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Objective To investigate the clinical effect of transhepatic arterial chemoembolization(TACE)combined with tyrosine kinase inhibitors(TKIs)and programmed death receptors-1(PD-1)inhibitors(TACE+TKIs+PD-1 antibody)in the treatment of moderate advanced unresectable hepatocellular carcinoma(HCC).Methods The clinical data of 65 patients with moderate advanced unresectable hepatocellular carcinoma admitted to the Affiliated Hospital of North Sichuan Medical College from January 2020 to January 2022 were analyzed retrospectively.65 patients were treated with TACE+TKIs+PD-1 antibody.The observation indexes were tumor response,objective response rate(ORR),disease control rate(DCR),total survival time,progression free survival time,conversion operation rate and adverse drug reaction.Results The ORR of 65 p-atients with hepatocellular carcinoma was 49.2%(32/65),and the DCR was 89.2%(58/65).Among them,there were 2 patients with complete remission(CR),30 patients with partial remission(PR),26 patients with stable disease(SD),and 7 patients with progression disease(PD).Among 65 patients with hepatocellular carcinoma,18 patients were transformed into resectable hepatocell-ular carcinoma and underwent RO surgery.The conversion rate was 27.6%(18/65).65 patients were followed up for 3 to 22.4 months,The median follow-up time was 16.5 months.The median overall survival time and median disease progression free survival time of 65 patients were 14.5 months(95%CI:12.3~16.6 months)and 8.8 months(95%CI:6.9~10.6 months),respectively.After treatment,65 patients all had post embolism syndrome(abdominal pain,fever,nausea,vomiting and other symptoms),and some patients had transient abnormal liver function.Adverse drug reactions below grade 3 recovered within a few days.Some patients were associated with multiple adverse drug reactions.1 patient(1.5%)stopped using TACE because of stubborn vomiting,and 5 patients(7.6%)stopped using Lenvatinib because of severe liver function damage during treatment,2 patients(3%)stopped using Camrelizumab because of severe reactive capillary hyperplasia,one patient(1.5%)stopped using Tislelizumab because of severe hypothyroidism,one patient(1.5%)stopped the treatment of Lenvatinib and Sintilimab due to severe gastrointestinal bleeding.The adverse drug reactions of grade 3~4 occurred in other patients were alleviated after drug reduction,symptomatic treatment and hormone treatment.Conclusion TACE+TKIs+PD-1 antibody can obtain reliable clinical efficacy and anti-tumor activity in the treatment of moderate advanced unresectable hepatocellular carcinoma.
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Integrating the internet and financial services gives people the luxury to reduce financial stress and anxiety by giving consumers more power over their financial situation. Likewise, the adoption of environmental technologies helps improve environmental quality, which positively impacts mental and physical health and thus increases the sense of well-being and happiness. Therefore, the main focus of the study is to analyze the influence of financial services and environmental technologies on happiness. For analyzing the short and long-run impacts of financial services and environmental technologies on happiness, we have utilized the ARDL model and QARDL models. The findings of the ARDL model confirm the positive influence of financial services, environmental technologies, national income, financial development, and education on happiness in the short and long term. Similarly, the QARDL model also suggests the favorable long-run effects of financial services and environmental technologies on happiness at most quantiles. The long-run Wald test confirms the asymmetric influence of all variables on happiness, while in the short-term, excluding education, all other variables exert asymmetric impacts on happiness. Thus, to promote happiness, policymakers should try to increase the role of internet-based financial services and increases investment in research and development activities to enhance environment-related technologies. However, the study is limited to China, it should be expanded to other regions.
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Felicidad , Desarrollo Sostenible , Humanos , Escolaridad , China , Internet , Tecnología , Desarrollo Económico , Dióxido de CarbonoRESUMEN
This study aims to provide evidence regarding whether Qingufei paidu decoction (, QFPD) treatment in the acute phase shows long-term benefits for coronavirus disease 2019-associated sequelae. The 10 databases will be retrieved. Every reference list of related trials and gray literature will be searched as well. Study screening, data extraction, and risk of bias evaluation will be performed by two reviewers (CUI Hanjin and FAN Rong). Data analysis will be conducted by using STATA (version 14). Statistical heterogeneity will be explored by a standard χ2 test with a significance level of P < 0.10. Funnel plots, Egger's & Begg's test, and Trim and Fill analysis will be used for publication bias assessment. The results of the present Meta-analysis and systematic review will be disseminated via peer-review journal publication. Ethical approval is not required, as this Meta-analysis will not contain any individual patient data. This systematic review has been registered on PROSPERO (registration number: CRD42021246937) on 15 April 2021.
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COVID-19 , Neumonía , Humanos , Revisiones Sistemáticas como Asunto , Metaanálisis como AsuntoRESUMEN
Social and organizational innovations are one of the most effective ways to gain social collaboration for effective, rapid, and coordinated interventions. An analysis of the relationship among organizational performance (OP), social innovations (SI) and organizational innovation (OI) in social organizations (SOs) is little discussed in the literature and much less with main component analysis. This paper is an effort to provide some empirical evidences about social and organizational innovations that social organizations in China have implemented to address the social issues of the society. A survey of Chinese SO's is conducted during beginning two months of 2022 in provinces of Jiangsu, Guangdong and Zhejiang to attain the statistics and assessing the insights of the executives of the SOs participating in this study with respect to organizational performance, social and organizational innovations. The technique used to select the sample is a non-probabilistic sampling and multiple linear regression model is applied to determine the partial impact of organizational innovations and social innovations on the organizational performance. The grouping of the variables is carried out through main components analysis. The empirical findings of the study highlight that Chinese SOs are innovative because they adopt management strategies to address the social issues associated with their institutional mission. There are four groups of derived components from organizational and social innovations based on the empirical evidence: SO's innovative activities to modify the environment; inside innovative measures to enhance SO's performance; innovative activities of SO's to enhance their relationships with outside actors; innovative measures to improve the management of SOs related to their mission and institutional projects. The findings of this study offer an efficient solution to government and policy makers for involving SOs in terms of planning of social development in China. The social and organizational innovations are very necessary to overcome the social issues so government should encourage the establishment and sustainability of social organizations.
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Gobierno , Cultura Organizacional , Innovación Organizacional , Encuestas y Cuestionarios , ChinaRESUMEN
Glial cells in the central nervous system (CNS) are composed of oligodendrocytes, astrocytes and microglia. They contribute more than half of the total cells of the CNS, and are essential for neural development and functioning. Studies on the fate specification, differentiation, and functional diversification of glial cells mainly rely on the proper use of cell- or stage-specific molecular markers. However, as cellular markers often exhibit different specificity and sensitivity, careful consideration must be given prior to their application to avoid possible confusion. Here, we provide an updated overview of a list of well-established immunological markers for the labeling of central glia, and discuss the cell-type specificity and stage dependency of their expression.
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Neuroglía/metabolismo , Sistema Nervioso Central , Oligodendroglía/metabolismo , Astrocitos/metabolismo , MicroglíaRESUMEN
Objective: To analyze the difference in blood uric acid levels between patients with polycystic ovary syndrome (PCOS) and healthy women of childbearing age, and to investigate the correlation between body composition and blood uric acid levels. Methods: A total of 153 eligible childbearing age patients with PCOS treated at Tianjin Medical University General Hospital from January 2018 to March 2022 were selected, and 153 healthy women with normal menstruation were selected as the control group. Fasting blood uric acid levels were measured by venous blood test, and body composition was measured by a body composition analyzer. Group comparisons were made to analyze the correlation between body composition and blood uric acid levels. Results: The incidence of hyperuricemia was higher in patients with PCOS than that in the control group [30.1% (46/153) vs 2.0% (3/153)], with a statistically significant difference (χ2=44.429, P<0.001). Blood uric acid level was also significantly higher in patients with PCOS than that in the control group [(371±98) vs (265±67) μmol/L; t=11.170, P<0.001]. Among PCOS patients, there were statistically significant differences in weight, body mass index (BMI), body fat mass, skeletal muscle mass, percent body fat, lean body weight, fat mass/lean body weight, percent skeletal muscle, and visceral fat level between the hyperuricemia group and the normal blood uric acid group (all P<0.001), but no significant difference was observed in waist-hip ratio (P=0.348). The following body composition indicators: weight, BMI, waist-hip ratio, body fat mass, skeletal muscle mass, percent body fat, visceral fat level, lean body weight, and fat mass/lean body weight in all subjects, the PCOS patients and the control group, were positively correlated with blood uric acid levels (all P<0.01). The blood uric acid level in PCOS obese patients was higher than that in non-obese PCOS patients, and the difference was statistically significant [(425±83) vs (336±91) μmol/L; t=6.133, P<0.001]. The blood uric acid level in central obesity PCOS patients was also higher than that in non-central obesity PCOS patients [(385±95) vs (299±79) μmol/L], the difference was statistically significant (t=4.261, P<0.001). The blood uric acid level in normal-weight obese PCOS patients was higher than that in normal-weight non-obese PCOS patients [(333±73) vs (277±54) μmol/L], and the difference was statistically significant (t=2.848, P=0.006). Blood uric acid levels in normal-weight [(315±74) vs (255±67) μmol/L], overweight [(362±102) vs (276±57) μmol/L], and obese PCOS patients [(425±83) vs (303±74) μmol/L] were all higher than those in the corresponding control groups, with statistically significant differences (all P<0.001). Conclusions: PCOS patients have a higher incidence of hyperuricemia than healthy women of childbearing age. Blood uric acid levels are closely correlated with body composition indicators, such as weight, BMI, waist-hip ratio, body fat mass, skeletal muscle mass, percent body fat, and visceral fat level. Body composition analysis of women with PCOS could help identify potentially obese people more accurately and carry out individualized treatment, thereby reducing the risk of metabolic abnormalities.
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Humanos , Femenino , Síndrome del Ovario Poliquístico/complicaciones , Ácido Úrico , Hiperuricemia/complicaciones , Insulina , Composición Corporal/fisiología , Obesidad/complicaciones , Índice de Masa CorporalRESUMEN
A giant cervical goiter, defined as a thyroid mass larger than 8 cm in diameter, is usually a nodular or adenomatous goiter. A giant cervical goiter can also be caused by hyperthyroidism (i.e., Hashimoto's thyroiditis). The surgical indications for patients with Hashimoto's disease include suspected malignant tumors, persistent symptoms related to the disease, or persistent enlargement of the goiter. We herein describe a woman who developed symptoms of compression from a thyroid tumor, the volume of which was almost the largest reported in the relevant literature to date. The bilateral lobes of the giant thyroid tumor were removed by total en bloc excision. We protected the bilateral recurrent laryngeal nerve and preserved the bilateral upper and lower parathyroid glands in situ. The excised left lobe tumor was 16 × 9 × 5.5 cm, whereas the right lobe tumor was 12 × 8 × 4 cm. The pathological diagnosis was Hashimoto's thyroiditis. Although surgical excision is difficult, it is still the main treatment modality for giant goiters in patients with Hashimoto's thyroiditis and can help to reduce the occurrence of complications.
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Bocio , Enfermedad de Hashimoto , Hipertiroidismo , Enfermedades de la Tiroides , Neoplasias de la Tiroides , Femenino , Bocio/complicaciones , Bocio/cirugía , Enfermedad de Hashimoto/complicaciones , Enfermedad de Hashimoto/cirugía , Humanos , Hipertiroidismo/complicaciones , Neoplasias de la Tiroides/complicacionesRESUMEN
This study was designed to identify the pathogen causing soft rot of Pinellia ternata in Qianjiang of Hubei province and screen out the effective bactericides, so as to provide a theoretical basis for the control of soft rot of P. ternata. In this study, the pathogen was identified based on molecular biology and physiological biochemistry, followed by the detection of pathogenicity and pathogenicity spectrum via plant tissue inoculation in vitro and the indoor toxicity determination using the inhibition zone method to screen out bactericide with good antibacterial effects. The control effect of the bactericide against P. ternata soft rot was verified by the leave and tuber inoculation in vitro. The phylogenetic tree was constructed based on the 16 S rDNA, dnaX gene, and recA gene sequences, respectively, and the result showed that the pathogen belonged to the same branch as the type strain Dickeya fangzhongdai JS5. The physiological and biochemical tests showed that the pathogen was identical to D. fangzhongdai, which proved that the pathogen was D. fangzhongdai. The pathogenicity test indicated that the pathogen could obviously infect leaves at 24 h and tubers in 3 d. As revealed by the indoor toxicity test, 0.3% tetramycin, 5% allicin, and 80% ethylicin had good antibacterial activities, with EC_(50) values all less than 50 mg·L~(-1). Tests in tissues in vitro showed that 5% allicin exhibited the best control effect, followed by 0.3% tetramycin and 10% zhongshengmycin oligosaccharide, and their preventive effects were better than curative effects. Therefore, 5% allicin can be used as the preferred agent for the control of P. ternata soft rot, and 0.3% tetramycin and 10% zhongshengmycin oligosaccharide as the alternatives. This study has provided a certain theoretical basis for the control of P. ternata soft rot.
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Filogenia , Pinellia/química , Hojas de la Planta , Tubérculos de la PlantaRESUMEN
Chronic and infectious wound healing has always been an issue of concern in clinical and scientific research, in which bacterial infection and oxidative damage are the key factors hindering wound healing. Carbon dots, as a new material, has attracted much attention because of its unique physical and chemical properties and good biological safety. In recent years, the researches on the antibacterial property, antioxidant, and photoluminescence properties of carbon dots are more and more extensive and carbon dots have great potential in the treatment of chronic and infectious wounds. This paper reviews the research progress of carbon dots in three aspects: antibacterial, anti-oxidation and monitoring of wound infection are reviewed, and further discusses its specific mechanism, potential research direction, and application prospect.
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Humanos , Antibacterianos/uso terapéutico , Infecciones Bacterianas/tratamiento farmacológico , Carbono/uso terapéutico , Cicatrización de Heridas , Infección de Heridas/tratamiento farmacológicoRESUMEN
Extracellular vesicles (EVs) are lipid bilayer-enclosed structures containing diverse bioactive cargoes that play a major role in intercellular communication in both physiological and pathological conditions. Currently, the field of EV-based therapy has been rapidly growing, and two main therapeutic uses of EVs can be surmised: (i) exploiting stem cell-derived EVs as therapeutic agents; and (ii) employing EVs as natural therapeutic vectors for drug delivery. This review will discuss the recent advances in EV-based therapy in the treatment of renal disease.
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Humanos , Comunicación Celular , Sistemas de Liberación de Medicamentos , Vesículas Extracelulares , Enfermedades Renales/terapiaRESUMEN
In this paper, a cascade double-loop control (DLC) combined with modeling compensation methods is proposed to improve the tracking precision of the multiaperture imaging system (MAIS). The application of the flexible thin-wall ring mechanism in the coupling rotating prism (CRP) system causes a series of tracking and pointing challenges. Disturbances such as friction, shaft deformation, and model perturbation significantly deteriorate the tracking and pointing accuracy of the CRP. Two different modeling compensation methods that are interfaced with classical DLC are proposed to guarantee the tracking precision of the MAIS. Moreover, the disturbance observation and compensation performance of two different modeling compensation methods are analyzed and compared. Finally, simulation and experiment results indicate that the proposed control methods, especially model compensation based on speed close-loop control, obtain the best performance for disturbance rejection in the MAIS.
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To develop a drug carrier sensitive to reactive oxygen species (ROS), a nanocomplex (NCs) based on sulfuric hyaluronic acid (sHA)-anthocyanin (ATC) was developed. Doxorubicin (DOX) is loaded into the sHA-ATC NCs (AD@sHA) through intermolecular π-π stacking and hydrophobic interactions. AD@sHA can be prepared in aqueous phase by simple mixing method. In AD@sHA, DOX content and load efficiency are high. Compared with D@sHA (without ATC), the ROS-ATC co-mediated responsive degradation and drug release of AD@sHA was confirmed. In addition, AD@sHA also improved apoptosis of CD44+ colon cancer HT29 cells. HT29 tumor-bearing mice model was used to confirm the role of AD@SHA in targeted tumor therapy. The results showed that AD@SHA could optimize the biodistribution of DOX. These data, from tumor volume and TUNEL analysis, observed the delay of tumor growth and apoptosis of cancer cells. Even more exciting is that AD@sHA significantly reduces the myelosuppression of DOX. This study means that AD@sHA has a better effect on chemotherapy for CD44-positive tumors.
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Doxorrubicina , Neoplasias , Animales , Línea Celular Tumoral , Doxorrubicina/uso terapéutico , Sistemas de Liberación de Medicamentos , Liberación de Fármacos , Ácido Hialurónico/uso terapéutico , Ratones , Ratones Endogámicos BALB C , Neoplasias/tratamiento farmacológico , Especies Reactivas de Oxígeno , Distribución TisularRESUMEN
Purpose@#Current variability in methods for tumor mutational burden (TMB) estimation and reporting demonstrates the urgent need for a homogeneous TMB assessment approach. Here, we compared TMB distributions in different cancer types using two customized targeted panels commonly used in clinical practice. @*Materials and Methods@#TMB spectra of 295- and 1021-gene panels in multiple cancer types were compared using targeted next-generation sequencing (NGS). The TMB distributions across a diverse cohort of 2,332 cancer cases were then investigated for their associations with clinical features. Treatment response data were collected for 222 patients who received immune-checkpoint inhibitors (ICIs) and their homologous recombination DNA damage repair (HR-DDR) and programmed death-ligand 1 (PD-L1) expression were additionally assessed and compared with the TMB and response rate. @*Results@#The median TMB between gene panels was similar despite a wide range in TMB values. The highest TMB was 8 and 10 in patients with squamous cell carcinoma and esophageal carcinoma according to the classification of histopathology and cancer types, respectively. Twenty-three out of 103 patients (22.3%) were HR-DDR‒positive and could benefit from ICI therapy; out of those 23 patients, seven patients had high TMB (p=0.004). Additionally, PD-L1 expression was not associated with TMB or treatment response among patients receiving ICIs. @*Conclusion@#Targeted NGS assays demonstrated the ability to evaluate TMB in pan-cancer samples as a tool to predict response to ICIs. In addition, TMB integrated with HR-DDR‒positive status could be a significant biomarker for predicting ICI response in patients.
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Accumulating evidence indicates an unexpected role of aberrant splicing in hepatocellular carcinoma (HCC) that has been seriously neglected in previous studies. There is a need for a detailed analysis of alternative splicing (AS) and its underlying biological and clinical relevance in HCC. In this study, clinical information and corresponding RNA sequencing data of HCC patients were obtained from The Cancer Genome Atlas. Percent spliced in (PSI) values and transcriptional splicing patterns of genes were determined from the original RNA sequencing data using SpliceSeq. Then, based on the PSI values of AS events in different patients, a series of bioinformatics methods was used to identify differentially expressed AS events (DEAS), determine potential regulatory relationships, and investigate the correlation between DEAS and the patients' clinicopathological features. Finally, 25,934 AS events originating from 8,795 genes were screened with high reliability; 263 of these AS events were identified as DEAS. The parent genes of these DEAS formed an intricate network with roles in the regulation of cancer-related pathway and liver metabolism. In HCC, 36 splicing factors were involved in the dysregulation of part DEAS, 100 DEAS events were correlated with overall survival, and 71 DEAS events were correlated with disease-free survival. Stratifying HCC patients according to DEAS resulted in four clusters with different survival patterns. Significant variations in AS occurred during HCC initiation and maintenance; these are likely to be vital both for biological processes and in prognosis. The HCC-related AS events identified here and the splicing networks constructed will be valuable in deciphering the underlying role of AS in HCC.
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BackgroundThe severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has progressed to a pandemic associated with substantial morbidity and mortality. The WHO and the United States Center for Disease Control and Prevention (CDC) have issued interim clinical guidance for management of patients with confirmed coronavirus disease (COVID-19), but there is limited data on the virologic and clinical characteristics for prognosis of severe COVID-19. MethodsA total of 50 patients with severe COVID-19 were divided into good and poor recovery groups. The dynamic viral shedding and serological characteristics of SARS-CoV-2 were explored. The risk factors associated with poor recovery and lung lesion resolutions were identified. In addition, the potential relationships among the viral shedding, the pro-inflammatory response, and lung lesion evolutions were characterized. ResultsA total of 58% of the patients had poor recovery and were more likely to have a prolonged interval of viral shedding. The longest viral shedding was 57 days after symptom onset. Older age, hyperlipemia, hypoproteinemia, corticosteroid therapy, consolidation on chest computed-tomography (CT), and prolonged SARS-CoV-2 IgM positive were all associated with poor recovery. Additionally, the odds of impaired lung lesion resolutions were higher in patients with hypoproteinemia, hyperlipemia, and elevated levels of IL-4 and ferritin. Finally, viral shedding and proinflammatory responses were closely correlated with lung lesion evolutions on chest CT. ConclusionsPatients with severe COVID-19 have prolonged SARS-CoV-2 infection and delayed intermittent viral shedding. Older age, hyperlipemia, hypoproteinemia, corticosteroid usage, and prolonged SARS-CoV-2 IgM positive might be utilized as predicative factors for the patients with poor recovery.
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Objective To investigate the relationship between axial length (AL)elongation and the progression of spherical equivalent refraction (SER) and its influential factors in school-aged children with myopia based on machine learning (ML).Methods A cross-sectional study evaluated 1 011 eyes of school-aged myopic children admitted to the optometry center of Peking University People's Hospital from January 2017 to December 2018,and data from the right eyes were used for analysis.All the collected data were used to train ML algorithms.When building predictive models,the input features included age,gender,central corneal thickness (CCT),mean K readings (K-mean),horizontal visible iris diameter (HIVD),lens power,and axial length (AL),and the output parameter was SER.A five-fold cross validation scheme randomly divided all the data into five groups,of which four were used as training data,and one group was used as validation data.This process was repeated five times so that all the data were validated by this model,which allowed a better prediction of the overall sample.The prediction accuracy of different models was evaluated by the R-value and R2.The best-performing algorithm was applied to investigate the relationship between AL elongation and the progression of SER and its influencing factors.Written informed consent was obtained from each guardian of each patient prior to entering the study cohort.This study followed the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Peking University People's Hospital (No.2019PHB280-01).Results In the comparison of the R-value and R2 of six ML algorithms based on five-fold cross validation,among all models,the best was the quadratic SVM regression model,with an R-value and R2 of 0.99 and 0.98,respectively.The results of Pearson correlation analysis showed that lens power was negatively correlated with age (r =-0.301,P<0.01).According to the results calculated by the Bennett-Rabbetts formula,the average lens power of the 6-year-old myopic group was higher than that of the 18-year-old myopic group.According to this model,the SER change caused by AL elongation was not a constant value,which was estimated from plano to nearly-3.00 D,depending mainly on the time needed for 1-mm AL elongation.According to the results calculated by this model,the longer it took for the AL to grow by 1 mm,the smaller the corresponding SER change.In myopic children over an age span of one year,for example,from 6-7 years or 12-13 years,1-mm elongation of the AL corresponded to-2.50 D and-2.33 D of SER change,respectively.Over a three years span,for example,from 6-9 years,a 1-mm elongation of the AL corresponded to-1.77 D of SER change.Conclusions For myopic children,the longer the age span required for 1-mm elongation of the AL,the smaller the SER change.An ML algorithm can provide clinical practitioners with a relatively precise estimation for the relationship between AL elongation and myopia progression.
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Objective:To explore the material basis and mechanism of acute stroke treated with Rhei Radix et Rhizoma based on Homotherapy for Heteropathy using the analysis of proteomics and bioinformatics. Method:A total of 60 male Sprague-Dawley(SD)rats were randomly divided into ischemic stroke(IS) sham-operation group (Sham1), IS model group (IS), IS+ Rhei Radix et Rhizoma treatment group (DH1),ICH sham-operation group (Sham2), intracerebral hemorrhage(ICH) model group (ICH), and ICH + Rhei Radix et Rhizoma treatment group (DH2), with 10 rats in each group. After cerebral perfusion, the brain tissues were quantified by proteomic analysis, and differentially expressed proteins (DEPs) were identified. Specimens of IS, Sham1, and DH1 groups were collected at 24 hours, while those of ICH, Sham2, and DH2 groups were collected at 48 hours. The common DEPs were analyzed by bioinformatics, and the relevant DEPs were verified by Western blot. Result:Rhei Radix et Rhizoma regulated 21 common DEPs associated with acute stroke (including 12 up-regulated and 9 down-regulated). According to Kyoto Encyclopedia of Genes and Genomes(KEGG) analysis, amyotrophic lateral sclerosis (ALS) pathway was enriched, and three proteins [Neurofilament light polypeptide (Nefl), Neurofilament medium polypeptide (Nefm), Neurofilament heavy polypeptide (Nefh)] involved in this pathway. Energy metabolism, ion homeostasis, regulation of synaptophysin, cell cycle and neurogenesis were the common mechanisms of "Homotherapy for Heteropathy". After treatment with Rhei Radix et Rhizoma, the expression levels of GTP binding protein REM2 (Rem2), tyrosine 3-monooxygena (Th), Nefl and neuromodulin (Gap43) were significantly higher than those of the corresponding model group (P<0.05). The expression of Nefl was down-regulated, while the expressions of Rem2,Th and Gap43 were up-regulated, which was consistent with the results of proteomics. Conclusion:Rhei Radix et Rhizoma-homotherapy-differential protein expression profile is established is study. Energy metabolism, ion homeostasis, regulation of synaptophysin, cell cycle and neurogenesis are the common mechanisms.
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Objective@#To investigate the relationship between axial length (AL)elongation and the progression of spherical equivalent refraction (SER) and its influential factors in school-aged children with myopia based on machine learning (ML).@*Methods@#A cross-sectional study evaluated 1 011 eyes of school-aged myopic children admitted to the optometry center of Peking University People's Hospital from January 2017 to December 2018, and data from the right eyes were used for analysis.All the collected data were used to train ML algorithms.When building predictive models, the input features included age, gender, central corneal thickness (CCT), mean K readings (K-mean), horizontal visible iris diameter (HIVD), lens power, and axial length (AL), and the output parameter was SER.A five-fold cross validation scheme randomly divided all the data into five groups, of which four were used as training data, and one group was used as validation data.This process was repeated five times so that all the data were validated by this model, which allowed a better prediction of the overall sample.The prediction accuracy of different models was evaluated by the R-value and R2.The best-performing algorithm was applied to investigate the relationship between AL elongation and the progression of SER and its influencing factors.Written informed consent was obtained from each guardian of each patient prior to entering the study cohort.This study followed the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Peking University People's Hospital (No.2019PHB280-01).@*Results@#In the comparison of the R-value and R2 of six ML algorithms based on five-fold cross validation, among all models, the best was the quadratic SVM regression model, with an R-value and R2 of 0.99 and 0.98, respectively.The results of Pearson correlation analysis showed that lens power was negatively correlated with age (r=-0.301, P<0.01). According to the results calculated by the Bennett-Rabbetts formula, the average lens power of the 6-year-old myopic group was higher than that of the 18-year-old myopic group.According to this model, the SER change caused by AL elongation was not a constant value, which was estimated from plano to nearly -3.00 D, depending mainly on the time needed for 1-mm AL elongation.According to the results calculated by this model, the longer it took for the AL to grow by 1 mm, the smaller the corresponding SER change.In myopic children over an age span of one year, for example, from 6-7 years or 12-13 years, 1-mm elongation of the AL corresponded to -2.50 D and -2.33 D of SER change, respectively.Over a three years span, for example, from 6-9 years, a 1-mm elongation of the AL corresponded to -1.77 D of SER change.@*Conclusions@#For myopic children, the longer the age span required for 1-mm elongation of the AL, the smaller the SER change.An ML algorithm can provide clinical practitioners with a relatively precise estimation for the relationship between AL elongation and myopia progression.
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Objective:To explore systematic implementation of World Health Organization Family International Classifications (WHO-FICs) in the field of rehabilitation: the theoretical and policy framework at macro level, governance and management mechanism at meso level, and implementation modules at micro levels, respectively. Methods:The policy and theoretical framework of rehabilitation development was discussed based on the international rehabilitation policy documents of WHO, mainly as World Report on Disability, Global Action Plan on Disability and Rehabilitation in Health Service System. Protocol and roadmap of systematic implementation of WHO-FICs, including International Classification of Diseases (ICD-11), International Classification of Functioning, Disability and Health (ICF), and International Classification of Health Intervention (ICHIβ-2) was proposed. Results:With the use of WHO-FICs, the theoretical and policy framework of rehabilitation was constructed, and the contents and principles of modern rehabilitation services were clarified at macro-level. Rehabilitation is an important part of health service, there are six building blocks: i.e. leadership and governance, financing, human resources for health, service providing, medical technology and health information system. It proposed to use knowledge management system of WHO-FICs, including the classification, nomenclature, definitions, descriptions, terminology and coding systems, to standardize rehabilitation evaluation and statistics. The management and governance system of rehabilitation should be implemented using WHO-FICs. Rehabilitation services are based on the bio-psycho-social model and implemented the principles of people-centered and functioning-oriented. The systematic implementation of WHO-FICs in rehabilitation abide by the model of "Evaluation (ICHI)-Evaluation, Description, Classification and Coding of Functioning (ICF)-Disease Classification, Diagnosis and Coding (ICD)-Rehabilitation Intervention (ICHI)", and with the standardized process of "Evaluation (Functioning and unmet needs)-Diagnose (Disease and Functioning)-Planning of Rehabilitation-Intervention-Evaluation of Outcome". The mic-modules of implementation of WHO-FICs in rehabilitation had been constructed. There were 28 categories of diseases, 7 categories of functioning and 6 categories of rehabilitation interventions in rehabilitation proposed by International Society of Physical and Rehabilitation Medicine. According to ICD-11 and ICF, it proposed to use WHO Disability Assessment Schedule 2.0 (WHODAS 2.0), Brief Model Disability Survey (MDS-B) and VB40 Generic Functioning Domains (VB40), and the ICF core-sets in evaluation of functioning and rehabilitation outcome. The implementation of WHO-FICs in management of medical records and reporting realized the standardized management of medical record, encoding of diseases, functioning and intervention, reporting of performance, and provided tools for billing, reimbursement and payment management of rehabilitation. It proposed to develop WHO-FICs based clinical data sets and big data to implement functioning-related Diagnosis Related Groups and case-mix statistics. Conclusion:With the systematic implementation of WHO-FICs in rehabilitation, the policy and theoretical framework at macro level had been developed. The mechanism of management and governance at meso level had been explored. The application modules and approaches at micro level had been established. A scientific and effective overall solution had been proposed to enhance the scientific, standardized, refined and informatization level, strengthen the level and governance capacity, and improve the quality, safety and the coverage of rehabilitation services.
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A kind of adjustable external fixation device for lower extremity is designed. The circuit is mainly composed of TEC1-00703 semiconductor refrigeration chip, HZC-30A pressure sensor, STC89C52RC single chip microcomputer and other electrical components. It can realize the timing intelligent temperature control and meet the local fixed-point refrigeration. The design of adjustable structure and the application of intelligent air cushion can satisfy the full fixation of lower limbs of different individuals. Its operation does not need much medical knowledge. It can solve the problem of emergency transportation and follow-up treatment of lower limb injury in ice and snow sports. It has a good application prospect and universality.