Clinical evaluation of timing of endovascular embolization treatment for intracranial aneurysm

Objective To evaluate the effects of endovascular embolization treatment for intracranial aneurysms in different time. Methods The clinical data of 165 cases of ruptured intracranial aneurysm treated by endovascular treatment were analysed retrospectively. The patients were divided into 3 groups accrodding to

Professor YANG Yu-fei’s Experience on the Integrated Chinese and Western Medicine Treatment Strategy for Advanced Colorectal Cancer

Colorectal cancer is one of the common malignant tumors in China.It poses a serious threat to the national health of China.For advanced colorectal cancer, the main goal of treatment is to prolong survival and improve quality of life.It complements other advantages, showing good therapeutic results.However, how to grasp the timing of integrated Chinese and Western Medicine for the treatment of advanced colorectal cancer and use the integrated Chinese and Western Medicine treatment methods flexibly contains profound therapeutic art.Prof.YANG Yu-fei is an authoritative expert in the field of integrated Chinese and Western medicine for colorectal cancer.She is good at accurately grasping the timing of treatment of integrated Chinese and Western Medicine, and flexibly adjusts the treatment strategy according to the specific conditions.In this paper, we shared Professor YANG Yu-fei's strategy for treating advanced colorectal cancer with emphasis on integrated Chinese and Western Medicine and attached a typical case, with a view to provide reference for the treatment of advanced colorectal cancer with integrated Chinese and Western Medicine.

Stochastic Model of a Cold-Stand by System with Waiting for Arrival &Treatment of Server

The service facility or server is the key constituent to keep a system operational for desired period of time. As any eventuality with the system necessitates immediate presence of it (server) so the time point of arrival and treatment of server significantly affects the system performance. This paper works out the steady state behavior of a cold standby system equipped with two similar units and a server with elapsed arrival and treatment times following general probability distributions. It practices the theory of semi-Markov processes, regenerative point technique and Laplace transforms to derive the expressions for state transition probabilities, mean sojourn times, mean time to system failure, system availability, server busy period and expected frequencies of repairs and treatments. The profit function is also developed taking different costs and revenue in to account. For tracing wider applicability of the model for different reliability and cost-effective systems, a particular case study is also presented as an illustration.

Changes in clinical indicators among human immunodeficiency virus patients who failed in antiretroviral therapy during 2004–2016 in Yunnan, China: an observational cohort study

Background:This study aimed to investigate the changes in the clinical indicators and influencing factors of treatment duration among human immunodeficiency virus(HIV)patients in whom antiretroviral therapy(ART)was unsuccessful.Methods:In this retrospective study,a total of 9,418 HIV patients who failed in ART during 2004–2016 were included and divided into two treatment groups—Group 1(treatment time≤3 years,n1=5,218)and Group 2(treatment time>3 years,n2=4,200).Patient follow-up data,including age,cluster of differentiation 4(CD4)count,and viral load,glucose,creatinine,and triglyceride levels,were extracted from electronic health record databases.Covariance analysis for repeated measures was used to analyze the biochemical indicators,and multiple logistic regression modeling was used to compare relevant data extracted from the Group 1 and Group 2 HIV patient cohorts with different treatment time.Results:The median initial CD4 count was 175.0 cells/μl(interquartile range,77.0–282.0),while the initial CD4 counts for Group 1 were lower than those for Group 2(P<0.05).A significant interaction between group and time effects was observed(P<0.05)in total cholesterol(TC).Changes in hemoglobin level among HIV patients were also significantly associated with treatment time(P=0.001).The initial CD4 count(odds ratio[OR]=0.756),female sex(OR=0.713),Zerit(d4T)(OR=1.443),TC(OR=1.285),and aspartate aminotransferase level(OR=1.002)were significantly associated with the survival time of dead patients with HIV(P<0.05).Additionally,the initial CD4 count(OR=1.456),age(OR=1.022),time interval(OR=0.903),patient’s living status(OR=0.597),d4T(OR=2.256),and triglyceride(OR=0.930)and hemoglobin levels(OR=0.997)were significantly associated with the treatment time of HIV patients with drug withdrawal(P<0.05).Conclusion:The initial biochemical parameters can affect the survival and treatment time of HIV patients.With a comprehensive understanding of the physiological and biochemical indicators of patients,we can reduce the probability of drug withdrawal and prolong the survival time of HIV patients.

The effect of treatment package time in head and neck cancer patients treated with adjuvant radiotherapy and concurrent systemic therapy

Objectives:In patients with head and neck carcinoma,“treatment package time”(TPT)was proven to impact outcomes in cases receiving adjuvant radiotherapy alone.Its impact in patients receiving radiotherapy with concurrent systemic therapy has not been studied previously.The TPT influence on survival endpoints for patients treated with surgery followed by radiation and concurrent systemic therapy was analyzed.Methods:Institutional database to identify head and neck carcinoma cases treated with definitive surgery followed by concomitant chemo(bio)radiotherapy(CRT)was used.TPT was the number of days elapsed between surgery and the last day of radiation.%FINDCUT SAS macro tool was used to search for the cutoff TPT that was associated with significant survival benefit.Kaplan-Meier curves,log-rank tests as well as univariate and multivariate analyses were used to assess overall survival(OS)and recurrence free survival(RFS).Results:One hundred and three cases with a median follow up of 37 months were included in the study.Oropharyngeal tumors were 43%,oral cavity 40%and laryngeal 17%of cases.Concurrent systemic therapy included platinum and cetuximab in 72%and 28%,respectively.Optimal TPT was found to be<100 days with significantly better OS(P=0.002)and RFS(P=0.043)compared to TPT≥100 days.On multivariate analysis;TPT<100 days,extracapsular nodal extension,high-risk score,iymphovascular space and perineural invasion were independent predictors for worse OS(P<0.05).T4,extracapsular nodal extension and high-risk score were all significantly detrimental to RFS(P<0.05).Conclusions:Addition of concomitant systemic therapy to adjuvant radiotherapy did not compensate for longer TPT in head and neck squamous cell carcinoma.Multidisciplinary coordinated care must be provided to ensure the early start of CRT with minimal treatment breaks.

Examination of care processes and treatment optimization for head and neck cancer patients in a community setting"hub and hub"model

Objective:To examine referral pattern,the timing of diagnostic/staging processes,and treatment initiation for new head and neck cancer patients in a community setting.Methods:Patients with a newly diagnosed previously untreated diagnosis of head neck cancer managed at Asplundh Cancer Pavilion/Abington Memorial Hospital from October 2018 to March 2020.Source of referral and preceding workup were examined as well as intervals between initial head and neck consult and various timepoints of treatment initiation.Results:One hundred and five patients were included in the study.The primary referral sources were external general otolaryngology(56.3%).Oral surgery and dermatology obtained tissue biopsy approximately 80%of the time before referral.The average time from the ordering of initial staging positron emission tomography/computed tomography to finalized results was 14 days(range:10-25 days).Patients referred from dermatology and oral surgery were more likely to require single modality care,namely definitive surgical management.Time to treatment initiation average was 37 days(range:29-41 days).Patients with longer treatment times noted significantly higher times to both radiation and medical oncology consults(48.42 vs.18.13 days;P<0.001).Conclusions:No notable differences in treatment initiation times were identified based on referral source or extent of workup performed before head/neck surgery consult.It appears the largest opportunities for improvement in terms of reducing overall treatment length exist in the optimization of radiation initiation time.

A global synthesis of the effectiveness and ecological impacts of management interventions for Spartina species

Invasions by Spartina species pose serious threats to global coastal ecosystems.Although many studies have examined the effectiveness and ecological impacts of invasive Spartina management,no comprehensive global synthesis has been conducted to assess the effects of management on Spartina per se and on wider non-targets.Here,we conducted a global meta-analysis of 3,459 observations from 102 studies to quantify the effects of different management interventions(physical,chemical,biological,and integrated control)on Spartina per se and native biodiversity and environments.We found that physical measures quickly suppressed Spartina but that their effectiveness declined over time.By contrast,chemical measures decreased the abundance and growth of Spartina to a lesser degree in the early stage,but the effectiveness increased over time.Different management measures did not significantly decrease the diversity of native biota on the whole,but native-plant diversity significantly decreased with time after physical control.Different management measures did not affect abiotic factors differently.These results support the use of chemical measures to control invasive Spartina,although their effectiveness would depend on the time since the management intervention.Addressing the problem of Spartina regrowth following physical control requires improved techniques.We hold that initial states of invaders and subsequent environmental changes after management interventions should be weighed in evaluating control efficacy.

A Two-Way Interfacial Condition for Lattice Simulations

In this paper,we formulate a two-way interfacial condition for simulating lattice dynamics in one space dimension.With a time history treatment,the incoming waves are incorporated into the motion of the boundary atoms accurately.This condition reduces to the absorbing boundary condition when there is no incoming wave.Numerical tests validate the effectiveness of the proposed condition in treating simultaneously incoming waves and outgoing waves.