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1.
EClinicalMedicine ; 72: 102622, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38745965

ABSTRACT

Background: The role of transarterial chemoembolization (TACE) in the treatment of advanced hepatocellular carcinoma (HCC) is unconfirmed. This study aimed to assess the efficacy and safety of immune checkpoint inhibitors (ICIs) plus anti-vascular endothelial growth factor (anti-VEGF) antibody/tyrosine kinase inhibitors (TKIs) with or without TACE as first-line treatment for advanced HCC. Methods: This nationwide, multicenter, retrospective cohort study included advanced HCC patients receiving either TACE with ICIs plus anti-VEGF antibody/TKIs (TACE-ICI-VEGF) or only ICIs plus anti-VEGF antibody/TKIs (ICI-VEGF) from January 2018 to December 2022. The study design followed the target trial emulation framework with stabilized inverse probability of treatment weighting (sIPTW) to minimize biases. The primary outcome was overall survival (OS). Secondary outcomes included progression-free survival (PFS), objective response rate (ORR), and safety. The study is registered with ClinicalTrials.gov, NCT05332821. Findings: Among 1244 patients included in the analysis, 802 (64.5%) patients received TACE-ICI-VEGF treatment, and 442 (35.5%) patients received ICI-VEGF treatment. The median follow-up time was 21.1 months and 20.6 months, respectively. Post-application of sIPTW, baseline characteristics were well-balanced between the two groups. TACE-ICI-VEGF group exhibited a significantly improved median OS (22.6 months [95% CI: 21.2-23.9] vs 15.9 months [14.9-17.8]; P < 0.0001; adjusted hazard ratio [aHR] 0.63 [95% CI: 0.53-0.75]). Median PFS was also longer in TACE-ICI-VEGF group (9.9 months [9.1-10.6] vs 7.4 months [6.7-8.5]; P < 0.0001; aHR 0.74 [0.65-0.85]) per Response Evaluation Criteria in Solid Tumours (RECIST) version 1.1. A higher ORR was observed in TACE-ICI-VEGF group, by either RECIST v1.1 or modified RECIST (41.2% vs 22.9%, P < 0.0001; 47.3% vs 29.7%, P < 0.0001). Grade ≥3 adverse events occurred in 178 patients (22.2%) in TACE-ICI-VEGF group and 80 patients (18.1%) in ICI-VEGF group. Interpretation: This multicenter study supports the use of TACE combined with ICIs and anti-VEGF antibody/TKIs as first-line treatment for advanced HCC, demonstrating an acceptable safety profile. Funding: National Natural Science Foundation of China, National Key Research and Development Program of China, Jiangsu Provincial Medical Innovation Center, Collaborative Innovation Center of Radiation Medicine of Jiangsu Higher Education Institutions, and Nanjing Life Health Science and Technology Project.

2.
Psychiatr Q ; 95(2): 233-252, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38639873

ABSTRACT

This study investigated the healthcare utilization and medical expenditure of type 2 diabetes mellitus (T2DM) patients with generalized anxiety disorder (GAD) and identified the associated factors. The healthcare utilization and expenditure of T2DM patients with (case group) and without (control group) GAD between 2002 and 2013 were examined using the population-based Taiwan National Health Insurance Research Database. Healthcare utilization included outpatient visits and hospitalization; health expenditure included outpatient, inpatient, and total medical expenditure. Moreover, nonpsychiatric healthcare utilization and medical expenditure were distinguished from total healthcare utilization and medical expenditure. The average healthcare utilization, including outpatient visits and hospitalization, was significantly higher for the case group than for the control group (total and nonpsychiatric). The results regarding differences in average outpatient expenditure (total and nonpsychiatric), inpatient expenditure (total and nonpsychiatric), and total expenditure (total and nonpsychiatric) between the case and control groups are inconsistent. Sex, age, income, comorbidities/complications, and the diabetes mellitus complication severity index were significantly associated with outpatient visits, medical expenditure, and hospitalization in the case group (total and nonpsychiatric). Greater knowledge of factors affecting healthcare utilization and expenditure in comorbid individuals may help healthcare providers intervene to improve patient management and possibly reduce the healthcare burden in the future.


Subject(s)
Anxiety Disorders , Comorbidity , Diabetes Mellitus, Type 2 , Health Expenditures , Hospitalization , Patient Acceptance of Health Care , Humans , Diabetes Mellitus, Type 2/epidemiology , Diabetes Mellitus, Type 2/therapy , Diabetes Mellitus, Type 2/economics , Male , Female , Middle Aged , Anxiety Disorders/epidemiology , Adult , Taiwan/epidemiology , Patient Acceptance of Health Care/statistics & numerical data , Aged , Hospitalization/statistics & numerical data , Health Expenditures/statistics & numerical data , Ambulatory Care/statistics & numerical data , Ambulatory Care/economics
4.
Horm Metab Res ; 2024 Feb 14.
Article in English | MEDLINE | ID: mdl-38354749

ABSTRACT

Interleukin-18 (IL-18) is a proinflammatory cytokine that primarily stimulates the Th1 immune response. IL-18 exhibits anticancer activity and has been evaluated in clinical trials as a potential cancer treatment. However, evidence suggests that it may also facilitate the development and progression of some cancers. So far, the impact of IL-18 on papillary thyroid cancer (PTC) has not been investigated. In this study, we found that the expression of IL-18 was significantly increased in PTC compared to normal thyroid tissue. Elevated IL-18 expression was closely associated with lymphovascular invasion and lymph node metastases. Furthermore, compared to PTC patients with no nodal metastasis, serum IL-18 levels were slightly increased in patients with 1-4 nodal metastases and significantly elevated in patients with 5 or more nodal metastases. The pro-metastatic effect of IL-18 may be attributed to the simultaneous increase in the expression of S100A10, a known factor that is linked to nodal metastasis in PTC. In addition, the activation of several pathways, such as the intestinal immune network for lgA production and Staphylococcus aureus infection, may be involved in the metastasis process. Taken together, IL-18 may trigger pro-metastatic activity in PTC. Therefore, suppressing the function of IL-18 rather than enhancing it appears to be a reasonable strategy for treating aggressive PTC.

5.
Int Dent J ; 74(3): 616-621, 2024 Jun.
Article in English | MEDLINE | ID: mdl-38242810

ABSTRACT

OBJECTIVES: Generative artificial intelligence (GenAI), including large language models (LLMs), has vast potential applications in health care and education. However, it is unclear how proficient LLMs are in interpreting written input and providing accurate answers in dentistry. This study aims to investigate the accuracy of GenAI in answering questions from dental licensing examinations. METHODS: A total of 1461 multiple-choice questions from question books for the US and the UK dental licensing examinations were input into 2 versions of ChatGPT 3.5 and 4.0. The passing rates of the US and UK dental examinations were 75.0% and 50.0%, respectively. The performance of the 2 versions of GenAI in individual examinations and dental subjects was analysed and compared. RESULTS: ChatGPT 3.5 correctly answered 68.3% (n = 509) and 43.3% (n = 296) of questions from the US and UK dental licensing examinations, respectively. The scores for ChatGPT 4.0 were 80.7% (n = 601) and 62.7% (n = 429), respectively. ChatGPT 4.0 passed both written dental licensing examinations, whilst ChatGPT 3.5 failed. ChatGPT 4.0 answered 327 more questions correctly and 102 incorrectly compared to ChatGPT 3.5 when comparing the 2 versions. CONCLUSIONS: The newer version of GenAI has shown good proficiency in answering multiple-choice questions from dental licensing examinations. Whilst the more recent version of GenAI generally performed better, this observation may not hold true in all scenarios, and further improvements are necessary. The use of GenAI in dentistry will have significant implications for dentist-patient communication and the training of dental professionals.


Subject(s)
Artificial Intelligence , Educational Measurement , Licensure, Dental , Humans , Educational Measurement/methods , United States , United Kingdom
7.
Front Neurosci ; 17: 1198839, 2023.
Article in English | MEDLINE | ID: mdl-37946728

ABSTRACT

Background: The brain in resting state has complex dynamic properties and shows frequency dependent characteristics. The frequency-dependent whole-brain dynamic changes of resting state across the scans have been ignored in Alzheimer's disease (AD). Objective: Coactivation pattern (CAP) analysis can identify different brain states. This paper aimed to investigate the dynamic characteristics of frequency dependent whole-brain CAPs in AD. Methods: We utilized a multiband CAP approach to model the state space and study brain dynamics in both AD and NC. The correlation between the dynamic characteristics and the subjects' clinical index was further analyzed. Results: The results showed similar CAP patterns at different frequency bands, but the occurrence of patterns was different. In addition, CAPs associated with the default mode network (DMN) and the ventral/dorsal visual network (dorsal/ventral VN) were altered significantly between the AD and NC groups. This study also found the correlation between the altered dynamic characteristics of frequency dependent CAPs and the patients' clinical Mini-Mental State Examination assessment scale scores. Conclusion: This study revealed that while similar CAP spatial patterns appear in different frequency bands, their dynamic characteristics in subbands vary. In addition, delineating subbands was more helpful in distinguishing AD from NC in terms of CAP.

8.
Chem Commun (Camb) ; 59(80): 11947-11950, 2023 Oct 05.
Article in English | MEDLINE | ID: mdl-37668093

ABSTRACT

We present a partially-oxidised bimetallic Mo-Pt subnanoparticle (Mo4Pt8Ox) enabling thermally-driven CO2 hydrogenation to CO at room temperature and atmospheric pressure. A mechanistic study explained the full catalytic cycle of the reaction from CO2 activation to catalyst reactivation. DFT calculations revealed that alloying with Mo lowers the activation barrier by weakening the CO adsorption. This finding could be a first step for low-energy CO2 conversion.

9.
Dent J (Basel) ; 11(8)2023 Aug 08.
Article in English | MEDLINE | ID: mdl-37623285

ABSTRACT

Oral diseases are largely preventable. However, as the number of older adults is expected to increase, along with the high cost and various barriers to seeking continuous professional care, a sustainable approach is needed to assist older adults in maintaining their oral health. Mobile health (mHealth) technologies may facilitate oral disease prevention and management through oral health education. This review aims to provide an overview of existing evidence on using mHealth to promote oral health through education among older adults. A literature search was performed across five electronic databases. A total of five studies were identified, which provided low to moderate evidence to support using mHealth among older adults. The selected studies showed that mHealth could improve oral health management, oral health behavior, and oral health knowledge among older adults. However, more quality studies regarding using mHealth technologies in oral health management, oral health behavior, and oral health knowledge among older adults are needed.

10.
Chaos ; 33(7)2023 Jul 01.
Article in English | MEDLINE | ID: mdl-37459222

ABSTRACT

Chimera states in spatiotemporal dynamical systems have been investigated in physical, chemical, and biological systems, while how the system is steering toward different final destinies upon spatially localized perturbation is still unknown. Through a systematic numerical analysis of the evolution of the spatiotemporal patterns of multi-chimera states, we uncover a critical behavior of the system in transient time toward either chimera or synchronization as the final stable state. We measure the critical values and the transient time of chimeras with different numbers of clusters. Then, based on an adequate verification, we fit and analyze the distribution of the transient time, which obeys power-law variation process with the increase in perturbation strengths. Moreover, the comparison between different clusters exhibits an interesting phenomenon, thus we find that the critical value of odd and even clusters will alternatively converge into a certain value from two sides, respectively, implying that this critical behavior can be modeled and enabling the articulation of a phenomenological model.

11.
PLoS One ; 18(6): e0286872, 2023.
Article in English | MEDLINE | ID: mdl-37289761

ABSTRACT

A new type of paste filling material was created using fluorogypsum, a byproduct of hydrofluoric acid, as the raw material to address the issue of the filling material's high cost. The effects of five factors, including gangue, fly ash, fluorogypsum, lime content, and mass concentration on the physical and mechanical properties of filling material were also examined. In addition to analyzing slump and extension changes, the filler's mineral composition and microstructure were examined using SEM and XRD examinations. The results show that the best ratio of the developed filling material was 1000g coal gangue, 300g fly ash, 300g fluorogypsum, and 50g lime and mass concentration is 78%, and its compressive strength can reach 4-5MPa at 28 days. Raw materials such as gangue and fly ash will have a certain influence on the mechanical properties of the filling material. The hydration products of the developed filling material prepared by XRD and SEM were ettringite, calcium sulfate dihydrate, and calcium silicate hydrate gel. The new fluorogypsum-based paste filling material can be used to consolidate loose rock strata and fill goaf. It solves the problem of disposal of industrial waste fluoropgypsum and also solves the problem of coal mine gangue stacking, which has a far-reaching influence on ecological environment management.


Subject(s)
Coal Ash , Oxides , Coal Ash/chemistry , Oxides/chemistry , Calcium Sulfate/chemistry , Dental Materials , Coal/analysis
12.
Opt Express ; 31(6): 9236-9250, 2023 Mar 13.
Article in English | MEDLINE | ID: mdl-37157497

ABSTRACT

We study the enhanced sensing of optomechanically induced nonlinearity (OMIN) in a cavity-waveguide coupled system. The Hamiltonian of the system is anti-PT symmetric, with the two involved cavities being dissipatively coupled via the waveguide. The anti-PT symmetry may break down when a weak waveguide-mediated coherent coupling is introduced. However, we find a strong bistable response of the cavity intensity to the OMIN near the cavity resonance, benefiting from linewidth suppression caused by the vacuum induced coherence. The joint effect of optical bistability and the linewidth suppression is inaccessible by the anti-PT symmetric system involving only dissipative coupling. Due to that, the sensitivity measured by an enhancement factor is greatly enhanced by two orders of magnitude compared to that for the anti-PT symmetric model. Moreover, the enhancement factor shows resistance to a reasonably large cavity decay and robustness to fluctuations in the cavity-waveguide detuning. Based on the integrated optomechanical cavity-waveguide systems, the scheme can be used for sensing different physical quantities related to the single-photon coupling strength and has potential applications in high-precision measurements with systems involving Kerr-type nonlinearity.

13.
Int Dent J ; 73(5): 724-730, 2023 Oct.
Article in English | MEDLINE | ID: mdl-37117096

ABSTRACT

OBJECTIVES: Gingivitis is one of the most prevalent plaque-initiated dental diseases globally. It is challenging to maintain satisfactory plaque control without continuous professional advice. Artificial intelligence may be used to provide automated visual plaque control advice based on intraoral photographs. METHODS: Frontal view intraoral photographs fulfilling selection criteria were collected. Along the gingival margin, the gingival conditions of individual sites were labelled as healthy, diseased, or questionable. Photographs were randomly assigned as training or validation datasets. Training datasets were input into a novel artificial intelligence system and its accuracy in detection of gingivitis including sensitivity, specificity, and mean intersection-over-union were analysed using validation dataset. The accuracy was reported according to STARD-2015 statement. RESULTS: A total of 567 intraoral photographs were collected and labelled, of which 80% were used for training and 20% for validation. Regarding training datasets, there were total 113,745,208 pixels with 9,270,413; 5,711,027; and 4,596,612 pixels were labelled as healthy, diseased, and questionable respectively. Regarding validation datasets, there were 28,319,607 pixels with 1,732,031; 1,866,104; and 1,116,493 pixels were labelled as healthy, diseased, and questionable, respectively. AI correctly predicted 1,114,623 healthy and 1,183,718 diseased pixels with sensitivity of 0.92 and specificity of 0.94. The mean intersection-over-union of the system was 0.60 and above the commonly accepted threshold of 0.50. CONCLUSIONS: Artificial intelligence could identify specific sites with and without gingival inflammation, with high sensitivity and high specificity that are on par with visual examination by human dentist. This system may be used for monitoring of the effectiveness of patients' plaque control.


Subject(s)
Dental Plaque , Gingivitis , Humans , Artificial Intelligence , Gingivitis/diagnosis
14.
Molecules ; 28(3)2023 Feb 03.
Article in English | MEDLINE | ID: mdl-36771160

ABSTRACT

Four novel indane derivatives, anisotindans A-D (1-4), were isolated from the roots of Anisodus tanguticus. Their structures were established using comprehensive spectroscopic analyses, and their absolute configurations were determined by electronic circular dichroism (ECD) calculations and single-crystal X-ray diffraction analyses. Anisotindans C and D (3 and 4) are two unusual indenofuran analogs. ABTS•+ and DPPH•+ assays of radical scavenging activity reveal that all compounds (1-4) are active. Specifically, the ABTS•+ assay results show that anisotindan A (1) exhibits the best antioxidant activity with an IC50 value of 15.62 ± 1.85 µM (vitamin C, IC50 = 22.54 ± 5.18 µM).


Subject(s)
Antioxidants , Antioxidants/pharmacology , Antioxidants/chemistry , Molecular Structure
15.
Signal Transduct Target Ther ; 8(1): 58, 2023 02 08.
Article in English | MEDLINE | ID: mdl-36750721

ABSTRACT

There is considerable potential for integrating transarterial chemoembolization (TACE), programmed death-(ligand)1 (PD-[L]1) inhibitors, and molecular targeted treatments (MTT) in hepatocellular carcinoma (HCC). It is necessary to investigate the therapeutic efficacy and safety of TACE combined with PD-(L)1 inhibitors and MTT in real-world situations. In this nationwide, retrospective, cohort study, 826 HCC patients receiving either TACE plus PD-(L)1 blockades and MTT (combination group, n = 376) or TACE monotherapy (monotherapy group, n = 450) were included from January 2018 to May 2021. The primary endpoint was progression-free survival (PFS) according to modified RECIST. The secondary outcomes included overall survival (OS), objective response rate (ORR), and safety. We performed propensity score matching approaches to reduce bias between two groups. After matching, 228 pairs were included with a predominantly advanced disease population. Median PFS in combination group was 9.5 months (95% confidence interval [CI], 8.4-11.0) versus 8.0 months (95% CI, 6.6-9.5) (adjusted hazard ratio [HR], 0.70, P = 0.002). OS and ORR were also significantly higher in combination group (median OS, 19.2 [16.1-27.3] vs. 15.7 months [13.0-20.2]; adjusted HR, 0.63, P = 0.001; ORR, 60.1% vs. 32.0%; P < 0.001). Grade 3/4 adverse events were observed at a rate of 15.8% and 7.5% in combination and monotherapy groups, respectively. Our results suggest that TACE plus PD-(L)1 blockades and MTT could significantly improve PFS, OS, and ORR versus TACE monotherapy for Chinese patients with predominantly advanced HCC in real-world practice, with an acceptable safety profile.


Subject(s)
Carcinoma, Hepatocellular , Chemoembolization, Therapeutic , Liver Neoplasms , Humans , Carcinoma, Hepatocellular/pathology , Chemoembolization, Therapeutic/adverse effects , Chemoembolization, Therapeutic/methods , Cohort Studies , Liver Neoplasms/pathology , Molecular Targeted Therapy , Retrospective Studies
16.
J Prosthet Dent ; 2023 Jan 09.
Article in English | MEDLINE | ID: mdl-36631366

ABSTRACT

STATEMENT OF PROBLEM: Computer-aided design and computer-aided manufacturing (CAD-CAM) technology has greatly improved the efficiency of the fabrication of dental prostheses. However, the design process (CAD stage) is still time-consuming and labor intensive. PURPOSE: The purpose of this feasibility study was to investigate the accuracy of a novel artificial intelligence (AI) system in designing biomimetic single-molar dental prostheses by comparing and matching them to the natural molar teeth. MATERIAL AND METHODS: A total of 169 maxillary casts were obtained from healthy dentate participants. The casts were digitized, duplicated, and processed with the removal of the maxillary right first molar. A total of 159 pairs of original and processed casts were input into the Generative Adversarial Networks (GANs) for training. In validation, 10 sets of processed casts were input into the AI system, and 10 AI-designed teeth were generated through backpropagation. Individual AI-designed teeth were then superimposed onto each of the 10 original teeth, and the morphological differences in mean Hausdorff distance were measured. True reconstruction was defined as correct matching between the AI-designed and original teeth with the smallest mean Hausdorff distance. The ratio of true reconstruction was calculated as the Intersection-over-Union. The reconstruction performance of the AI system was determined by the Hausdorff distance and Intersection-over-Union. RESULTS: Data of validation showed that the mean Hausdorff distance ranged from 0.441 to 0.752 mm and the Intersection-over-Union of the system was 0.600 (60%). CONCLUSIONS: This study demonstrated the feasibility of AI in designing single-molar dental prostheses. With further training and optimization of algorithms, the accuracy of biomimetic AI-designed dental prostheses could be further enhanced.

17.
J Nurs Scholarsh ; 55(1): 291-303, 2023 01.
Article in English | MEDLINE | ID: mdl-36056586

ABSTRACT

PURPOSE: The use of technology-assisted interventions in dementia care contributes to increased communication, reduced burden on the caregivers, improved health outcomes, and improved expense management. Technology-assisted interventions can be provided remotely to monitor, improve, and enable home care, benefiting the health of both patients and caregivers. Despite increasing use, the effectiveness of technology-assisted interventions for dementia care remains uncertain, with studies reporting inconclusive findings subject to interpretation. Therefore, the current study investigated the available evidence to explore the efficacy of technology-assisted interventions for people with dementia. DESIGN: Systematic review and meta-analysis. METHODS: The study was preregistered with the PROSPERO international prospective register of systematic reviews using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA)-guided protocol. The primary search was conducted in eight databases from database inception to January 29, 2022. Using a random-effects model, the standardized mean differences (SMDs) with 95% confidence intervals (CIs) were synthesized to obtain pooled effect sizes (using Stata 16.0). The updated Cochrane Risk of Bias 2 tool (RoB-2) was used to evaluate the methodological quality of the studies. FINDINGS: A pooled analysis of 12 trials, including 584 people with dementia, showed more improvement associated with technology-assisted interventions compared with standard care, including in the domains of cognitive function (SMD = 0.39; 95% CI: 0.14 to 0.64; p < 0.001) and depression (SMD = -0.75; 95% CI: -1.33 to -0.17; p = 0.01). However, no significant effects were observed for activities of daily living (ADL) or quality of life. CONCLUSION: Technology-assisted interventions appear to improve cognitive function and reduce depression in people with dementia compared with standard care. CLINICAL RELEVANCE: This study may be used to demonstrate that interventions incorporating many modalities or technologies can be used to enhance dementia care, which may improve favorable outcomes when using technology-assisted interventions to remotely initiate appropriate activities for people with dementia. Because technology allows for simultaneous communication and access to shared multimedia, it removes environmental constraints and allows treatment to be administered remotely.


Subject(s)
Dementia , Humans , Dementia/psychology , Activities of Daily Living , Quality of Life , Cognition , Palliative Care
18.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-994400

ABSTRACT

To evaluate the association between serum anti-tissue transglutaminase antibody (anti-tTG) titers and the severity of histological damage to the duodenal mucosa and to predict a possible anti-tTG cutoff value for diagnosing celiac disease (CD) and villous atrophy in the domestic population. Clinical and pathological data from 76 adult CD patients with positive anti-tTG titers and duodenal biopsy results who were treated at the People′s Hospital of Xinjiang Uygur Autonomous Region from July 2017 to January 2022 were retrospectively analyzed. The correlation between anti-tTG titers and the severity of duodenal mucosal damage was statistically assessed to predict the optimal anti-tTG titer cut-off value for diagnosing CD and villous atrophy. Of the 76 patients, 10 had underlying CD, and of the 66 patients with duodenal histopathology, four were Marsh Ⅰ, six were Marsh Ⅱ, and 56 were Marsh Ⅲa-c grade. In adults with CD, anti-tTG titers were shown to be associated with the severity of histological damage to the duodenal mucosa. When the anti-tTG level was ≥5 times the upper limit of normal (ULN), the sensitivity and specificity for diagnosing CD were 83.9% and 92.9%, respectively. When the anti-tTG titer was ≥8 times the ULN, the sensitivity and specificity for diagnosing villous atrophy were 67.9% and 90.0%, respectively. Anti-tTG levels had a strong predictive value for diagnosing CD in adults when titers exceeded 10 times the ULN. Thus, the anti-tTG cut-off value can be combined with clinical judgment to diagnose CD, limiting the use of invasive endoscopy.

19.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-994385

ABSTRACT

Objective:The study aimed to analyze the clinical and endoscopic characteristics of adult celiac disease (CD) to provide a scientific basis for more effective CD diagnosis and treatment.Methods:In this cross-sectional study, the clinical and endoscopic data of 96 adult CD patients treated in the Department of Gastroenterology of the People′s Hospital of Xinjiang Uygur Autonomous Region from March 2016 to December 2021 were retrospectively collected and analyzed.Results:A total of 96 CD patients were diagnosed, including 33 men and 63 women. The average age was 47±14 years (range, 18-81 years). The disease occurred mainly in the age group of 31-60 years. The median course of the disease was 2.0 (0.2-40.0) years. There were 41 (42.7%) classical and 55 (57.3%) non-classical CD patients. All patients with classical CD showed chronic diarrhea, often accompanied by abdominal pain (46.3%, 19/41), abdominal distension (17.1%, 7/41), anemia (65.9%, 27/41), and chronic fatigue (48.8%, 20/41). The main manifestations of non-classical CD were chronic abdominal pain (58.2%, 32/55), abdominal distension (32.7%, 18/55), anemia (40.0%, 22/55), and osteopenia/osteoporosis (38.2%, 21/55). Compared with non-classical CD, anemia developed more frequently in classical CD, and the difference was statistically significant ( P = 0.012). The incidence of complications in CD patients was 36.5% (35/96), and the main complications were thyroid disease (19.8%, 19/96), connective tissue disease (6.2%, 6/96), and kidney disease (6.2%, 6/96). There was no significant difference between classical and non-classical CD ( P>0.05). The frequency of endoscopic manifestations in CD patients was 84.4% (81/96). Duodenal bulb endoscopy showed nodular changes (72.9%, 70/96), grooved changes (10.4%, 10/96), and focal villous atrophy (9.4%, 9/96). The main manifestations of descending endoscopy were the decrease, flattening, or disappearance of duodenal folds (43.8%, 42/96), scallop-like changes (38.5%, 37/96), and nodular changes (34.4%, 33/96). Conclusions:Adult CD patients are mostly female. CD occurred mainly in the age group of 31-60 years. The clinical manifestations were mainly those of non-classical CD. Some patients often had other autoimmune diseases. Patients with characteristic endoscopic manifestations should be warned about the possibility of developing CD. Clinicians should strengthen the understanding of CD and reduce the related rates of missed diagnosis.

20.
Article in Chinese | WPRIM (Western Pacific) | ID: wpr-992148

ABSTRACT

Dialectical behavior therapy (DBT), as an important representative of the " third wave" of cognitive behavior therapy (CBT), has been paid more attention. Since the publication of the treatment manual in 1993, DBT has been widely spread in several treatment settings, including outpatient, community, and inpatient settings, and has been applied to the diagnosis and treatment of various mental disorders. In recent years, more and more studies have proved that DBT has a clear effect on a variety of mental disorders and psychological and behavioral problems, especially the clinical problems related to emotion regulation. This article summarizes and evaluates the effectiveness of DBT in the treatment of mental disorders and discusses the limitations of the current research and the future development direction.

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