BACKGROUND Elective cholecystectomy(CCY)is recommended for patients with gallstone-related acute cholangitis(AC)following endoscopic decompression to prevent recurrent biliary events.However,the optimal timing and imp...BACKGROUND Elective cholecystectomy(CCY)is recommended for patients with gallstone-related acute cholangitis(AC)following endoscopic decompression to prevent recurrent biliary events.However,the optimal timing and implications of CCY remain unclear.AIM To examine the impact of same-admission CCY compared to interval CCY on patients with gallstone-related AC using the National Readmission Database(NRD).METHODS We queried the NRD to identify all gallstone-related AC hospitalizations in adult patients with and without the same admission CCY between 2016 and 2020.Our primary outcome was all-cause 30-d readmission rates,and secondary outcomes included in-hospital mortality,length of stay(LOS),and hospitalization cost.RESULTS Among the 124964 gallstone-related AC hospitalizations,only 14.67%underwent the same admission CCY.The all-cause 30-d readmissions in the same admission CCY group were almost half that of the non-CCY group(5.56%vs 11.50%).Patients in the same admission CCY group had a longer mean LOS and higher hospitalization costs attrib-utable to surgery.Although the most common reason for readmission was sepsis in both groups,the second most common reason was AC in the interval CCY group.CONCLUSION Our study suggests that patients with gallstone-related AC who do not undergo the same admission CCY have twice the risk of readmission compared to those who undergo CCY during the same admission.These readmis-sions can potentially be prevented by performing same-admission CCY in appropriate patients,which may reduce subsequent hospitalization costs secondary to readmissions.展开更多
BACKGROUND Pancreatic ductal adenocarcinoma is a common malignancy.Despite all advancements,the prognosis remains,poor with an overall 5-year survival of only 10.8%.Recently,a robotic platform has become an attractive...BACKGROUND Pancreatic ductal adenocarcinoma is a common malignancy.Despite all advancements,the prognosis remains,poor with an overall 5-year survival of only 10.8%.Recently,a robotic platform has become an attractive tool for treating pancreatic cancer(PC).While recent studies indicated improved lymph node(LN)harvest during robotic pancreaticoduodenectomy(PD),data on long-term outcomes are insufficient.AIM To evaluate absolute LN harvest during PD.Secondary outcomes included evaluating the association between LN harvest and short-and long-term oncological outcomes for three different surgical approaches.METHODS We conducted an analysis of the National Cancer Database,including patients diagnosed with PC who underwent open,laparoscopic,or robotic PD in 2010-2018.One-way analysis of variance was used to compare continuous variables,chi-square test-for categorical.Overall survival was defined as the time between surgery and death.Median survival time was estimated with the Kaplan-Meier method,and groups were compared with the Wilcoxon test.A Cox proportional hazards model was used to assess the association of covariates with survival after controlling for patient characteristics and procedure type.RESULTS 17169 patients were included,8859(52%)males;mean age 65;14509(85%)white.13816(80.5%)patients had an open PD,2677(15.6%)and 676(3.9%)-laparoscopic and robotic PD respectively.Mean comorbidity index(Charlson-Deyo Score)0.50.On average,18.84 LNs were harvested.Mean LN harvest during open,laparoscopic and robotic PD was 18.59,19.65 and 20.70 respectively(P<0.001).On average 2.49 LNs were positive for cancer and did not differ by the procedure type(P=0.26).Vascular invasion was noted in 42.6%of LNs and did differ by the approach:42.1%for open,44.0%for laparoscopic and 47.2%for robotic PD(P=0.015).Median survival for open PD was 26.1 mo,laparoscopic-27.2 mo,robotic-29.1 mo(P=0.064).Survival was associated with higher LN harvest,while higher number of positive LNs was associated with higher mortality.CONCLUSION Our study suggests that robotic PD is associated with increased intraoperative LN harvest and has comparable short-term oncological outcomes and survival compared to open and laparoscopic approaches.展开更多
Through collecting, summarizing and effectively classifying the image resources in Daur nationality,and applying the theories and methods of costume design,ethnology and computer science,it investigates into the retri...Through collecting, summarizing and effectively classifying the image resources in Daur nationality,and applying the theories and methods of costume design,ethnology and computer science,it investigates into the retrieval method and indicator system of images resources in Daur nationality in the context of digitalization. The preliminarily established application model of Daur costume design database can search out all qualified image resources from the database quickly according to the prerequisites given by users so that they can obtain information promptly. In particular,costume designers can get inspirations of creation and enlightenment on their creative thinking. Therefore,the effective integration of art and scientific researches can be realized.展开更多
OBJECTIVE In patients undergoing cardiac surgery,reduced preoperative ejection fraction(EF)and senior age are associated with a worse outcome.As most outcome data available for these patients are mainly from Western s...OBJECTIVE In patients undergoing cardiac surgery,reduced preoperative ejection fraction(EF)and senior age are associated with a worse outcome.As most outcome data available for these patients are mainly from Western surgical populations involving specific surgery types,our aim is to evaluate the real-world characteristics and perioperative outcomes of surgery in senior-aged heart failure patients with reduced EF across a broad range cardiac surgeries.METHODS Data were obtained from the China Heart Failure Surgery Registry(China-HFSR)database,a nationwide multicenter registry study in China's Mainland.Multiple variable regression analysis was performed in patients over 75 years old to identify risk factors associated with mortality.RESULTS From 2012 to 2017,578 senior-aged(>75 years)patients were enrolled in China HFSR,21.1%of whom were female.Isolated coronary bypass grafting(CABG)were performed in 71.6%of patients,10.1%of patients underwent isolated valve surgery and 8.7%received CABG combined with valve surgery.In-hospital mortality was 10.6%,and the major complication rate was 17.3%.Multivariate analysis identified diabetes mellitus(odds ratio(OR)=1.985),increased creatinine(OR=1.007),New York Heart Association(NYHA)Class III(OR=1.408),NYHA class IV(OR=1.955),cardiogenic shock(OR,6.271),and preoperative intra-aortic balloon pump insertion(OR=3.426)as independent predictors of in-hospital mortality.CONCLUSIONS In senior-aged patients,preoperative evaluation should be carefully performed,and strict management of reversible factors needs more attention.Senior-aged patients commonly have a more severe disease status combined with more frequent comorbidities,which may lead to a high risk in mortality.展开更多
The kickoff meeting of the vegetable quality big data service platform was held by National Vegetable Quality Standard Center on March 23 in Shouguang City of Shandong Province.It is reported that the Center has compl...The kickoff meeting of the vegetable quality big data service platform was held by National Vegetable Quality Standard Center on March 23 in Shouguang City of Shandong Province.It is reported that the Center has completed the estabLishment of national.vegetable quality standards database,including 1,920 standards related to vegetable quality and 54 technitaL specifications on the production of 37 kinds of vegetables.展开更多
Flora Cryptogamica Sinica is a phytotaxonomic corpus specializing in recording endemic cryptogamic species of unvascular plants in China. It was compiled and published by its Editorial Committee affiliated to the CAS ...Flora Cryptogamica Sinica is a phytotaxonomic corpus specializing in recording endemic cryptogamic species of unvascular plants in China. It was compiled and published by its Editorial Committee affiliated to the CAS headquarters. Divided by specific contents, it consists of five parts, namely, Marine Flora Algae of China, Fresh water Flora Algae of China, Fungal Flora of China,展开更多
BACKGROUND There are rising numbers of patients who have heart failure with preserved ejection fraction(HFpEF).Poorly understood pathophysiology of heart failure with preserved and reduced ejection fraction and due to...BACKGROUND There are rising numbers of patients who have heart failure with preserved ejection fraction(HFpEF).Poorly understood pathophysiology of heart failure with preserved and reduced ejection fraction and due to a sparsity of studies,the management of HFpEF is challenging.AIM To determine the hospital readmission rate within 30 d of acute or acute on chronic heart failure with preserved ejection fraction and its effect on mortality and burden on health care in the United States.METHODS We performed a retrospective study using the Agency for Health-care Research and Quality Health-care Cost and Utilization Project,Nationwide Readmissions Database for the year 2017.We collected data on hospital readmissions of 60514 adults hospitalized for acute or acute on chronic HFpEF.The primary outcome was the rate of all-cause readmission within 30 d of discharge.Secondary outcomes were cause of readmission,mortality rate in readmitted and index patients,length of stay,total hospitalization costs and charges.Independent risk factors for readmission were identified using Cox regression analysis.RESULTS The thirty day readmission rate was 21%.Approximately 9.17%of readmissions were in the setting of acute on chronic diastolic heart failure.Hypertensive chronic kidney disease with heart failure(1245;9.7%)was the most common readmission diagnosis.Readmitted patients had higher in-hospital mortality(7.9%vs 2.9%,P=0.000).Our study showed that Medicaid insurance,higher Charlson co-morbidity score,patient admitted to a teaching hospital and longer hospital stay were significant variables associated with higher readmission rates.Lower readmission rate was found in residents of small metropolitan or micropolitan areas,older age,female gender,and private insurance or no insurance were associated with lower risk of readmission.CONCLUSION We found that patients hospitalized for acute or acute on chronic HFpEF,the thirty day readmission rate was 21%.Readmission cases had a higher mortality rate and increased healthcare resource utilization.The most common cause of readmission was cardio-renal syndrome.展开更多
Background:Studies on myocardial infarction(MI)based on large medical databases have become popular in recent years.The influence of the National Inpatient Sample(NIS),the largest collection of administrative healthca...Background:Studies on myocardial infarction(MI)based on large medical databases have become popular in recent years.The influence of the National Inpatient Sample(NIS),the largest collection of administrative healthcare data across the United States,on the field of MI has not been well investigated.This study aimed to quantify the contribution of NIS to MI research using bibliometric methods.Methods:We searched the Web of Science Core Collection database to identify publications on MI using NIS from 2000 to 2022.Bibliometric indicators,such as the number of publications,citations,and Hirsch index(H-index),were summarized by years,authors,organizations,and journals.VOSviewer and CiteSpace software were used to analyze the keywords and trends of the hot spots.Results:A total of 342 articles on MI based on NIS were included.A significant growth in outputs related to MI using the NIS from 2000 to 2020 was observed.The publications were mainly from the United States.The Mayo Clinic was the most prolific institution and had the most citations and the highest H-index.The American Journal of Cardiology ranked first among journals with the highest number of publications,citations,and H-index.Mortality and healthcare management are the main focuses of this field.Personalized risks and care are receiving increased attention.Conclusion:This study suggests that NIS significantly contributes to high-quality output in MI research.More efforts are needed to improve the impact of knowledge gained from the NIS on MI.展开更多
Landslide research at the British Geological Survey (BGS) is carried out through a number of activities, including surveying, database development and real-time monitoring of landslides. Landslide mapping across the...Landslide research at the British Geological Survey (BGS) is carried out through a number of activities, including surveying, database development and real-time monitoring of landslides. Landslide mapping across the UK has been carried out since BGS started geological mapping in 1835. Today, BGS geologists use a combination of remote sensing and ground-based investigations to survey landslides. The development of waterproof tablet computers (BGS'SIGMAmobile), with inbuilt GPS and GIS for field data capture provides an accurate and rapid mapping methodology for field surveys. Regional and national mapping of landslides is carried out in conjunction with site-specific monitoring, using terrestrial LiDAR and differential GPS technologies, which BGS has successfully developed for this application. In addition to surface monitoring, BGS is currently developing geophysical ground-imaging systems for landslide monitoring, which provide real-time information on subsurface changes prior to failure events. BGS's mapping and monitoring activities directly feed into the BGS National Landslide Database, the most extensive source of information on landslides in Great Britain. It currently holds over 14 000 records of landslide events. By combining BGS's corporate datasets with expert knowledge, BGS has developed a landslide hazard assessment tool, GeoSure, which provides information on the relative landslide hazard susceptibility at national scale.展开更多
Many high quality studies have emerged from public databases,such as Surveillance,Epidemiology,and End Results(SEER),National Health and Nutrition Examination Survey(NHANES),The Cancer Genome Atlas(TCGA),and Medical I...Many high quality studies have emerged from public databases,such as Surveillance,Epidemiology,and End Results(SEER),National Health and Nutrition Examination Survey(NHANES),The Cancer Genome Atlas(TCGA),and Medical Information Mart for Intensive Care(MIMIC);however,these data are often characterized by a high degree of dimensional heterogeneity,timeliness,scarcity,irregularity,and other characteristics,resulting in the value of these data not being fully utilized.Data-mining technology has been a frontier field in medical research,as it demonstrates excellent performance in evaluating patient risks and assisting clinical decision-making in building disease-prediction models.Therefore,data mining has unique advantages in clinical big-data research,especially in large-scale medical public databases.This article introduced the main medical public database and described the steps,tasks,and models of data mining in simple language.Additionally,we described data-mining methods along with their practical applications.The goal of this work was to aid clinical researchers in gaining a clear and intuitive understanding of the application of data-mining technology on clinical big-data in order to promote the production of research results that are beneficial to doctors and patients.展开更多
The British Geological Survey(BGS)is the national geological agency for Great Britain and provides geoscientific information to government, other institutions and the general public.Landslide research at BGS is carrie...The British Geological Survey(BGS)is the national geological agency for Great Britain and provides geoscientific information to government, other institutions and the general public.Landslide research at BGS is carried out through a number of activities including surveying,database development and real-time monitoring of landslides.By underta-展开更多
Background:Carcinosarcomas are rare,aggressive malignancies that can arise in the nasal cavity and paranasal sinuses.There are limited outcome data available.Accordingly,we sought to use the National Cancer Database(N...Background:Carcinosarcomas are rare,aggressive malignancies that can arise in the nasal cavity and paranasal sinuses.There are limited outcome data available.Accordingly,we sought to use the National Cancer Database(NCDB)to characterize patient demographics and outcomes.Method:A retrospective analysis of the NCDB from 2004 to 2016 for patients with sinonasal carcinosarcoma was conducted.Results:Thirty patients were included.The patients were predominantly male(n=20),white(n=23),and privately insured(n=15),with an average age of 62.4 years.The nasal cavity was the most common subsite(n=14),followed by the maxillary sinus(n=8).Most patient were treated with surgery followed by radiation(n=23),with the remaining undergoing surgery alone(n=4),radiation alone(n=2),or no treatment(n=1).One-third(n=10)received adjuvant chemotherapy.The 1-and 5-year overall survival(OS)in the cohort were 79.2%and 43.3%,respectively.Univariate log-rank testing showed OS varied based on intervention(P<0.029),sex(P<0.042),and age(P<0.025),while on multivariate analysis none of these factors independently predicted OS.Conclusions:We describe the demographics and presenting features of a national cohort of sinonasal carcinosarcoma patients.Future research is needed to identify predictors of overall survival,and to assess the optimal roles for radiation and systemic chemotherapy.展开更多
BACKGROUND Liver cancer is among the top five most common cancers globally. Lipid-lowering drugs such as statins can lower the risk of liver cancer, but may also cause liver damage. LipoCol Forte capsules(LFC), a red ...BACKGROUND Liver cancer is among the top five most common cancers globally. Lipid-lowering drugs such as statins can lower the risk of liver cancer, but may also cause liver damage. LipoCol Forte capsules(LFC), a red yeast rice product, have demonstrated significant antihypercholesterolemic effects and a good safety profile in clinical studies.AIM To evaluate whether LFC lowers the risk of liver cancer in adults in this propensity score-matched, nationwide, population-based cohort study.METHODS We used data from Taiwan’s National Health Insurance Research Database, which includes electronic medical records for up to 99.99% of Taiwan’s population. LFC users and LFC non-users were matched 1:1 by propensity scores between January 2010 and December 2017. All had followup data for at least 1 year. Statistical analyses compared demographic distributions including sex, age, comorbidities, and prescribed medications. Cox regression analyses estimated adjusted hazard ratios(aHRs) after adjusting for potential confounders.RESULTS We enrolled 33231 LFC users and 33231 non-LFC users(controls). No significant differences between the study cohorts were identified regarding comorbidities and medications [standardized mean difference(SMD) < 0.05]. At follow-up, the overall incidence of liver cancer was significantly lower in the LFC cohort compared with controls [aHR 0.91;95% confidence interval(CI): 0.86-0.95;P < 0.001]. The risk of liver cancer was significantly reduced in both females(aHR 0.87;95%CI: 0.8-0.94;P < 0.001) and males(aHR 0.93;95%CI: 0.87-0.98;P < 0.01) in the LFC cohort compared with their counterparts in the non-LFC cohort. The antitumor protective effects applied to patients with comorbidities(including hypertension, ischemic stroke, diabetes mellitus, hyperlipidemia, hepatitis B infection and hepatitis C infection). Those using LFC for more than 84 drug days had a 0.64-fold lower risk of liver cancer compared with controls(P < 0.001). Compared with controls, the risk of developing liver cancer in the LFC cohort progressively decreased over time;the lowest incidence of liver cancer occurred in LFC users followed-up for more than 6 years(27.44 vs 31.49 per 1,000 person-years;aHR 0.75;95%CI: 0.68-0.82;P < 0.001).CONCLUSION This retrospective cohort study indicates that LFC has a significantly protective effect on lowering the risk of liver cancer, in a dose-dependent and time-dependent manner.展开更多
BACKGROUND Type 2 diabetes mellitus(DM)is an independent risk factor for hepatocellular carcinoma(HCC),while insulin is a potent mitogen.Identifying a new therapeutic modality for preventing insulin users from develop...BACKGROUND Type 2 diabetes mellitus(DM)is an independent risk factor for hepatocellular carcinoma(HCC),while insulin is a potent mitogen.Identifying a new therapeutic modality for preventing insulin users from developing HCC is a critical goal for researchers.AIM To investigate whether regular herbal medicine use can decrease HCC risk in DM patients with regular insulin control.METHODS We used data acquired from the Taiwan,Chinaese National Health Insurance research database between 2000 and 2017.We identified patients with DM who were prescribed insulin for>3 months.The herb user group was further defined as patients prescribed herbal medication for DM for>3 months per annum during RESULTS We initially enrolled 657144 DM patients with regular insulin use from 2000 to 2017.Among these,46849 patients had used a herbal treatment for DM,and 140547 patients were included as the matched control group.The baseline variables were similar between the herb users and nonusers.DM patients with regular herb use had a 12%decreased risk of HCC compared with the control group[adjusted hazard ratio(aHR)=0.88,95%CI=0.80–0.97].The cumulative incidence of HCC in the herb users was significantly lower than that of the nonusers.Patients with a herb use of>5 years cumulatively exhibited a protective effect against development of HCC(aHR=0.82,P<0.05).Of patients who developed HCC,herb users exhibited a longer survival time than nonusers(aHR=0.78,P=0.0001).Additionally,we report the top 10 herbs and formulas in prescriptions and summarize the potential pharmacological effects of the constituents.Our analysis indicated that Astragalus propinquus(Huang Qi)plus Salvia miltiorrhiza Bunge(Dan Shen),and Astragalus propinquus(Huang Qi)plus Trichosanthes kirilowii Maxim.(Tian Hua Fen)were the most frequent combination of single herbs.Meanwhile,Ji Sheng Shen Qi Wan plus Dan Shen was the most frequent combination of herbs and formulas.CONCLUSION This large-scale retrospective cohort study reveals that herbal medicine may decrease HCC risk by 12%in DM patients with regular insulin use.展开更多
BACKGROUND Immunotherapy have demonstrated promising outcomes in patients with high microsatellite instability(MSI)(MSI-H)metastatic colorectal cancer.However,the comparative effectiveness of Immunotherapy and chemoth...BACKGROUND Immunotherapy have demonstrated promising outcomes in patients with high microsatellite instability(MSI)(MSI-H)metastatic colorectal cancer.However,the comparative effectiveness of Immunotherapy and chemotherapy for patients with low MSI(MSI-L),and microsatellite stable(MSS)metastatic colorectal cancer remains unclear.AIM To investigate immunotherapy vs chemotherapy for treatment of MSI-L/MSS metastatic colorectal cancer,and to evaluate the success of immunotherapy against chemotherapy in managing MSI-H metastatic colorectal cancer during a follow-up of 50 months.METHODS We conducted a retrospective cohort study using the National Cancer Database(NCDB)to evaluate the overall survival(OS)of patients with metastatic colorectal cancer treated with immunotherapy or chemotherapy.The study population was stratified by MSI status(MSI-H,MSI-L,and MSS).Multivariable Cox proportional hazard models were used to assess the association between treatment modality and OS,adjusting for potential confounders.RESULTS A total of 21951 patients with metastatic colorectal cancer were included in the analysis,of which 2358 were MSI-H,and 19593 were MSI-L/MSS.In the MSI-H cohort,immunotherapy treatment(n=142)was associated with a significantly improved median OS compared to chemotherapy(n=860).After adjusting for potential confounders,immunotherapy treatment remained significantly associated with better OS in the MSI-H cohort[adjusted hazard ratio(aHR):0.57,95%confidence interval(95%CI):0.43-0.77,P<0.001].In the MSS cohort,no significant difference in median OS was observed between immunotherapy treatment and chemotherapy(aHR:0.94,95%CI:0.69-1.29,P=0.715).CONCLUSION In this population-based study using the NCDB,immunotherapy treatment was associated with significantly improved OS compared to chemotherapy in patients with MSI-H metastatic colorectal cancer,but not in those with MSI-L/MSS metastatic colorectal cancer.Further studies are warranted to determine the optimal therapeutic approach for patients with MSI-L/MSS metastatic colorectal cancer.展开更多
文摘BACKGROUND Elective cholecystectomy(CCY)is recommended for patients with gallstone-related acute cholangitis(AC)following endoscopic decompression to prevent recurrent biliary events.However,the optimal timing and implications of CCY remain unclear.AIM To examine the impact of same-admission CCY compared to interval CCY on patients with gallstone-related AC using the National Readmission Database(NRD).METHODS We queried the NRD to identify all gallstone-related AC hospitalizations in adult patients with and without the same admission CCY between 2016 and 2020.Our primary outcome was all-cause 30-d readmission rates,and secondary outcomes included in-hospital mortality,length of stay(LOS),and hospitalization cost.RESULTS Among the 124964 gallstone-related AC hospitalizations,only 14.67%underwent the same admission CCY.The all-cause 30-d readmissions in the same admission CCY group were almost half that of the non-CCY group(5.56%vs 11.50%).Patients in the same admission CCY group had a longer mean LOS and higher hospitalization costs attrib-utable to surgery.Although the most common reason for readmission was sepsis in both groups,the second most common reason was AC in the interval CCY group.CONCLUSION Our study suggests that patients with gallstone-related AC who do not undergo the same admission CCY have twice the risk of readmission compared to those who undergo CCY during the same admission.These readmis-sions can potentially be prevented by performing same-admission CCY in appropriate patients,which may reduce subsequent hospitalization costs secondary to readmissions.
文摘BACKGROUND Pancreatic ductal adenocarcinoma is a common malignancy.Despite all advancements,the prognosis remains,poor with an overall 5-year survival of only 10.8%.Recently,a robotic platform has become an attractive tool for treating pancreatic cancer(PC).While recent studies indicated improved lymph node(LN)harvest during robotic pancreaticoduodenectomy(PD),data on long-term outcomes are insufficient.AIM To evaluate absolute LN harvest during PD.Secondary outcomes included evaluating the association between LN harvest and short-and long-term oncological outcomes for three different surgical approaches.METHODS We conducted an analysis of the National Cancer Database,including patients diagnosed with PC who underwent open,laparoscopic,or robotic PD in 2010-2018.One-way analysis of variance was used to compare continuous variables,chi-square test-for categorical.Overall survival was defined as the time between surgery and death.Median survival time was estimated with the Kaplan-Meier method,and groups were compared with the Wilcoxon test.A Cox proportional hazards model was used to assess the association of covariates with survival after controlling for patient characteristics and procedure type.RESULTS 17169 patients were included,8859(52%)males;mean age 65;14509(85%)white.13816(80.5%)patients had an open PD,2677(15.6%)and 676(3.9%)-laparoscopic and robotic PD respectively.Mean comorbidity index(Charlson-Deyo Score)0.50.On average,18.84 LNs were harvested.Mean LN harvest during open,laparoscopic and robotic PD was 18.59,19.65 and 20.70 respectively(P<0.001).On average 2.49 LNs were positive for cancer and did not differ by the procedure type(P=0.26).Vascular invasion was noted in 42.6%of LNs and did differ by the approach:42.1%for open,44.0%for laparoscopic and 47.2%for robotic PD(P=0.015).Median survival for open PD was 26.1 mo,laparoscopic-27.2 mo,robotic-29.1 mo(P=0.064).Survival was associated with higher LN harvest,while higher number of positive LNs was associated with higher mortality.CONCLUSION Our study suggests that robotic PD is associated with increased intraoperative LN harvest and has comparable short-term oncological outcomes and survival compared to open and laparoscopic approaches.
基金the Fundamental Research Funds for the Central Universities,China(No.14D110722)
文摘Through collecting, summarizing and effectively classifying the image resources in Daur nationality,and applying the theories and methods of costume design,ethnology and computer science,it investigates into the retrieval method and indicator system of images resources in Daur nationality in the context of digitalization. The preliminarily established application model of Daur costume design database can search out all qualified image resources from the database quickly according to the prerequisites given by users so that they can obtain information promptly. In particular,costume designers can get inspirations of creation and enlightenment on their creative thinking. Therefore,the effective integration of art and scientific researches can be realized.
文摘OBJECTIVE In patients undergoing cardiac surgery,reduced preoperative ejection fraction(EF)and senior age are associated with a worse outcome.As most outcome data available for these patients are mainly from Western surgical populations involving specific surgery types,our aim is to evaluate the real-world characteristics and perioperative outcomes of surgery in senior-aged heart failure patients with reduced EF across a broad range cardiac surgeries.METHODS Data were obtained from the China Heart Failure Surgery Registry(China-HFSR)database,a nationwide multicenter registry study in China's Mainland.Multiple variable regression analysis was performed in patients over 75 years old to identify risk factors associated with mortality.RESULTS From 2012 to 2017,578 senior-aged(>75 years)patients were enrolled in China HFSR,21.1%of whom were female.Isolated coronary bypass grafting(CABG)were performed in 71.6%of patients,10.1%of patients underwent isolated valve surgery and 8.7%received CABG combined with valve surgery.In-hospital mortality was 10.6%,and the major complication rate was 17.3%.Multivariate analysis identified diabetes mellitus(odds ratio(OR)=1.985),increased creatinine(OR=1.007),New York Heart Association(NYHA)Class III(OR=1.408),NYHA class IV(OR=1.955),cardiogenic shock(OR,6.271),and preoperative intra-aortic balloon pump insertion(OR=3.426)as independent predictors of in-hospital mortality.CONCLUSIONS In senior-aged patients,preoperative evaluation should be carefully performed,and strict management of reversible factors needs more attention.Senior-aged patients commonly have a more severe disease status combined with more frequent comorbidities,which may lead to a high risk in mortality.
文摘The kickoff meeting of the vegetable quality big data service platform was held by National Vegetable Quality Standard Center on March 23 in Shouguang City of Shandong Province.It is reported that the Center has completed the estabLishment of national.vegetable quality standards database,including 1,920 standards related to vegetable quality and 54 technitaL specifications on the production of 37 kinds of vegetables.
文摘Flora Cryptogamica Sinica is a phytotaxonomic corpus specializing in recording endemic cryptogamic species of unvascular plants in China. It was compiled and published by its Editorial Committee affiliated to the CAS headquarters. Divided by specific contents, it consists of five parts, namely, Marine Flora Algae of China, Fresh water Flora Algae of China, Fungal Flora of China,
文摘BACKGROUND There are rising numbers of patients who have heart failure with preserved ejection fraction(HFpEF).Poorly understood pathophysiology of heart failure with preserved and reduced ejection fraction and due to a sparsity of studies,the management of HFpEF is challenging.AIM To determine the hospital readmission rate within 30 d of acute or acute on chronic heart failure with preserved ejection fraction and its effect on mortality and burden on health care in the United States.METHODS We performed a retrospective study using the Agency for Health-care Research and Quality Health-care Cost and Utilization Project,Nationwide Readmissions Database for the year 2017.We collected data on hospital readmissions of 60514 adults hospitalized for acute or acute on chronic HFpEF.The primary outcome was the rate of all-cause readmission within 30 d of discharge.Secondary outcomes were cause of readmission,mortality rate in readmitted and index patients,length of stay,total hospitalization costs and charges.Independent risk factors for readmission were identified using Cox regression analysis.RESULTS The thirty day readmission rate was 21%.Approximately 9.17%of readmissions were in the setting of acute on chronic diastolic heart failure.Hypertensive chronic kidney disease with heart failure(1245;9.7%)was the most common readmission diagnosis.Readmitted patients had higher in-hospital mortality(7.9%vs 2.9%,P=0.000).Our study showed that Medicaid insurance,higher Charlson co-morbidity score,patient admitted to a teaching hospital and longer hospital stay were significant variables associated with higher readmission rates.Lower readmission rate was found in residents of small metropolitan or micropolitan areas,older age,female gender,and private insurance or no insurance were associated with lower risk of readmission.CONCLUSION We found that patients hospitalized for acute or acute on chronic HFpEF,the thirty day readmission rate was 21%.Readmission cases had a higher mortality rate and increased healthcare resource utilization.The most common cause of readmission was cardio-renal syndrome.
基金National Clinical Research Center for geriatric diseases(Jianchao Liu,grant number NCRCG-PLAGH-2019001)National Natural Science Foundation of China(Zhouheng Ye,grant number 82000587)。
文摘Background:Studies on myocardial infarction(MI)based on large medical databases have become popular in recent years.The influence of the National Inpatient Sample(NIS),the largest collection of administrative healthcare data across the United States,on the field of MI has not been well investigated.This study aimed to quantify the contribution of NIS to MI research using bibliometric methods.Methods:We searched the Web of Science Core Collection database to identify publications on MI using NIS from 2000 to 2022.Bibliometric indicators,such as the number of publications,citations,and Hirsch index(H-index),were summarized by years,authors,organizations,and journals.VOSviewer and CiteSpace software were used to analyze the keywords and trends of the hot spots.Results:A total of 342 articles on MI based on NIS were included.A significant growth in outputs related to MI using the NIS from 2000 to 2020 was observed.The publications were mainly from the United States.The Mayo Clinic was the most prolific institution and had the most citations and the highest H-index.The American Journal of Cardiology ranked first among journals with the highest number of publications,citations,and H-index.Mortality and healthcare management are the main focuses of this field.Personalized risks and care are receiving increased attention.Conclusion:This study suggests that NIS significantly contributes to high-quality output in MI research.More efforts are needed to improve the impact of knowledge gained from the NIS on MI.
基金part of a project financially supported by the Natural Environment Research Council(NERC)
文摘Landslide research at the British Geological Survey (BGS) is carried out through a number of activities, including surveying, database development and real-time monitoring of landslides. Landslide mapping across the UK has been carried out since BGS started geological mapping in 1835. Today, BGS geologists use a combination of remote sensing and ground-based investigations to survey landslides. The development of waterproof tablet computers (BGS'SIGMAmobile), with inbuilt GPS and GIS for field data capture provides an accurate and rapid mapping methodology for field surveys. Regional and national mapping of landslides is carried out in conjunction with site-specific monitoring, using terrestrial LiDAR and differential GPS technologies, which BGS has successfully developed for this application. In addition to surface monitoring, BGS is currently developing geophysical ground-imaging systems for landslide monitoring, which provide real-time information on subsurface changes prior to failure events. BGS's mapping and monitoring activities directly feed into the BGS National Landslide Database, the most extensive source of information on landslides in Great Britain. It currently holds over 14 000 records of landslide events. By combining BGS's corporate datasets with expert knowledge, BGS has developed a landslide hazard assessment tool, GeoSure, which provides information on the relative landslide hazard susceptibility at national scale.
基金the National Social Science Foundation of China(No.16BGL183).
文摘Many high quality studies have emerged from public databases,such as Surveillance,Epidemiology,and End Results(SEER),National Health and Nutrition Examination Survey(NHANES),The Cancer Genome Atlas(TCGA),and Medical Information Mart for Intensive Care(MIMIC);however,these data are often characterized by a high degree of dimensional heterogeneity,timeliness,scarcity,irregularity,and other characteristics,resulting in the value of these data not being fully utilized.Data-mining technology has been a frontier field in medical research,as it demonstrates excellent performance in evaluating patient risks and assisting clinical decision-making in building disease-prediction models.Therefore,data mining has unique advantages in clinical big-data research,especially in large-scale medical public databases.This article introduced the main medical public database and described the steps,tasks,and models of data mining in simple language.Additionally,we described data-mining methods along with their practical applications.The goal of this work was to aid clinical researchers in gaining a clear and intuitive understanding of the application of data-mining technology on clinical big-data in order to promote the production of research results that are beneficial to doctors and patients.
文摘The British Geological Survey(BGS)is the national geological agency for Great Britain and provides geoscientific information to government, other institutions and the general public.Landslide research at BGS is carried out through a number of activities including surveying,database development and real-time monitoring of landslides.By underta-
文摘Background:Carcinosarcomas are rare,aggressive malignancies that can arise in the nasal cavity and paranasal sinuses.There are limited outcome data available.Accordingly,we sought to use the National Cancer Database(NCDB)to characterize patient demographics and outcomes.Method:A retrospective analysis of the NCDB from 2004 to 2016 for patients with sinonasal carcinosarcoma was conducted.Results:Thirty patients were included.The patients were predominantly male(n=20),white(n=23),and privately insured(n=15),with an average age of 62.4 years.The nasal cavity was the most common subsite(n=14),followed by the maxillary sinus(n=8).Most patient were treated with surgery followed by radiation(n=23),with the remaining undergoing surgery alone(n=4),radiation alone(n=2),or no treatment(n=1).One-third(n=10)received adjuvant chemotherapy.The 1-and 5-year overall survival(OS)in the cohort were 79.2%and 43.3%,respectively.Univariate log-rank testing showed OS varied based on intervention(P<0.029),sex(P<0.042),and age(P<0.025),while on multivariate analysis none of these factors independently predicted OS.Conclusions:We describe the demographics and presenting features of a national cohort of sinonasal carcinosarcoma patients.Future research is needed to identify predictors of overall survival,and to assess the optimal roles for radiation and systemic chemotherapy.
基金Supported by the Ministry of Science and Technology of Taiwan,No. NSTC111-2320-B-039-025China Medical University Hospital,No. DMR-111-013 and No. DMR-111-195
文摘BACKGROUND Liver cancer is among the top five most common cancers globally. Lipid-lowering drugs such as statins can lower the risk of liver cancer, but may also cause liver damage. LipoCol Forte capsules(LFC), a red yeast rice product, have demonstrated significant antihypercholesterolemic effects and a good safety profile in clinical studies.AIM To evaluate whether LFC lowers the risk of liver cancer in adults in this propensity score-matched, nationwide, population-based cohort study.METHODS We used data from Taiwan’s National Health Insurance Research Database, which includes electronic medical records for up to 99.99% of Taiwan’s population. LFC users and LFC non-users were matched 1:1 by propensity scores between January 2010 and December 2017. All had followup data for at least 1 year. Statistical analyses compared demographic distributions including sex, age, comorbidities, and prescribed medications. Cox regression analyses estimated adjusted hazard ratios(aHRs) after adjusting for potential confounders.RESULTS We enrolled 33231 LFC users and 33231 non-LFC users(controls). No significant differences between the study cohorts were identified regarding comorbidities and medications [standardized mean difference(SMD) < 0.05]. At follow-up, the overall incidence of liver cancer was significantly lower in the LFC cohort compared with controls [aHR 0.91;95% confidence interval(CI): 0.86-0.95;P < 0.001]. The risk of liver cancer was significantly reduced in both females(aHR 0.87;95%CI: 0.8-0.94;P < 0.001) and males(aHR 0.93;95%CI: 0.87-0.98;P < 0.01) in the LFC cohort compared with their counterparts in the non-LFC cohort. The antitumor protective effects applied to patients with comorbidities(including hypertension, ischemic stroke, diabetes mellitus, hyperlipidemia, hepatitis B infection and hepatitis C infection). Those using LFC for more than 84 drug days had a 0.64-fold lower risk of liver cancer compared with controls(P < 0.001). Compared with controls, the risk of developing liver cancer in the LFC cohort progressively decreased over time;the lowest incidence of liver cancer occurred in LFC users followed-up for more than 6 years(27.44 vs 31.49 per 1,000 person-years;aHR 0.75;95%CI: 0.68-0.82;P < 0.001).CONCLUSION This retrospective cohort study indicates that LFC has a significantly protective effect on lowering the risk of liver cancer, in a dose-dependent and time-dependent manner.
基金the National Science and Technology Council of Taiwan,China,No.NSC112-2320-B-039-045-China Medical University Hospital,No.DMR-111-013,No.DMR-111-195,No.DMR-112-004 and No.DMR-112-177Department of Chinese Medicine and Pharmacy and Ministry of Health and Welfare,No.MOHW-112-CMC-03.
文摘BACKGROUND Type 2 diabetes mellitus(DM)is an independent risk factor for hepatocellular carcinoma(HCC),while insulin is a potent mitogen.Identifying a new therapeutic modality for preventing insulin users from developing HCC is a critical goal for researchers.AIM To investigate whether regular herbal medicine use can decrease HCC risk in DM patients with regular insulin control.METHODS We used data acquired from the Taiwan,Chinaese National Health Insurance research database between 2000 and 2017.We identified patients with DM who were prescribed insulin for>3 months.The herb user group was further defined as patients prescribed herbal medication for DM for>3 months per annum during RESULTS We initially enrolled 657144 DM patients with regular insulin use from 2000 to 2017.Among these,46849 patients had used a herbal treatment for DM,and 140547 patients were included as the matched control group.The baseline variables were similar between the herb users and nonusers.DM patients with regular herb use had a 12%decreased risk of HCC compared with the control group[adjusted hazard ratio(aHR)=0.88,95%CI=0.80–0.97].The cumulative incidence of HCC in the herb users was significantly lower than that of the nonusers.Patients with a herb use of>5 years cumulatively exhibited a protective effect against development of HCC(aHR=0.82,P<0.05).Of patients who developed HCC,herb users exhibited a longer survival time than nonusers(aHR=0.78,P=0.0001).Additionally,we report the top 10 herbs and formulas in prescriptions and summarize the potential pharmacological effects of the constituents.Our analysis indicated that Astragalus propinquus(Huang Qi)plus Salvia miltiorrhiza Bunge(Dan Shen),and Astragalus propinquus(Huang Qi)plus Trichosanthes kirilowii Maxim.(Tian Hua Fen)were the most frequent combination of single herbs.Meanwhile,Ji Sheng Shen Qi Wan plus Dan Shen was the most frequent combination of herbs and formulas.CONCLUSION This large-scale retrospective cohort study reveals that herbal medicine may decrease HCC risk by 12%in DM patients with regular insulin use.
文摘BACKGROUND Immunotherapy have demonstrated promising outcomes in patients with high microsatellite instability(MSI)(MSI-H)metastatic colorectal cancer.However,the comparative effectiveness of Immunotherapy and chemotherapy for patients with low MSI(MSI-L),and microsatellite stable(MSS)metastatic colorectal cancer remains unclear.AIM To investigate immunotherapy vs chemotherapy for treatment of MSI-L/MSS metastatic colorectal cancer,and to evaluate the success of immunotherapy against chemotherapy in managing MSI-H metastatic colorectal cancer during a follow-up of 50 months.METHODS We conducted a retrospective cohort study using the National Cancer Database(NCDB)to evaluate the overall survival(OS)of patients with metastatic colorectal cancer treated with immunotherapy or chemotherapy.The study population was stratified by MSI status(MSI-H,MSI-L,and MSS).Multivariable Cox proportional hazard models were used to assess the association between treatment modality and OS,adjusting for potential confounders.RESULTS A total of 21951 patients with metastatic colorectal cancer were included in the analysis,of which 2358 were MSI-H,and 19593 were MSI-L/MSS.In the MSI-H cohort,immunotherapy treatment(n=142)was associated with a significantly improved median OS compared to chemotherapy(n=860).After adjusting for potential confounders,immunotherapy treatment remained significantly associated with better OS in the MSI-H cohort[adjusted hazard ratio(aHR):0.57,95%confidence interval(95%CI):0.43-0.77,P<0.001].In the MSS cohort,no significant difference in median OS was observed between immunotherapy treatment and chemotherapy(aHR:0.94,95%CI:0.69-1.29,P=0.715).CONCLUSION In this population-based study using the NCDB,immunotherapy treatment was associated with significantly improved OS compared to chemotherapy in patients with MSI-H metastatic colorectal cancer,but not in those with MSI-L/MSS metastatic colorectal cancer.Further studies are warranted to determine the optimal therapeutic approach for patients with MSI-L/MSS metastatic colorectal cancer.