Real life efficacy and safety of direct-acting antiviral therapy for treatment of patients infected with hepatitis C virus genotypes 1, 2and 3 in northwest China

BACKGROUND Regimens involving direct-acting antiviral agents(DAAs)are recommended for the treatment of infection with hepatitis C virus(HCV)genotypes 1,2 and 3.But real-world data is still not enough,especially in Asia.AIM To investigate the efficacy and safety of DAA-based regimens in a real-life setting in China.METHODS This study included 366 patients infected with HCV genotypes 1,2 and 3,with or without cirrhosis,who were observed between May 2015 and December 2018.They were treated with ledipasvir and sofosbuvir(SOF)(genotype 1)with or without ribavirin(RBV),SOF and RBV(genotype 2),or SOF and daclatasvir(genotype 3),with or without RBV,for 12 or more wk.The participants’sustained virological responses(SVR)at post-treatment week 12(SVR12)was the primary endpoint.The occurrence of adverse events and drug-drug interactions were recorded.RESULTS In the 366 patients,genotype 1(59.0%)was the most common genotype,followed by genotypes 2(34.4%)and 3(6.6%).Liver cirrhosis was diagnosed in 154(42.1%)patients.Fifty(13.7%)patients were treatment-experienced.Intention-to-treat analysis revealed that SVR12 was 86.3%(316/366).For modified intention-totreat analysis,SVR12 was achieved in 96.6%of overall patients(316/327),96.3%in patients with genotype 1,97.5%in those with genotype 2,and 95.0%in those with genotype 3.Most of the treatment failures were due to lack of follow-up(3cases had non-responses,1 had virological breakthrough,11 relapsed and 36 did not participate in the follow-up).There was no significant difference in SVR between different genotypes and liver statuses(P<0.05).Patients with lower alanine aminotransferase levels at baseline who achieved an end of treatment response were more likely to achieve SVR12(P<0.05).High SVR was observed regardless of age,gender,liver status,alpha-fetoprotein,HCV RNA levels or history of antiviral therapy(P>0.05 for all).The cumulative hepatocellular carcinoma occurrence and recurrence rate after using the DAAs was 0.9%.Most of the adverse events were mild.We found two cases of special adverse events.One case involved facial and bilateral lower extremity edema,and the other case showed an interesting change in lipid levels while on medication.No severe adverse events were noted.CONCLUSION The DAA-based regimens tested in this study have excellent effectiveness and safety in all patients infected with HCV genotypes 1,2 and 3,including those with cirrhosis.

System Safety Management of Whole Life Cycle of Chemical Process Unit

Guaranteeing the safety performance of chemical process units is the premise for the safety production of chemical enterprises.Only to have the system safety management of the whole life cycle of the process units can operate the process systems under the state of controllable risk.

Standards Ensure Basic Life Quality and Safety

October 14th will be an important day for all of our colleagues engaged in standardization.The theme of the 2008 World Standards Day is'Intelli-gent and sustainable buildings'.The requirements for urban residential developments are rising daily,accompanied by increasing public awareness

Efficacy and safety of controlled-release oxycodone/naloxone versus controlled-release oxycodone in Korean patients with cancer-related pain: a randomized controlled trial

Background: Controlled-release oxycodone/naloxone(OXN-CR) maintains the effect of opioid-induced analgesia through oxycodone while reducing the occurrence rate of opioid-induced constipation through naloxone. The present study was designed to assess the non-inferiority of OXN-CR to controlled-release oxycodone(OX-CR) for the control of cancer-related pain in Korean patients.Methods: In this randomized, open-labeled, parallel-group, phase IV study, we enrolled patients aged 20 years or older with moderate to severe cancer-related pain [numeric rating scale(NRS) pain score ≥4] from seven Korean oncology/hematology centers. Patients in the intention-to-treat(ITT) population were randomized(1:1) to OXNCR or OX-CR groups. OXN-CR was administered starting at 20 mg/10 mg per day and up-titrated to a maximum of80 mg/40 mg per day for 4 weeks, and OX-CR was administered starting at 20 mg/day and up-titrated to a maximum of 80 mg/day for 4 weeks.The primary efficacy endpoint was the change in NRS pain score from baseline to week4, with non-inferiority margin of-1.5. Secondary endpoints included analgesic rescue medication intake, patientreported change in bowel habits, laxative intake, quality of life(QoL), and safety assessments.Results: Of the ITT population comprising 128 patients, 7 with missing primary efficacy data and 4 who violated the eligibility criteria were excluded from the efficacy analysis. At week 4, the mean change in NRS pain scores was not significantly different between the OXN-CR group(n = 58) and the OX-CR group(n = 59)(-1.586 vs.-1.559,P = 0.948). The lower limit of the one-sided 95% confidence interval(-0.776 to 0.830) for the difference exceeded the non-inferiority margin(P < 0.001). The OXN-CR and OX-CR groups did not differ significantly in terms of analgesic rescue medication intake, change in bowel habits, laxative intake, QoL, and safety assessments.Conclusions: OXN-CR was non-inferior to OX-CR in terms of pain reduction after 4 weeks of treatment and had a similar safety profile. Studies in larger populations of Korean patients with cancer-related pain are needed to further investigate the effectiveness of OXN-CR for long-term pain control and constipation alleviation.Trial registration ClinicalTrials.gov NCT01313780, registered March 8。

Multicenter Clinical Study for Evaluation of Efficacy and Safety of Transdermal Fentanyl Matrix Patch in Treatment of Moderate to Severe Cancer Pain in 474 Chinese Cancer Patients

Objective: Although a new matrix formulation fentanyl has been used throughout the world for cancer pain management, few data about its efficacy and clinical outcomes associated with its use in Chinese patients have been obtained. This study aimed to assess the efficacy and safety of the new system in Chinese patients with moderate to severe cancer pain. Methods: A total of 474 patients with moderate to severe cancer pain were enrolled in this study and were treated with the new transdermal fentanyl matrix patch (TDF) up to 2 weeks. All the patients were asked to record pain intensity, side effects, quality of life (QOL), adherence and global satisfaction. The initial dose of fentanyl was 25 ?g/h titrated with opioid or according to National Comprehensive Cancer Network (NCCN) guidelines. Transdermal fentanyl was changed every three days. Results: After 2 weeks. The mean pain intensity of the 459 evaluated patients decreased significantly from 5.63?1.26 to 2.03?1.46 (P<0.0001). The total remission rate was 91.29%, of which moderate remission rate 53.16%, obvious remission rate 25.49% and complete remission rate 12.64%. The rate of adverse events was 33.75%, 18.78% of which were moderate and 3.80% were severe. The most frequent adverse events were constipation and nausea. No fatal events were observed. The quality of life was remarkably improved after the treatment (P<0.0001). Conclusion: The new TDF is effective and safe in treating patients with moderate to severe cancer pain, and can significantly improve the quality of life.

Theory and Application of Loss of Life Risk Analysis for Dam Break

The loss of life risk evaluation model for dam break is built in this paper.By using an improved Monte Carlo method,the overtopping probability induced by concurrent flood and wind is calculated,and the Latin Hypercube Sampling is used to generate random numbers.The Graham method is used to calculate the loss of life resulting from dam failure.With Dongwushi reservoir located at Hebei Province taken as an example,the overtopping probability induced by concurrent flood and wind is calculated as 4.77×10-6.Los...

Safety Aspects of Sustainable Storage Dams and Earthquake Safety of Existing Dams

The basic element in any sustainable dam project is safety, which includes the following safety elements： O structural safety, dam safety monitoring, operational safety and maintenance, and emergency planning. Long-term safety primarily includes the analysis of all hazards affecting the project; that is, hazards from the natural environment, hazards from the man-made environment, and project-specific and site-specific hazards. The special features of the seismic safety of dams are discussed. Large dams were the first structures to be systematically designed against earthquakes, starting in the 1930s. How- ever, the seismic safety of older dams is unknown, as most were designed using seismic design criteria and methods of dynamic analysis that are considered obsolete today. Therefore, we need to reevaluate the seismic safety of existing dams based on current state-of-the-art practices and rehabilitate deficient dams. For large dams, a site-specific seismic hazard analysis is usually recommended. Today, large dams and the safety-relevant elements used for controlling the reservoir after a strong earthquake must be able to withstand the ground motions of a safety evaluation earthquake. The ground motion parameters can be determined either by a probabilistic or a deterministic seismic hazard analysis. During strong earthquakes, inelastic deformations may occur in a dam; therefore, the seismic analysis has to be car- ried out in the time domain. Furthermore, earthquakes create multiple seismic hazards for dams such as ground shaking, fault movements, mass movements, and others. The ground motions needed by the dam engineer are not real earthquake ground motions but models of the ground motion, which allow the safe design of dams. It must also be kept in mind that darn safety evaluations must be carried out several times during the long life of large storage dams. These features are discussed in this paper.

Quality Changes and Safety Evaluation of Ready-to-Eat Roasted Antarctic Krill(Euphausia superba)During Storage at Room Temperature(25℃)

The objective of this study was to determine the quality changes and shelf life of ready-to-eat roasted Antarctic krill,either untreated(CT)or treated with sodium diacetate(SD)or sodium diacetate and a deoxidizer(SDD),during storage at room temperature(25℃)by using sensory,physiochemical,and microbial assessment.Additionally,fluoride accumulation in this food product was used to evaluate its safety.Analysis showed that the addition of SD and SDD resulted in better sensory scores compared of that of CT samples(P<0.05).Accordingly,microorganism growth and total basic nitrogen(TVB-N)were maintained at a low level for the duration of storage with SD and SDD treatments.The total viable counts of SD and SDD reached(4.58±0.08)log(CFU g^(−1))and(4.20±0.11)log(CFUg^(−1)),respectively.The mold was found after 6 and 18 days for SD and SDD treatment,and the numbers reached 5.2×10^(6) and 8.5×10^(4) respectively at the end of shelf life.The TVB-N values from CT continuously increased during the whole storage.While TVB-N values from SD and SDD remained significantly less change(P<0.05)during the early 20 days of the storage,and the values reached(12.11±0.07)mg(100 g)^(−1) and(10.88±0.15)mg(100 g)^(−1) on day 33 and day 70,respectively.Importantly,SDD treatment effectively minimized the oxidation values and retained the color of ready-to-eat roasted Antarctic krill.Our results showed that the shelf life of ready-to-eat roasted Antarctic krill treated with SDD was extended by up to 52 days.Additionally,rats fed ready-to-eat roasted Antarctic krill showed accumulation of fluoride exclusively in the thighbone.The accumulation of fluoride residues in the thighbone showed concentration-dependent.The concentrations of fluoride residues in rats were(1760.03±38.21),(2371.52±42.15)mgkg^(−1) and(3615.44±30.53)mgkg^(−1),which were less than sodium fluoride feeding group(4621.01±28.67)mgkg^(−1).The results suggested that the SD and SDD treatments led to better quality and shelf life extension of ready-to-eat roasted Antarctic krill during storage at room temperature(25℃).Therefore,the ready-to-eat roasted Antarctic krill can be of great interest to the seafood industry.

Safety Analysis and Optimization on Ship⁃Borne Vehicle Mooring

Aiming at the mooring stability of the ship⁃borne vehicles and the safety of steel chain links under high sea condition,the rigid⁃flexible coupling dynamics model of deck⁃vehicle⁃mooring chain was established,the load characteristics of the mooring chain under class⁃9 sea state were obtained.The failure mode of the chain link and the influence law of the torsion angle on the stress distribution was obtained.Based on Miner's linear cumulative damage theory,the fatigue life of the mooring chain link was analyzed using the corrected mooring link S-N curve.The existing safety hazards were pointed out.The optimization of the mooring scheme was proposed.The conclusions are as follows:1)The mooring scheme can meet the mooring stability requirements of vehicles under high sea condition.2)The failure mode on the outside of the link crown was mainly tensile failure,and the failure mode on the inside is mainly contact fatigue failure under compression.3)The torsion angle had a significant effect on the stress situation of the chain link.When it exceeds 15 degrees,it will no longer meet the strength requirements.4)Through the optimization of the mooring scheme,the fatigue life of the steel chain link has been significantly increased.

Proposed Simplified Procedure for Safety Factor Scaling for Various Life Cycles

It is common to assume that structures are designed in view of 50 year life cycle as per Euro-Code 2 and other codes. In special cases, structures are designed in view of longer life cycle, such as bridges, important infrastructure facilities, important religious structures or in case of extended returning period of seismic event or floods. Beside issues of durability and maintenance aspects, this involves also the need to cover the probability of exceeding characteristic design live loads during the extended period, while keeping the same levels of the accepted risk that were assumed by the various codes, as good enough for the standard 50 year life cycle. Bearing in mind that design procedures, formulations, materials characteristic strengths and partial safety factors are used for these structures as per the existing codes, scaling of partial safety factors, or alternatively an additional ＂compensating＂ factor is required. A simplified approach and procedure to arrive at a reasonable calibration of the code safety factors based on 50 years to compensate for an extended life cycle, based upon structural reliability considerations, is proposed.

Application effect of case management nursing based on patient safety in patients with prostate cancer

BACKGROUND Globally,prostate cancer has become a major threat to men's health,with an increasing incidence and causes serious effects on the quality and length of life of patients.Despite the rapid development of medical technology,which provides treatments,including surgery,radiotherapy,and endocrine therapy,the treatment of patients with prostate cancer,especially with endocrine therapy,has become a major challenge in clinical treatment owing to the lengthy course of treatment,side effects of drugs,and impact of the disease on the psychological and physiological functioning of the patient,producing poor treatment adherence and a decline in quality of life.After the nursing intervention,the anxiety and depression scores of the observation group were significantly lower than those of the control group(P<0.05).The quality of life score,sexual function,and hormone function were significantly higher than those in the control group(P<0.05).CONCLUSION Case management guidance based on patient safety effectively reduced anxiety and depression in patients undergoing endocrine therapy for prostate cancer and improved their quality of life,treatment compliance,and satisfaction.

Safety estimation of high-pressure hydraulic cylinder using FSI method

Hydraulic cylinder is a primary component of the hydraulic valve systems.The numerical study of hydraulic cylinder to evaluate the stress analysis,the life assessment and the performance of operation characteristics in hydraulic cylinder were described.The calculation of safety factor,fatigue life,piston chamber pressure,rod chamber pressure and the change of velocity of piston with flow time after the beginning of hydraulic cylinder were incorporated.Numerical analysis was performed using the commercial CFD code,ANSYS with unsteady,dynamic mesh model,two-way FSI(fluid-structure interaction)method and k-εturbulent model.The internal pressure in hydraulic cylinder through stress analysis show higher than those of the yield strength.

Long-term effectiveness,outcomes and complications of bariatric surgery

Dietary imbalance and overeating can lead to an increasingly widespread disease-obesity.Aesthetic considerations aside,obesity is defined as an excess of adipose tissue that can lead to serious health problems and can predispose to a number of pathological changes and clinical diseases,including diabetes;hypertension;atherosclerosis;coronary artery disease and stroke;obstructive sleep apnea;depression;weight-related arthropathies and endometrial and breast cancer.A body weight 20%above ideal for age,gender and height is a severe health risk.Bariatric surgery is a set of surgical methods to treat morbid obesity when other treatments such as diet,increased physical activity,behavioral changes and drugs have failed.The two most common procedures currently used are sleeve gastrectomy and gastric bypass.This procedure has gained popularity recently and is generally considered safe and effective.Although current data show that perioperative mortality is low and better control of comorbidities and short-term complications is achieved,more randomized trials are needed to evaluate the long-term outcomes of bariatric procedures.This review aims to synthesize and summarize the growing evidence on the long-term effectiveness,outcomes and complications of bariatric surgery.

Long Undersea Tunnels： Recognizing and Overcoming the Logistics of Operation and Construction

Long undersea tunnels, and particularly those that are built for transportation purposes, are not commonplace infrastructure. Although their planning and construction take a considerable amount of time, they form important fixed links once in operation. The fact that these tunnels are located under the sea gen- erally involves unique challenges including complex issues with construction and operations, which relate to the lack of intermediate access points along the final route of the tunnel. Similar issues are asso- ciated with long under-land tunnels, such as those under mountain ranges such as the Alps. This paper identifies the key issues related to the design and construction of such tunnels, and suggests a potential solution using proven technology from another engineering discipline.

50Ah LiFePO_4聚合物锂离子单体电池的制备

以LiFePO4、中间相碳微球(MCMB)为正、负极活性物质,制作了50 Ah LiFePO4聚合物锂离子单体电池。过充、针刺的结果表明,单体电池的安全性能较高。不同倍率放电、1.00C循环及不同温度下的放电等结果表明,单体电池的电性能和循环性能较好,能量密度和比能量分别为236.2 Wh/L和134 Wh/kg。

Perceptions of People on Police Efficiency and Crime Prevention in Urban Areas in Malaysia

Crime cases from snatch thefts to murders, are becoming increasingly common in Malaysia according to the database of the Royal Malaysian Police （RMP）, the current overall Crime Index in Malaysia was 147,062 for 2013 compared with 65,237 in 1977. The database also revealed that the number of property crimes reported in this country has always exceeded the number of violent crimes. Although in 2013, crimes related to property are higher （117,687） than violent crime （29,375）, the gradual increase in the latter does worry Malaysians. Likewise, Malaysian Government had implemented a ＂safe community＂ concept, inspired by the Malaysian Crime Prevention Foundation （MCPF）, a non-government organization, as they were concerned that the threat of violent crime and non-violent crime would eventually reduce the quality of life for many individuals. The concept is very important to the public as it is perceived as improved safety for the public with less crime. This study analyzes the public safety through their perceptions on the effectiveness of the policeman and suggesting few prevention actions against crime. The data were collected using a self-administered survey questionnaire. Specifically, this study focuses on the more developed states in this country. From the cross tabulation analysis, the majority of respondents agreed that the police are effective in controlling crime. Approximately, 72.1% of respondents felt that the police are efficient in controlling crime.

基于Android平台的安全工器具全寿命周期管理系统研究

目前,在电力系统中安全工器具种类比较多,对工器具各环节管理,主要利用传统的人工记录和查询,工作较为繁琐且效率不高,而工器具是否规范准确管理,影响工作人员的人身安全,与安全生产息息相关。本文利用网络技术、无线通信技术、WebSer vice技术、XML解析技术及二维条码扫描技术等最前沿的先进技术,研究一种基于A ndroid平台安全工器具全寿命周期管理系统,简化了安全工器具的管理方式,降低了工作的繁琐程度,提高了运维检修班组的工作效率,减少生产中非必要的错误,降低了安全隐患,实现田湾核电站电厂对于安全工器具进行全方位的管理。

Human Rights Protection and Global Action under the Impact of the COVID-19 Pandemic——Overview of“2021·China-Europe Seminar on Human Rights”

The COVID-19 pandemic is the largest ever infectious disease facing mankind.It challenges national governance capabilities and international patterns.On June 8,2021,the“2021 China-Europe Seminar on Human Rights”was held in Chongqing,China.Its theme was“COVID-19 Pandemic and the Protection of the Right to Life and Health,”which focused on five topics:the impact of the COVID-19 pandemic on the protection of the rights to life and health,the response of countries against the pandemic,the protection of the right to life and health of specific groups during the pandemic response,the national responsibility for the protection of the right to life and health in the public health crisis,and global cooperation in the prevention and control of the COVID-19 pandemic.The conference reached two consensuses:First,in the face of the pandemic,countries must take responsibility for the people and protect the people’s right to life and health;second,an effective international mechanism for fighting the COVID-19 pandemic must be established as soon as possible.

水凝胶在前列腺癌图像引导放疗中的应用

目的:评价前列腺癌(PCa)图像引导放疗(IGRT)中水凝胶注入后的不良事件(AE)、患者直肠毒性和生活质量(QOL)。方法:筛选2022年10月至2023年3月在我院放疗科接受IGRT的PCa患者70例。采用简单随机分配法将患者均分为注入水凝胶的试验组(n=35)和未注入的对照组(n=35)。采用疼痛视觉模拟评分(VAS)和常见不良事件评价标准(CTCAE)5.0评价术后AE。比较两组急性和晚期放射性直肠炎(RP)发生率和QOL评分。结果:试验组水凝胶注入术中和术后6 h VAS分别为(2.31±0.59)分和(1.43±0.47)分,首次大小便后分别为(1.52±0.33)分和(1.10±0.28)分。试验组5.71%和2.86%的患者分别存在严重出血和手术区域感染。试验组8.57%的患者发生了急性Ⅰ级RP,2.86%的患者发生了晚期Ⅰ级RP;对照组28.57%的患者发生了急性Ⅰ级RP,11.43%的患者发生了急性Ⅱ级RP;对照组17.14%的患者发生晚期Ⅰ级RP,5.71%的患者发生晚期Ⅱ级RP。试验组RP发生率低于对照组,水凝胶的注入降低了患者直肠毒性。自IGRT开始后第3周起,试验组QOL评分显著高于对照组(均P<0.05),水凝胶的注入在一定程度上提高了患者QOL。结论:水凝胶在PCa IGRT中应用时安全性较为理想,能够降低患者直肠毒性和在一定程度上提高QOL,具有一定临床应用价值。

达托霉素对感染性心内膜炎患者炎症指标及生活质量的影响

目的探讨达托霉素对感染性心内膜炎患者炎症指标及生活质量的影响。方法本研究所选观察对象为衢州市人民医院2021年1月至2023年9月收治的87例感染性心内膜炎患者,按照两组患者就诊顺序分组,将2021年1月至2022年4月就诊的43例患者纳入对照组,将2022年5月至2023年9月收治的44例患者纳入观察组,对照组在常规治疗基础上予以阿莫西林克拉维酸钾联合依替米星治疗,观察组在常规治疗基础上予以达托霉素治疗,比较两组患者治疗效果、炎症指标、赘生物直径、生存质量及不良反应发生情况。结果在治疗总有效率方面,观察组(95.45%,42/44)相较于对照组(79.06%,34/43)更高(χ^(2)=5.286,P=0.021);观察组治疗后ESR、Hs-CRP、PCT及赘生物直径[分别为(14.31±1.50)mm·h^(-1)、(8.26±1.35)mg·L^(-1)、(0.38±0.10)ng·mL^(-1)、(3.25±0.33)mm]低于对照组[分别为(22.04±1.87)mm·h^(-1)、(12.10±1.67)mg·L^(-1)、(0.45±0.11)ng·mL^(-1)、(3.72±0.39)mm],差异均有统计学意义(t=21.292、11.807、3.107、6.073,均P<0.05);观察组治疗后生理领域、心理领域、社会关系领域及环境领域评分[分别为(75.49±5.54)分、(78.05±5.68)分、(76.10±4.69)分、(72.18±4.26)分]高于对照组[分别为(70.58±4.87)分、(73.53±5.26)分、(73.27±4.53)分、(68.96±4.6)分],差异均有统计学意义(t=8.161、4.765、3.088、3.373,均P<0.05)。在不良反应发生率方面,观察组2.27%(1/44),对照组为9.30%(4/43),组间差异无统计学意义(χ^(2)=0.898,P=0.343)。结论应用达托霉素治疗感染性心内膜炎患者能够改善炎症反应,提高生存质量,且安全性好。