The report of the 18th National Congress of the CPC for the first time put forward that "We will take solid steps to promote public diplomacy as well as people-to-people and cultural exchanges",and has eleva...The report of the 18th National Congress of the CPC for the first time put forward that "We will take solid steps to promote public diplomacy as well as people-to-people and cultural exchanges",and has elevated public diplomacy and people-topeople and cultural exchanges to the status of consolidating the social foundation for state-tostate relations,which highlights the展开更多
Since 2014,the Nanjing Foreign Affairs Office has cooperated with the Japan Association of History Educators to organize three annual exchanges of Chinese and Japanese history teachers as one part of a series of activ...Since 2014,the Nanjing Foreign Affairs Office has cooperated with the Japan Association of History Educators to organize three annual exchanges of Chinese and Japanese history teachers as one part of a series of activities under the theme'Joining hands with foreign friends to build peace cities'.The Japanese association is a nongovernmental organization with展开更多
BACKGROUND Return to work(RTW)serves as an indication for young and middle-aged colorectal cancer(CRC)survivors to resume their normal social lives.However,these survivors encounter significant challenges during their...BACKGROUND Return to work(RTW)serves as an indication for young and middle-aged colorectal cancer(CRC)survivors to resume their normal social lives.However,these survivors encounter significant challenges during their RTW process.Hence,scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC survivors.AIM To examine the current RTW status among young and middle-aged CRC survivors and to analyze the impact of RTW self-efficacy(RTW-SE),fear of progression(FoP),eHealth literacy(eHL),family resilience(FR),and financial toxicity(FT)on their RTW outcomes.METHODS A cross-sectional investigation was adopted in this study.From September 2022 to February 2023,a total of 209 participants were recruited through a convenience sampling method from the gastrointestinal surgery department of a class A tertiary hospital in Chongqing.The investigation utilized a general information questionnaire alongside scales assessing RTW-SE,FoP,eHL,FR,and FT.To analyze the factors that influence RTW outcomes among young and middle-aged CRC survivors,Cox regression modeling and Kaplan-Meier survival analysis were used.RESULTS A total of 43.54%of the participants successfully returned to work,with an average RTW time of 100 days.Cox regression univariate analysis revealed that RTW-SE,FoP,eHL,FR,and FT were significantly different between the non-RTW and RTW groups(P<0.05).Furthermore,Cox regression multivariate analysis identified per capita family monthly income,job type,RTW-SE,and FR as independent influencing factors for RTW(P<0.05).CONCLUSION The RTW rate requires further improvement.Elevated levels of RTW-SE and FR were found to significantly increase RTW among young and middle-aged CRC survivors.Health professionals should focus on modifiable factors,such as RTW-SE and FR,to design targeted RTW support programs,thereby facilitating their timely reintegration into mainstream society.展开更多
BACKGROUND Autoimmune enteropathy(AIE)is a rare disease whose diagnosis and long-term prognosis remain challenging,especially for adult AIE patients.AIM To improve overall understanding of this disease’s diagnosis an...BACKGROUND Autoimmune enteropathy(AIE)is a rare disease whose diagnosis and long-term prognosis remain challenging,especially for adult AIE patients.AIM To improve overall understanding of this disease’s diagnosis and prognosis.METHODS We retrospectively analyzed the clinical,endoscopic and histopathological characteristics and prognoses of 16 adult AIE patients in our tertiary medical center between 2011 and 2023,whose diagnosis was based on the 2007 diagnostic criteria.RESULTS Diarrhea in AIE patients was characterized by secretory diarrhea.The common endoscopic manifestations were edema,villous blunting and mucosal hyperemia in the duodenum and ileum.Villous blunting(100%),deep crypt lymphocytic infiltration(67%),apoptotic bodies(50%),and mild intraepithelial lymphocytosis(69%)were observed in the duodenal biopsies.Moreover,there were other remarkable abnormalities,including reduced or absent goblet cells(duodenum 94%,ileum 62%),reduced or absent Paneth cells(duodenum 94%,ileum 69%)and neutrophil infiltration(duodenum 100%,ileum 69%).Our patients also fulfilled the 2018 diagnostic criteria but did not match the 2022 diagnostic criteria due to undetectable anti-enterocyte antibodies.All patients received glucocorticoid therapy as the initial medication,of which 14/16 patients achieved a clinical response in 5(IQR:3-20)days.Immunosuppressants were administered to 9 patients with indications of steroid dependence(6/9),steroid refractory status(2/9),or intensified maintenance medication(1/9).During the median of 20.5 months of followup,2 patients died from multiple organ failure,and 1 was diagnosed with non-Hodgkin’s lymphoma.The cumulative relapse-free survival rates were 62.5%,55.6%and 37.0%at 6 months,12 months and 48 months,respectively.CONCLUSION Certain histopathological findings,including a decrease or disappearance of goblet and Paneth cells in intestinal biopsies,might be potential diagnostic criteria for adult AIE.The long-term prognosis is still unsatisfactory despite corticosteroid and immunosuppressant medications,which highlights the need for early diagnosis and novel medications.展开更多
BACKGROUND Eosinophilic gastroenteritis(EGE)is a chronic recurrent disease with abnormal eosinophilic infiltration in the gastrointestinal tract.Glucocorticoids remain the most common treatment method.However,disease ...BACKGROUND Eosinophilic gastroenteritis(EGE)is a chronic recurrent disease with abnormal eosinophilic infiltration in the gastrointestinal tract.Glucocorticoids remain the most common treatment method.However,disease relapse and glucocorticoid dependence remain notable problems.To date,few studies have illuminated the prognosis of EGE and risk factors for disease relapse.AIM To describe the clinical characteristics of EGE and possible predictive factors for disease relapse based on long-term follow-up.METHODS This was a retrospective cohort study of 55 patients diagnosed with EGE admitted to one medical center between 2013 and 2022.Clinical records were collected and analyzed.Kaplan-Meier curves and log-rank tests were conducted to reveal the risk factors for long-term relapse-free survival(RFS).RESULTS EGE showed a median onset age of 38 years and a slight female predominance(56.4%).The main clinical symptoms were abdominal pain(89.1%),diarrhea(61.8%),nausea(52.7%),distension(49.1%)and vomiting(47.3%).Forty-three(78.2%)patients received glucocorticoid treatment,and compared with patients without glucocorticoid treatments,they were more likely to have elevated serum immunoglobin E(IgE)(86.8%vs 50.0%,P=0.022)and descending duodenal involvement(62.8%vs 27.3%,P=0.046)at diagnosis.With a median follow-up of 67 mo,all patients survived,and 56.4%had at least one relapse.Six variables at baseline might have been associated with the overall RFS rate,including age at diagnosis<40 years[hazard ratio(HR)2.0408,95%confidence interval(CI):1.0082–4.1312,P=0.044],body mass index(BMI)>24 kg/m^(2)(HR 0.3922,95%CI:0.1916-0.8027,P=0.014),disease duration from symptom onset to diagnosis>3.5 mo(HR 2.4725,95%CI:1.220-5.0110,P=0.011),vomiting(HR 3.1259,95%CI:1.5246-6.4093,P=0.001),total serum IgE>300 KU/L at diagnosis(HR 0.2773,95%CI:0.1204-0.6384,P=0.022)and glucocorticoid treatment(HR 6.1434,95%CI:2.8446-13.2676,P=0.003).CONCLUSION In patients with EGE,younger onset age,longer disease course,vomiting and glucocorticoid treatment were risk factors for disease relapse,whereas higher BMI and total IgE level at baseline were protective.展开更多
Objective To analyze the differences in the correlation of tongue image indicators among patients with benign lung nodules and lung cancer.Methods From July 1;2020 to March 31;2022;clinical information of lung cancer ...Objective To analyze the differences in the correlation of tongue image indicators among patients with benign lung nodules and lung cancer.Methods From July 1;2020 to March 31;2022;clinical information of lung cancer patients and benign lung nodules patients was collected at the Oncology Department of Longhua Hos-pital Affiliated to Shanghai University of Traditional Chinese Medicine and the Physical Ex-amination Center of Shuguang Hospital Affiliated to Shanghai University of Traditional Chi-nese Medicine;respectively.We obtained tongue images from patients with benign lung nod-ules and lung cancer using the TFDA-1 digital tongue diagnosis instrument;and analyzed these images with the TDAS V2.0 software.The extracted indicators included color space pa-rameters in the Lab system for both the tongue body(TB)and tongue coating(TC)(TB/TC-L;TB/TC-a;and TB/TC-b);textural parameters[TB/TC-contrast(CON);TB/TC-angular second moment(ASM);TB/TC-entropy(ENT);and TB/TC-MEAN];as well as TC parameters(perAll and perPart).The bivariate correlation of TB and TC features was analyzed using Pearson’s or Spearman’s correlation analysis;and the overall correlation was analyzed using canonical correlation analysis(CCA).Results Samples from 307 patients with benign lung nodules and 276 lung cancer patients were included after excluding outliers and extreme values.Simple correlation analysis indi-cated that the correlation of TB-L with TC-L;TB-b with TC-b;and TB-b with perAll in lung cancer group was higher than that in benign nodules group.Moreover;the correlation of TB-a with TC-a;TB-a with perAll;and the texture parameters of the TB(TB-CON;TB-ASM;TB-ENT;and TB-MEAN)with the texture parameters of the TC(TC-CON;TC-ASM;TC-ENT;and TC-MEAN)in benign nodules group was higher than lung cancer group.CCA further demon-strated a strong correlation between the TB and TC parameters in lung cancer group;with the first and second pairs of typical variables in benign nodules and lung cancer groups indicat-ing correlation coefficients of 0.918 and 0.817(P<0.05);and 0.940 and 0.822(P<0.05);re-spectively.Conclusion Benign lung nodules and lung cancer patients exhibited differences in correla-tion in the L;a;and b values of the TB and TC;as well as the perAll value of the TC;and the texture parameters(TB/TC-CON;TB/TC-ASM;TB/TC-ENT;and TB/TC-MEAN)between the TB and TC.Additionally;there were differences in the overall correlation of the TB and TC be-tween the two groups.Objective tongue diagnosis indicators can effectively assist in the diag-nosis of benign lung nodules and lung cancer;thereby providing a scientific basis for the ear-ly detection;diagnosis;and treatment of lung cancer.展开更多
To enrich the specific methods of narrative clinical practice in Chinese medicine and stimulate the innovation of narrative medicine practice in China,we advise that medical professionals should integrate theories and...To enrich the specific methods of narrative clinical practice in Chinese medicine and stimulate the innovation of narrative medicine practice in China,we advise that medical professionals should integrate theories and treatments related to acupuncture,massage and positive psychology into their narrative medicine practice,taking into account the current state of clinical practice of acupuncturists and the importance of positive emotions in the field of psychology.This paper elucidates the value of combining acupuncture,massage,and positive psychology from the perspectives of mechanisms and clinical correlations,highlighting their impacts on patients'physical and mental health.To promote the integration of positive psychology with acupuncture and massage,it is proposed to refine the understanding of the efficacy of acupuncture points and develop theories on stimulating positive psychology in acupuncture and massage further more.展开更多
Graduate course teaching plays an irreplaceable role in knowledge mastery,skill enhancement,and quality cultivation of graduate students.This paper addresses current issues in graduate course teaching,such as ambiguou...Graduate course teaching plays an irreplaceable role in knowledge mastery,skill enhancement,and quality cultivation of graduate students.This paper addresses current issues in graduate course teaching,such as ambiguous objectives,formulaic content,formalistic operation,and oversimplified evaluation.It proposes corresponding solutions with the hope of steering graduate course teaching back to its original purpose and realizing its true significance.展开更多
Through a case study of a college student experiencing anxiety,this paper elucidates the structured consultation process of cognitive behavioral therapy,highlighting the application,techniques,and outcomes of relevant...Through a case study of a college student experiencing anxiety,this paper elucidates the structured consultation process of cognitive behavioral therapy,highlighting the application,techniques,and outcomes of relevant consultation methods.The consultation aims to assist the client in overcoming challenges,improving emotional well-being,and reshaping thought patterns to achieve the desired therapeutic effects.展开更多
The Equilibrium Optimiser(EO)has been demonstrated to be one of the metaheuristic algorithms that can effectively solve global optimisation problems.Balancing the paradox between exploration and exploitation operation...The Equilibrium Optimiser(EO)has been demonstrated to be one of the metaheuristic algorithms that can effectively solve global optimisation problems.Balancing the paradox between exploration and exploitation operations while enhancing the ability to jump out of the local optimum are two key points to be addressed in EO research.To alleviate these limitations,an EO variant named adaptive elite-guided Equilibrium Optimiser(AEEO)is introduced.Specifically,the adaptive elite-guided search mechanism enhances the balance between exploration and exploitation.The modified mutualism phase reinforces the information interaction among particles and local optima avoidance.The cooperation of these two mechanisms boosts the overall performance of the basic EO.The AEEO is subjected to competitive experiments with state-of-the-art algorithms and modified algorithms on 23 classical benchmark functions and IEE CEC 2017 function test suite.Experimental results demonstrate that AEEO outperforms several well-performing EO variants,DE variants,PSO variants,SSA variants,and GWO variants in terms of convergence speed and accuracy.In addition,the AEEO algorithm is used for the edge server(ES)placement problem in mobile edge computing(MEC)environments.The experimental results show that the author’s approach outperforms the representative approaches compared in terms of access latency and deployment cost.展开更多
Ototoxic drug-induced apoptosis of inner ear cells has been shown to be associated with calpain expression. Cisplatin has severe ototoxicity, and can induce cochlear cell apoptosis. This study assumed that cisplatin a...Ototoxic drug-induced apoptosis of inner ear cells has been shown to be associated with calpain expression. Cisplatin has severe ototoxicity, and can induce cochlear cell apoptosis. This study assumed that cisplatin activated calpain expression in apoptotic cochlear cells. A mouse model of cisplatin-induced ototoxicity was established by intraperitoneal injection with cisplatin （2.5, 3.5, 4.5, 5.5 mg/kg）. Immunofluorescence staining, image analysis and western blotting were used to detect the expression of calpain 1 and calpain 2 in the mouse cochlea. At the same time, the auditory brainstem response was measured to observe the change in hearing. Results revealed that after intraperitoneal injection with cisplatin for 5 days, the auditory brainstem response threshold shifts increased in mice. Calpain 1 and calpain 2 expression significantly increased in outer hair cells, the spiral ganglion and stria vascularis. Calpain 2 protein expression markedly increased with an increased dose of cisplatin. Results suggested that calpain 1 and calpain 2 mediated cisplatin-induced ototoxicity in BALB/c mice. During this process, calpain 2 plays a leading role.展开更多
Objective To assess the association of socioeconomic status with the burden of cataract blindness in terms of year lived with disability(YLD) rates and to determine whether ultraviolet radiation(UVR) levels modify the...Objective To assess the association of socioeconomic status with the burden of cataract blindness in terms of year lived with disability(YLD) rates and to determine whether ultraviolet radiation(UVR) levels modify the effect of socioeconomic status on this health burden.Methods National and subnational age-standardized YLD rates associated with cataract-related blindness were derived from the Global Burden of Disease(GBD) study 2017. The human development index(HDI) from the Human Development Report was used as a measure of socioeconomic status.Estimated ground-level UVR exposure was obtained from the Ozone Monitoring Instrument(OMI)dataset of the National Aeronautics and Space Administration(NASA).Results Across 185 countries, socioeconomic status was inversely associated with the burden of cataract blindness. Countries with a very high HDI had an 84% lower age-standardized YLD rate [95%confidence interval(CI): 60%–93%, P < 0.001] than countries with a low HDI;for high-HDI countries, the proportion was 76%(95% CI: 53%–88%, P < 0.001), and for medium-HDI countries, the proportion was48%(95% CI: 15%–68%, P = 0.010;P for trend < 0.001). The interaction analysis showed that UVR exposure played an interactive role in the association between socioeconomic status and cataract blindness burden(P value for interaction = 0.047).Conclusion Long-term high-UVR exposure amplifies the association of poor socioeconomic status with the burden of cataract-related blindness. The findings emphasize the need for strengthening UVR exposure protection interventions in developing countries with high-UVR exposure.展开更多
In the video-based surveillance application, moving shadows can affect the correct localization and detection of moving objects. This paper aims to present a method for shadow detection and suppression used for moving...In the video-based surveillance application, moving shadows can affect the correct localization and detection of moving objects. This paper aims to present a method for shadow detection and suppression used for moving visual object detection. The major novelty of the shadow suppression is the integration of several features including photometric invariant color feature, motion edge feature, and spatial feature etc. By modifying process for false shadow detected, the averaging detection rate of moving object reaches above 90% in the test of Hall-Monitor sequence.展开更多
Acute respiratory distress syndrome(ARDS)is a syndrome characterized by significant lung edema,impaired permeability of lung microvascular endothelial cells with the mal-expression of aquaporins(AQPs).In this study,a ...Acute respiratory distress syndrome(ARDS)is a syndrome characterized by significant lung edema,impaired permeability of lung microvascular endothelial cells with the mal-expression of aquaporins(AQPs).In this study,a two-hit porcine model of ARDS induced by smoking and methicillinresistant Staphylococcus aureus(MRSA)was developed,we investigate the AQPs expression and the influence of Ulinastatin(UTI)to them.Forty-nine healthy male domestic pigs aged 8–10 weeks and weighing 30±2 kg were used for the study.Anesthesia was maintained through continuous intravenous infusion of pentobarbital[8 mg/(kg∙h)].A 5-Fr PiCCO catheter(Pulsiocath PV2015L20;Pulsion Medical Systems,Munich,Germany)and a central venous catheter was inserted for hemodynamic monitoring,including mean arterial pressure(MAP),cardiac index(CI),systemic vascular resistance index(SVRI)and extravascular lung water index(ELWI).展开更多
In machine learning,randomness is a crucial factor in the success of ensemble learning,and it can be injected into tree-based ensembles by rotating the feature space.However,it is a common practice to rotate the featu...In machine learning,randomness is a crucial factor in the success of ensemble learning,and it can be injected into tree-based ensembles by rotating the feature space.However,it is a common practice to rotate the feature space randomly.Thus,a large number of trees are required to ensure the performance of the ensemble model.This random rotation method is theoretically feasible,but it requires massive computing resources,potentially restricting its applications.A multimodal genetic algorithm based rotation forest(MGARF)algorithm is proposed in this paper to solve this problem.It is a tree-based ensemble learning algorithm for classification,taking advantage of the characteristic of trees to inject randomness by feature rotation.However,this algorithm attempts to select a subset of more diverse and accurate base learners using the multimodal optimization method.The classification accuracy of the proposed MGARF algorithm was evaluated by comparing it with the original random forest and random rotation ensemble methods on 23 UCI classification datasets.Experimental results show that the MGARF method outperforms the other methods,and the number of base learners in MGARF models is much fewer.展开更多
COVID-19 has changed the way of learning and life of college students.The purpose is to explore the relationship between perceived stress and anxiety,and the mediating effect of resilience and regulatory emotional sel...COVID-19 has changed the way of learning and life of college students.The purpose is to explore the relationship between perceived stress and anxiety,and the mediating effect of resilience and regulatory emotional self-efficacy in college students during COVID-19.309 students from three colleges were selected as research participants(average age 19.79±1.11 years).SPSS was used to measure the correlation between variables.Amos was used to test the path coefficient and mediating effect of the hypothetical model.The results show that:Firstly,perceived stress has a significantly and positively predictive effect on anxiety.Secondly,psychological resilience and regu-latory emotional self-efficacy independently played a significant and partially mediating effect between perceived stress and anxiety.Among them,perceived stress had a negative predictive effect on psychological resilience and regulatory emotional self-efficacy.Psychological resilience and regulatory emotional self-efficacy had a negative predictive effect on anxiety.Thirdly,psychological resilience and regulatory emotional self-efficacy play a chain mediation role between psychological stress and anxiety.Regulatory emotional self-efficacy cannot only directly predict the level of anxiety,but also indirectly predict the level of anxiety by regulating psychological resilience.This study reveals the relationship between college students’perceived stress and anxiety,and the mediating effect of psychological resilience and regulatory emotional self-efficacy in the new time of COVID-19.The chain mediation role of psychological resilience and regulatory emotional self-efficacy reminds college mental health educators that improving students’regulatory emotional self-efficacy is an important way to promote students’mental health.展开更多
The purpose of hierarchical medical system is to lead in terms of improving efficiency, differentiating healthcare services and promoting labor division by changing the healthcare seeking behavior. The purpose of this...The purpose of hierarchical medical system is to lead in terms of improving efficiency, differentiating healthcare services and promoting labor division by changing the healthcare seeking behavior. The purpose of this research aims to discuss the public awareness of hierarchical medical system in Taiwan for the reference of health policy makers. We obtained our research data using a questionnaire survey;the total number of qualified patients was 1340. This research finds that more subjects agreed to the hierarchical medical system and medical referral system, but many people still disagreed with changes to their healthcare seeking choices due to policy promotion. Subtle changes, therefore, are observed that imply a crisis in terms of the trust in healthcare. The healthcare seeking behavior will not change if there is a difference between the medical awareness of patients and policy implementation, and the government needs to be concerned with this result when making policies.展开更多
Objective:To examine the effects of coronavirus disease-2019(COVID-19)exposure,expressive suppression/cognitive reappraisal,and demographic variables on post-traumatic stress symptoms(PTS)among Chinese.Methods:Partici...Objective:To examine the effects of coronavirus disease-2019(COVID-19)exposure,expressive suppression/cognitive reappraisal,and demographic variables on post-traumatic stress symptoms(PTS)among Chinese.Methods:Participants were recruited by social media through We Chat and 6049 Chinese(aged from 17 to 63 years;median=24)from 31 provinces were included in the study.PTS symptoms,expressive suppression,and cognitive reappraisal were assessed after the outbreak of COVID-19.A regression mixture analysis was conducted in Mplus 7.Results:A regression mixture model identified three latent classes that were primarily distinguished by differential effects of COVID-19 exposures on PTS symptoms:(1)Class 1(mildly PTS symptoms,80.9%),(2)Class 2(moderate PTS symptoms,13.0%),and(3)Class 3(high PTS symptoms,6.1%).The results demonstrated that the young,women and people with responsibilities and concerns for others were more vulnerable to PTS symptoms;and they had more expression inhibition and less cognitive reappraisal in three latent classes.Conclusions:The findings suggest that more attention needs to be paid to vulnerable groups such as the young,women and people with responsibilities and concerns for others.Therapies to encourage emotional expression and increase cognitive reappraisal may also be helpful for trauma survivors.展开更多
The development of Internet technology has brought convenience to the development of education and teaching,and has also changed the traditional methods and means of education and teaching. The construction of an inte...The development of Internet technology has brought convenience to the development of education and teaching,and has also changed the traditional methods and means of education and teaching. The construction of an integrated network teaching platform based on Internet technology brings new opportunities for the development of higher education. Taking the construction of the integrated network teaching platform of Northwest A&F University as an example,the current situation and existing problems in the construction of the integrated network teaching platform of the Northwest A&F University are explained. By proposing the promotion strategies for the application of the integrated network teaching platform,the construction of the integrated network teaching platform is improved,thereby facilitating the online and offline mixed teaching and further promoting the improvement of teaching level and teaching effect.展开更多
General education has become more and more attention.The culture has a more long-term and lasting contribution,so more and more colleges and universities have adopted a series of reform measures.Effect of the practice...General education has become more and more attention.The culture has a more long-term and lasting contribution,so more and more colleges and universities have adopted a series of reform measures.Effect of the practice of general education,however,still cannot satisfactory.In this paper,main factors affecting was analyzed on the basis of extensive research and questionnaire data analysis and targeted put forward the optimization effect of general education.It is important to make every effort to make the general education in China to achieve"Phoenix Nirvana".展开更多
文摘The report of the 18th National Congress of the CPC for the first time put forward that "We will take solid steps to promote public diplomacy as well as people-to-people and cultural exchanges",and has elevated public diplomacy and people-topeople and cultural exchanges to the status of consolidating the social foundation for state-tostate relations,which highlights the
文摘Since 2014,the Nanjing Foreign Affairs Office has cooperated with the Japan Association of History Educators to organize three annual exchanges of Chinese and Japanese history teachers as one part of a series of activities under the theme'Joining hands with foreign friends to build peace cities'.The Japanese association is a nongovernmental organization with
基金Supported by the Chongqing Medical University Program for Youth Innovation in Future Medicine,No.W0019Chongqing Municipal Education Commission’s 14th Five-Year Key Discipline Support Project,No.20240101 and No.20240102。
文摘BACKGROUND Return to work(RTW)serves as an indication for young and middle-aged colorectal cancer(CRC)survivors to resume their normal social lives.However,these survivors encounter significant challenges during their RTW process.Hence,scientific research is necessary to explore the barriers and facilitating factors of returning to work for young and middle-aged CRC survivors.AIM To examine the current RTW status among young and middle-aged CRC survivors and to analyze the impact of RTW self-efficacy(RTW-SE),fear of progression(FoP),eHealth literacy(eHL),family resilience(FR),and financial toxicity(FT)on their RTW outcomes.METHODS A cross-sectional investigation was adopted in this study.From September 2022 to February 2023,a total of 209 participants were recruited through a convenience sampling method from the gastrointestinal surgery department of a class A tertiary hospital in Chongqing.The investigation utilized a general information questionnaire alongside scales assessing RTW-SE,FoP,eHL,FR,and FT.To analyze the factors that influence RTW outcomes among young and middle-aged CRC survivors,Cox regression modeling and Kaplan-Meier survival analysis were used.RESULTS A total of 43.54%of the participants successfully returned to work,with an average RTW time of 100 days.Cox regression univariate analysis revealed that RTW-SE,FoP,eHL,FR,and FT were significantly different between the non-RTW and RTW groups(P<0.05).Furthermore,Cox regression multivariate analysis identified per capita family monthly income,job type,RTW-SE,and FR as independent influencing factors for RTW(P<0.05).CONCLUSION The RTW rate requires further improvement.Elevated levels of RTW-SE and FR were found to significantly increase RTW among young and middle-aged CRC survivors.Health professionals should focus on modifiable factors,such as RTW-SE and FR,to design targeted RTW support programs,thereby facilitating their timely reintegration into mainstream society.
基金Supported by National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-022 and No.2022-PUMCH-D-002CAMS Innovation Fund for Medical Sciences,No.2021-1-I2M-003+1 种基金Undergraduate Innovation Program,No.2023-zglc-06034National Key Clinical Specialty Construction Project,No.ZK108000。
文摘BACKGROUND Autoimmune enteropathy(AIE)is a rare disease whose diagnosis and long-term prognosis remain challenging,especially for adult AIE patients.AIM To improve overall understanding of this disease’s diagnosis and prognosis.METHODS We retrospectively analyzed the clinical,endoscopic and histopathological characteristics and prognoses of 16 adult AIE patients in our tertiary medical center between 2011 and 2023,whose diagnosis was based on the 2007 diagnostic criteria.RESULTS Diarrhea in AIE patients was characterized by secretory diarrhea.The common endoscopic manifestations were edema,villous blunting and mucosal hyperemia in the duodenum and ileum.Villous blunting(100%),deep crypt lymphocytic infiltration(67%),apoptotic bodies(50%),and mild intraepithelial lymphocytosis(69%)were observed in the duodenal biopsies.Moreover,there were other remarkable abnormalities,including reduced or absent goblet cells(duodenum 94%,ileum 62%),reduced or absent Paneth cells(duodenum 94%,ileum 69%)and neutrophil infiltration(duodenum 100%,ileum 69%).Our patients also fulfilled the 2018 diagnostic criteria but did not match the 2022 diagnostic criteria due to undetectable anti-enterocyte antibodies.All patients received glucocorticoid therapy as the initial medication,of which 14/16 patients achieved a clinical response in 5(IQR:3-20)days.Immunosuppressants were administered to 9 patients with indications of steroid dependence(6/9),steroid refractory status(2/9),or intensified maintenance medication(1/9).During the median of 20.5 months of followup,2 patients died from multiple organ failure,and 1 was diagnosed with non-Hodgkin’s lymphoma.The cumulative relapse-free survival rates were 62.5%,55.6%and 37.0%at 6 months,12 months and 48 months,respectively.CONCLUSION Certain histopathological findings,including a decrease or disappearance of goblet and Paneth cells in intestinal biopsies,might be potential diagnostic criteria for adult AIE.The long-term prognosis is still unsatisfactory despite corticosteroid and immunosuppressant medications,which highlights the need for early diagnosis and novel medications.
基金National High Level Hospital Clinical Research Funding,No.2022-PUMCH-B-022CAMS Innovation Fund for Medical Sciences,No.CIFMS 2021-1-I2M-003and Undergraduate Innovation Program,No.2023zglc06076.
文摘BACKGROUND Eosinophilic gastroenteritis(EGE)is a chronic recurrent disease with abnormal eosinophilic infiltration in the gastrointestinal tract.Glucocorticoids remain the most common treatment method.However,disease relapse and glucocorticoid dependence remain notable problems.To date,few studies have illuminated the prognosis of EGE and risk factors for disease relapse.AIM To describe the clinical characteristics of EGE and possible predictive factors for disease relapse based on long-term follow-up.METHODS This was a retrospective cohort study of 55 patients diagnosed with EGE admitted to one medical center between 2013 and 2022.Clinical records were collected and analyzed.Kaplan-Meier curves and log-rank tests were conducted to reveal the risk factors for long-term relapse-free survival(RFS).RESULTS EGE showed a median onset age of 38 years and a slight female predominance(56.4%).The main clinical symptoms were abdominal pain(89.1%),diarrhea(61.8%),nausea(52.7%),distension(49.1%)and vomiting(47.3%).Forty-three(78.2%)patients received glucocorticoid treatment,and compared with patients without glucocorticoid treatments,they were more likely to have elevated serum immunoglobin E(IgE)(86.8%vs 50.0%,P=0.022)and descending duodenal involvement(62.8%vs 27.3%,P=0.046)at diagnosis.With a median follow-up of 67 mo,all patients survived,and 56.4%had at least one relapse.Six variables at baseline might have been associated with the overall RFS rate,including age at diagnosis<40 years[hazard ratio(HR)2.0408,95%confidence interval(CI):1.0082–4.1312,P=0.044],body mass index(BMI)>24 kg/m^(2)(HR 0.3922,95%CI:0.1916-0.8027,P=0.014),disease duration from symptom onset to diagnosis>3.5 mo(HR 2.4725,95%CI:1.220-5.0110,P=0.011),vomiting(HR 3.1259,95%CI:1.5246-6.4093,P=0.001),total serum IgE>300 KU/L at diagnosis(HR 0.2773,95%CI:0.1204-0.6384,P=0.022)and glucocorticoid treatment(HR 6.1434,95%CI:2.8446-13.2676,P=0.003).CONCLUSION In patients with EGE,younger onset age,longer disease course,vomiting and glucocorticoid treatment were risk factors for disease relapse,whereas higher BMI and total IgE level at baseline were protective.
基金National Natural Science Foundation of China(82305090)Science and Technology Commission of Shanghai Municipality(22YF1448900)Shanghai Municipal Health Commission(20234Y0168).
文摘Objective To analyze the differences in the correlation of tongue image indicators among patients with benign lung nodules and lung cancer.Methods From July 1;2020 to March 31;2022;clinical information of lung cancer patients and benign lung nodules patients was collected at the Oncology Department of Longhua Hos-pital Affiliated to Shanghai University of Traditional Chinese Medicine and the Physical Ex-amination Center of Shuguang Hospital Affiliated to Shanghai University of Traditional Chi-nese Medicine;respectively.We obtained tongue images from patients with benign lung nod-ules and lung cancer using the TFDA-1 digital tongue diagnosis instrument;and analyzed these images with the TDAS V2.0 software.The extracted indicators included color space pa-rameters in the Lab system for both the tongue body(TB)and tongue coating(TC)(TB/TC-L;TB/TC-a;and TB/TC-b);textural parameters[TB/TC-contrast(CON);TB/TC-angular second moment(ASM);TB/TC-entropy(ENT);and TB/TC-MEAN];as well as TC parameters(perAll and perPart).The bivariate correlation of TB and TC features was analyzed using Pearson’s or Spearman’s correlation analysis;and the overall correlation was analyzed using canonical correlation analysis(CCA).Results Samples from 307 patients with benign lung nodules and 276 lung cancer patients were included after excluding outliers and extreme values.Simple correlation analysis indi-cated that the correlation of TB-L with TC-L;TB-b with TC-b;and TB-b with perAll in lung cancer group was higher than that in benign nodules group.Moreover;the correlation of TB-a with TC-a;TB-a with perAll;and the texture parameters of the TB(TB-CON;TB-ASM;TB-ENT;and TB-MEAN)with the texture parameters of the TC(TC-CON;TC-ASM;TC-ENT;and TC-MEAN)in benign nodules group was higher than lung cancer group.CCA further demon-strated a strong correlation between the TB and TC parameters in lung cancer group;with the first and second pairs of typical variables in benign nodules and lung cancer groups indicat-ing correlation coefficients of 0.918 and 0.817(P<0.05);and 0.940 and 0.822(P<0.05);re-spectively.Conclusion Benign lung nodules and lung cancer patients exhibited differences in correla-tion in the L;a;and b values of the TB and TC;as well as the perAll value of the TC;and the texture parameters(TB/TC-CON;TB/TC-ASM;TB/TC-ENT;and TB/TC-MEAN)between the TB and TC.Additionally;there were differences in the overall correlation of the TB and TC be-tween the two groups.Objective tongue diagnosis indicators can effectively assist in the diag-nosis of benign lung nodules and lung cancer;thereby providing a scientific basis for the ear-ly detection;diagnosis;and treatment of lung cancer.
文摘To enrich the specific methods of narrative clinical practice in Chinese medicine and stimulate the innovation of narrative medicine practice in China,we advise that medical professionals should integrate theories and treatments related to acupuncture,massage and positive psychology into their narrative medicine practice,taking into account the current state of clinical practice of acupuncturists and the importance of positive emotions in the field of psychology.This paper elucidates the value of combining acupuncture,massage,and positive psychology from the perspectives of mechanisms and clinical correlations,highlighting their impacts on patients'physical and mental health.To promote the integration of positive psychology with acupuncture and massage,it is proposed to refine the understanding of the efficacy of acupuncture points and develop theories on stimulating positive psychology in acupuncture and massage further more.
基金Research on the Dilemma and Path of Cultivating Medical Students’Professionalism in the Perspective of Newcomers of the Times(Y202354086)。
文摘Graduate course teaching plays an irreplaceable role in knowledge mastery,skill enhancement,and quality cultivation of graduate students.This paper addresses current issues in graduate course teaching,such as ambiguous objectives,formulaic content,formalistic operation,and oversimplified evaluation.It proposes corresponding solutions with the hope of steering graduate course teaching back to its original purpose and realizing its true significance.
文摘Through a case study of a college student experiencing anxiety,this paper elucidates the structured consultation process of cognitive behavioral therapy,highlighting the application,techniques,and outcomes of relevant consultation methods.The consultation aims to assist the client in overcoming challenges,improving emotional well-being,and reshaping thought patterns to achieve the desired therapeutic effects.
基金National Nature Science Foundation of China under-Grant 61461053,Grant 61461054,and Grant 61072079Yunnan Provincial Education Department Scientific Research Fund Project under-Grant 2022Y008+1 种基金Yunnan University’s Research Innovation Fund for Graduate Students under-Grant KC-22222706project of fund YNWR-QNBJ under-Grant 2018-310.
文摘The Equilibrium Optimiser(EO)has been demonstrated to be one of the metaheuristic algorithms that can effectively solve global optimisation problems.Balancing the paradox between exploration and exploitation operations while enhancing the ability to jump out of the local optimum are two key points to be addressed in EO research.To alleviate these limitations,an EO variant named adaptive elite-guided Equilibrium Optimiser(AEEO)is introduced.Specifically,the adaptive elite-guided search mechanism enhances the balance between exploration and exploitation.The modified mutualism phase reinforces the information interaction among particles and local optima avoidance.The cooperation of these two mechanisms boosts the overall performance of the basic EO.The AEEO is subjected to competitive experiments with state-of-the-art algorithms and modified algorithms on 23 classical benchmark functions and IEE CEC 2017 function test suite.Experimental results demonstrate that AEEO outperforms several well-performing EO variants,DE variants,PSO variants,SSA variants,and GWO variants in terms of convergence speed and accuracy.In addition,the AEEO algorithm is used for the edge server(ES)placement problem in mobile edge computing(MEC)environments.The experimental results show that the author’s approach outperforms the representative approaches compared in terms of access latency and deployment cost.
基金funded by the Scientific Technology Project of Technology Department of Liaoning Province,No.2011225015
文摘Ototoxic drug-induced apoptosis of inner ear cells has been shown to be associated with calpain expression. Cisplatin has severe ototoxicity, and can induce cochlear cell apoptosis. This study assumed that cisplatin activated calpain expression in apoptotic cochlear cells. A mouse model of cisplatin-induced ototoxicity was established by intraperitoneal injection with cisplatin （2.5, 3.5, 4.5, 5.5 mg/kg）. Immunofluorescence staining, image analysis and western blotting were used to detect the expression of calpain 1 and calpain 2 in the mouse cochlea. At the same time, the auditory brainstem response was measured to observe the change in hearing. Results revealed that after intraperitoneal injection with cisplatin for 5 days, the auditory brainstem response threshold shifts increased in mice. Calpain 1 and calpain 2 expression significantly increased in outer hair cells, the spiral ganglion and stria vascularis. Calpain 2 protein expression markedly increased with an increased dose of cisplatin. Results suggested that calpain 1 and calpain 2 mediated cisplatin-induced ototoxicity in BALB/c mice. During this process, calpain 2 plays a leading role.
基金supported by a grant from the National Natural Science Foundation of China No. 81673133 and No.81273034。
文摘Objective To assess the association of socioeconomic status with the burden of cataract blindness in terms of year lived with disability(YLD) rates and to determine whether ultraviolet radiation(UVR) levels modify the effect of socioeconomic status on this health burden.Methods National and subnational age-standardized YLD rates associated with cataract-related blindness were derived from the Global Burden of Disease(GBD) study 2017. The human development index(HDI) from the Human Development Report was used as a measure of socioeconomic status.Estimated ground-level UVR exposure was obtained from the Ozone Monitoring Instrument(OMI)dataset of the National Aeronautics and Space Administration(NASA).Results Across 185 countries, socioeconomic status was inversely associated with the burden of cataract blindness. Countries with a very high HDI had an 84% lower age-standardized YLD rate [95%confidence interval(CI): 60%–93%, P < 0.001] than countries with a low HDI;for high-HDI countries, the proportion was 76%(95% CI: 53%–88%, P < 0.001), and for medium-HDI countries, the proportion was48%(95% CI: 15%–68%, P = 0.010;P for trend < 0.001). The interaction analysis showed that UVR exposure played an interactive role in the association between socioeconomic status and cataract blindness burden(P value for interaction = 0.047).Conclusion Long-term high-UVR exposure amplifies the association of poor socioeconomic status with the burden of cataract-related blindness. The findings emphasize the need for strengthening UVR exposure protection interventions in developing countries with high-UVR exposure.
文摘In the video-based surveillance application, moving shadows can affect the correct localization and detection of moving objects. This paper aims to present a method for shadow detection and suppression used for moving visual object detection. The major novelty of the shadow suppression is the integration of several features including photometric invariant color feature, motion edge feature, and spatial feature etc. By modifying process for false shadow detected, the averaging detection rate of moving object reaches above 90% in the test of Hall-Monitor sequence.
文摘Acute respiratory distress syndrome(ARDS)is a syndrome characterized by significant lung edema,impaired permeability of lung microvascular endothelial cells with the mal-expression of aquaporins(AQPs).In this study,a two-hit porcine model of ARDS induced by smoking and methicillinresistant Staphylococcus aureus(MRSA)was developed,we investigate the AQPs expression and the influence of Ulinastatin(UTI)to them.Forty-nine healthy male domestic pigs aged 8–10 weeks and weighing 30±2 kg were used for the study.Anesthesia was maintained through continuous intravenous infusion of pentobarbital[8 mg/(kg∙h)].A 5-Fr PiCCO catheter(Pulsiocath PV2015L20;Pulsion Medical Systems,Munich,Germany)and a central venous catheter was inserted for hemodynamic monitoring,including mean arterial pressure(MAP),cardiac index(CI),systemic vascular resistance index(SVRI)and extravascular lung water index(ELWI).
基金Project(61603274)supported by the National Natural Science Foundation of ChinaProject(2017KJ249)supported by the Research Project of Tianjin Municipal Education Commission,China。
文摘In machine learning,randomness is a crucial factor in the success of ensemble learning,and it can be injected into tree-based ensembles by rotating the feature space.However,it is a common practice to rotate the feature space randomly.Thus,a large number of trees are required to ensure the performance of the ensemble model.This random rotation method is theoretically feasible,but it requires massive computing resources,potentially restricting its applications.A multimodal genetic algorithm based rotation forest(MGARF)algorithm is proposed in this paper to solve this problem.It is a tree-based ensemble learning algorithm for classification,taking advantage of the characteristic of trees to inject randomness by feature rotation.However,this algorithm attempts to select a subset of more diverse and accurate base learners using the multimodal optimization method.The classification accuracy of the proposed MGARF algorithm was evaluated by comparing it with the original random forest and random rotation ensemble methods on 23 UCI classification datasets.Experimental results show that the MGARF method outperforms the other methods,and the number of base learners in MGARF models is much fewer.
文摘COVID-19 has changed the way of learning and life of college students.The purpose is to explore the relationship between perceived stress and anxiety,and the mediating effect of resilience and regulatory emotional self-efficacy in college students during COVID-19.309 students from three colleges were selected as research participants(average age 19.79±1.11 years).SPSS was used to measure the correlation between variables.Amos was used to test the path coefficient and mediating effect of the hypothetical model.The results show that:Firstly,perceived stress has a significantly and positively predictive effect on anxiety.Secondly,psychological resilience and regu-latory emotional self-efficacy independently played a significant and partially mediating effect between perceived stress and anxiety.Among them,perceived stress had a negative predictive effect on psychological resilience and regulatory emotional self-efficacy.Psychological resilience and regulatory emotional self-efficacy had a negative predictive effect on anxiety.Thirdly,psychological resilience and regulatory emotional self-efficacy play a chain mediation role between psychological stress and anxiety.Regulatory emotional self-efficacy cannot only directly predict the level of anxiety,but also indirectly predict the level of anxiety by regulating psychological resilience.This study reveals the relationship between college students’perceived stress and anxiety,and the mediating effect of psychological resilience and regulatory emotional self-efficacy in the new time of COVID-19.The chain mediation role of psychological resilience and regulatory emotional self-efficacy reminds college mental health educators that improving students’regulatory emotional self-efficacy is an important way to promote students’mental health.
文摘The purpose of hierarchical medical system is to lead in terms of improving efficiency, differentiating healthcare services and promoting labor division by changing the healthcare seeking behavior. The purpose of this research aims to discuss the public awareness of hierarchical medical system in Taiwan for the reference of health policy makers. We obtained our research data using a questionnaire survey;the total number of qualified patients was 1340. This research finds that more subjects agreed to the hierarchical medical system and medical referral system, but many people still disagreed with changes to their healthcare seeking choices due to policy promotion. Subtle changes, therefore, are observed that imply a crisis in terms of the trust in healthcare. The healthcare seeking behavior will not change if there is a difference between the medical awareness of patients and policy implementation, and the government needs to be concerned with this result when making policies.
基金supported by the research grant from Hainan Medical University(No.XGZX2020003)the fund from Working Committee for Talents of Hainan Province(No.20192166)+2 种基金the Project of Basic Platform of National Science and Technology Resources of the Ministry of Sciences and Technology of China(No.TDRC-2019-194-30)Science and Technology Planning Project of Guangdong Province(No.2019B030316025)the 111 Project(No.B12003)
文摘Objective:To examine the effects of coronavirus disease-2019(COVID-19)exposure,expressive suppression/cognitive reappraisal,and demographic variables on post-traumatic stress symptoms(PTS)among Chinese.Methods:Participants were recruited by social media through We Chat and 6049 Chinese(aged from 17 to 63 years;median=24)from 31 provinces were included in the study.PTS symptoms,expressive suppression,and cognitive reappraisal were assessed after the outbreak of COVID-19.A regression mixture analysis was conducted in Mplus 7.Results:A regression mixture model identified three latent classes that were primarily distinguished by differential effects of COVID-19 exposures on PTS symptoms:(1)Class 1(mildly PTS symptoms,80.9%),(2)Class 2(moderate PTS symptoms,13.0%),and(3)Class 3(high PTS symptoms,6.1%).The results demonstrated that the young,women and people with responsibilities and concerns for others were more vulnerable to PTS symptoms;and they had more expression inhibition and less cognitive reappraisal in three latent classes.Conclusions:The findings suggest that more attention needs to be paid to vulnerable groups such as the young,women and people with responsibilities and concerns for others.Therapies to encourage emotional expression and increase cognitive reappraisal may also be helpful for trauma survivors.
文摘The development of Internet technology has brought convenience to the development of education and teaching,and has also changed the traditional methods and means of education and teaching. The construction of an integrated network teaching platform based on Internet technology brings new opportunities for the development of higher education. Taking the construction of the integrated network teaching platform of Northwest A&F University as an example,the current situation and existing problems in the construction of the integrated network teaching platform of the Northwest A&F University are explained. By proposing the promotion strategies for the application of the integrated network teaching platform,the construction of the integrated network teaching platform is improved,thereby facilitating the online and offline mixed teaching and further promoting the improvement of teaching level and teaching effect.
基金Effect of general education in colleges and universities practice researchEducation in Jiangsu province“Twelfth Five-year Plan”scientific research project.No.:C-b/2011/01/28
文摘General education has become more and more attention.The culture has a more long-term and lasting contribution,so more and more colleges and universities have adopted a series of reform measures.Effect of the practice of general education,however,still cannot satisfactory.In this paper,main factors affecting was analyzed on the basis of extensive research and questionnaire data analysis and targeted put forward the optimization effect of general education.It is important to make every effort to make the general education in China to achieve"Phoenix Nirvana".
