RESUMO
PURPOSE: As agricultural technology continues to develop, the scale of planting and production of date fruit is increasing, which brings higher yields. However, the increasing yields also put a lot of pressure on the classification step afterward. Image recognition based on deep learning algorithms can help to identify and classify the date fruit species, even in natural light. METHOD: In this paper, a deep fusion model based on whale optimization and an artificial neural network for Arabian date classification is proposed. The dataset used in this study includes five classes of date fruit images (Barhi, Khalas, Meneifi, Naboot Saif, Sullaj). The process of designing each model can be divided into three phases. The first phase is feature extraction. The second phase is feature selection. The third phase is the training and testing phase. Finally, the best-performing model was selected and compared with the currently established models (Alexnet, Squeezenet, Googlenet, Resnet50). RESULTS: The experimental results show that, after trying different combinations of optimization algorithms and classifiers, the highest test accuracy achieved by DeepDate was 95.9%. It takes less time to achieve a balance between classification accuracy and time consumption. In addition, the performance of DeepDate is better than that of many deep transfer learning models such as Alexnet, Squeezenet, Googlenet, VGG-19, NasNet, and Inception-V3. CONCLUSION: The proposed DeepDate improves the accuracy and efficiency of classifying date fruits and achieves better results in classification metrics such as accuracy and F1. DeepDate provides a promising classification solution for date fruit classification with higher accuracy. To further advance the industry, it is recommended that stakeholders invest in technology transfer programs to bring advanced image recognition and AI tools to smaller producers, enhancing sustainability and productivity across the sector. Collaborations between agricultural technologists and growers could also foster more tailored solutions that address specific regional challenges in date fruit production.
Assuntos
Algoritmos , Aprendizado Profundo , Redes Neurais de Computação , Phoeniceae/classificação , Frutas , Animais , Processamento de Imagem Assistida por Computador/métodosRESUMO
In recent decades, the term "ecosystem" has garnered substantial attention in scholarly and managerial discourse, featuring prominently in academic and applied contexts. While individual scholars have made significant contributions to the study of various types of ecosystem, there appears to be a research gap marked by a lack of comprehensive synthesis and refinement of findings across diverse ecosystems. This paper systematically addresses this gap through a hybrid methodology, employing bibliometric and content analyses to systematically review the literature from 1993 to 2023. The primary research aim is to critically examine theoretical studies on different ecosystem types, specifically focusing on business, innovation, and platform ecosystems. The methodology of this study involves a content review of the identified literature, combining quantitative bibliometric analyses to differentiate patterns and content analysis for in-depth exploration. The core findings center on refining and summarizing the definitions of business, innovation, and platform ecosystems, shedding light on both commonalities and distinctions. Notably, the research unveils shared characteristics such as openness and diversity across these ecosystems while highlighting significant differences in terms of participants and objectives. Furthermore, the paper delves into the interconnections within these three ecosystem types, offering insights into their dynamics and paving the way for discussions on future research directions. This comprehensive examination not only advances our understanding of business, innovation, and platform ecosystems but also lays the groundwork for future scholarly inquiries in this dynamic and evolving field.
RESUMO
Ultra-thick offshore steel, known for its high strength, high toughness, and corrosion resistance, is commonly used in marine platforms and ship components. However, when offshore steel is in service for an extended period under conditions of high pressure, extreme cold, and high-frequency impact loads, the weld joints are prone to fatigue failure or even fractures. Addressing these issues, this study designed a narrow-gap laser wire filling welding process and successfully welded a 100-mm new type of ultra-thick offshore steel. Using finite element simulation, EBSD testing, SEM analysis, and impact experiments, this study investigates the weld's microstructure, impact toughness, and fracture mechanisms. The research found that at -80 °C, the welded joint exhibited good impact toughness (>80 J), with the impact absorption energy on the surface of the weld being 217.7 J, similar to that of the base material (225.3 J), and the fracture mechanism was primarily a ductile fracture. The impact absorption energy in the core of the weld was 103.7 J, with the fracture mechanism mainly being a brittle fracture. The EBSD results indicated that due to the influence of the welding thermal cycle and the cooling effect of the narrow-gap process, the grains gradually coarsened from the surface of the welded plate to the core of the weld, which was the main reason for the decreased impact toughness at the joint core. This study demonstrates the feasibility of using narrow-gap laser wire filling welding for 100-mm new type ultra-thick offshore steel and provides a new approach for the joining of ultra-thick steel plates.
RESUMO
OBJECTIVE: To compare the outcomes of patients undergoing Retroperitoneal laparoscopic Radical nephrectomy (RLRN) and Transperitoneal laparoscopic Radical nephrectomy (TLRN). METHODS: A total of 120 patients with localized renal cell carcinoma were randomized into either RLRN or TLRN group. Mainly by comparing the patient perioperative related data, surgical specimen integrity, pathological results and tumor results. RESULTS: Each group comprised 60 patients. The two group were equivalent in terms of perioperative and pathological outcomes. The mean integrity score was significantly lower in the RLRN group than TLRN group. With a median follow-up of 36.4 months after the operation, Kaplan-Meier survival analysis showed no significant difference between RLRN and TLRN in overall survival (89.8% vs. 88.5%; P = 0.898), recurrence-free survival (77.9% vs. 87.7%; P = 0.180), and cancer-specific survival (91.4% vs. 98.3%; P = 0.153). In clinical T2 subgroup, the recurrence rate and recurrence-free survival in the RLRN group was significantly worse than that in the TLRN group (43.2% vs. 76.7%, P = 0.046). Univariate and multivariate COX regression analysis showed that RLRN (HR: 3.35; 95%CI: 1.12-10.03; P = 0.030), male (HR: 4.01; 95%CI: 1.07-14.99; P = 0.039) and tumor size (HR: 1.23; 95%CI: 1.01-1.51; P = 0.042) were independent risk factor for recurrence-free survival. CONCLUSIONS: Our study showed that although RLRN versus TLRN had roughly similar efficacy, TLRN outperformed RLRN in terms of surgical specimen integrity. TLRN was also significantly better than RLRN in controlling tumor recurrence for clinical T2 and above cases. TRIAL REGISTRATION: Chinese Clinical Trial Registry ( https://www.chictr.org.cn/showproj.html?proj=24400 ), identifier: ChiCTR1800014431, date: 13/01/2018.
Assuntos
Carcinoma de Células Renais , Neoplasias Renais , Laparoscopia , Humanos , Masculino , Neoplasias Renais/patologia , Resultado do Tratamento , Complicações Pós-Operatórias/etiologia , Recidiva Local de Neoplasia/cirurgia , Nefrectomia/métodos , Carcinoma de Células Renais/patologia , Laparoscopia/métodos , Estudos RetrospectivosRESUMO
PURPOSE: To present the widely unknown perioperative outcomes and continence status of bladder cancer patients following robotic-assisted radical cystectomy (RARC) with Mainz pouch II urinary diversion (UD). MATERIALS AND METHODS: From November 2020 to December 2023, 37 bladder cancer patients who underwent RARC with Mainz pouch II UD were retrospectively assessed (ChiCTR2300070279). The results, which included patient demographics, perioperative data, continence, and complications (early ≤ 30 days and late ≤ 30 days) were reported using the RC-pentafecta criteria. RC-pentafecta criteria included ≥ 16 lymph nodes removed, negative soft tissue surgical margins, absence of major (Grade III-IV) complication at 90 days, absence of clinical recurrence at ≤ 12 months, and absence of long-term UD-related sequelae. A numeric rating scale assessed patient satisfaction with urinary continence 30 days after surgery. The validated Patient Assessment of Constipation Symptoms (PAC-SYM) questionnaire was used to evaluate bowel function. The Kaplan-Meier curve was used to evaluate overall survival (OS). RESULTS: Of the 37 patients evaluated over a median (range) follow-up period of 23.0 (12.0-36.5) months. The median (range) age was 65 (40-81) years. The median (range) time to urinary continence after surgery was 2.3 (1.5-6) months. Of the 37 patients, 31 (83.8%) were continent both during the day and at night, 34 (91.9%) were continent during the day, 32 (86.5%) were continent at night, 35 (94.6%) were satisfied with their urinary continence status, and 21 (56.8%) were very satisfied. The mean (range) voiding frequency was 6 (4-10) during the day and 3 (2-5.5) at night. The mean (range) PAC-SYM total score was 9.50 (4.00-15.00). In 12 (32.4%) of the patients, RC-pentafecta was achieved, and achieving RC-pentafecta was linked to better satisfaction scores (7.3 vs. 5.5, p = 0.034). There was no significant difference between RC-pentafecta and No RC-pentafecta groups in terms of OS (25.6 vs. 21.5 months, p = 0.16). 7 (19.4%) patients experienced late complications. CONCLUSIONS: Mainz pouch II UD following RARC in bladder cancer patients results in a satisfactory continence rate. Achieving RC-pentafecta was correlated with better satisfaction scores. The intracorporeal approach to Mainz pouch II UD is beneficial for female patients due to its reduced invasiveness. TRIAL REGISTRATION: ChiCTR2300070279; Registration: 07/04/2023, Last updated version: 01/06/2023. Retrospectively registered.
Assuntos
Parede Abdominal , Procedimentos Cirúrgicos Robóticos , Neoplasias da Bexiga Urinária , Derivação Urinária , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Cistectomia/efeitos adversos , Procedimentos Cirúrgicos Robóticos/efeitos adversos , Neoplasias da Bexiga Urinária/cirurgia , Derivação Urinária/efeitos adversos , Constipação Intestinal , Progressão da DoençaRESUMO
Artificial intelligence (AI) refers to the field of computer science theory and technology [...].
RESUMO
The metabolic score for insulin resistance (METS-IR) was recently proposed as a non-insulin-based, novel index for assessing insulin resistance (IR) in the Western population. However, evidence for the link between METS-IR and prediabetes or type 2 diabetes mellitus (T2DM) among the elderly Chinese population was still limited. We aimed to investigate the associations between METS-IR and prediabetes or T2DM based on large-scale, cross-sectional, routine physical examination data. In a total of 18,112 primary care service users, an increased METS-IR was independently associated with a higher prevalence of prediabetes (adjusted odds ratio [aOR] = 1.457, 95% confidence interval [CI]: 1.343 to 1.581, p < 0.001) and T2DM (aOR = 1.804, 95%CI: 1.720 to 1.891, p < 0.001), respectively. The aOR for prediabetes in subjects with the highest quartile of METS-IR was 3.060-fold higher than that in those with the lowest quartile of METS-IR. The aOR for T2DM in subjects with the highest quartile of METS-IR was 6.226-fold higher than that in those with the lowest quartile of METS-IR. Consistent results were obtained in subgroup analyses. Our results suggested that METS-IR was significantly associated with both prediabetes and T2DM. The monitoring of METS-IR may add value to early identification of individuals at risk for glucose metabolism disorders in primary care.
Assuntos
Diabetes Mellitus Tipo 2 , Resistência à Insulina , Síndrome Metabólica , Estado Pré-Diabético , Humanos , Idoso , Diabetes Mellitus Tipo 2/epidemiologia , Estado Pré-Diabético/epidemiologia , Estudos Transversais , Medição de Risco , Síndrome Metabólica/epidemiologiaRESUMO
In the global epidemic, distance learning occupies an increasingly important place in teaching and learning because of its great potential. This paper proposes a web-based app that includes a proposed 8-layered lightweight, customized convolutional neural network (LCCNN) for COVID-19 recognition. Five-channel data augmentation is proposed and used to help the model avoid overfitting. The LCCNN achieves an accuracy of 91.78%, which is higher than the other eight state-of-the-art methods. The results show that this web-based app provides a valuable diagnostic perspective on the patients and is an excellent way to facilitate medical education. Our LCCNN model is explainable for both radiologists and distance education users. Heat maps are generated where the lesions are clearly spotted. The LCCNN can detect from CT images the presence of lesions caused by COVID-19. This web-based app has a clear and simple interface, which is easy to use. With the help of this app, teachers can provide distance education and guide students clearly to understand the damage caused by COVID-19, which can increase interaction with students and stimulate their interest in learning.
RESUMO
Breast cancer is a major public health concern that affects women worldwide. It is a leading cause of cancer-related deaths among women, and early detection is crucial for successful treatment. Unfortunately, breast cancer can often go undetected until it has reached advanced stages, making it more difficult to treat. Therefore, there is a pressing need for accurate and efficient diagnostic tools to detect breast cancer at an early stage. The proposed approach utilizes SqueezeNet with fire modules and complex bypass to extract informative features from mammography images. The extracted features are then utilized to train a support vector machine (SVM) for mammography image classification. The SqueezeNet-guided SVM model, known as SNSVM, achieved promising results, with an accuracy of 94.10% and a sensitivity of 94.30%. A 10-fold cross-validation was performed to ensure the robustness of the results, and the mean and standard deviation of various performance indicators were calculated across multiple runs. This model also outperforms state-of-the-art models in all performance indicators, indicating its superior performance. This demonstrates the effectiveness of the proposed approach for breast cancer diagnosis using mammography images. The superior performance of the proposed model across all indicators makes it a promising tool for early breast cancer diagnosis. This may have significant implications for reducing breast cancer mortality rates.
RESUMO
Designing metal-organic framework (MOF)-based catalysts with superior oxygen evolution reaction (OER) activity and robust durability simultaneously is highly required yet very challenging due to the limited intrinsic activity and their elusive evolution under harsh OER conditions. Herein, a steady self-reconstructed MOF heterojunction is constructed via redox electrochemistry and topology-guided strategy. Thanks to the inhibiting effect from hydrogen bonds of Ni-BDC-1 (BDC=1,4-benzenedicarboxylic acid), the obatained MOF heterojunction shows greatly improved OER activity with low overpotential of 225â mV at 10â mA cm-2 , relative to the totally reconstructed Ni-BDC-3 (332â mV). Density function theory calculations reveal that the formed built-in electric field in the MOF heterojunction remarkably optimizes the ad/desorption free energy of active Ni sites. Moreover, such MOF heterojunction shows superior durability attributed to the shielding effect of the surface-evolved NiOOH coating.
RESUMO
The hot deformation behavior and dynamic recrystallization (DRX) of Fe-15Mn-15Al-5Ni-1C low-density steel in the as-cast state was investigated via hot compression experiments over temperature and strain rate ranges of 925 to 1150 °C and 0.01 to 10 s-1, respectively. A constitutive equation and a critical DRX model of the Fe-15Mn-15Al-5Ni-1C low-density steel were also constructed. The results showed that higher strain rates resulted in significant work hardening and subsequent rapid softening of the Fe-15Mn-15Al-5Ni-1C low-density steel, while lower strain rates resulted in predominantly steady-state flow behavior. The activation energy of deformation for the Fe-15Mn-15Al-5Ni-1C low-density steel was Q = 540 kJ mol-1 and the stress index was n = 4. The hot deformation mechanism was solute dragging and dislocation climbing, which was controlled by the strain rate. Increasing the deformation temperature or strain rate reduced the critical stress value σc of the DRX of the Fe-15Mn-15Al-5Ni-1C low-density steel and contributed to the DRX of austenite and δ-ferrite. The Fe-15Mn-15Al-5Ni-1C low-density steel after the hot compression deformation was mainly composed of austenite, ferrite, and κ carbide phases.
RESUMO
BACKGROUND: Patients with multimorbidity often experience treatment burden as a result of fragmented, specialist-driven healthcare. The 'family doctor team' is an emerging service model in China to address the increasing need for high-quality routine primary care. OBJECTIVE: This study aimed to explore the extent to which treatment burden was associated with healthcare needs and patients' experiences. METHODS: Multisite surveys were conducted in primary care facilities in Guangdong province, southern China. Interviewer-administered questionnaires were used to collect data from patients (N = 2160) who had ≥2 clinically diagnosed long-term conditions (multimorbidity) and had ≥1 clinical encounter in the past 12 months since enrolment registration with the family doctor team. Patients' experiences and treatment burden were measured using a previously validated Chinese version of the Primary Care Assessment Tool (PCAT) and the Treatment Burden Questionnaire, respectively. RESULTS: The mean age of the patients was 61.4 years, and slightly over half were females. Patients who had a family doctor team as the primary source of care reported significantly higher PCAT scores (mean difference 7.2 points, p < .001) and lower treatment burden scores (mean difference -6.4 points, p < .001) when compared to those who often bypassed primary care. Greater healthcare needs were significantly correlated with increased treatment burden (ß-coefficient 1.965, p < .001), whilst better patients' experiences were associated with lower treatment burden (ß-coefficient -0.252, p < .001) after adjusting for confounders. CONCLUSION: The inverse association between patients' experiences and treatment burden supports the importance of primary care in managing patients with multimorbidity. PATIENT CONTRIBUTION: Primary care service users were involved in the instrument development and data collection.
Assuntos
Multimorbidade , Atenção Primária à Saúde , Estudos Transversais , Atenção à Saúde , Feminino , Humanos , Pessoa de Meia-Idade , Inquéritos e QuestionáriosRESUMO
The pandemic of COVID-19 is continuing to wreak havoc in 2021, with at least 170 million victims around the world. Healthcare systems are overwhelmed by the large-scale virus infection. Luckily, Internet of Things (IoT) is one of the most effective paradigms in the intelligent world, in which the technology of artificial intelligence (AI), like cloud computing and big data analysis, is playing a vital role in preventing the spread of the pandemic of COVID-19. AI and 5G technologies are advancing by leaps and bounds, further strengthening the intelligence and connectivity of IoT applications, and conventional IoT has been gradually upgraded to be more powerful AI + IoT (AIoT). For example, in terms of remote screening and diagnosis of COVID-19 patients, AI technology based on machine learning and deep learning has recently upgraded medical equipment significantly and has reshaped the workflow with minimal contact with patients, so medical specialists can make clinical decisions more efficiently, providing the best protection not only to patients but also to specialists themselves. This paper reviews the latest progress made in combating COVID-19 with both IoT and AI and also provides comprehensive details on how to combat the pandemic of COVID-19 as well as the technologies that may be applied in the future.
Assuntos
Inteligência Artificial , COVID-19/prevenção & controle , Atenção à Saúde/normas , Internet das Coisas/estatística & dados numéricos , Aprendizado de Máquina , SARS-CoV-2/isolamento & purificação , COVID-19/virologia , HumanosRESUMO
BACKGROUND: Follow-up care is crucial but challenging for disease management particularly in rural areas with limited healthcare resources and clinical capacity, yet few studies have been conducted from the perspective of rural primary care physicians (PCPs). We assessed the frequency of follow-up care delivered by rural PCPs for hypertension and type 2 diabetes - the two most common long-term conditions. METHODS: We conducted a multi-centre, self-administered survey study built upon existing general practice course programmes for rural PCPs in four provinces. Information on follow-up care delivery were collected from rural PCPs attending centralised in-class teaching sessions using a set of close-ended, multiple choice questions. Binary logistic regression analysis was performed to examine physician-level factors associated with non-attainment of the target frequency of follow-up care for hypertension and type 2 diabetes, respectively. The final sample consisted of rural PCPs from 52 township-level regions. The Complex Samples module was used in the statistical analysis to account for the multistage sample design. RESULTS: The overall response rate was 91.4%. Around one fifth of PCPs in rural practices did not achieve the target frequency of follow-up care delivery (18.7% for hypertension; 21.6% for type 2 diabetes). Higher education level of physicians, increased volume of daily patients seen, and no provision of home visits were risk factors for non-attainment of the target frequency of follow-up care for both conditions. Moreover, village physicians with less working experiences tended to have less frequent follow-up care delivery in type 2 diabetes management. CONCLUSIONS: Efforts that are solely devoted to enhancing rural physicians' education may not directly translate into strong motivation and active commitment to service provision given the possible existence of clinical inertia and workload-related factors. Risk factors identified for target non-attainment in the follow-up care delivery may provide areas for capacity building programmes in rural primary care practice.
Assuntos
Diabetes Mellitus Tipo 2 , Hipertensão , Médicos de Atenção Primária , Assistência ao Convalescente , China/epidemiologia , Diabetes Mellitus Tipo 2/epidemiologia , Diabetes Mellitus Tipo 2/terapia , Humanos , Hipertensão/epidemiologia , Hipertensão/terapiaRESUMO
BACKGROUND: Adherence to lifestyle recommendations remains insufficient in cardiovascular (CV) health management globally. Body constitution, from the perspective of traditional Chinese medicine, is primarily influenced by an individual's internal metabolism and susceptibility to external pathogenic factors. Nevertheless, less is known about whether body constitutions may play a role in the presence of unhealthy lifestyles. We aimed to explore the associations between body constitutions and unhealthy lifestyles among Chinese individuals at high CV risk. METHODS: Computerised data were retrieved from a primary care population-based health record for all 1739 eligible individuals at high CV risk who attended routine check-up in an urbanised, medium-size district in Guangzhou, China. Unhealthy lifestyles were determined in accordance with guideline recommendations. The body constitution was assessed on the basis of physical signs, personality, body symptoms, and the susceptibility to environmental changes, following nationally standard procedure. Binary logistic regression analyses were performed using marginal standardisation method. RESULTS: The participants ranged in age from 20 to 96 years, with a mean age of 69.55 years. There were slightly more females than males (52.3% vs 47.7%). Current smoking, regular drinking, and physical inactivity were most common. Participants with a body constitution of phlegm-and-dampness type (adjusted odds ratio [aOR]=1.999, 95% confidence interval [CI]=1.003-3.984; p=0.049) tended to be current smokers, and those assessed with special diathesis type (aOR=2.166, 95% CI=1.029-4.559; p=0.042) had a higher likelihood of being regular drinkers. Having a body constitution type of blood stasis (aOR=1.375, 95% CI=1.029-1.838; p=0.031) or qi deficient (aOR=1.711, 95% CI=1.080-2.709; p=0.022) was associated with physical inactivity. CONCLUSION: Our findings add to current evidence suggesting that an individual's body constitution is closely related to the presence of unhealthy lifestyles. This offers new insights for health management through body constitution-based strategies to target those at high CV risk who need tailor-made attention in lifestyle modifications during routine primary care.
RESUMO
OBJECTIVE: To validate the efficacy and safety of Ningmitai capsule (NMT) in the patients with chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS). METHODS: We conducted a multicenter, randomized, double-blind, placebo-controlled trial in 120 men with CP/CPPS to evaluate the efficacy and safety of NMT. Participants were randomly assigned (1:1) to NMT or placebo treatment for 4 weeks at 3 centres. The patients were evaluated by the National Institutes of Health Chronic Prostatitis Symptom Index (NIH-CPSI) at baseline, the end of 2 and 4 weeks of treatment. The primary endpoints were the changes of the NIH-CPSI pain scores from baseline to the end of 2 and 4 weeks of the treatment. The secondary endpoints include the changes of the NIH-CPSI total scores, urinary symptoms scores and the quality of life (QoL) as well as the responder rate. RESULTS: After 2 and 4 weeks of treatment, the mean decreases of the NIH-CPSI pain scores, total scores and QoL in the NMT group were all significantly superior to those in the placebo group. The responder rate was significantly higher in the NMT group than that in the placebo group at both 2 and 4 weeks. No adverse events were reported during the treatment. CONCLUSION: NMT could significantly improve the pain symptoms and QoL in the patients with CP/CPPS as early as in 2 weeks, and the efficacy enhanced at the end of the 4-week treatment. The safety of NMT was confirmed in this trial.
Assuntos
Dor Crônica/tratamento farmacológico , Medicina Tradicional Chinesa , Dor Pélvica/tratamento farmacológico , Prostatite/tratamento farmacológico , Adolescente , Adulto , Doença Crônica/tratamento farmacológico , Método Duplo-Cego , Humanos , Masculino , Pessoa de Meia-Idade , Medição da Dor , Qualidade de Vida , Adulto JovemRESUMO
AIM: To assess the influence of health education for type 2 diabetic patients with and without coexisting hypertension in routine primary care where intensive educational consultations were absent. METHODS: A longitudinal cohort was constructed from 342 diabetic subjects who previously had regular exposure to face-to-face health education delivered quarterly during 2016-2017 under the national basic public health (BPH) service provision in an urbanised township in China. Clinical parameters were retrieved electronically from computerised BPH data platform at prior check-ups (2016-2017) and at the most recent check-up (2019). RESULTS: The satisfactory clinical improvements upon health education were not sustained during subsequent observational years among study subjects. A significant increase in total cholesterol (0.28 mmol/L for between-group net changes, 95% confidence interval [CI] = 0.01-0.55 mmol/L, p = 0.039) were observed in diabetic subjects with coexisting hypertension. Older patients (adjusted odds ratio [aOR] = 0.87, 95%CI = 0.83-0.91, p less than 0.001), males (aOR = 0.50, 95%CI = 0.26-0.98, p = 0.043), and subjects with lower education level (aOR = 0.34, 95%CI = 0.17-0.67, p = 0.002) were less likely to maintain improvement of biomedical parameters. CONCLUSION: The influence of face-to-face health education may not be prolonged in routine primary care where intensive provisions of educational consultations were less common. Diabetic patients with coexisting hypertension tend to have more difficulties in maintaining optimal lipid profiles.
Assuntos
Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia , Educação em Saúde/métodos , Hipertensão/etiologia , Adulto , Estudos de Coortes , Feminino , Humanos , Estudos Longitudinais , Masculino , Atenção Primária à SaúdeRESUMO
OBJECTIVE: To study the inhibitory effect of Biejiajian pills (BJJ) agaisnt diethylnitrosamine (DEN)-induced hepatocarcinogenesis and explore the relation between this effect and the inflammasome signaling pathway. METHODS: Sixty-five male SD rats were randomly divided into control group, DEN model group, and 3 BJJ treatment groups at low, medium and high dose (with daily dose of 0.55, 1.1 and 2.2 g/kg, respectively, for 12 consecutive weeks starting from the 5th week after modeling). The pathological changes of the liver tissue were observed with HE and Masson staining, and serum levels of alanine transaminase (ALT), glutamic oxaloacetic transaminase (AST), alkaline phosphatase (ALP) and total bilirubin (TBIL) of the rats were detected using ELISA. Oxidation stress in the liver tissue was assessed with ELISA, and Western blotting and ELISA were used to detect the molecular expressions of inflammasome-related pathway. RESULTS: BJJ significantly inhibited tumor growth in the liver of the rats. HE and Masson staining showed that BJJ treatment obviously ameliorated liver fibrosis and reduced cancer cell and inflammatory cell infiltration in the liver. BJJ significantly reduced elevations of serum ALT, AST, ALP and TBIL levels, increased the contents of superoxide dismutase, catalase and glutathione peroxidase in the liver and suppressed malondialdehyde in Den-treated rats. BJJ also dose-dependently decreased the expressions of NLRP3, apoptosis-associated speck-like protein (ASC), caspase-1, pro-IL-1ß, pro-IL-18, IL-1ß and IL-18 in the liver of Den-treated rats. CONCLUSIONS: BJJ treatment can dose-dependently inhibit DEN-induced hepatocarcinogenesis by enhancing antioxidant capacity and down-regulating inflammatory-related pathways in rats.