Evaluation of a gamma technique for the assay of radioactive waste drums using two measurements from opposing directions

A technique using two measurements from opposing directions for the assay of the activity of radioactive waste drums, mainly consisting of organic materials, has been studied. A model for the calculation of systematic errors is given by simulating the measurement system. The calculated values are in good agreement with the experimental values. This confirms the validity of the model and proofs the good performance of this technique in practice. These results may provide guidelines for setting up a measuring system for the assay the radwaste drums.     

The prognostic value of platelet-to-lymphocyte ratio on the long-term renal survival in patients with IgA nephropathy

Purpose

Platelet-to-lymphocyte ratio (PLR) was established showing the poor prognosis in several diseases, such as malignancies and cardiovascular diseases. But limited study has been conducted about the prognostic value of PLR on the long-term renal survival of patients with Immunoglobulin A nephropathy (IgAN).

Methods

We performed an observational cohort study enrolling patients with biopsy-proven IgAN recorded from November 2011 to March 2016. The definition of composite endpoint was eGFR decrease by 50%, eGFR?<?15 mL/min/1.73 m², initiation of dialysis, or renal transplantation. Patients were categorized by the magnitude of PLR tertiles into three groups. The Kaplan–Meier curves and multivariate Cox models were performed to determine the association of PLR with the renal survival of IgAN patients.

Results

330 patients with a median age of 34.0 years were followed for a median of 47.4 months, and 27 patients (8.2%) had reached the composite endpoints. There were no differences among the three groups (PLR?<?106, 106?≤?PLR?≤?137, and PLR?>?137) in demographic characteristics, mean arterial pressure (MAP), proteinuria, and estimated glomerular filtration rate (eGFR) at baseline. The Kaplan–Meier curves showed that the PLR?>?137 group was significantly more likely to poor renal outcomes than the other two groups. Using univariate and multivariate cox regression analyses, we found that PLR?>?137 was an independent prognostic factor for poor renal survival in patients with IgAN. Subgroup analysis revealed that the PLR remained the prognostic value for female patients or patients with eGFR less than 60 mL/min/1.73 m².

Conclusions

Our results underscored that baseline PLR was an independent prognostic factor for poor renal survival in patients with IgAN, especially for female patients or those patients with baseline eGFR less than 60 mL/min/1.73 m².

     

METTL3-Mediated m6A mRNA Methylation Modulates Tooth Root Formation by Affecting NFIC Translation

N6-methyladenosine (m⁶A), as a eukaryotic mRNA modification catalyzed by methyltransferase METTL3, is involved in various processes of development or diseases via regulating RNA metabolism. However, the effect of METTL3-mediated m⁶A modification in tooth development has remained elusive. Here we show that METTL3 is prevalently expressed in odontoblasts, dental pulp cells, dental follicle cells, and epithelial cells in Hertwig's epithelial root sheath during tooth root formation. Depletion of METTL3 in human dental pulp cells (hDPCs) impairs proliferation, migration, and odontogenic differentiation. Furthermore, conditional knockout of Mettl3 in Osterix-expressing cells leads to short molar roots and thinner root dentin featured by decreased secretion of pre-dentin matrix and formation of the odontoblast process. Mechanistically, loss of METTL3 cripples the translational efficiency of the key root-forming regulator nuclear factor I-C (NFIC). The odontogenic capacity of METTL3-silenced hDPCs is partially rescued via overexpressing NFIC. Our findings suggest that m⁶A methyltransferase METTL3 is crucial for tooth root development, uncovering a novel epigenetic mechanism in tooth root formation. © 2020 American Society for Bone and Mineral Research (ASBMR).     

Guidelines for the diagnosis,treatment, prevention and control of infections caused by carbapenem-resistant gram-negative bacilli

The dissemination of carbapenem-resistant Gram-negative bacilli (CRGNB) is a global public health issue. CRGNB isolates are usually extensively drug-resistant or pandrug-resistant, resulting in limited antimicrobial treatment options and high mortality. A multidisciplinary guideline development group covering clinical infectious diseases, clinical microbiology, clinical pharmacology, infection control, and guideline methodology experts jointly developed the present clinical practice guidelines based on best available scientific evidence to address the clinical issues regarding laboratory testing, antimicrobial therapy, and prevention of CRGNB infections. This guideline focuses on carbapenem-resistant Enterobacteriales (CRE), carbapenem-resistant Acinetobacter baumannii (CRAB), and carbapenem-resistant Pseudomonas aeruginosa (CRPA). Sixteen clinical questions were proposed from the perspective of current clinical practice and translated into research questions using PICO (population, intervention, comparator, and outcomes) format to collect and synthesize relevant evidence to inform corresponding recommendations. The grading of recommendations, assessment, development and evaluation (GRADE) approach was used to evaluate the quality of evidence, benefit and risk profile of corresponding interventions and formulate recommendations or suggestions. Evidence extracted from systematic reviews and randomized controlled trials (RCTs) was considered preferentially for treatment-related clinical questions. Observational studies, non-controlled studies, and expert opinions were considered as supplementary evidence in the absence of RCTs. The strength of recommendations was classified as strong or conditional (weak). The evidence informing recommendations derives from studies worldwide, while the implementation suggestions combined the Chinese experience. The target audience of this guideline is clinician and related professionals involved in management of infectious diseases.     

A nationwide post-marketing survey of knowledge,attitude and practice toward human papillomavirus vaccine in general population: Implications for vaccine roll-out in mainland China

BackgroundHuman papillomavirus (HPV) vaccine has been increasingly discussed in mainland China since its first approval in 2016. To date, nearly all studies assessing HPV vaccine perceptions and attitudes were implemented during pre-licensure period. Therefore, the nationwide post-marketing survey was conducted to update knowledge, attitudes and practice on HPV vaccine among general population in mainland China.MethodsParticipants aged 18–45 years living in mainland China were recruited in April 2019 by multi-stage non-randomized sampling. Sociodemographic factors, HPV and HPV vaccine related awareness, knowledge, attitudes, vaccine uptake and potential obstacles were assessed in questionnaires. Bivariate analysis and multivariate regression were used to identify disparity among subgroups with different sociodemographic characteristics.Results4,000 women (32.1 ± 7.81y) and 1,000 men (31.8 ± 7.96y) were included in final analysis. Less than one third of participants had heard of HPV (female: 31%; male: 22%) and HPV vaccine (female: 34%; male: 23%). Knowledge score was also unfavorable on HPV (female: 3 out of 13; male: 1.8 out of 13) and HPV vaccine (female: 3 out of 6; male: 2 out of 5). Only 3% females had been vaccinated three years after HPV licensure in China, although willingness to get vaccinated among those unvaccinated were high (mean willingness score ± SD: female: 3.3 ± 0.97; male: 3.0 ± 0.98). Industry of employment and household income were the major factors related to awareness and knowledge of vaccine, whereas HPV and HPV vaccine awareness were key influential factors for willingness. The main obstacles of vaccination were safety concerns, lack of knowledge, and high price of HPV vaccines.ConclusionsFindings highlight a lack of vaccine awareness, knowledge, and poor uptake in mainland China and underscore the necessity of health education campaigns. The identified priority groups, contents to be delivered and practical obstacles could furthermore provide insight into health education to reduce disparities and accelerate HPV vaccine roll-out in China.     

双通道客观视觉质量分析系统评估多焦点人工晶状体植入术后视觉质量

目的：应用双通道客观视觉质量分析系统(OQAS)测量区域折射型(SBL-3)和衍射折射型(SN6AD1)多焦点人工晶状体(MIOL)植入术后患者的视觉质量。

方法：选取2017-03/2018-04在我院行白内障超声乳化吸除联合人工晶状体植入术的年龄相关性白内障患者47例47眼。根据植入MIOL的不同分为SBL-3组(22例22眼)和SN6AD1组(25例25眼)。术后随访3mo,比较两组患者的裸眼及矫正远、中、近视力,并采用OQAS检查客观视觉质量。

结果：术后3mo,SBL-3组患者裸眼中视力优于SN6AD1组\〖0.14(0.04,0.26)vs 0.26(0.12,0.40),P<0.05\〗,客观散射指数\〖2.52(2.35,3.86)vs 1.89(1.39,2.28)\〗和人工晶状体眼伪调节力(2.47±0.88D vs 1.25±0.70D)均显著高于SN6AD1组,MTF-cut/off、SR及模拟对比度视力均显著低于SN6AD1组(P<0.01)。

结论：SBL-3和SN6AD1 MIOL植入术后患者均能够获得较好的主观视觉质量,但OQAS系统能够反映二者产生的客观视觉质量差异。     

胸主动脉腔内修复术采用裙边型烟囱支架（Longuette™）的PATENCY临床试验研究结果

背景与目的 烟囱技术是胸主动脉腔内修复术（TEVAR）中重建左锁骨下动脉（LSA）的方法,Ⅰa型内漏是其主要并发症。裙边型烟囱支架（Longuette?）专为烟囱技术设计,用于重建LSA时降低Ⅰa型内漏。为评估Longuette?烟囱支架联合TEVAR治疗累及LSA的Stanford B型主动脉夹层（TBAD）的疗效,笔者开展了前瞻性、多中心临床试验（PATENCY临床试验）。本研究总结PATENCY临床试验的1年结果和经验。方法 2018年10月—2022年3月,全国26家血管外科中心参与PATENCY临床试验,共纳入150例符合标准的TBAD患者。所有患者均在TEVAR术中采用Longuette?烟囱支架重建LSA。评估患者围手术期和术后12个月的临床效果和不良事件,并分析患者术后1年累积生存率、LSA通畅率和无内漏率。结果 患者年龄30~77岁,平均（54.48±11.12）岁,138例（92.0%）患者合并高血压病;急性、亚急性和慢性TBAD分别占74.7%,17.3%和8.0%。124例（82.7%）患者采用全身麻醉。手术成功率为99.33%（149/150）,手术时间（91.67±41.47）min,X线暴露时间（31.36±16.71）min,手术出血量为（71.55±60.40）mL。围手术期内漏发生率为5.33%（8/150）,包括Ⅰ型6例、Ⅱ型1例、Ⅳ型1例;1例（0.67%）患者发生Longuette?烟囱支架急性闭塞,再次实施腔内手术后恢复通畅;1例（0.67%）患者术后发生急性脑梗死;2例（1.33%）患者术后发生逆撕的Stanford A型主动脉夹层,其中1例术后3周死亡。术后30 d死亡2例（1.33%）。142例患者进行了密切随访,随访时间为11.67（5~16）个月。无主动脉支架和Longuette?烟囱支架移位。2例Ⅰ型内漏患者分别于术后6个月和1年进行了再次介入栓塞手术治疗,术后1年随访仍有6例患者有轻微的内漏持续存在,患者TBAD假腔保持稳定,无明显症状,均予以保守治疗。Longuette?烟囱支架内狭窄和闭塞分别发生1例和2例,逆撕的Stanford A型主动脉夹层患者1例,假腔增大,患者均无明显症状,予以保守治疗。无发生脑卒中、截瘫、左上肢缺血等并发症。术后12个月累积生存率、LSA通畅率、无内漏率分别为97.96%、97.96%和91.91%。结论 采用Longuette?烟囱支架在TBAD腔内治疗中重建LSA简便、安全、有效,其能够有效降低围手术期Ⅰa型内漏的发生率,为微创治疗主动脉弓部病变提供新的治疗方式。     

卵巢子宫内膜异位囊肿超声分型及其临床价值

目的 分型认识卵巢子宫内膜异位囊肿的复杂声像图,以求提高超声对本病的诊断符合率。方法 回顾性分析131例卵巢子宫内膜异位囊肿患者共139个肿块的声像图特点,分型观察,计算各型诊断符合率。结果依据肿块声像特点共分7种类型。囊内均匀光点型的符合率最高（88．3％）,单纯囊肿型符合率最低（12．0％）。易误诊为单纯囊肿、囊腺瘤、炎性包块、畸胎瘤、子宫肌瘤、卵巢癌等。结论 分型可使子宫内膜异位囊肿复杂的声像简单化,鉴别重点更明确,有助于提高对本病的认识。