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基于Mann-Kendall的广东省长效避孕服务利用和人工流产的趋势与突变分析
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作者 马远珠 吴颖芳 +4 位作者 武丽 夏建红 赵庆国 吴云涛 朱颖贤 《中国生育健康杂志》 2024年第5期416-423,共8页
目的了解广东省长效避孕服务利用和人工流产变化趋势,为制定有效的生殖保健服务策略,提高妇女生殖健康提供依据。方法采用Mann-Kendall检验法对2008—2021年广东省长效避孕服务利用总例数、各种长效避孕方法例数与占比、人工流产例数、... 目的了解广东省长效避孕服务利用和人工流产变化趋势,为制定有效的生殖保健服务策略,提高妇女生殖健康提供依据。方法采用Mann-Kendall检验法对2008—2021年广东省长效避孕服务利用总例数、各种长效避孕方法例数与占比、人工流产例数、人工流产活产比进行趋势和突变分析。结果2008—2021年广东省长效避孕服务利用总例数呈现下降趋势,长效不可逆避孕方法例数呈先增后降的趋势、长效可逆避孕方法例数呈现下降趋势;这三个指标突变点分别出现在2016、2018、2014年。各种长效避孕方法服务利用上,放置宫内节育器术占67.3%,输卵管绝育术占29.1%,输精管绝育术占3.5%,放置皮下填埋剂术占0.1%。全省人工流产例数呈下降趋势,突变点出现在2018年;人工流产活产比相对稳定,年均人工流产活产比为76.5%。从区域层面看,全省与珠三角地区长效可逆避孕方法例数和人工流产例数的变化趋势呈现出平行关系,粤东、粤西和粤北地区长效可逆避孕方法例数变化趋势与人工流产例数变化趋势的关联各异。结论广东省放置宫内节育器术在长效避孕方法中占主导地位,输卵管绝育术次之,长效避孕责任主要由女性群体承担。区域间长效可逆避孕方法与人工流产变化趋势呈现出不同的关系,有必要深入了解导致这些地区差异的因素,促进不同区域避孕服务的有效落实,避免发生意外妊娠。此外,建议地区积极探讨将避孕服务与妇女全生命周期服务整合,提高妇女生殖健康水平。 展开更多
关键词 长效避孕 人工流产 -肯德尔 趋势分析 突变检验
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六味地黄丸介导RAGE抑制MMP-2/MMP-9对Aβ_(1-40)损伤bEnd.3细胞紧密连接蛋白的影响
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作者 丁蕊 袁永 +3 位作者 贾亚泉 高爱社 张振强 宋军营 《中成药》 CAS CSCD 北大核心 2024年第2期424-430,共7页
目的探讨六味地黄丸对β淀粉样蛋白1-40(Aβ_(1-40))损伤的小鼠脑微血管内皮细胞(bEnd.3)的保护作用及其机制。方法采用CCK8法检测Aβ_(1-40)和六味地黄丸含药血清(MSLDP)对细胞活性的影响,筛选合适的作用浓度。将bEnd.3细胞分为对照组... 目的探讨六味地黄丸对β淀粉样蛋白1-40(Aβ_(1-40))损伤的小鼠脑微血管内皮细胞(bEnd.3)的保护作用及其机制。方法采用CCK8法检测Aβ_(1-40)和六味地黄丸含药血清(MSLDP)对细胞活性的影响,筛选合适的作用浓度。将bEnd.3细胞分为对照组、Aβ_(1-40)组、MSLDP+Aβ_(1-40)组和MSLDP组,采用Western blot检测低密度脂蛋白相关蛋白1(LRP1)、晚期糖基化终末产物受体(RAGE)、基质金属蛋白酶2(MMP-2)、MMP-9、闭锁小带蛋白-1(ZO-1)、脑源性神经营养因子(BDNF)蛋白表达,免疫荧光检测LRP1、RAGE、ZO-1表达;再将bEnd.3细胞分为对照组、Aβ_(1-40)组、FPS-ZM1(RAGE抑制剂)+Aβ_(1-40)组和FPS-ZM1+Aβ_(1-40)+MSLDP组,Western blot检测RAGE、MMP-9、MMP-2、ZO-1蛋白表达。结果Aβ_(1-40)呈剂量依赖性降低bEnd.3细胞活性(P<0.01),MSLDP对Aβ_(1-40)损伤的细胞活性具有保护作用(P<0.05,P<0.01),因此选择10μmol/L Aβ_(1-40)和10%MSLDP进行后续实验。与对照组比较,Aβ_(1-40)组RAGE、MMP-2、MMP-9蛋白表达升高(P<0.01),LRP1、ZO-1、BDNF蛋白表达降低(P<0.05,P<0.01),并且LRP1、ZO-1荧光强度降低(P<0.01),RAGE荧光增强(P<0.01);与Aβ_(1-40)组比较,MSLDP组RAGE、MMP-2、MMP-9蛋白表达和RAGE荧光强度降低(P<0.05,P<0.01),而LRP1、ZO-1、BDNF蛋白表达和LRP1、ZO-1荧光强度升高(P<0.05,P<0.01)。与Aβ_(1-40)组比较,Aβ_(1-40)+FPS-ZM1组MMP-2、MMP9、RAGE蛋白表达降低(P<0.05,P<0.01),ZO-1蛋白表达升高(P<0.05);Aβ_(1-40)+FPS-ZM1+MSLDP组MMP-2、MMP9、RAGE蛋白表达降低(P<0.01),ZO-1蛋白表达升高(P<0.01),FPS-ZM1和MSLDP联合使用的效果更佳。结论六味地黄丸能够保护Aβ_(1-40)损伤的脑微血管内皮的细胞紧密连接,减轻血脑屏障障碍,保护神经血管单元防治阿尔茨海默病,可能通过调节RAGE途径抑制MMP-2/MMP-9途径实现。 展开更多
关键词 六味地黄丸 阿尔茨海默病 脑微血管内皮细胞 β淀粉样蛋白1-40(Aβ_(1-40)) 晚期糖基化终末产物受体(RAGE) 基质金属蛋白酶家族(MMPs)
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维持性血液透析患者血清Endocan-1、Lp-PLA2水平与自体动静脉内瘘血栓形成的相关性
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作者 陈建平 杨阳 +3 位作者 方梦婕 陈蓉 金哲 廖爱能 《医学理论与实践》 2024年第10期1730-1733,共4页
目的:探讨维持性血液透析(MHD)患者血清内皮细胞特异分子-1(Endocan-1)、脂蛋白相关磷脂酶A2(Lp-PLA2)的表达水平,分析其与自体动静脉内瘘(AVF)血栓形成的相关性。方法:纳入2021年6月—2023年3月我院MHD患者120例,根据是否发生AVF血栓分... 目的:探讨维持性血液透析(MHD)患者血清内皮细胞特异分子-1(Endocan-1)、脂蛋白相关磷脂酶A2(Lp-PLA2)的表达水平,分析其与自体动静脉内瘘(AVF)血栓形成的相关性。方法:纳入2021年6月—2023年3月我院MHD患者120例,根据是否发生AVF血栓分成AVF通畅组(n=64)与AVF血栓形成组(n=56),门诊健康体检者90例作为对照组。收集MHD患者相关临床指标。ELISA法检测Endocan-1、Lp-PLA2表达水平。ROC曲线分析Endocan-1、Lp-PLA2对AVF血栓形成的诊断价值,Logistic回归分析影响AVF血栓的危险因素。结果:(1)MHD组Endocan-1、Lp-PLA2水平较对照组升高(均P<0.05)。(2)AVF血栓形成组心脏瓣膜钙化比例、SBP、DBP、MHR、NLR、Endocan-1、Lp-PLA2、血磷、D-二聚体、FIB、β_(2)-MG、iPTH、C反应蛋白、透析龄、冠脉钙化评分、超滤量均较AVF通畅组升高(均P<0.01)。(3)血清Endocan-1、Lp-PLA2对预测AVF血栓形成的敏感度分别为76.1%、82.1%,特异度分别为95.3%、93.7%,截断值分别为767.5pg/mL、518.5ng/mL,曲线下面积分别为0.854、0.915。(4)Logistic回归分析显示:Endocan-1、Lp-PLA2、MHR、NLR、SBP、FIB、冠脉钙化评分、超滤量是AVF血栓形成危险因素(均P<0.01或P<0.05)。结论:血清Endocan-1、Lp-PLA2水平升高是MHD患者AVF血栓形成的危险因素,可能参与了AVF血栓的发生与发展。 展开更多
关键词 维持性血液透析 内瘘血栓形成 内皮细胞特异分子-1 脂蛋白相关磷脂酶A2 危险因素
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High glucose reduces Nrf2-dependent cRAGE release and enhances inflammasome-dependent IL-1βproduction in monocytes:the modulatory effects of EGCG 被引量:1
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作者 Chi-Hao Wu Yin-Hsuan Chang +2 位作者 Chin-Lin Hsu Sheng-Yi Chen Gow-Chin Yen 《Food Science and Human Wellness》 SCIE CSCD 2024年第3期1531-1542,共12页
Soluble receptor for advanced glycation end products(sRAGE)acts as a decoy sequestering of RAGE ligands,thus preventing the activation of the ligand-RAGE axis linking human diseases.However,the molecular mechanisms un... Soluble receptor for advanced glycation end products(sRAGE)acts as a decoy sequestering of RAGE ligands,thus preventing the activation of the ligand-RAGE axis linking human diseases.However,the molecular mechanisms underlying sRAGE remain unclear.In this study,THP-1 monocytes were cultured in normal glucose(NG,5.5 mmol/L)and high glucose(HG,15 mmol/L)to investigate the effects of diabetesrelevant glucose concentrations on sRAGE and interleukin-1β(IL-1β)secretion.The modulatory effects of epigallocatechin gallate(EGCG)in response to HG challenge were also evaluated.HG enhanced intracellular reactive oxygen species(ROS)generation and RAGE expression.The secretion of sRAGE,including esRAGE and cRAGE,was reduced under HG conditions,together with the downregulation of a disintegrin and metallopeptidase 10(ADAM10)and nuclear factor erythroid 2-related factor 2(Nrf2)nuclear translocation.Mechanistically,the HG effects were counteracted by siRAGE and exacerbated by siNrf2.Chromatin immunoprecipitation results showed that Nrf2 binding to the ADAM10 promoter and HG interfered with this binding.Our data reinforce the notion that RAGE and Nrf2 might be sRAGE-regulating factors.Under HG conditions,the treatment of EGCG reduced ROS generation and RAGE activation.EGCG-stimulated cRAGE release was likely caused by the upregulation of the Nrf2-ADAM10 pathway.EGCG inhibited HG-mediated NLRP3 inflammasome activation at least partly by stimulating sRAGE,thereby reducing IL-1βrelease. 展开更多
关键词 Epigallocatechin gallate(EGCG) INFLAMMASOME Nuclear factor erythroid 2-related factor 2(Nrf2) Receptor for advanced glycation end products(RAGE) Soluble RAGE(sRAGE)
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Effect of Bogie Cavity End Wall Inclination on Flow Field and Aerodynamic Noise in the Bogie Region of High-Speed Trains
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作者 Jiawei Shi Jiye Zhang 《Computer Modeling in Engineering & Sciences》 SCIE EI 2024年第5期2175-2195,共21页
Combining the detached eddy simulation(DES)method and Ffowcs Williams-Hawkings(FW-H)equation,the effect of bogie cavity end wall inclination on the flow field and aerodynamic noise in the bogie region is numerically s... Combining the detached eddy simulation(DES)method and Ffowcs Williams-Hawkings(FW-H)equation,the effect of bogie cavity end wall inclination on the flow field and aerodynamic noise in the bogie region is numerically studied.First,the simulation is conducted based on a simplified cavity-bogie model,including five cases with different inclination angles of the front and rear walls of the cavity.By comparing and analyzing the flow field and acoustic results of the five cases,the influence of the regularity and mechanism of the bogie cavity end wall inclination on the flow field and the aerodynamic noise of the bogie region are revealed.Then,the noise reduction strategy determined by the results of the simplified cavity-bogie model is applied to a three-car marshaling train model to verify its effectiveness when applied to the real train.The results reveal that the forward inclination of the cavity front wall enlarges the influence area of shear vortex structures formed at the leading edge of the cavity and intensifies the interaction between the vortex structures and the front wheelset,frontmotor,and front gearbox,resulting in the increase of the aerodynamic noise generated by the bogie itself.The backward inclination of the cavity rear wall is conducive to guiding the vortex structures flow out of the cavity and weakening the interaction between the shear vortex structures and the cavity rear wall,leading to the reduction of the aerodynamic noise generated by the bogie cavity.Inclining the rear end wall of the foremost bogie cavity of the head car is a feasible aerodynamic noise reduction measure for high-speed trains. 展开更多
关键词 BOGIE cavity flow aerodynamic noise end wall inclination
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End-group modulation of phenazine based non-fullerene acceptors for efficient organic solar cells with high open-circuit voltage
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作者 Yahui Zhang Yafeng Li +7 位作者 Ruixiang Peng Yi Qiu Jingyu Shi Zhenyu Chen Jinfeng Ge Cuifen Zhang Zheng Tang Ziyi Ge 《Journal of Energy Chemistry》 SCIE EI CAS CSCD 2024年第1期461-468,I0011,共9页
Phenazine-based non-fullerene acceptors(NFAs)have demonstrated great potential in improving the power conversion efficiency(PCE)of organic solar cells(OSCs).Halogenation is known to be an effective strategy for increa... Phenazine-based non-fullerene acceptors(NFAs)have demonstrated great potential in improving the power conversion efficiency(PCE)of organic solar cells(OSCs).Halogenation is known to be an effective strategy for increasing optical absorption,refining energy levels,and improving molecular packing in organic semiconductors.Herein,a series of NFAs(Pz IC-4H,Pz IC-4F,Pz IC-4Cl,Pz IC-2Br)with phenazine as the central core and with/without halogen-substituted(dicyanomethylidene)-indan-1-one(IC)as the electron-accepting end group were synthesized,and the effect of end group matched phenazine central unit on the photovoltaic performance was systematically studied.Synergetic photophysical and morphological analyses revealed that the PM6:Pz IC-4F blend involves efficient exciton dissociation,higher charge collection and transfer rates,better crystallinity,and optimal phase separation.Therefore,OSCs based on PM6:Pz IC-4F as the active layer exhibited a PCE of 16.48%with an open circuit voltage(Voc)and energy loss of 0.880 V and 0.53 e V,respectively.Accordingly,this work demonstrated a promising approach by designing phenazine-based NFAs for achieving high-performance OSCs. 展开更多
关键词 Organic solar cells Non-fullerene acceptor PHENAZINE Central core end group
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MGMT activated by Wnt pathway promotes cisplatin tolerance through inducing slow-cycling cells and nonhomologous end joining in colorectal cancer
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作者 Haowei Zhang Qixin Li +9 位作者 Xiaolong Guo Hong Wu Chenhao Hu Gaixia Liu Tianyu Yu Xiake Hu Quanpeng Qiu Gang Guo Junjun She Yinnan Chen 《Journal of Pharmaceutical Analysis》 SCIE CAS CSCD 2024年第6期863-877,共15页
Chemotherapy resistance plays a pivotal role in the prognosis and therapeutic failure of patients with colorectal cancer(CRC).Cisplatin(DDP)-resistant cells exhibit an inherent ability to evade the toxic chemotherapeu... Chemotherapy resistance plays a pivotal role in the prognosis and therapeutic failure of patients with colorectal cancer(CRC).Cisplatin(DDP)-resistant cells exhibit an inherent ability to evade the toxic chemotherapeutic drug effects which are characterized by the activation of slow-cycle programs and DNA repair.Among the elements that lead to DDP resistance,O^(6)-methylguanine(O^(6)-MG)-DNA-methyltransferase(MGMT),a DNA-repair enzyme,performs a quintessential role.In this study,we clarify the significant involvement of MGMT in conferring DDP resistance in CRC,elucidating the underlying mechanism of the regulatory actions of MGMT.A notable upregulation of MGMT in DDP-resistant cancer cells was found in our study,and MGMT repression amplifies the sensitivity of these cells to DDP treatment in vitro and in vivo.Conversely,in cancer cells,MGMT overexpression abolishes their sensitivity to DDP treatment.Mechanistically,the interaction between MGMT and cyclin dependent kinase 1(CDK1)inducing slow-cycling cells is attainted via the promotion of ubiquitination degradation of CDK1.Meanwhile,to achieve nonhomologous end joining,MGMT interacts with XRCC6 to resist chemotherapy drugs.Our transcriptome data from samples of 88 patients with CRC suggest that MGMT expression is co-related with the Wnt signaling pathway activation,and several Wnt inhibitors can repress drug-resistant cells.In summary,our results point out that MGMT is a potential therapeutic target and predictive marker of chemoresistance in CRC. 展开更多
关键词 Colorectal cancer MGMT Chemotherapy resistance Slow-cycling cells Nonhomologous end joining Wnt pathway
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End-of-Pregnancy Monitoring at CHUMEFJE through the Functional Investigation Centre (FIC) in 2022
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作者 Ulysse Pascal Minkobame Zaga Minko Opheelia Makoyo Komba +5 位作者 Pamphile Assoumou Obiang Anouchka Mewie Lendzinga Elsy Ntsame Mezui Irenee Edzo Mvono Jacques Albert Bang Ntamack Jean François Meye 《Open Journal of Obstetrics and Gynecology》 2024年第1期186-192,共7页
Introduction: The end of pregnancy is a high-risk period for both mother and foetus. Rigorous monitoring can prevent complications before delivery. Materials and Method: We conducted a descriptive cross-sectional obse... Introduction: The end of pregnancy is a high-risk period for both mother and foetus. Rigorous monitoring can prevent complications before delivery. Materials and Method: We conducted a descriptive cross-sectional observational study. It took place in the delivery room of the Teacher hospital Mother and Child of Jeanne Ebori Fondation from the 01 October 2020 to 01 October 2021. All patients followed at the Functional Investigation Centre (FIC) of the CHUMEFJE and who gave birth in that same hospital were included. Data were collected on the basis of pregnancy diaries, the fic register and delivery room registers. They were analysed using SPSS Statistical Software. Results: During the period of our study, 4086 parturients arrived in the delivery room. Of these, 150 were followed up at the FIC, giving a prevalence of 3.7%. The majority of parturients (48%) had only one prenatal contact. 6 (4%) patients underwent pelvic scans, and 4 (2.6%) presented with a narrowed pelvis. A vaginal delivery was performed in 80% of cases, and of the caesarean sections, 9 (30%) could be scheduled. The maternal prognosis was marred by one post-partum complication of hypertension, and newborns with poor adaptation to life outside the womb accounted for 3.3% of cases. Conclusion: The Functional Investigation Centre makes it possible to detect anomalies at the end of pregnancy with a view to better planning of delivery. 展开更多
关键词 FOLLOW-UP end of Pregnancy Scheduled Caesarean Section Prognosis
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Prognostic value of neutrophil-to-lymphocyte ratio in end-stage liver disease:A meta-analysis
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作者 Xiang-Hao Cai Yun-Ming Tang +4 位作者 Shu-Ru Chen Jia-Hui Pang Yu-Tian Chong Hong Cao Xin-Hua Li 《World Journal of Hepatology》 2024年第3期477-489,共13页
BACKGROUND The neutrophil-to-lymphocyte ratio(NLR)is commonly utilized as a prognostic indicator in end-stage liver disease(ESLD),encompassing conditions like liver failure and decompensated cirrhosis.Nevertheless,som... BACKGROUND The neutrophil-to-lymphocyte ratio(NLR)is commonly utilized as a prognostic indicator in end-stage liver disease(ESLD),encompassing conditions like liver failure and decompensated cirrhosis.Nevertheless,some studies have contested the prognostic value of NLR in ESLD.AIM To investigate the ability of NLR to predict ESLD.METHODS Databases,such as Embase,PubMed,Web of Science,Cochrane Library,China National Knowledge Infrastructure,Weipu,and Wanfang,were comprehensively searched to identify studies published before October 2022 assessing the prognostic ability of NLR to predict mortality in patients with ESLD.Effect sizes were calculated using comprehensive meta-analysis software and SATAT 15.1.RESULTS A total of thirty studies involving patients with end-stage liver disease(ESLD)were included in the evaluation.Among the pooled results of eight studies,it was observed that the Neutrophil-to-Lymphocyte Ratio(NLR)was significantly higher in non-survivors compared to survivors(random-effects model:standardized mean difference=1.02,95%confidence interval=0.67-1.37).Additionally,twenty-seven studies examined the associations between NLR and mortality in ESLD patients,reporting either hazard ratios(HR)or odds ratios(OR).The combined findings indicated a link between NLR and ESLD mortality(randomeffects model;univariate HR=1.07,95%CI=1.05-1.09;multivariate HR=1.07,95%CI=1.07-1.09;univariate OR=1.29,95%CI=1.18-1.39;multivariate OR=1.29,95%CI=1.09-1.49).Furthermore,subgroup and meta-regression analyses revealed regional variations in the impact of NLR on ESLD mortality,with Asian studies demonstrating a more pronounced effect.CONCLUSION Increased NLR in patients with ESLD is associated with a higher risk of mortality,particularly in Asian patients.NLR is a useful prognostic biomarker in patients with ESLD. 展开更多
关键词 Neutrophil-to-lymphocyte ratio end stage liver diseases PROGNOSIS META-ANALYSIS MORTALITY
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血清Syndecan-1、Endocan-1及炎症因子评估脓毒症患者病情严重程度及预后的价值
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作者 吴静静 张福森 +1 位作者 李冬梅 刘霞 《检验医学与临床》 CAS 2024年第14期2053-2056,2061,共5页
目的 探讨血清多配体聚糖-1(Syndecan-1)、内皮细胞特异分子1(Endocan-1)及炎症因子评估脓毒症患者病情严重程度及预后的临床价值。方法 选取2019年10月至2020年6月泰安市中心医院收治的122例脓毒症患者作为研究组,按照病情严重程度分... 目的 探讨血清多配体聚糖-1(Syndecan-1)、内皮细胞特异分子1(Endocan-1)及炎症因子评估脓毒症患者病情严重程度及预后的临床价值。方法 选取2019年10月至2020年6月泰安市中心医院收治的122例脓毒症患者作为研究组,按照病情严重程度分为轻度脓毒症组(63例)、重度脓毒症组(41例)和脓毒症休克组(18例)。另选取同期收治的68例全身炎症反应综合征患者作为对照组。分析血清Syndecan-1、Endocan-1表达水平与炎症因子、急性生理学与慢性健康状况评分Ⅱ(APACHEⅡ评分)、快速序贯器官衰竭评分(qSOFA评分)的相关性,以及血清Syndecan-1、Endocan-1对脓毒症患者预后的预测效能。结果 研究组与对照组APACHEⅡ评分、qSOFA评分及血清Syndecan-1、Endocan-1表达水平比较,差异均有统计学意义(P<0.05);脓毒症休克组患者血清Syndecan-1和Endocan-1表达水平、APACHEⅡ评分、qSOFA评分,以及血清降钙素原(PCT)、C反应蛋白(CRP)、白细胞介素-6(IL-6)水平均高于轻度脓毒症组和重度脓毒症组(P<0.05),且重度脓毒症组高于轻度脓毒症组(P<0.05)。血清Syndecan-1、Endocan-1表达水平与各项炎症因子水平及APACHEⅡ评分、qSOFA评分均呈正相关(P<0.05)。血清Syndecan-1和Endocan-1联合预测脓毒症患者预后的效能优于二者单独预测(Z_(二者联合-Syndecan-1)=2.842,P=0.004 5;Z_(二者联合-Endocan-1)=3.054,P=0.002 3)。结论 血清Syndecan-1、Endocan-1表达水平与脓毒症患者病情严重程度有关,二者联合检测对脓毒症患者预后具有较高的预测效能。 展开更多
关键词 多配体聚糖-1 内皮细胞特异分子1 脓毒症 C反应蛋白 白细胞介素-6
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Palliative care for end-stage liver disease and acute on chronic liver failure:A systematic review
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作者 Vakaola I Pulotu Mafi Jonathan Soldera 《World Journal of Methodology》 2024年第4期131-148,共18页
BACKGROUND End stage liver disease(ESLD)represents a growing health concern characterized by elevated morbidity and mortality,particularly among individual ineligible for liver transplantation.The demand for palliativ... BACKGROUND End stage liver disease(ESLD)represents a growing health concern characterized by elevated morbidity and mortality,particularly among individual ineligible for liver transplantation.The demand for palliative care(PC)is pronounced in patients grappling with ESLD and acute on chronic liver failure(ACLF).Unfortunately,the historical underutilization of PC in ESLD patients,despite their substantial needs and those of their family caregivers,underscores the imperative of seamlessly integrating PC principles into routine healthcare practices across the entire disease spectrum.AIM To comprehensively investigate the evidence surrounding the benefits of incorporating PC into the comprehensive care plan for individuals confronting ESLD and/or ACLF.METHODS A systematic search in the Medline(PubMed)database was performed using a predetermined search command,encompassing studies published in English without any restrictions on the publication date.Subsequently,the retrieved studies were manually examined.Simple descriptive analyses were employed to summarize the results.RESULTS The search strategies yielded 721 references.Following the final analysis,32 fulllength references met the inclusion criteria and were consequently incorporated into the study.Meticulous data extraction from these 32 studies was undertaken,leading to the execution of a comprehensive narrative systematic review.The review found that PC provides significant benefits,reducing symptom burden,depressive symptoms,readmission rates,and hospital stays.Yet,barriers like the appeal of transplants and misconceptions about PC hinder optimal utilization.Integrating PC early,upon the diagnosis of ESLD and ACLF,regardless of transplant eligibility and availability,improves the quality of life for these patients.CONCLUSION Despite the substantial suffering and poor prognosis associated with ESLD and ACLF,where liver transplantation stands as the only curative treatment,albeit largely inaccessible,PC services have been overtly provided too late in the course of the illness.A comprehensive understanding of PC's pivotal role in treating ESLD and ACLF is crucial for overcoming these barriers,involving healthcare providers,patients,and caregivers. 展开更多
关键词 end stage liver disease Acute on chronic liver failure Palliative care Liver transplantation Quality of life
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Bilateral pericapsular end nerve blocks for steroid-induced avascular necrosis following COVID-19 infection requiring bilateral total hip replacement
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作者 Somita Christopher Sweety Dutta Thota Venkata Sanjeev Gopal 《World Journal of Anesthesiology》 2024年第1期1-8,共8页
BACKGROUND Osteonecrosis or avascular necrosis(AVN)of the hip was one of the dreaded complications of coronavirus disease 2019(COVID-19),which emerged in patients who received steroid therapy.Corticosteroids have been... BACKGROUND Osteonecrosis or avascular necrosis(AVN)of the hip was one of the dreaded complications of coronavirus disease 2019(COVID-19),which emerged in patients who received steroid therapy.Corticosteroids have been a mainstay in the treatment protocol of COVID-19 patients.Popular corticosteroid drugs used in patients suffering from COVID-19 were intravenous(IV)or oral dexamethasone,methylprednisolone or hydrocortisone.The use of such high doses of corticost-eroids has shown very positive results and has been lifesaving in many cases.Still,long-term consequences were drug-induced diabetes,osteoporosis,Cushing syndrome,muscle wasting,peripheral fat mobilization,AVN,hirsutism,sleep disturbances and poor wound healing.A significant number of young patients were admitted for bilateral total hip replacements(THR)secondary to AVN following steroid use for COVID-19 treatment.AIM To assess the efficacy of bilateral pericapsular end nerve group(PENG)blocks in patients posted for bilateral THR post-steroid therapy after COVID-19 infection and assess the time taken to first ambulate after surgery.METHODS This prospective observational study was conducted between January 2023 and August 2023 at Care Hospitals,Hyderabad,India.Twenty young patients 30-35 years of age who underwent bilateral THR were studied after due consent over 8 months.All the patients received spinal anaesthesia for surgery and bilateral PENG blocks for postoperative analgesia.RESULTS The duration of surgery was 2.5 h on average.Seventeen out of twenty patients(85%)had a Visual Analog Score(VAS)of less than 2 and did not require any supplementation.One patient was removed from the study,as he required re-exploration.The remaining two patients had a VAS of more than 8 and received IV morphine post-operatively as a rescue analgesic drug.Fifteen out of seventeen patients(88.2%)could be mobilized 12 h after the procedure.CONCLUSION Osteonecrosis or AVN of the hip was one of the dreaded complications of COVID-19,which surfaced in patients who received steroid therapy requiring surgical intervention.Bilateral PENG block is an effective technique to provide post-operative analgesia resulting in early mobilization and enhanced recovery after surgery. 展开更多
关键词 Avascular necrosis Pericapsular end nerve group block ANALGESIA Hip replacement COVID-19 STEROIDS
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融合Dead-ends和离线监督Actor-Critic的动态治疗策略生成模型
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作者 杨莎莎 于亚新 +3 位作者 王跃茹 许晶铭 魏阳杰 李新华 《计算机科学》 CSCD 北大核心 2024年第7期80-88,共9页
强化学习对数学模型依赖性低,利用经验便于架构和优化模型,非常适合用于动态治疗策略学习。但现有研究仍存在以下问题:1)学习策略最优性的同时未考虑风险,导致学到的策略存在一定的风险;2)忽略了分布偏移问题,导致学到的策略与医生策略... 强化学习对数学模型依赖性低,利用经验便于架构和优化模型,非常适合用于动态治疗策略学习。但现有研究仍存在以下问题:1)学习策略最优性的同时未考虑风险,导致学到的策略存在一定的风险;2)忽略了分布偏移问题,导致学到的策略与医生策略完全不同;3)忽略患者的历史观测数据和治疗史,从而不能很好地得到患者状态,进而导致不能学到最优策略。基于此,提出了融合Dead-ends和离线监督Actor-Critic的动态治疗策略生成模型DOSAC-DTR。首先,考虑学到的策略所推荐的治疗行动的风险性,在Actor-Critic框架中融入Dead-ends概念;其次,为缓解分布偏移问题,在Actor-Critic框架中融入医生监督,在最大化预期回报的同时,最小化所学策略与医生策略之间的差距;最后,为了得到包含患者关键历史信息的状态表示,使用基于LSTM的编码器解码器模型对患者的历史观测数据和治疗史进行建模。实验结果表明,DOSAC-DTR相比基线方法有更好的性能,可以得到更低的估计死亡率以及更高的Jaccard系数。 展开更多
关键词 动态治疗策略 Dead-ends Actor-Critic 状态表征
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Investigation of Student Nurses’Attitudes towards End-of-Life Care and Their Influencing Factors
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作者 Lei Peng Jingxian Wang +1 位作者 Jia Wang Qiangqiang Liu 《Open Journal of Nursing》 2024年第5期183-191,共9页
Background: This cross-sectional investigative study aimed to determine student nurses’ attitudes towards end-of-life care. Methods: This study used a descriptive research design with stratified sampling to survey st... Background: This cross-sectional investigative study aimed to determine student nurses’ attitudes towards end-of-life care. Methods: This study used a descriptive research design with stratified sampling to survey student nurses enrolled in one of four nursing colleges in China from January 2023 to December 2023. Student nurses’ general demographic and prior related information, attitudes towards death and attitudes towards end-of-life care were determined using a general information questionnaire, the Death Attitude Profile—Revised scale and the Professional End-of-Life Attitude Scale (PEAS), respectively. Results: The total PEAS score was 122.91 ± 16.123. Significant differences were noted in the attitude towards end-of-life care scores according to sources of end-of-life care knowledge (P Conclusions: Student nurses lacked an optimistic attitude towards end-of-life care, which was influenced by differences in the sources of end-of-life care knowledge. 展开更多
关键词 Nursing Students end-of-Life Care ATTITUDE
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Exendin-4对小鼠黑质网状部神经元自发放电影响
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作者 沈方帅 李筱雪 +3 位作者 刘翠 陈心怡 薛雁 陈蕾 《青岛大学学报(医学版)》 CAS 2024年第4期491-495,共5页
目的探究胰高血糖素样肽-1(GLP-1)受体激动剂Exendin-4对小鼠黑质网状部神经元自发放电的影响。方法采用免疫荧光染色观察GLP-1受体(GLP-1R)在小鼠黑质网状部的表达。使用在体电生理微电极注射10μmol/L的Exendin-4到小鼠黑质网状部神... 目的探究胰高血糖素样肽-1(GLP-1)受体激动剂Exendin-4对小鼠黑质网状部神经元自发放电的影响。方法采用免疫荧光染色观察GLP-1受体(GLP-1R)在小鼠黑质网状部的表达。使用在体电生理微电极注射10μmol/L的Exendin-4到小鼠黑质网状部神经元表面,观察黑质网状部非多巴胺能(假定为γ-氨基丁酸能)神经元的自发放电变化。结果免疫荧光染色结果显示,小鼠黑质网状部有GLP-1R的高表达。在所记录到的13个黑质网状部神经元中,Exendin-4可显著降低其中9个神经元的自发放电,其放电频率由加药前(18.62±3.19)Hz降低到(14.615±3.06)Hz,差异有显著性(t=7.257,P<0.05);其放电频率平均降低(21.85±7.72)%,较生理盐水组的(1.15±9.67)%显著升高(Z=2.282,P<0.05)。在另外的4个黑质网状部神经元中,Exendin-4对放电频率无明显影响,其放电频率由(13.49±7.16)Hz变为(13.54±7.45)Hz,差异无显著性。结论Exendin-4能降低部分黑质网状部神经元的自发放电频率。 展开更多
关键词 艾塞那肽 黑质 网状部 胰高血糖素样肽-1受体 电生理学 小鼠 近交C57BL
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Building Custom Spreadsheet Functions with Python: End-User Software Engineering Approach
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作者 Tamer Bahgat Elserwy Atef Tayh Nour El-Din Raslan +1 位作者 Tarek Ali Mervat H. Gheith 《Journal of Software Engineering and Applications》 2024年第5期246-258,共13页
End-user computing empowers non-developers to manage data and applications, enhancing collaboration and efficiency. Spreadsheets, a prime example of end-user programming environments widely used in business for data a... End-user computing empowers non-developers to manage data and applications, enhancing collaboration and efficiency. Spreadsheets, a prime example of end-user programming environments widely used in business for data analysis. However, Excel functionalities have limits compared to dedicated programming languages. This paper addresses this gap by proposing a prototype for integrating Python’s capabilities into Excel through on-premises desktop to build custom spreadsheet functions with Python. This approach overcomes potential latency issues associated with cloud-based solutions. This prototype utilizes Excel-DNA and IronPython. Excel-DNA allows creating custom Python functions that seamlessly integrate with Excel’s calculation engine. IronPython enables the execution of these Python (CSFs) directly within Excel. C# and VSTO add-ins form the core components, facilitating communication between Python and Excel. This approach empowers users with a potentially open-ended set of Python (CSFs) for tasks like mathematical calculations, statistical analysis, and even predictive modeling, all within the familiar Excel interface. This prototype demonstrates smooth integration, allowing users to call Python (CSFs) just like standard Excel functions. This research contributes to enhancing spreadsheet capabilities for end-user programmers by leveraging Python’s power within Excel. Future research could explore expanding data analysis capabilities by expanding the (CSFs) functions for complex calculations, statistical analysis, data manipulation, and even external library integration. The possibility of integrating machine learning models through the (CSFs) functions within the familiar Excel environment. 展开更多
关键词 end-User Software Engineering Custom Spreadsheet Functions (CSFs)
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Exosome-Transmitted miR-224-5p Promotes Colorectal Cancer Cell Proliferation via Targeting ULK2 in p53-Dependent Manner
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作者 YANG Le Mei ZHENG Qi +5 位作者 LIU Xiao Jia LI Xian Xian Veronica Lim CHEN Qi ZHAO Zhong Hua WANG Shu Yang 《Biomedical and Environmental Sciences》 SCIE CAS CSCD 2024年第1期71-84,共14页
Objective To investigate the role and molecular mechanism of exosomal miR-224-5p in colorectal cancer(CRC).Methods The miR-224-5p expression in CRC patient tissues and cell-derived exosomes was measured by laser captu... Objective To investigate the role and molecular mechanism of exosomal miR-224-5p in colorectal cancer(CRC).Methods The miR-224-5p expression in CRC patient tissues and cell-derived exosomes was measured by laser capture microdissection and qRT-PCR,respectively.Dual-luciferase reporter gene assay was used to determine the target gene of miR-224-5p.The protein expressions of p53 and unc-51 like kinase 2(ULK2)in CRC cells were detected by western blot.Flow cytometry was used to detect cell cycle and apoptosis.Cell proliferation was measured by CCK8 and EdU assay.Results The miR-224-5p expression was upregulated in CRC tissues and increased progressively with the rise of CRC stage.CRC cells secreted extracellular miR-224-5p mainly in an exosome-dependent manner,and then miR-224-5p could be transferred to surrounding tumor cells to regulate cell proliferation in the form of autocrine or paracrine.Moreover,ULK2 was characterized as a direct target of miR-224-5p and was downregulated in CRC tissues.Interestingly,ULK2 inhibited CRC cell proliferation in a p53-dependent manner.Furthermore,exosome-derived miR-224-5p partially reversed the proliferation regulation of ULK2 on CRC cells.Conclusion Our findings demonstrate that exosome-transmitted miR-224-5p promotes p53-dependent cell proliferation by targeting ULK2 in CRC,which may offer promising targets for CRC prevention and therapy. 展开更多
关键词 miR-224-5p EXOSOME ULK2 P53 Cell proliferation Colorectal cancer
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高中英语阅读教学“教-学-评”一体化的实践——以Living Legends一课教学为例
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作者 赵珍龙 李灵枫 《广西教育》 2024年第11期72-75,共4页
“教-学-评”一体化教学模式,以核心素养为导向,整合课程教学、学习活动和教学评价三个方面的相关理论和实践经验。教师可从文本分析、教学目标、评价指令、互动评价、学习效果、评价活动、教师反馈等七个维度设计实施步骤,并采用填写... “教-学-评”一体化教学模式,以核心素养为导向,整合课程教学、学习活动和教学评价三个方面的相关理论和实践经验。教师可从文本分析、教学目标、评价指令、互动评价、学习效果、评价活动、教师反馈等七个维度设计实施步骤,并采用填写阅读教学效果评价表的方式,对学生在本节课的学习效果进行实质性、全面性的反馈,从而全面发展学生的英语学科核心素养。 展开更多
关键词 高中英语阅读 “教--评”一体化 师生互动 评价反馈 核心素养
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急性心肌梗死患者PCI术前血清MMP-9、endocan水平与术后冠状动脉慢血流/无复流的相关性
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作者 邱崇荣 彭金亮 +2 位作者 王萍 付幼林 周宇明 《医学理论与实践》 2024年第18期3175-3177,共3页
目的:探讨急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术前血清基质金属蛋白酶-9(MMP-9)、内皮细胞特异性分子1(endocan)水平与术后冠状动脉慢血流(CSF)/无复流(CNR)的相关性。方法:选择2022年4月-2023年7月在本院行PCI术治疗的200例AM... 目的:探讨急性心肌梗死(AMI)患者经皮冠状动脉介入(PCI)术前血清基质金属蛋白酶-9(MMP-9)、内皮细胞特异性分子1(endocan)水平与术后冠状动脉慢血流(CSF)/无复流(CNR)的相关性。方法:选择2022年4月-2023年7月在本院行PCI术治疗的200例AMI患者设为病例组,40例健康体检者纳入对照组,检测血清endocan、MMP-9水平,对比两组血清endocan、MMP-9水平差异,将AMI术后出现CSF/CNR设为无复流/慢血流组,未出现CSF/CNR设为再灌注组,对比两组血清endocan、MMP-9水平差异,分析MMP-9、endocan与AMI患者PCI术后CSF/CNR的关系及预测价值。结果:病例组血清endocan、MMP-9检测值较对照组高(P<0.05);无复流/慢血流组血清endocan、MMP-9检测值较再灌注组高(P<0.05);经logistic回归分析显示,MMP-9、endocan均是AMI患者PCI术后发生CSF/CNR的独立危险因素(P<0.05);血清MMP-9、endocan联合预测AMI患者PCI术后发生CSF/CNR的AUC为0.872(95%CI:0.798~0.947),灵敏度为0.878、特异度为0.786,均高于单一检测。结论:AMI患者PCI术前血清MMP-9、endocan水平与其CSF/CNR发生密切相关,联合检测可更准确预测CSF/CNR发生情况。 展开更多
关键词 急性心肌梗死 经皮冠状动脉介入 基质金属蛋白酶-9 内皮细胞特异性分子1 冠状动脉慢血流/无复流
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Enable Excel-Based Basic Cybersecurity Features for End Users by Using Python-Excel Integration
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作者 Mohamed Breik Osama Magdy +2 位作者 Essam Amin Tarek Aly Mervat Gheith 《Journal of Software Engineering and Applications》 2024年第6期522-529,共8页
In the digital age, the global character of the Internet has significantly improved our daily lives by providing access to large amounts of knowledge and allowing for seamless connections. However, this enormously int... In the digital age, the global character of the Internet has significantly improved our daily lives by providing access to large amounts of knowledge and allowing for seamless connections. However, this enormously interconnected world is not without its risks. Malicious URLs are a powerful menace, masquerading as legitimate links while holding the intent to hack computer systems or steal sensitive personal information. As the sophistication and frequency of cyberattacks increase, identifying bad URLs has emerged as a critical aspect of cybersecurity. This study presents a new approach that enables the average end-user to check URL safety using Microsoft Excel. Using the powerful VirusTotal API for URL inspections, this study creates an Excel add-in that integrates Python and Excel to deliver a seamless, user-friendly interface. Furthermore, the study improves Excel’s capabilities by allowing users to encrypt and decrypt text communications directly in the spreadsheet. Users may easily encrypt their conversations by simply typing a key and the required text into predefined cells, enhancing their personal cybersecurity with a layer of cryptographic secrecy. This strategy democratizes access to advanced cybersecurity solutions, making attentive digital integrity a feature rather than a daunting burden. 展开更多
关键词 Python end-User Approach EXCEL Excel Add-In CYBERSECURITY URL Check API Virustotal API Encryption Decryption Vigenère Cipher Python-Excel Integration
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