh...Genetic improvement of drought resistance is one of the main breeding goals for common bean,so molecular markers must be identified to facilitate drought resistance breeding.In this study,we evaluated the proline,trehalose,raffinose,and stachyose contents of 210 common bean accessions under two watering conditions and found large variations in all four.The coefficients of variation ranged from 21.21%for proline content to 78.69%for stachyose content under well-watered conditions,and from 20.11%for proline content to 50.08%for trehalose content under drought stress.According to our genome-wide association analysis,32 quantitative trait loci were associated with drought resistance,seven of which overlapped with known loci.Four hotspot regions were identified at Pv01,Pv07 and Pv11.A set of candidate genes was identified,including genes encoding MYB,bZIP,bHLH,ERF,and protein kinases.Among these genes,Phvul.001G189400,Phvul.007G273000 and Phvul.008G270500 were annotated as bZIP,ERF and WRKY,respectively.These genes are reportedly involved in drought stress responses in Arabidopsis thaliana and were induced by drought stress in common bean.Significant SNPs in six candidate gene regions formed different haplotypes,and phenotypic analysis revealed significant differences among the haplotypes.These results provide new insight into the genetic basis of drought resistance in common bean and reveal candidate genes and superior natural variations that will be useful for improving common bean.展开更多
While endoscopic retrograde cholangiopancreatography(ERCP)remains the primary treatment modality for common bile duct stones(CBDS)or choledocho-lithiasis due to advancements in instruments,surgical intervention,known ...While endoscopic retrograde cholangiopancreatography(ERCP)remains the primary treatment modality for common bile duct stones(CBDS)or choledocho-lithiasis due to advancements in instruments,surgical intervention,known as common bile duct exploration(CBDE),is still necessary in cases of difficult CBDS,failed endoscopic treatment,or altered anatomy.Recent evidence also supports CBDE in patients requesting single-step cholecystectomy and bile duct stone removal with comparable outcomes.This review elucidates relevant clinical anatomy,selection indications,and outcomes to enhance surgical understanding.The selection between trans-cystic(TC)vs trans-choledochal(TD)approaches is described,along with stone removal techniques and ductal closure.Detailed surgical techniques and strategies for both the TC and TD approaches,including instrument selection,is also provided.Additionally,this review comprehensively addresses operation-specific complications such as bile leakage,stricture,and entrapment,and focuses on preventive measures and treatment strategies.This review aims to optimize the management of CBDS through laparoscopic CBDE,with the goal of improving patient outcomes and minimizing risks.展开更多
In this paper,we present a distal-scanning common path probe for optical coherence tomography(OCT)equipped with a hollow ultrasonic motor and a simple and specially designed beam-splitter.This novel probe proves to be...In this paper,we present a distal-scanning common path probe for optical coherence tomography(OCT)equipped with a hollow ultrasonic motor and a simple and specially designed beam-splitter.This novel probe proves to be able to effectively circumvent polarization and dispersion mismatch caused by fiber motion and is more robust to a variety of interfering factors during the imaging process,experimentally compared to a conventional noncommon path probe.Furthermore,our design counteracts the attenuation of backscattering with depth and the fall-off of the signal,resulting in a more balanced signal range and greater imaging depth.Spectral-domain OCT imaging of phantom and biological tissue is also demonstrated with a sensitivity of∼100dB and a lateral resolution of∼3μm.This low-cost probe offers simplified system configuration and excellent robustness,and is therefore particularly suitable for clinical diagnosis as one-off medical apparatus.展开更多
Many birds develop brood patches on their ventral apterium under hormonal regulation to effectively transmit body heat to eggs during incubation.The developed patch has several characteristics,including de-feathering,...Many birds develop brood patches on their ventral apterium under hormonal regulation to effectively transmit body heat to eggs during incubation.The developed patch has several characteristics,including de-feathering,vascularization,and edema.However,little is known about whether avian brood parasites that do not incubate their eggs exhibit brood patch development during the breeding season.In this study,we measured the size of the ventral apterium in 114 Common Cuckoos(Cuculus canorus)captured in the field throughout the breeding season and examined the appearance of the ventral apterium to confirm the development of brood patches.We also examined whether morphological traits and various factors correlated with the size of the ventral apterium(sternal apterium and abdominal apterium)and how it changed during the breeding season.We found no clear signs of brood patch development in Common Cuckoos captured throughout the breeding season,indicating that they likely did not develop brood patches on the ventral apterium during this period.We also found that ventral apterium size was positively correlated with wing length and body weight.In addition,Common Cuckoos with newly growing feathers on the boundary of the ventral apterium with pteryla were frequently observed as seasons progressed to the end.In conclusion,Common Cuckoos exhibit neither brood patch development nor the vestigial characteristics of ancestral brood patches,except for the growth of feathers on boundary the ventral apterium.Further studies examining brood patches across different groups of avian brood parasites are valuable for enhancing our understanding of the developmental and physiological adaptations of avian brood parasites.展开更多
Introduction: In Cameroon, surgery remains the only approach in malignant obstructions of the common bile duct (MOCBD) even in palliative situations. The aim of this work was to describe the modalities of surgical tre...Introduction: In Cameroon, surgery remains the only approach in malignant obstructions of the common bile duct (MOCBD) even in palliative situations. The aim of this work was to describe the modalities of surgical treatment of MOCBD, evaluate the results and detect the factors associated with postoperative morbidity and mortality. Patients and Methods: We conducted an analytical observational study, with retrospective data collection from the files of patients operated upon for MOCBD. This was done in four referral hospitals in the city of Yaoundé for a 42-month period spanning from January 1, 2020 to June 30, 2023. Demographic data, clinical presentation, surgical data, and 30-day postoperative outcomes were collected. Results: We collected 71 files. The sex ratio was 1.4 and the mean age was 56 ± 11 years. Fifty-three (53) patients (74.6%) were overweight or obese and 10 patients (14.1%) were hypertensive. A clinical cholestasis syndrome was present in 69 patients (97.2%). Fifty-five (55) patients (77.5%) had a cancer of the head of the pancreas, 8 patients (11.3%) had an extra-hepatic cholangiocarcinoma and 8 patients (11.3%) had an ampullary adenocarcinoma. Eight (8) resections (11.3%) with curative intent had been carried out and in 63 cases (88.7%), surgery was palliative. Postoperative morbidity was 55.7%, influenced by advanced WHO stage (p = 0.02). Postoperative mortality was 25.7%, associated with a high ASA score (p = 0.01). Conclusion: Pancreatic head cancer is the main etiology of malignant obstructions of the common bile duct in Cameroon. Surgical treatment is most often palliative. Postoperative morbidity and mortality are high, influenced by high WHO and ASA scores.展开更多
The Oriental Reed Warbler(Acrocephalus orientalis)is one of the most commonly used hosts for the parasitic Common Cuckoo(Cuculus canorus).However,as hosts that feed unrelated parasitic nestlings may suffer extra repro...The Oriental Reed Warbler(Acrocephalus orientalis)is one of the most commonly used hosts for the parasitic Common Cuckoo(Cuculus canorus).However,as hosts that feed unrelated parasitic nestlings may suffer extra reproductive costs,they may be less willing to care for nestlings that have prolonged nestling periods.To test this hypothesis,the duration of feeding by Oriental Reed Warblers under natural conditions for their own nestlings was compared with the duration of feeding under natural conditions for Common Cuckoo nestlings and for artificially prolonged cuckoo nestlings.The results showed that Oriental Reed Warblers did not starve,drive away,or desert any of the nestlings in the experiment,and neither parent was left alone.Our experimental study indicates that both Oriental Reed Warbler parents were willing to care for nestlings with a prolonged nestling period(up to 30 days,twice the average duration time that the Oriental Reed Warblers fed their own chicks in natural conditions).However,further experiments and observations are required in other host bird species to examine whether both parents or one of the parents may exhibit the behavior of abandoning nestlings with a prolonged nestling period.展开更多
It is common to observe the epidemic risk perception(ERP)and a decline in subjective well-being(SWB)in the context of public health events,such as Corona Virus Disease 2019(COVID-19).However,there have been few studie...It is common to observe the epidemic risk perception(ERP)and a decline in subjective well-being(SWB)in the context of public health events,such as Corona Virus Disease 2019(COVID-19).However,there have been few studies exploring the impact of individuals’ERP within living space on their SWB,especially from a geographical and daily activity perspective after the resumption of work and other activities following a wave of the pandemic.In this paper,we conducted a study with 789 participants in urban China,measuring their ERP within living space and examining its influence on their SWB using path analysis.The results indicated that individuals’ERP within their living space had a significant negative effect on their SWB.The density of certain types of facilities within their living space,such as bus stops,subway stations,restaurants,fast food shops,convenience shops,hospitals,and public toilets,had a significantly negative impact on their SWB,mediated by their ERP within living space.Additionally,participation in out-of-home work and other activities not only increased individuals’ERP within living space,but also strengthened its negative effect on their SWB.展开更多
Background:The enduring and detrimental impact of childhood trauma on later health and well-being is now well established.However,research on the relationship between childhood trauma and depressive symptoms,along wit...Background:The enduring and detrimental impact of childhood trauma on later health and well-being is now well established.However,research on the relationship between childhood trauma and depressive symptoms,along with the potential risk and protective factors,is insufficient in the context of Chinese college student population.Methods:Data on childhood trauma,depressive symptoms,resilience,and subjective well-being were collected through surveys conducted with 367 Chinese university students.The data collected in this study were analyzed using SPSS 26.0 and PROCESS 3.5.Results:The results revealed that subjective well-being mediated the relationship between childhood trauma and depressive symptoms among college students,with direct and indirect effects accounting for 59.46%and 40.54%of the total effect,respectively.The pathway process between subjective well-being and depressive symptoms was moderated by resilience,whereby an increase in resilience levels corresponded to a gradual escalation in the predictive power of subjective well-being on depressive symptoms.Conclusion:The study indicates that childhood trauma significantly and positively predicts depressive symptoms among college students,and it can also directly predict depressive symptoms through the mediating effect of subjective well-being.Elevating levels of psychological resilience and subjective well-being among college students can mitigate depression and promote psychological well-being.From the perspective of positive psychology,the present study provides a new perspective for the prevention and intervention of depressive symptoms among college students.展开更多
Objective:Cancer survivors have experienced subjective cognitive impairment(SCI)when they received cancer diagnoses or treatments.Their psychosocial and emotional statuses were also impacted.With the advancement of we...Objective:Cancer survivors have experienced subjective cognitive impairment(SCI)when they received cancer diagnoses or treatments.Their psychosocial and emotional statuses were also impacted.With the advancement of web technologies,web-based cognitive interventions have been implemented in the management and the alleviation of the SCI,the psychosocial distress,and the emotional distress in cancer survivors.This review aimed to summarize the intervention contents of web-based cognitive interventions for SCI,and to explore the effects of the interventions on SCI,psychosocial status,and emotional health.Methods:Six databases(CINAHL Plus,Cochrane Library,Embase,APA PsycInfo,PubMed and CNKI)were searched from the establishment of databases up to December 2023.Literature references were also manually searched for related articles.Results:This review contained 21 studies that covered the contents of web-based cognitive interventions,such as computer-assisted cognitive training,online cognitive rehabilitation,cognitive behavior therapy with the Internet,telehealth physical exercise,and web-based mindfulness interventions.The effects of web-based cognitive interventions positively impacted SCI for cancer survivors.Also,these interventions showed varying degrees of effectiveness in alleviating psychosocial and emotional distresses.Conclusion:By summarizingfive types of cognitive intervention contents delivered via web technology,this review demonstrated that web-based cognitive interventions optimized SCI and overall psychosocial and emotional statuses for the cancer survivors.It is recommended that future research focus on the development of customized web-based cognitive interventions for individuals with SCI,along with their psychosocial and emotional statuses.展开更多
Common prosperity is an important goal of China’s modernization efforts,and narrowing the income gap among different regions and populations is crucial to achieving common prosperity.The construction of digital infra...Common prosperity is an important goal of China’s modernization efforts,and narrowing the income gap among different regions and populations is crucial to achieving common prosperity.The construction of digital infrastructure has significantly boosted productivity and facilitated the diffusion of technology in less developed regions,leading to notable changes in labor employment and the income gap,which aligns with the goal of common prosperity.This paper explores the mechanism through which digital infrastructure influences common prosperity with a focus on employment,using panel data from 30 provinces in China between 2011 and 2021 for an empirical test.The research finds that digital infrastructure significantly promotes common prosperity.By expanding employment and increasing labor remuneration,the influence of digital infrastructure on common prosperity exhibits regional heterogeneity and a nonlinear threshold effect.The research suggests that the government should enhance investment in and construction of digital infrastructure,reduce the digital divide through policy support in rural areas,promote digital employment and skills training,and encourage industrial integration and enterprise participation.展开更多
Under the historical background of promoting agricultural and rural modernization in an all-round way,this paper deeply analyzes the practical significance of digital construction in rural China,and explores the probl...Under the historical background of promoting agricultural and rural modernization in an all-round way,this paper deeply analyzes the practical significance of digital construction in rural China,and explores the problems in the digitalization level of rural infrastructure,farmers digitalization awareness and accomplishment,and agricultural digital system.Countermeasures and suggestions are put forward from four aspects:digital village construction policy system,rural digital infrastructure construction,rural digital talent cultivation system,and agricultural digital system,and the rural digital construction of Huzhou City is taken as an example,in order to further realize the goal of empowering rural farmers with digital technology for common prosperity.展开更多
Virginia Woolf’s essay“Street Haunting:A London Adventure”highlights the complex relationships between things and the subject.On the individual’s level,indoor things construct and limit the subject’s identity,whi...Virginia Woolf’s essay“Street Haunting:A London Adventure”highlights the complex relationships between things and the subject.On the individual’s level,indoor things construct and limit the subject’s identity,while outdoor things allow fluid identities;these things reveal Woolf’s dual identity as both a rebel against and a ruler of the hierarchical system.On the intersubjective level,subjects are linked through common aesthetic experience mediated by things,which enjoys a high degree of arbitrariness.With the help of things,subjects form an“imagined community”.Concerning the relationship between things and the mind,things also endow order in the fragmented reality,yet in this sense they are abstract,metaphysical and universal rather than specific in Virginia Woolf’s thoughts.They are the withdrawn things expressed by sensual qualities.These sensual aspects,however,are tools to reveal the essence and meaning of life,secondary to the mind.展开更多
BACKGROUND Undifferentiated pleomorphic sarcoma(UPS)is a rare malignant mesenchymal tumor with a poor prognosis.It mainly occurs in the extremities,trunk,head and neck,and retroperitoneum regions.Owing to the lack of ...BACKGROUND Undifferentiated pleomorphic sarcoma(UPS)is a rare malignant mesenchymal tumor with a poor prognosis.It mainly occurs in the extremities,trunk,head and neck,and retroperitoneum regions.Owing to the lack of specific clinical manifestations and imaging features,UPS diagnosis mainly depends on pathological and immunohistochemical examinations for exclusive diagnosis.Here we report an extremely rare case of high-grade UPS in the common bile duct(CBD).There are limited available data on such cases.CASE SUMMARY A 70-year-old woman was admitted to our department with yellow eyes and urine accompanied by upper abdominal distending pain for 2 wk.Her laboratory data suggested significantly elevated hepatorenal function levels.The imaging data revealed calculous cholecystitis,intrahepatic and extrahepatic bile duct dilation with extrahepatic bile duct calculi,and a space-occupying lesion at the distal CBD.After endoscopic biliary stenting and symptomatic support therapy,CBD exploration and biopsy were performed.The frozen section indicated malignant spindle cell tumor of the CBD mass,and further radical pancreaticoduodenectomy was performed.Finally,the neoplasm was diagnosed as a high-grade UPS combined with the light-microscopic morphology and immunohistochemical results.CONCLUSION This extremely rare case highlighted the need for increasing physicians'vigilance,reducing the odds of misdiagnosis,and providing appropriate treatment strategies.展开更多
Large Language Models (LLMs) have revolutionized Generative Artificial Intelligence (GenAI) tasks, becoming an integral part of various applications in society, including text generation, translation, summarization, a...Large Language Models (LLMs) have revolutionized Generative Artificial Intelligence (GenAI) tasks, becoming an integral part of various applications in society, including text generation, translation, summarization, and more. However, their widespread usage emphasizes the critical need to enhance their security posture to ensure the integrity and reliability of their outputs and minimize harmful effects. Prompt injections and training data poisoning attacks are two of the most prominent vulnerabilities in LLMs, which could potentially lead to unpredictable and undesirable behaviors, such as biased outputs, misinformation propagation, and even malicious content generation. The Common Vulnerability Scoring System (CVSS) framework provides a standardized approach to capturing the principal characteristics of vulnerabilities, facilitating a deeper understanding of their severity within the security and AI communities. By extending the current CVSS framework, we generate scores for these vulnerabilities such that organizations can prioritize mitigation efforts, allocate resources effectively, and implement targeted security measures to defend against potential risks.展开更多
BACKGROUND The incidence of cholelithiasis has been on the rise in recent years,but the choice of procedure is controversial.AIM To investigate the efficacy of laparoscopic cholecystectomy(LC)combined with endoscopic ...BACKGROUND The incidence of cholelithiasis has been on the rise in recent years,but the choice of procedure is controversial.AIM To investigate the efficacy of laparoscopic cholecystectomy(LC)combined with endoscopic papillary balloon dilation(EPBD)in patients with gallbladder stones(GS)with common bile duct stones(CBDS).METHODS The clinical data of 102 patients with GS combined with CBDS were selected for retrospective analysis and divided into either an LC+EPBD group(n=50)or an LC+endoscopic sphincterotomy(EST)group(n=52)according to surgical methods.Surgery-related indexes,postoperative recovery,postoperative complications,and expression levels of inflammatory response indexes were compared between the two groups.RESULTS Total surgical time,stone free rate,rate of conversion to laparotomy,and successful stone extraction rate did not differ significantly between the LC+EPBD group and LC+EST group.Intraoperative hemorrhage,time to ambulation,and length of hospitalization in the LC+EPBD group were lower than those of the LC+EST group(P<0.05).The rate of total complications of the two groups was 9.80%and 17.65%,respectively,and the difference was not statistically significant.No serious complications occurred in either group.At 48 h postoperatively,the expression levels of interleukin-6,tumor necrosis factor-α,high-sensitivity Creactive protein,and procalcitonin were lower in the LC+EPBD group than in the LC+EST group(P<0.05).At 3 d postoperatively,the expression levels of aspartate transaminase,alanine transaminase,and total bilirubin were lower in the LC+EPBD group than in the LC+EST group(P<0.05).CONCLUSION LC combined with EPBD and LC combined with EST are both effective procedures for the treatment of GS with CBDS,in which LC combined with EPBD is beneficial to shorten the patient’s hospitalization time,reduce the magnitude of elevated inflammatory response indexes,and promote postoperative recovery.展开更多
BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an accurate diagnostic method for choledocholithiasis and treatment option for stone removal.Additionally,ursodeoxycholic acid(UDCA)can dissolve choles...BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an accurate diagnostic method for choledocholithiasis and treatment option for stone removal.Additionally,ursodeoxycholic acid(UDCA)can dissolve cholesterol stones and prevent their development and reappearance by lowering the cholesterol concen-tration in bile.Despite these treatment options,there are still patients who experience stone recurrence.The clinical data of 100 patients with choledochal stones who were hospitalized at the Yixing People’s Hospital and underwent ERCP for successful stone extraction between June 2020 and December 2022 were retrospectively collected.According to the post-ERCP treatment plan,100 patients were classified into UDCA(n=47)and control(n=53)groups.We aimed to assess the clinical efficacy and rate of relapse in the two patient populations.We then collected information(basic demographic data,clinical characteristics,and serum biochemical indicators)and determined the factors contributing to relapse using logistic regression analysis.Our secondary goal was to determine the effects of UDCA on liver function after ERCP.Compared to the control group,the UDCA group demonstrated a higher clinical effectiveness rate of 92.45%vs 78.72%(P<0.05).No significant differences were observed in liver function indices,including total bilirubin,direct bilirubin,gamma-glutamyl transpeptidase,alanine aminotransferase,alkaline phosphatase,and aspartate aminotransferase,between the two groups before treatment.After treatment,all liver function indices were significantly reduced.Comparing the control vs UDCA groups,the UDCA group exhibited significantly lower levels of all indices(55.39±6.53 vs 77.31±8.52,32.10±4.62 vs 45.39±5.69,142.32±14.21 vs 189.63±16.87,112.52±14.25 vs 149.36±15.36,122.61±16.00 vs 171.33±22.09,96.98±10.44 vs 121.35±11.57,respectively,all P<0.05).The stone recurrence rate was lower in the UDCA group(13.21%)in contrast with the control group(44.68%).Periampullary diverticula(OR:6.00,95%CI:1.69-21.30),maximum stone diameter(OR:1.69,95%CI:1.01-2.85),stone quantity>3(OR:4.23,95%CI:1.17-15.26),and positive bile culture(OR:7.61,95%CI:2.07-27.91)were independent factors that influenced the relapse of common bile duct stones after ERCP(P<0.05).Furthermore,postoperative UDCA was identified as a preventive factor(OR:0.07;95%CI:0.08-0.09).CONCLUSION The intervention effect of UDCA after ERCP for common bile duct stones is adequate,providing new research directions and references for the prevention and treatment of stone recurrence.展开更多
The energy-saving renovation of existing residential buildings is a crucial measure to achieve the strategic goal of energy conservation and emission reduction in China and build ecologically livable cities.This artic...The energy-saving renovation of existing residential buildings is a crucial measure to achieve the strategic goal of energy conservation and emission reduction in China and build ecologically livable cities.This article focuses on the perspective of subject behavior,starting from analyzing the current situation and difficulties of the operation of the energy-saving renovation market for existing residential buildings in China,drawing on the practical experience of the operation of the existing residential building energy-saving renovation market abroad.Based on principles such as systematicity,humanization,feasibility,and sustainability,the article constructs an operation optimization system of the existing residential building energy-saving renovation market from the perspective of subject behavior.In order to provide a reference for the healthy and orderly operation of the existing residential building energy-saving renovation market,this paper proposes implementation strategies for optimizing the operation of the existing residential building energy-saving renovation market.Suggestions are proposed from four aspects:optimizing the market environment,innovating the financing model,building the information sharing platform,and utilizing the synergies of the main subjects.展开更多
文摘Purpose: This study aimed to characterize mood and quality of life and to examine the associations of these areas with subjective cognitive concerns and attitudes toward genetic testing for the Common Hispanic Mutation, a gene that has been associated with increased risk for CCM1. Method: Fifty-four adults with previous genetic testing for the Common Hispanic Mutation completed a mail survey that included assessments of the above identified areas. Results: Self-reported depressive symptoms and quality of life did not differ between those with positive and negative genetic test results. The negative group expressed a more favorable attitude toward genetic testing (p p = 0.06). Using generalized linear regression, more subjective cognitive concerns were associated with poorer quality of life and more depressive symptoms (p p Conclusions: Subjective cognitive concerns and negative attitudes toward genetic testing may influence emotional well-being after genetic testing for the Common Hispanic Mutation. Additional research is needed that uses objective neuropsychological measures to understand the associations of subjective cognitive concerns, emotional well-being, and cognitive test performance in individuals with CCM1. There is also a need for research that focuses on protective factors and resiliency following genetic testing for CCM1 and the development of mental health interventions to preempt psychosocial difficulties.
文摘The joint development of teachers and young children is the basis for promoting the development of high-quality preschool education in the new era,and encouraging early childhood teachers to make playthings according to local conditions is both the fine tradition of China's early childhood education and the direct orientation of China's preschool education policy.Homemade play and teaching aids are some of the methods often used in kindergartens,which skillfully combine young children's daily life objects with toys and early childhood teaching,not only enriching the collective activities of young children but also cultivating children's abilities in various aspects.Kindergarten homemade"play and teaching aids"for early childhood teachers and children have their special educational significance and value,therefore,this paper is based on the children and teachers double subject basis,discussing the homemade"play and teaching aids"for children and teachers of the double subject meanings,and puts forward the realization of the This paper discusses the double-subjective meaning of homemade teaching aids for children and teachers on the basis of the double-subjective foundation of children and teachers,and puts forward specific suggestions for realizing the double-subjectivity of kindergarten homemade teaching aids to enrich the theoretical value and practical significance of homemade teaching aids,to provide theoretical references and support for the relevant staff.
文摘Introduction: Acute coronary syndrome is often the first event of coronary disease of young subjects. Objective: To study sociodemographic, clinical, paraclinical, therapeutic and evolutionary aspects of acute coronary syndrome of young subjects. Patients and Methods: Descriptive cross-sectional study with prospective recruitment from October 01, 2020 to March 31, 2022. Were included all patients admitted for acute coronary syndrome whose age was less or equal to 45 years and who had undergone coronary angiography at the Mother-Child University Hospital on Luxembourg from Bamako. Results: During the study period, we collected 60 patient files out of 198. These 60 patient files met our inclusion criteria. Hospital frequency was 30.30%. Average age of patients was 40.43 ± 3.9 years. Sex ratio M/F was 5.3. Main cardiovascular risk factor was smoking tobacco (23.42%), followed by dyslipidemia (13.92%). Functional signs were dominated by angina 62% followed by dyspnea 25.3%. Persistent ST-segment elevation on electrocardiogram was present in 76.4%. Left ventricular systolic dysfunction was present in 26.5%. Time to first medical contact was more than 12 hours in 62.7% of cases. Radial approach was adopted in 94% of cases. Coronary angiography was pathological in 85% (n = 51) of cases. Lesions were single-vessel disease in 47.1% and culprit artery was anterior interventricular in 51% of cases. Dual anti-platelet aggregation was aspirin and ticagrelor in 91.8% of cases. Angioplasty was performed in all patients who had significant abnormalities at coronary angiography. In-hospital mortality was 3.9%. Conclusion: Acute coronary syndromes exist in young Africans with a male predominance. Main cardiovascular risk factor is smoking tobacco. Coronary lesions are single vessel disease in the majority of case. Most of patients meet medical team after 12 hours. Time to first medical contact is a main challenge in our country.
基金supported by the National Key Research and Development Program of China(2019YFD1001300 and 2019YFD1001305)the Fundamental Research Funds for the Central Universities,China(SWUKQ22042)+1 种基金the China Agriculture Research System of MOF and MARA(CARS-08)the Agricultural Science and Technology Innovation Program of Chinese Academy of Agricultural Sciences。
文摘Genetic improvement of drought resistance is one of the main breeding goals for common bean,so molecular markers must be identified to facilitate drought resistance breeding.In this study,we evaluated the proline,trehalose,raffinose,and stachyose contents of 210 common bean accessions under two watering conditions and found large variations in all four.The coefficients of variation ranged from 21.21%for proline content to 78.69%for stachyose content under well-watered conditions,and from 20.11%for proline content to 50.08%for trehalose content under drought stress.According to our genome-wide association analysis,32 quantitative trait loci were associated with drought resistance,seven of which overlapped with known loci.Four hotspot regions were identified at Pv01,Pv07 and Pv11.A set of candidate genes was identified,including genes encoding MYB,bZIP,bHLH,ERF,and protein kinases.Among these genes,Phvul.001G189400,Phvul.007G273000 and Phvul.008G270500 were annotated as bZIP,ERF and WRKY,respectively.These genes are reportedly involved in drought stress responses in Arabidopsis thaliana and were induced by drought stress in common bean.Significant SNPs in six candidate gene regions formed different haplotypes,and phenotypic analysis revealed significant differences among the haplotypes.These results provide new insight into the genetic basis of drought resistance in common bean and reveal candidate genes and superior natural variations that will be useful for improving common bean.
文摘While endoscopic retrograde cholangiopancreatography(ERCP)remains the primary treatment modality for common bile duct stones(CBDS)or choledocho-lithiasis due to advancements in instruments,surgical intervention,known as common bile duct exploration(CBDE),is still necessary in cases of difficult CBDS,failed endoscopic treatment,or altered anatomy.Recent evidence also supports CBDE in patients requesting single-step cholecystectomy and bile duct stone removal with comparable outcomes.This review elucidates relevant clinical anatomy,selection indications,and outcomes to enhance surgical understanding.The selection between trans-cystic(TC)vs trans-choledochal(TD)approaches is described,along with stone removal techniques and ductal closure.Detailed surgical techniques and strategies for both the TC and TD approaches,including instrument selection,is also provided.Additionally,this review comprehensively addresses operation-specific complications such as bile leakage,stricture,and entrapment,and focuses on preventive measures and treatment strategies.This review aims to optimize the management of CBDS through laparoscopic CBDE,with the goal of improving patient outcomes and minimizing risks.
基金supported in part by the National Natural Science Foundation of China under Grants 61975091,61905015,61575108,and 61505034by the Tsinghua Precision Medicine Foundation and“Bio-Brain+X”Advanced Imaging Instrument Development Seed Grant.
文摘In this paper,we present a distal-scanning common path probe for optical coherence tomography(OCT)equipped with a hollow ultrasonic motor and a simple and specially designed beam-splitter.This novel probe proves to be able to effectively circumvent polarization and dispersion mismatch caused by fiber motion and is more robust to a variety of interfering factors during the imaging process,experimentally compared to a conventional noncommon path probe.Furthermore,our design counteracts the attenuation of backscattering with depth and the fall-off of the signal,resulting in a more balanced signal range and greater imaging depth.Spectral-domain OCT imaging of phantom and biological tissue is also demonstrated with a sensitivity of∼100dB and a lateral resolution of∼3μm.This low-cost probe offers simplified system configuration and excellent robustness,and is therefore particularly suitable for clinical diagnosis as one-off medical apparatus.
基金financially supported by Basic Science Research Program through the National Research Foundation of Korea(NRF)funded by The Ministry of Education(NRF-2020R1I1A2063567)。
文摘Many birds develop brood patches on their ventral apterium under hormonal regulation to effectively transmit body heat to eggs during incubation.The developed patch has several characteristics,including de-feathering,vascularization,and edema.However,little is known about whether avian brood parasites that do not incubate their eggs exhibit brood patch development during the breeding season.In this study,we measured the size of the ventral apterium in 114 Common Cuckoos(Cuculus canorus)captured in the field throughout the breeding season and examined the appearance of the ventral apterium to confirm the development of brood patches.We also examined whether morphological traits and various factors correlated with the size of the ventral apterium(sternal apterium and abdominal apterium)and how it changed during the breeding season.We found no clear signs of brood patch development in Common Cuckoos captured throughout the breeding season,indicating that they likely did not develop brood patches on the ventral apterium during this period.We also found that ventral apterium size was positively correlated with wing length and body weight.In addition,Common Cuckoos with newly growing feathers on the boundary of the ventral apterium with pteryla were frequently observed as seasons progressed to the end.In conclusion,Common Cuckoos exhibit neither brood patch development nor the vestigial characteristics of ancestral brood patches,except for the growth of feathers on boundary the ventral apterium.Further studies examining brood patches across different groups of avian brood parasites are valuable for enhancing our understanding of the developmental and physiological adaptations of avian brood parasites.
文摘Introduction: In Cameroon, surgery remains the only approach in malignant obstructions of the common bile duct (MOCBD) even in palliative situations. The aim of this work was to describe the modalities of surgical treatment of MOCBD, evaluate the results and detect the factors associated with postoperative morbidity and mortality. Patients and Methods: We conducted an analytical observational study, with retrospective data collection from the files of patients operated upon for MOCBD. This was done in four referral hospitals in the city of Yaoundé for a 42-month period spanning from January 1, 2020 to June 30, 2023. Demographic data, clinical presentation, surgical data, and 30-day postoperative outcomes were collected. Results: We collected 71 files. The sex ratio was 1.4 and the mean age was 56 ± 11 years. Fifty-three (53) patients (74.6%) were overweight or obese and 10 patients (14.1%) were hypertensive. A clinical cholestasis syndrome was present in 69 patients (97.2%). Fifty-five (55) patients (77.5%) had a cancer of the head of the pancreas, 8 patients (11.3%) had an extra-hepatic cholangiocarcinoma and 8 patients (11.3%) had an ampullary adenocarcinoma. Eight (8) resections (11.3%) with curative intent had been carried out and in 63 cases (88.7%), surgery was palliative. Postoperative morbidity was 55.7%, influenced by advanced WHO stage (p = 0.02). Postoperative mortality was 25.7%, associated with a high ASA score (p = 0.01). Conclusion: Pancreatic head cancer is the main etiology of malignant obstructions of the common bile duct in Cameroon. Surgical treatment is most often palliative. Postoperative morbidity and mortality are high, influenced by high WHO and ASA scores.
基金supported by the National Natural Science Foundation of China(Nos.32270526 to WL,32260253 to LW and 32101242 to LM)。
文摘The Oriental Reed Warbler(Acrocephalus orientalis)is one of the most commonly used hosts for the parasitic Common Cuckoo(Cuculus canorus).However,as hosts that feed unrelated parasitic nestlings may suffer extra reproductive costs,they may be less willing to care for nestlings that have prolonged nestling periods.To test this hypothesis,the duration of feeding by Oriental Reed Warblers under natural conditions for their own nestlings was compared with the duration of feeding under natural conditions for Common Cuckoo nestlings and for artificially prolonged cuckoo nestlings.The results showed that Oriental Reed Warblers did not starve,drive away,or desert any of the nestlings in the experiment,and neither parent was left alone.Our experimental study indicates that both Oriental Reed Warbler parents were willing to care for nestlings with a prolonged nestling period(up to 30 days,twice the average duration time that the Oriental Reed Warblers fed their own chicks in natural conditions).However,further experiments and observations are required in other host bird species to examine whether both parents or one of the parents may exhibit the behavior of abandoning nestlings with a prolonged nestling period.
基金Under the auspices of the National Natural Science Foundation of China(No.42271234,42101246,42101223)Hong Kong Research Grants Council General Research Fund Grant(No.14605920,14611621,14606922)+1 种基金Hong Kong Research Grants Council Collaborative Research Fund Grant(No.C4023-20GF)Hong Kong Research Grants Council Research Matching Grants RMG(No.8601219,8601242)。
文摘It is common to observe the epidemic risk perception(ERP)and a decline in subjective well-being(SWB)in the context of public health events,such as Corona Virus Disease 2019(COVID-19).However,there have been few studies exploring the impact of individuals’ERP within living space on their SWB,especially from a geographical and daily activity perspective after the resumption of work and other activities following a wave of the pandemic.In this paper,we conducted a study with 789 participants in urban China,measuring their ERP within living space and examining its influence on their SWB using path analysis.The results indicated that individuals’ERP within their living space had a significant negative effect on their SWB.The density of certain types of facilities within their living space,such as bus stops,subway stations,restaurants,fast food shops,convenience shops,hospitals,and public toilets,had a significantly negative impact on their SWB,mediated by their ERP within living space.Additionally,participation in out-of-home work and other activities not only increased individuals’ERP within living space,but also strengthened its negative effect on their SWB.
基金Yunnan Provincial Department of Education Science Research Fund(2024J0412).
文摘Background:The enduring and detrimental impact of childhood trauma on later health and well-being is now well established.However,research on the relationship between childhood trauma and depressive symptoms,along with the potential risk and protective factors,is insufficient in the context of Chinese college student population.Methods:Data on childhood trauma,depressive symptoms,resilience,and subjective well-being were collected through surveys conducted with 367 Chinese university students.The data collected in this study were analyzed using SPSS 26.0 and PROCESS 3.5.Results:The results revealed that subjective well-being mediated the relationship between childhood trauma and depressive symptoms among college students,with direct and indirect effects accounting for 59.46%and 40.54%of the total effect,respectively.The pathway process between subjective well-being and depressive symptoms was moderated by resilience,whereby an increase in resilience levels corresponded to a gradual escalation in the predictive power of subjective well-being on depressive symptoms.Conclusion:The study indicates that childhood trauma significantly and positively predicts depressive symptoms among college students,and it can also directly predict depressive symptoms through the mediating effect of subjective well-being.Elevating levels of psychological resilience and subjective well-being among college students can mitigate depression and promote psychological well-being.From the perspective of positive psychology,the present study provides a new perspective for the prevention and intervention of depressive symptoms among college students.
基金The National Natural Science Foundation of China supports this review(No.82172844)The funder had no role in study design,data collection and analysis,manuscript preparation,or decision to publish.
文摘Objective:Cancer survivors have experienced subjective cognitive impairment(SCI)when they received cancer diagnoses or treatments.Their psychosocial and emotional statuses were also impacted.With the advancement of web technologies,web-based cognitive interventions have been implemented in the management and the alleviation of the SCI,the psychosocial distress,and the emotional distress in cancer survivors.This review aimed to summarize the intervention contents of web-based cognitive interventions for SCI,and to explore the effects of the interventions on SCI,psychosocial status,and emotional health.Methods:Six databases(CINAHL Plus,Cochrane Library,Embase,APA PsycInfo,PubMed and CNKI)were searched from the establishment of databases up to December 2023.Literature references were also manually searched for related articles.Results:This review contained 21 studies that covered the contents of web-based cognitive interventions,such as computer-assisted cognitive training,online cognitive rehabilitation,cognitive behavior therapy with the Internet,telehealth physical exercise,and web-based mindfulness interventions.The effects of web-based cognitive interventions positively impacted SCI for cancer survivors.Also,these interventions showed varying degrees of effectiveness in alleviating psychosocial and emotional distresses.Conclusion:By summarizingfive types of cognitive intervention contents delivered via web technology,this review demonstrated that web-based cognitive interventions optimized SCI and overall psychosocial and emotional statuses for the cancer survivors.It is recommended that future research focus on the development of customized web-based cognitive interventions for individuals with SCI,along with their psychosocial and emotional statuses.
基金This paper is a phased achievement of the National Social Science Foundation of China’s general project“Research on the Influence Mechanism of Transportation Network Optimization on the Spatio-temporal Allocation of Labor Resources and Its Realization Path”(22BJY082).
文摘Common prosperity is an important goal of China’s modernization efforts,and narrowing the income gap among different regions and populations is crucial to achieving common prosperity.The construction of digital infrastructure has significantly boosted productivity and facilitated the diffusion of technology in less developed regions,leading to notable changes in labor employment and the income gap,which aligns with the goal of common prosperity.This paper explores the mechanism through which digital infrastructure influences common prosperity with a focus on employment,using panel data from 30 provinces in China between 2011 and 2021 for an empirical test.The research finds that digital infrastructure significantly promotes common prosperity.By expanding employment and increasing labor remuneration,the influence of digital infrastructure on common prosperity exhibits regional heterogeneity and a nonlinear threshold effect.The research suggests that the government should enhance investment in and construction of digital infrastructure,reduce the digital divide through policy support in rural areas,promote digital employment and skills training,and encourage industrial integration and enterprise participation.
基金Supported by Social Science Funds for United Front Work Special Project of Fujian Provincial Department of Education(KJYT2204A).
文摘Under the historical background of promoting agricultural and rural modernization in an all-round way,this paper deeply analyzes the practical significance of digital construction in rural China,and explores the problems in the digitalization level of rural infrastructure,farmers digitalization awareness and accomplishment,and agricultural digital system.Countermeasures and suggestions are put forward from four aspects:digital village construction policy system,rural digital infrastructure construction,rural digital talent cultivation system,and agricultural digital system,and the rural digital construction of Huzhou City is taken as an example,in order to further realize the goal of empowering rural farmers with digital technology for common prosperity.
文摘Virginia Woolf’s essay“Street Haunting:A London Adventure”highlights the complex relationships between things and the subject.On the individual’s level,indoor things construct and limit the subject’s identity,while outdoor things allow fluid identities;these things reveal Woolf’s dual identity as both a rebel against and a ruler of the hierarchical system.On the intersubjective level,subjects are linked through common aesthetic experience mediated by things,which enjoys a high degree of arbitrariness.With the help of things,subjects form an“imagined community”.Concerning the relationship between things and the mind,things also endow order in the fragmented reality,yet in this sense they are abstract,metaphysical and universal rather than specific in Virginia Woolf’s thoughts.They are the withdrawn things expressed by sensual qualities.These sensual aspects,however,are tools to reveal the essence and meaning of life,secondary to the mind.
基金Supported by the People’s Livelihood Science and Technology Innovation Project of the Bureau of Science and Technology of Jiaxing City,No.2021AD30091.
文摘BACKGROUND Undifferentiated pleomorphic sarcoma(UPS)is a rare malignant mesenchymal tumor with a poor prognosis.It mainly occurs in the extremities,trunk,head and neck,and retroperitoneum regions.Owing to the lack of specific clinical manifestations and imaging features,UPS diagnosis mainly depends on pathological and immunohistochemical examinations for exclusive diagnosis.Here we report an extremely rare case of high-grade UPS in the common bile duct(CBD).There are limited available data on such cases.CASE SUMMARY A 70-year-old woman was admitted to our department with yellow eyes and urine accompanied by upper abdominal distending pain for 2 wk.Her laboratory data suggested significantly elevated hepatorenal function levels.The imaging data revealed calculous cholecystitis,intrahepatic and extrahepatic bile duct dilation with extrahepatic bile duct calculi,and a space-occupying lesion at the distal CBD.After endoscopic biliary stenting and symptomatic support therapy,CBD exploration and biopsy were performed.The frozen section indicated malignant spindle cell tumor of the CBD mass,and further radical pancreaticoduodenectomy was performed.Finally,the neoplasm was diagnosed as a high-grade UPS combined with the light-microscopic morphology and immunohistochemical results.CONCLUSION This extremely rare case highlighted the need for increasing physicians'vigilance,reducing the odds of misdiagnosis,and providing appropriate treatment strategies.
文摘Large Language Models (LLMs) have revolutionized Generative Artificial Intelligence (GenAI) tasks, becoming an integral part of various applications in society, including text generation, translation, summarization, and more. However, their widespread usage emphasizes the critical need to enhance their security posture to ensure the integrity and reliability of their outputs and minimize harmful effects. Prompt injections and training data poisoning attacks are two of the most prominent vulnerabilities in LLMs, which could potentially lead to unpredictable and undesirable behaviors, such as biased outputs, misinformation propagation, and even malicious content generation. The Common Vulnerability Scoring System (CVSS) framework provides a standardized approach to capturing the principal characteristics of vulnerabilities, facilitating a deeper understanding of their severity within the security and AI communities. By extending the current CVSS framework, we generate scores for these vulnerabilities such that organizations can prioritize mitigation efforts, allocate resources effectively, and implement targeted security measures to defend against potential risks.
基金Supported by Qiqihar Science and Technology Plan Joint Guidance Project,No.LHYD-2021058.
文摘BACKGROUND The incidence of cholelithiasis has been on the rise in recent years,but the choice of procedure is controversial.AIM To investigate the efficacy of laparoscopic cholecystectomy(LC)combined with endoscopic papillary balloon dilation(EPBD)in patients with gallbladder stones(GS)with common bile duct stones(CBDS).METHODS The clinical data of 102 patients with GS combined with CBDS were selected for retrospective analysis and divided into either an LC+EPBD group(n=50)or an LC+endoscopic sphincterotomy(EST)group(n=52)according to surgical methods.Surgery-related indexes,postoperative recovery,postoperative complications,and expression levels of inflammatory response indexes were compared between the two groups.RESULTS Total surgical time,stone free rate,rate of conversion to laparotomy,and successful stone extraction rate did not differ significantly between the LC+EPBD group and LC+EST group.Intraoperative hemorrhage,time to ambulation,and length of hospitalization in the LC+EPBD group were lower than those of the LC+EST group(P<0.05).The rate of total complications of the two groups was 9.80%and 17.65%,respectively,and the difference was not statistically significant.No serious complications occurred in either group.At 48 h postoperatively,the expression levels of interleukin-6,tumor necrosis factor-α,high-sensitivity Creactive protein,and procalcitonin were lower in the LC+EPBD group than in the LC+EST group(P<0.05).At 3 d postoperatively,the expression levels of aspartate transaminase,alanine transaminase,and total bilirubin were lower in the LC+EPBD group than in the LC+EST group(P<0.05).CONCLUSION LC combined with EPBD and LC combined with EST are both effective procedures for the treatment of GS with CBDS,in which LC combined with EPBD is beneficial to shorten the patient’s hospitalization time,reduce the magnitude of elevated inflammatory response indexes,and promote postoperative recovery.
文摘BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP)is an accurate diagnostic method for choledocholithiasis and treatment option for stone removal.Additionally,ursodeoxycholic acid(UDCA)can dissolve cholesterol stones and prevent their development and reappearance by lowering the cholesterol concen-tration in bile.Despite these treatment options,there are still patients who experience stone recurrence.The clinical data of 100 patients with choledochal stones who were hospitalized at the Yixing People’s Hospital and underwent ERCP for successful stone extraction between June 2020 and December 2022 were retrospectively collected.According to the post-ERCP treatment plan,100 patients were classified into UDCA(n=47)and control(n=53)groups.We aimed to assess the clinical efficacy and rate of relapse in the two patient populations.We then collected information(basic demographic data,clinical characteristics,and serum biochemical indicators)and determined the factors contributing to relapse using logistic regression analysis.Our secondary goal was to determine the effects of UDCA on liver function after ERCP.Compared to the control group,the UDCA group demonstrated a higher clinical effectiveness rate of 92.45%vs 78.72%(P<0.05).No significant differences were observed in liver function indices,including total bilirubin,direct bilirubin,gamma-glutamyl transpeptidase,alanine aminotransferase,alkaline phosphatase,and aspartate aminotransferase,between the two groups before treatment.After treatment,all liver function indices were significantly reduced.Comparing the control vs UDCA groups,the UDCA group exhibited significantly lower levels of all indices(55.39±6.53 vs 77.31±8.52,32.10±4.62 vs 45.39±5.69,142.32±14.21 vs 189.63±16.87,112.52±14.25 vs 149.36±15.36,122.61±16.00 vs 171.33±22.09,96.98±10.44 vs 121.35±11.57,respectively,all P<0.05).The stone recurrence rate was lower in the UDCA group(13.21%)in contrast with the control group(44.68%).Periampullary diverticula(OR:6.00,95%CI:1.69-21.30),maximum stone diameter(OR:1.69,95%CI:1.01-2.85),stone quantity>3(OR:4.23,95%CI:1.17-15.26),and positive bile culture(OR:7.61,95%CI:2.07-27.91)were independent factors that influenced the relapse of common bile duct stones after ERCP(P<0.05).Furthermore,postoperative UDCA was identified as a preventive factor(OR:0.07;95%CI:0.08-0.09).CONCLUSION The intervention effect of UDCA after ERCP for common bile duct stones is adequate,providing new research directions and references for the prevention and treatment of stone recurrence.
基金supported by the National Natural Science Foundation of China(Grant No.71872122)Late-stage Subsidy Project of Humanities and Social Sciences of the Education Department of China(Grant No.20JHQ095).
文摘The energy-saving renovation of existing residential buildings is a crucial measure to achieve the strategic goal of energy conservation and emission reduction in China and build ecologically livable cities.This article focuses on the perspective of subject behavior,starting from analyzing the current situation and difficulties of the operation of the energy-saving renovation market for existing residential buildings in China,drawing on the practical experience of the operation of the existing residential building energy-saving renovation market abroad.Based on principles such as systematicity,humanization,feasibility,and sustainability,the article constructs an operation optimization system of the existing residential building energy-saving renovation market from the perspective of subject behavior.In order to provide a reference for the healthy and orderly operation of the existing residential building energy-saving renovation market,this paper proposes implementation strategies for optimizing the operation of the existing residential building energy-saving renovation market.Suggestions are proposed from four aspects:optimizing the market environment,innovating the financing model,building the information sharing platform,and utilizing the synergies of the main subjects.