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BACKGROUND: Acute exacerbation (AE) of interstitial lung disease (ILD) is one of the most serious complications during perioperative period of lung cancer resection. This study aimed to investigate the correlation between preoperative 2- deoxy-2-[18F]fluoro-D-glucose (18F-FDG) PET/CT findings and AE in lung cancer patients with ILD. METHODS: We retrospectively reviewed the data of 210 patients who underwent lung resection for non-small cell lung cancer. Relationships between clinical data and PET images and AE were evaluated. The patients were divided into an AE(+) and an AE(-) group for multivariate logistic regression analysis. Receiver operating characteristic (ROC) curve analysis was conducted and the area under curve (AUC) was used to assess the predictive values. RESULTS: Among 210 patients, 48 (22.8%) were diagnosed with ILD based on chest CT. Among them, 9 patients (18.75%) developed AE after lung resection and were defined as AE(+) group. The course of ILD was longer in AE(+) group compared to AE(-) group. More patients in AE(+) group had a history of AE and chronic obstructive pulmonary disease (COPD) than in AE(-) group. The maximum standardized uptake value (SUVmax) of the noncancerous interstitial pneumonia (IP) area and cancers in AE(+) group was significantly higher compared to AE(-) group. Univariate logistic regression analysis showed that AE, COPD, SUVmax of the noncancerous IP area, SUVmax of cancer, surgical method were significantly correlated with AE. The course of ILD[OR(95%CI) 2.919; P = 0.032], SUVmax of the noncancerous IP area[OR(95%CI) 7.630;P = 0.012] and D-Dimer level[OR(95%CI) 38.39;P = 0.041] were identified as independent predictors for AE in patients with ILD after lung cancer surgery. When the three indicators were combined, we found significantly better predictive performance for postoperative AE than that of SUVmax of the noncancerous IP area alone [0.963 (95% CI 0.914-1.00); sensitivity, 100%, specificity 87.2%, P < 0.001 vs. 0.875 (95% CI 0.789 ~ 0.960); sensitivity, 88.9%, specificity, 76.9%, P = 0.001; difference in AUC = 0.088, Z = 1.987, P = 0.04]. CONCLUSION: The combination of the course of ILD, SUVmax of the noncancerous IP area and D-Dimer levels has high predictive value for the occurrence of AE in patients with concomitant interstitial lesions.
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Carcinoma de Pulmón de Células no Pequeñas , Fluorodesoxiglucosa F18 , Enfermedades Pulmonares Intersticiales , Neoplasias Pulmonares , Tomografía Computarizada por Tomografía de Emisión de Positrones , Complicaciones Posoperatorias , Humanos , Masculino , Femenino , Neoplasias Pulmonares/cirugía , Enfermedades Pulmonares Intersticiales/cirugía , Anciano , Persona de Mediana Edad , Estudios Retrospectivos , Carcinoma de Pulmón de Células no Pequeñas/cirugía , Complicaciones Posoperatorias/etiología , Complicaciones Posoperatorias/epidemiología , Modelos Logísticos , Progresión de la Enfermedad , Curva ROC , Radiofármacos , Neumonectomía/efectos adversos , Factores de RiesgoRESUMEN
INTRODUCTION: The term "health poverty trap" describes a vicious cycle in which developing countries or regions become trapped in low levels of health and poverty during the process of modernization. Although significant progress has been made in alleviating poverty in China, there is still a need to further enhance the living conditions of its impoverished population. METHODS: This research utilizes the data of the three national representative panel surveys from 2014 to 2020. The primary objective is to gain a better understanding of the intricate relationship between health and poverty. To examine the self-reinforcing effects of the cumulative cycle between health and poverty, we employ unconditional quantile regression analysis. RESULT: The low-income group exhibits lower overall health status compared to the average level. Economic constraints partially hinder the ability of low-income individuals to access healthcare resources, thereby reinforcing the cyclical relationship between health and poverty. Additionally, the unique psychological and behavioral preferences of individuals in health poverty act as indirect factors that further strengthen this cycle. Health poverty individuals can generate endogenous force to escape the "health poverty trap" by enhancing their confidence levels and digital literacy. CONCLUSIONS: The research examines the coexistence of health gradients and economic inequality among Chinese residents. Additionally, the study explores the endogenous force mechanism of escaping the health poverty trap from psychological and behavioral perspectives. This research also offers insights into optimizing government poverty alleviation programs to effectively address this issue.
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Pobreza , Cambio Social , Humanos , Factores Socioeconómicos , China , Dinámica PoblacionalRESUMEN
The inheritance of predisposition to nonsyndromic familial nonmedullary thyroid cancer (FNMTC) remains unclear. Here, we report six individuals with papillary thyroid cancer (PTC) in two unrelated nonsyndromic FNMTC families. Whole-exome sequencing revealed two germ-line loss-of-function variants occurring within a 28-bp fragment of WDR77, which encodes a core member of a transmethylase complex formed with the protein arginine methyltransferase PRMT5 that is responsible for histone H4 arginine 3 dimethylation (H4R3me2) in frogs and mammals. To date, the association of WDR77 with susceptibility to cancer in humans is unknown. A very rare heterozygous missense mutation (R198H) in WDR77 exon 6 was identified in one family of three affected siblings. A heterozygous splice-site mutation (c.619+1G > C) at the 5' end of intron 6 is present in three affected members from another family. The R198H variant impairs the interaction of WDR77 with PRMT5, and the splice-site mutation causes exon 6 skipping and results in a marked decrease in mutant messenger RNA, accompanied by obviously reduced H4R3me2 levels in mutation carriers. Knockdown of WDR77 results in increased growth of thyroid cancer cells. Whole-transcriptome analysis of WDR77 mutant patient-derived thyroid tissue showed changes in pathways enriched in the processes of cell cycle promotion and apoptosis inhibition. In summary, we report WDR77 mutations predisposing patients to nonsyndromic familial PTC and link germ-line WDR77 variants to human malignant disease.
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Predisposición Genética a la Enfermedad , Mutación de Línea Germinal , Cáncer Papilar Tiroideo/genética , Glándula Tiroides/patología , Neoplasias de la Tiroides/genética , Factores de Transcripción/genética , Adulto , Secuencia de Aminoácidos , Femenino , Regulación Neoplásica de la Expresión Génica , Humanos , Masculino , Persona de Mediana Edad , Modelos Moleculares , Mutación , Mutación Missense , Conformación Proteica , ARN Mensajero/genética , ARN Mensajero/metabolismo , Secuenciación del ExomaRESUMEN
To overcome or delay the drug-resistance of first-generation epidermal growth factor receptor (EGFR) kinase inhibitors and non-selectivity toxicity mediated by second-generation inhibitors, splicing principle was employed to design and synthesize a series of Osimertinib derivatives containing dihydroquinoxalinone (8-30) as the novel third-generation inhibitors against double mutant L858R/T790M in EGFR. Among them, compound 29 showed excellent kinase inhibitory activity against EGFRL858R/T790M with an IC50 value of 0.55 ± 0.02 nM and potent anti-proliferative activity against H1975 cells with an IC50 value of 5.88 ± 0.07 nM. Moreover, the strong down-regulation effect of EGFR-mediated signaling pathways and the promotion of apoptosis in H1975 cells confirmed its potent antitumor activities. Compound 29 was also demonstrated with good ADME profile in various in vitro assays. Further in vivo studies confirmed that compound 29 could suppress the growth of xenograft tumors. These results verified that compound 29 would be a promising lead compound for targeting drug-resistant EGFR mutations.
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Antineoplásicos , Carcinoma de Pulmón de Células no Pequeñas , Neoplasias Pulmonares , Humanos , Carcinoma de Pulmón de Células no Pequeñas/patología , Receptores ErbB , Neoplasias Pulmonares/patología , Mutación , Inhibidores de Proteínas Quinasas/farmacología , Inhibidores de Proteínas Quinasas/uso terapéutico , Línea Celular Tumoral , Proliferación Celular , Resistencia a Antineoplásicos , Antineoplásicos/farmacología , Antineoplásicos/uso terapéuticoRESUMEN
An alginate lyase gene aly644 encoding a member of polysaccharide lyase family 6 was obtained from a metagenome of Antarctic macroalgae-associated microbes. The gene was expressed heterologously in Escherichia coli, and the recombinant protein was purified using a Ni-NTA His Tag Kit. With sodium alginate as the substrate, recombinant Aly644 exhibited an optimum reaction temperature of 50°C and an optimum reaction pH of 7.0. The Vmax and Km values of Aly644 toward sodium alginate were 112.36 mg/mL·min and 16.75 mg/mL, respectively. Substrate specificity analysis showed that Aly644 was a bifunctional alginate lyase that hydrolyzed both polyguluronic acid and polymannuronic acid. The hydrolysis products of Aly644 with sodium alginate as the substrate were detected by thin-layer chromatography, and were mainly di- and trisaccharides. The oligosaccharides produced by degradation of sodium alginate by Aly644 inhibited the mycelial growth of the plant pathogens Phytophthora capsici and Fulvia fulva; the 50% maximal effective concentration (EC50) values were 297.45 and 452.89 mg/L, and the 90% maximal effective concentration (EC90) values were 1341.45 and 2693.83 mg/L, respectively. This highlights that Aly644 is a potential candidate enzyme for the industrial production of alginate oligosaccharides with low degree of polymerization. Enzyme-hydrolyzed alginate oligosaccharides could support the development of green agriculture as natural antimicrobial agents. KEY POINTS: ⢠An alginate lyase was obtained from a metagenome of Antarctic macroalgae-associated microbes. ⢠Aly644 is a bifunctional alginate lyase with excellent thermostability and pH stability. ⢠The enzymatic hydrolysates of Aly644 directly inhibited Phytophthora capsici and Fulvia fulva.
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Macroalgae and macroalgae-associated bacteria together constitute the most efficient metabolic cycling system in the ocean. Their interactions, especially the responses of macroalgae-associated bacteria communities to algae in different geographical locations, are mostly unknown. In this study, metagenomics was used to analyze the microbial diversity and associated algal-polysaccharide-degrading enzymes on the surface of red algae among three remote regions. There were significant differences in the macroalgae-associated bacteria community composition and diversity among the different regions. At the phylum level, Proteobacteria, Bacteroidetes, and Actinobacteria had a significantly high relative abundance among the regions. From the perspective of species diversity, samples from China had the highest macroalgae-associated bacteria diversity, followed by those from Antarctica and Indonesia. In addition, in the functional prediction of the bacterial community, genes associated with amino acid metabolism, carbohydrate metabolism, energy metabolism, metabolism of cofactors and vitamins, and membrane transport had a high relative abundance. Canonical correspondence analysis and redundancy analysis of environmental factors showed that, without considering algae species and composition, pH and temperature were the main environmental factors affecting bacterial community structure. Furthermore, there were significant differences in algal-polysaccharide-degrading enzymes among the regions. Samples from China and Antarctica had high abundances of algal-polysaccharide-degrading enzymes, while those from Indonesia had extremely low abundances. The environmental differences between these three regions may impose a strong geographic differentiation regarding the biodiversity of algal microbiomes and their expressed enzyme genes. This work expands our knowledge of algal microbial ecology, and contributes to an in-depth study of their metabolic characteristics, ecological functions, and applications.
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Rhodophyta , Algas Marinas , Metagenómica , Bacterias/genética , Bacterias/metabolismo , Rhodophyta/genética , Metagenoma , Polisacáridos/metabolismoRESUMEN
BACKGROUND: In the present study, the ι-carrageenase gene, Car1293, was obtained from the genome of Microbulbifer sp. YNDZ01, which was isolated from the surface of macroalgae. To date, there are few studies on ι-carrageenase and the anti-inflammatory activity of ι-carrageenan oligosaccharides (CGOS). To enhance our perspective on ι-carrageenase and ι-carrageen oligosaccharides, the sequence, protein structure, enzymatic properties, enzymatic digestion products and anti-inflammatory activity of the gene were investigated. RESULTS: The gene length of Car1293 is 2,589 bp, encoding an enzyme with 862 amino acids, which shares 34% similarity with any previously reported ι-carrageenase. The spatial structure of Car1293 consists of many α-helices with a ß-fold binding module located at its terminus, and eight binding sites were found in the binding module as a result of docking with CGOS-DP4 ligand. The optimum temperature and pH for the activity of recombinant Car1293 toward ι-carrageenan were 50 °C and 6.0, respectively. The hydrolysates of Car1293 are mainly degree of polymerization (DP)8, with minor products showing DP2, DP4, and DP6. The enzymatic hydrolysates CGOS-DP8 showed prominent anti-inflammatory activity, which was greater than that of the positive control l-monomethylarginine in lipopolysaccharide-induced RAW264.7 macrophages. It inhibited nitric oxide production, as well as significantly inhibited tumor necrosis factor-α and interleukin-6 secretion. CONCLUSION: The ι-carrageenase sequence encoded by Car1293 is novel and can hydrolyze carrageenan into CGOS-DP8 that has a significant anti-inflammatory effect. The present study fills a gap in the research on the biological activity of oligosaccharides in ι-carrageenan and provides promising data for the development of natural anti-inflammatory agent. © 2023 Society of Chemical Industry.
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Algas Marinas , Algas Marinas/metabolismo , Carragenina/química , Temperatura , Proteínas Bacterianas/metabolismo , Oligosacáridos/química , Glicósido Hidrolasas/químicaRESUMEN
The prevalence and adverse effects of learning burnout are a major concern in higher education. Based upon JD-R and COR theories, this study modeled the associations among social support that teachers and peers provide in class, academic buoyancy, learning burnout, and class level with respect to the degree of English proficiency. A sample of 1955 Chinese EFL learners in higher education participated in the cross-sectional survey. Structural equation modelling via partial least squares technique was utilized for statistical analysis. The results corroborated the protecting role that social support in class played against EFL students' learning burnout. In particular, the findings revealed that academic buoyancy both mediated and moderated the nexus between social support on EFL learners' burnout. Moreover, this study found that class level with respect to English proficiency moderated the relation between academic buoyancy and learning burnout and that the negative impact of academic buoyancy on burnout increased in classes in which students had lower English proficiency. Based upon the findings, certain targeted suggestions for educational practice were provided.
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BACKGROUND: Coronary computed tomography angiography (CCTA) is a well-established non-invasive diagnostic test for the assessment of coronary artery diseases (CAD). CCTA not only provides information on luminal stenosis but also permits non-invasive assessment and quantitative measurement of stenosis based on radiomics. PURPOSE: This study is aimed to develop and validate a CT-based radiomics machine learning for predicting chronic myocardial ischemia (MIS). METHODS: CCTA and SPECT-myocardial perfusion imaging (MPI) of 154 patients with CAD were retrospectively analyzed and 94 patients were diagnosed with MIS. The patients were randomly divided into two sets: training (n = 107) and test (n = 47). Features were extracted for each CCTA cross-sectional image to identify myocardial segments. Multivariate logistic regression was used to establish a radiomics signature after feature dimension reduction. Finally, the radiomics nomogram was built based on a predictive model of MIS which in turn was constructed by machine learning combined with the clinically related factors. We then validated the model using data from 49 CAD patients and included 18 MIS patients from another medical center. The receiver operating characteristic curve evaluated the diagnostic accuracy of the nomogram based on the training set and was validated by the test and validation set. Decision curve analysis (DCA) was used to validate the clinical practicability of the nomogram. RESULTS: The accuracy of the nomogram for the prediction of MIS in the training, test and validation sets was 0.839, 0.832, and 0.816, respectively. The diagnosis accuracy of the nomogram, signature, and vascular stenosis were 0.824, 0.736 and 0.708, respectively. A significant difference in the number of patients with MIS between the high and low-risk groups was identified based on the nomogram (P < .05). The DCA curve demonstrated that the nomogram was clinically feasible. CONCLUSION: The radiomics nomogram constructed based on the image of CCTA act as a non-invasive tool for predicting MIS that helps to identify high-risk patients with coronary artery disease.
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Enfermedad de la Arteria Coronaria , Isquemia Miocárdica , Angiografía por Tomografía Computarizada , Constricción Patológica/diagnóstico por imagen , Enfermedad de la Arteria Coronaria/diagnóstico por imagen , Humanos , Aprendizaje Automático , Isquemia Miocárdica/diagnóstico por imagen , Nomogramas , Estudios Retrospectivos , Tomografía Computarizada por Rayos XRESUMEN
OBJECTIVE: The purpose of this study was to evaluate the usefulness of intraprocedural CT and prior PET/CT fusion imaging in improving the diagnostic yield of CT-guided transthoracic core-needle biopsy (CNB) in lung masses. METHODS: In total, 145 subjects with lung masses suspicious for malignancy underwent image-guided transthoracic CNB. According to imaging modality the subjects were divided into two groups. PET/CT images obtained no more than 14 days before the biopsy were integrated with intraprocedural CT images. The integrated or fused images were then used to plan the puncture sites. The clinical characteristics, diagnostic yield of CNB, diagnostic accuracy rate, procedure-related complications and procedure duration were recorded and compared between the two groups. Final clinical diagnosis was determined by surgical pathology or at least 6-months follow-up. The diagnostic accuracy of CNB was obtained by comparing with final clinical diagnosis. RESULTS: 145 subjects underwent CNB with adequate samples, including 76 in fusion imaging group and 69 in routine group. The overall diagnostic yield and diagnostic accuracy rate were 80.3% (53/66), 82.9% (63/76) for fusion imaging group, 70.7% (41/58), 75.4% (52/69) for routine group, respectively. In addition, the diagnostic yield for malignancy in fusion imaging group (98.1%, 52/53) was higher than that in routine group (81.3%, 39/48). No serious procedure-related complications occurred in both two groups. CONCLUSION: CNB with prior PET/CT fusion imaging is particularly helpful in improving diagnostic yield and accurate rate of biopsy in lung masses, especially in heterogeneous ones, thus providing greater potential benefit for patients.
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Biopsia Guiada por Imagen , Tomografía Computarizada por Tomografía de Emisión de Positrones , Biopsia con Aguja Gruesa , Humanos , Biopsia Guiada por Imagen/métodos , Pulmón/diagnóstico por imagen , Pulmón/patología , Tomografía Computarizada por Tomografía de Emisión de Positrones/métodos , Tomografía Computarizada por Rayos X/métodosRESUMEN
CONTEXT: Danggui Niantong Granules (DGNTG) are a valid and reliable traditional herbal formula, commonly used in clinical practice to treat rheumatoid arthritis (RA). However, the mechanism of its effect on RA remains unclear. OBJECTIVE: An investigation of the therapeutic effects of DGNTG on RA. MATERIALS AND METHODS: Twenty-four male Sprague-Dawley (SD) rats were divided into four groups: control, model, DGNTG (2.16 g/kg, gavage), methotrexate (MTX) (1.35 mg/kg, gavage) for 28 days. The morphology of synovial and ankle tissues was observed by haematoxylin-eosin staining. The responses of mitochondrial apoptosis were assessed by qPCR, Western blotting and immunohistochemical staining. Rat faeces were analysed by 16S rRNA sequencing. RESULTS: Our results showed that DGNTG treatment reduced AI scores (7.83 ± 0.37 vs. 4.67 ± 0.47, p < 0.01) and paw volumes (7.63 ± 0.17 vs. 6.13 ± 0.11, p < 0.01) compared with the model group. DGNTG also increased the expression of Bax (0.34 ± 0.03 vs. 0.73 ± 0.03, p < 0.01), cytochrome c (CYTC) (0.24 ± 0.02 vs. 0.64 ± 0.01, p < 0.01) and cleaved caspase-9 (0.24 ± 0.04 vs. 0.83 ± 0.08, p < 0.01), and decreased bcl-2 (1.70 ± 0.11 vs. 0.60 ± 0.09, p < 0.01) expression. DGNTG treatment regulated the structure of gut microbiota. DISCUSSION AND CONCLUSIONS: DGNTG ameliorated RA by promoting mitochondrial apoptosis, which may be associated with regulating gut microbiota structure. DGNTG can be used as a supplement and alternative drug for the treatment of RA; its ability to prevent RA deserves further study.
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Apoptosis , Artritis Experimental , Artritis Reumatoide , Medicamentos Herbarios Chinos , Microbioma Gastrointestinal , Animales , Apoptosis/efectos de los fármacos , Artritis Experimental/tratamiento farmacológico , Artritis Reumatoide/tratamiento farmacológico , Artritis Reumatoide/metabolismo , Medicamentos Herbarios Chinos/farmacología , Microbioma Gastrointestinal/efectos de los fármacos , Masculino , ARN Ribosómico 16S/genética , Ratas , Ratas Sprague-Dawley , Membrana Sinovial/metabolismoRESUMEN
BACKGROUND: Radiotherapy (RT) following breast-conserving surgery (BCS) for ductal carcinoma in situ (DCIS) reduces ipsilateral breast event rates in clinical trials. This study assessed the impact of DCIS treatment on a 20-year risk of ipsilateral DCIS (iDCIS) and ipsilateral invasive breast cancer (iIBC) in a population-based cohort. METHODS: The cohort comprised all women diagnosed with DCIS in the Netherlands during 1989-2004 with follow-up until 2017. Cumulative incidence of iDCIS and iIBC following BCS and BCS + RT were assessed. Associations of DCIS treatment with iDCIS and iIBC risk were estimated in multivariable Cox models. RESULTS: The 20-year cumulative incidence of any ipsilateral breast event was 30.6% (95% confidence interval (CI): 28.9-32.6) after BCS compared to 18.2% (95% CI 16.3-20.3) following BCS + RT. Women treated with BCS compared to BCS + RT had higher risk of developing iDCIS and iIBC within 5 years after DCIS diagnosis (for iDCIS: hazard ratio (HR)age < 50 3.2 (95% CI 1.6-6.6); HRage ≥ 50 3.6 (95% CI 2.6-4.8) and for iIBC: HRage<50 2.1 (95% CI 1.4-3.2); HRage ≥ 50 4.3 (95% CI 3.0-6.0)). After 10 years, the risk of iDCIS and iIBC no longer differed for BCS versus BCS + RT (for iDCIS: HRage < 50 0.7 (95% CI 0.3-1.5); HRage ≥ 50 0.7 (95% CI 0.4-1.3) and for iIBC: HRage < 50 0.6 (95% CI 0.4-0.9); HRage ≥ 50 1.2 (95% CI 0.9-1.6)). CONCLUSION: RT is associated with lower iDCIS and iIBC risk up to 10 years after BCS, but this effect wanes thereafter.
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Neoplasias de la Mama/epidemiología , Carcinoma Intraductal no Infiltrante/epidemiología , Neoplasias Primarias Secundarias/epidemiología , Adulto , Anciano , Neoplasias de la Mama/radioterapia , Neoplasias de la Mama/cirugía , Carcinoma Intraductal no Infiltrante/radioterapia , Carcinoma Intraductal no Infiltrante/cirugía , Estudios de Cohortes , Femenino , Humanos , Incidencia , Persona de Mediana Edad , Neoplasias Primarias Secundarias/radioterapia , Neoplasias Primarias Secundarias/cirugía , Países Bajos/epidemiologíaRESUMEN
Novel divergent domino annulation reactions of sulfur ylides with aryldiazonium tetrafluoroborates have been developed, affording various tetra- and trisubstituted pyrazole derivatives in moderate to good yields. Three molecules of sulfur ylides were applied as C1 synthon to construct the complex products with five new chemical bonds formed in these one-pot reactions.
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Predicting the population density of key areas of the city is crucial. It helps reduce the spread risk of Covid-19 and predict individuals' travel needs. Although current researches focus on using the method of clustering to predict the population density, there is almost no discussion about using spatial-temporal models to predict the population density of key areas in a city without using actual regional images. We abstract 997 key areas and their regional connections into a graph structure and propose a model called Word Embedded Spatial-temporal Graph Convolutional Network (WE-STGCN). WE-STGCN is mainly composed of the Spatial Convolution Layer, the Temporal Convolution Layer, and the Feature Component. Based on the data set provided by the DataFountain platform, we evaluate the model and compare it with some typical models. Experimental results show that WE-STGCN has 53.97% improved to baselines on average and can commendably predicting the population density of key areas.
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PURPOSE: Image quality of positron emission tomography (PET) is limited by various physical degradation factors. Our study aims to perform PET image denoising by utilizing prior information from the same patient. The proposed method is based on unsupervised deep learning, where no training pairs are needed. METHODS: In this method, the prior high-quality image from the patient was employed as the network input and the noisy PET image itself was treated as the training label. Constrained by the network structure and the prior image input, the network was trained to learn the intrinsic structure information from the noisy image and output a restored PET image. To validate the performance of the proposed method, a computer simulation study based on the BrainWeb phantom was first performed. A 68Ga-PRGD2 PET/CT dataset containing 10 patients and a 18F-FDG PET/MR dataset containing 30 patients were later on used for clinical data evaluation. The Gaussian, non-local mean (NLM) using CT/MR image as priors, BM4D, and Deep Decoder methods were included as reference methods. The contrast-to-noise ratio (CNR) improvements were used to rank different methods based on Wilcoxon signed-rank test. RESULTS: For the simulation study, contrast recovery coefficient (CRC) vs. standard deviation (STD) curves showed that the proposed method achieved the best performance regarding the bias-variance tradeoff. For the clinical PET/CT dataset, the proposed method achieved the highest CNR improvement ratio (53.35% ± 21.78%), compared with the Gaussian (12.64% ± 6.15%, P = 0.002), NLM guided by CT (24.35% ± 16.30%, P = 0.002), BM4D (38.31% ± 20.26%, P = 0.002), and Deep Decoder (41.67% ± 22.28%, P = 0.002) methods. For the clinical PET/MR dataset, the CNR improvement ratio of the proposed method achieved 46.80% ± 25.23%, higher than the Gaussian (18.16% ± 10.02%, P < 0.0001), NLM guided by MR (25.36% ± 19.48%, P < 0.0001), BM4D (37.02% ± 21.38%, P < 0.0001), and Deep Decoder (30.03% ± 20.64%, P < 0.0001) methods. Restored images for all the datasets demonstrate that the proposed method can effectively smooth out the noise while recovering image details. CONCLUSION: The proposed unsupervised deep learning framework provides excellent image restoration effects, outperforming the Gaussian, NLM methods, BM4D, and Deep Decoder methods.
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Aprendizaje Profundo , Aumento de la Imagen/métodos , Tomografía de Emisión de Positrones , Relación Señal-Ruido , Aprendizaje Automático no Supervisado , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Procesamiento de Imagen Asistido por Computador , Neoplasias Pulmonares/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Fantasmas de Imagen , Control de CalidadRESUMEN
AIM: Double-balloon enteroscopy (DBE) is a useful tool for the evaluation and treatment of small bowel disease. Limited clinical data are available regarding the indications, clinical findings and safety associated with the use of DBE in children. The aim of this study is to investigate the utility and safety of DBE in children. METHODS: A total of 72 DBE procedures were performed on 61 children at the Sixth Affiliated Hospital, Sun Yat-sen University, between 1 April 2013 and 31 December 2017. The clinical data were analysed retrospectively. RESULTS: DBE was attempted 72 times in 61 children (45 boys and 16 girls) of an age range between 6 and 14 years (mean age: 11.9 years). The most common indication for DBE was occult gastrointestinal bleeding and abdominal pain. The positive rate of abnormal findings was 77.5% (55/72). Most children showed non-specific enteritis and Crohn's disease. Eight children underwent successful therapeutic enteroscopy. No serious complication was observed in any child in this case series. CONCLUSION: DBE can be a useful diagnostic and therapeutic tool for small bowel disorders in children.
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Enteroscopía de Doble Balón , Enfermedades Intestinales/cirugía , Evaluación de Resultado en la Atención de Salud , Adolescente , Niño , China , Femenino , Humanos , Masculino , Auditoría Médica , Estudios RetrospectivosRESUMEN
BACKGROUND: Public health emergencies have challenged the public health emergency management systems (PHEMSs) of many countries critically and frequently since this century. As the world's most populated country and the second biggest economy in the world, China used to have a fragile PHEMS; however, the government took forceful actions to build PHEMS after the 2003 SARS outbreak. After more than one decade's efforts, we tried to assess the improvements and problems of China's PHEMS between 2002 and 2012. METHODS: We conducted two rounds of national surveys and collected the data of the year 2002 and 2012, including all 32 provincial, 139 municipal, and 489 county CDCs. The municipal and county CDCs were selected by systematic random sampling. Twenty-one indicators of four stages (preparation, readiness, response and recovery) from the National Assessment Criteria for CDC Performance were chosen to assess the ten-year trends. RESULTS: At the preparation stage, organization, mechanisms, workforce, and stockpile across all levels and regions were significantly improved after one decade's efforts. At the readiness stage, the capability for formulating an emergency plan was also significantly improved during the same period. At the response stage, internet-based direct reporting was 98.8%, and coping scores were nearly full points of ten in 2012. At the recovery stage, the capabilities were generally lower than expected. CONCLUSIONS: Due to forceful leadership, sounder regulations, and intensive resources, China's PHEMS has been improved at the preparation, readiness, and response stages; however, the recovery stage was still weak and could not meet the requirements of crisis management and preventive governance. In addition, CDCs in the Western region and counties lagged behind in performance on most indicators. Future priorities should include developing the recovery stage, establishing a closed feedback loop, and strengthening the capabilities of CDCs in Western region and counties.
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Brotes de Enfermedades/prevención & control , Urgencias Médicas , Administración en Salud Pública/tendencias , Salud Pública , China/epidemiología , HumanosRESUMEN
OBJECTIVE: To assess the value of 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography-CT (PET-CT) in detection of primary tumor and pelvic lymph node metastasis in International Federation of Gynecology and Obstetrics (FIGO) stages â A2-â ¡A cervical cancer. METHODS: The clinical data of 91 patients with FIGO stagesâ A2-â ¡A cervical cancer were retrospectively analyzed. The sensitivity of 18F-FDG PET-CT in detection of cervical cancer was calculated. The long diameter, short diameter and SUVmax were compared between metastatic lymph nodes (MLN) and non-metastatic lymph nodes (NMLN). The optimal cut-off values of different indexes were determined by receiver operating characteristic (ROC) curve and area under curve (AUC), and the sensitivity, specificity and accuracy were calculated. RESULTS: 18F-FDG PET-CT examinations were positive in 89 patients (89/91, 96.7%). The short diameters of NMLN and MLN were (6.50±2.31)mm and (4.21±1.49)mm(t=4.855, P<0.05); the SUVmax of NMLN and MLN were 4.56±3.34 and 1.92±1.41(t=31.685, P<0.05). ROC AUCs of the short diameter and SUVmax in diagnosis of metastatic lymph nodes were 0.802 and 0.861. Taken short diameter ≥ 5.05 mm and SUVmax ≥ 2.05 as cut-off values, the corresponding sensitivity, specificity and accuracy in diagnosis of metastatic lymph nodes were 85.0%, 93.0% and 86.8%, respectively. CONCLUSIONS: 18F-FDG PET-CT is sensitive to detect primary lesion and pelvic lymph node metastases in FIGO stages â A2-â ¡ A cervical cancer, and the highest diagnostic accuracy may be obtained by taking short diameter ≥ 5.05 mm and SUVmax ≥ 2.05 as the standard.
Asunto(s)
Fluorodesoxiglucosa F18 , Ganglios Linfáticos , Tomografía Computarizada por Tomografía de Emisión de Positrones , Neoplasias del Cuello Uterino , Femenino , Humanos , Ganglios Linfáticos/diagnóstico por imagen , Radiofármacos , Estudios Retrospectivos , Sensibilidad y Especificidad , Neoplasias del Cuello Uterino/diagnóstico por imagenRESUMEN
In this Letter, we report the observational constraints on the Hu-Sawicki f(R) theory derived from weak lensing peak abundances, which are closely related to the mass function of massive halos. In comparison with studies using optical or x-ray clusters of galaxies, weak lensing peak analyses have the advantages of not relying on mass-baryonic observable calibrations. With observations from the Canada-France-Hawaii-Telescope Lensing Survey, our peak analyses give rise to a tight constraint on the model parameter |f_{R0}| for n=1. The 95% C.L. is log_{10}|f_{R0}|<-4.82 given WMAP9 priors on (Ω_{m}, A_{s}). With Planck15 priors, the corresponding result is log_{10}|f_{R0}|<-5.16.
RESUMEN
OBJECTIVES: To assess the improvements of the Chinese Centers for Disease Control and Prevention (CDCs) system between 2002 and 2012, and problems the system has encountered. METHODS: We obtained data from 2 national cross-sectional surveys in 2006 and 2013, including 32 provincial, 139 municipal, and 489 county-level CDCs throughout China. We performed a pre-post comparative analysis to determine trends in resource allocation and service delivery. RESULTS: The overall completeness of public health services significantly increased from 47.4% to 76.6%. Furthermore, the proportion of CDC staff with bachelor's or higher degrees increased from 14.6% to 32.6%, and governmental funding per CDC increased 5.3-fold (1.283-8.098 million yuan). The working area per CDC staff increased from 37.9 square meters to 63.3 square meters, and configuration rate of type A devices increased from 28.1% to 65.0%. Remaining problems included an 11.9% reduction in staff and the fact that financial investments covered only 71.1% of actual expenditures. CONCLUSIONS: China's CDC system has progressed remarkably, enabling quicker responses to emergent epidemics. Future challenges include establishing a sustainable financing mechanism and retaining a well-educated, adequately sized public health workforce.