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1.
Serrated polyps (SPs) are precursors to one-third of colorectal cancers (CRCs), with histological subtypes: hyperplastic polyps (HPs), sessile serrated lesions (SSLs) and traditional serrated adenomas (TSAs). The incidence of early-onset CRC before the age of 50 is increasing, with limited understanding of SPs in younger cohorts. Using a large colonoscopy-based cohort, we characterized epidemiologic profiles of SP subtypes, compared to conventional adenomas, with secondary analysis on early-onset polyps. Ninety-four thousand four hundred and twenty-seven patients underwent screening colonoscopies between 2010 and 2018. Demographic, endoscopic and histopathologic characteristics of each polyp subtype were described. High-risk polyps included SSLs ≥10 mm/with dysplasia and conventional adenomas ≥10 mm/with tubulovillous/villous histology/high-grade dysplasia. We examined polyp prevalence with age and compared early- (age < 50) and late-onset polyps (age ≥ 50). Eighteen thousand one hundred and twenty-five patients had SPs (4357 SSLs, 15 415 HPs, 120 TSAs) and 26 699 had conventional adenomas. High-risk SSLs were enriched in the ascending colon (44.1% vs 2.6-35.8% for other locations; P < .003). Early- and late-onset SPs had similar subsite distribution. Early-onset conventional adenomas were more enriched in the distal colon/rectum (51.8% vs 43.4%, P < .001). Multiple conventional adenomas were more represented in late-onset groups (40.8% vs 33.8%, P < .001), with no difference in SSLs. The prevalence of conventional adenomas/high-risk conventional adenomas increased continuously with age, whereas the prevalence of SSLs/high-risk SSLs was stable from age 40 years onwards. A higher proportion of women were diagnosed with early-onset than late-onset SSLs (62.9% vs 57.6%, P = .03). Conventional adenomas, SSLs, early- and late-onset polyps have distinct epidemiology. The findings have implications for improved colonoscopy screening and surveillance and understanding the etiologic heterogeneity of CRC.  相似文献   
2.
目的 基于核酸试纸条技术,建立一种快速检测蜡样芽胞杆菌entFM毒素基因的方法。 方法 煮沸法提取蜡样芽胞杆菌DNA,以蜡样芽胞杆菌entFM毒素基因作为靶基因,采用NCBI primer-BLAST 5.0软件设计特异性引物并通过克隆转化鉴定PCR产物,建立并组装核酸试纸条,评价核酸试纸条的特异性、灵敏度和稳定性。 结果 蜡样芽胞杆菌DNA浓度为300 mg?L-1,纯度约为1.60。PCR产物阳性条带经切胶回收、克隆转化和测序比对,与GenBank数据库中已登记的entFM相似性为100%。在pH值7.0条件下,每100 μL 胶体金溶液加入3.3 μg链霉亲和素浓度标记,质控线浓度为1.8 g?L-1,检测线浓度为1 g?L-1时,硝酸纤维素膜上质控线与检测线均可与PCR产物反应出现清晰的红色条带。按照最适条件组装成核酸试纸条,PCR产物6 μL,样品展开液100 μL,检测10 min后可观察结果。核酸试纸条特异性与电泳结果一致,仅蜡样芽胞杆菌为阳性结果,与金黄色葡萄球菌、铜绿假单胞杆菌、大肠埃希菌和沙门氏菌皆无交叉反应,为阴性结果;灵敏度检测,核酸试纸条DNA质量浓度同时降至10-3 mg?L-1仍可准确检测,普通PCR电泳结果显示DNA质量浓度同时降至10-1 mg?L-1出现目的条带,核酸试纸条比普通PCR灵敏度提高100倍;稳定性检测,核酸试纸条在第6、9和12个月进行检测稳定性一致。 结论 建立的核酸试纸条检测蜡样芽胞杆菌entFM毒素基因灵敏度高、特异性强且具有良好稳定性,适用于快速鉴别蜡样芽胞杆菌entFM毒素基因。  相似文献   
3.
目的优化费用成本转换法,进一步完善成本单元划分原则,提高费用成本转换法的核算准确性,推广方法学的应用价值。方法在已有研究的基础上,进一步细分成本单元,采用费用成本转换法测算病种成本,分析病种盈亏情况。结果甲状腺恶性肿瘤治疗成本为37444.48元,平均支付价格为22474.90元,亏损14945.50元,亏损率为39.94%。结论优化后的费用成本转换法更加契合当前医改政策,核算精度更高,有效提升部分专科医院的核算精度。费用成本转换法能够为政府的病种定价与医院运营管理提供科学的方法学支撑。  相似文献   
4.
5.
目的:比较手工清洗法和机械清洗法在腹腔镜手术器械清洗和灭菌中的应用价值。方法:选取2019年6月~2020年12月本院消毒供应中心接收并进行清洗、灭菌处理的腹腔镜手术器械5283件,根据其清洗、灭菌方法分为观察组和对照组,观察组包括2636件腔镜手术器械,对照组包括2647件腔镜手术器械。对照组2647件腹腔镜手术器械使用手工清洗法进行清洗和灭菌,观察组2636件腹腔镜手术器械使用机械清洗法进行清洗和灭菌。结果:观察组腹腔镜手术器械的清洗质量合格率和灭菌质量合格率均显著高于对照组,P<0.05,比较差异有统计学意义。医护人员对观察组的腹腔镜手术器械的满意度评分显著高于对照组,P<0.05,比较差异有统计学意义。结论:相比手工清洗法,机械清洗法能够显著提高腹腔镜手术器械的清洗和灭菌质量,从而显著提高其清洗质量合格率和灭菌质量合格率。  相似文献   
6.
《Drug discovery today》2022,27(3):808-821
Tyrosine kinases are enzymes that can transfer a phosphate group from ATP to a specific protein tyrosine, serine or threonine residue within a cell, operating as a switch that can turn ‘on’ and ‘off’ causing different physiological alterations in the body. Mutated kinases have been shown to display an equilibrium shift toward the activated state. Types I–III have been studied intensively leading to drugs like imatinib (type II), cobimetinib (type III), among others. It is the same scenario for types V–VII; however, there is a lacuna in information regarding type IV inhibitors, although recently some advances have surfaced. This review aims to accumulate the knowledge gained so far about type IV inhibitors.  相似文献   
7.
IntroductionLung cancer (LC) is usually diagnosed at advanced stages with only a 12% 5-year survival. Trials as NLST and NELSON show a mortality decrease, which justifies implementation of lung cancer screening in risk population. Our objective was to show survival results of the largest LC screening program in Spain with low dosage computed tomography (LDCT).MethodsClinical records from International Early Lung Cancer Detection Program (IELCAP) at Valencia, Spain were analysed. This program recruited volunteers, ever-smokers aged 40-80 years, since 2008. Results are compared to those from other similar sizeable programs.ResultsA total of 8278 participants were screened with at least two-rounds until November 2020. A mean of 6 annual screening rounds were performed. We detected 239 tumours along 12-year follow-up. Adenocarcinoma was the most common histology, being 61.3% at stage I. The lung cancer prevalence and incidence proportion was 1.5% and 1.4%, respectively with an annual detection rate of 0.17. One-year survival and 10-year survival were 90% and 80.1%, respectively. Adherence was 96.84%.ConclusionLargest lung cancer screening in Spain shows that survival is improved when is performed in multidisciplinary team experienced in management of LC, and is comparable to similar screening programs.  相似文献   
8.
目的 多样的环境因素使得不同产地栽培滇重楼的化学成分也丰富多样,不同居群栽培滇重楼的甾体皂苷类成分具有很大的差异,多源数据融合分析能更全面的表征药材化学信息,建立一个高效而准确的产地鉴别模型,为其资源合理开发利用提供依据。方法 以来自云南和四川的8个产地(保山、楚雄、大理、红河、丽江、成都、文山、玉溪)共366份栽培滇重楼根茎为实验材料,采集其傅里叶变换近红外光谱(FT-NIR)和衰减全反射-傅里叶变换中红外光谱(ATR-FTMIR)数据。采用Kennard-Stone算法将不同产地的样品分为2/3的训练集和1/3的预测集,基于4种特征变量提取方法(CARS、VIP、SPA、SO-Covsel)结合2种数据融合策略(低级数据融合和中级数据融合),建立偏最小二乘产地判别分析模型。根据模型参数交叉验证均方根误差(RMSECV)和预测均方根误差(RMSEP)评估模型的稳定性,模型训练集和预测集准确率(ACC)评估模型分类性能。结果 近红外光谱和中红外光谱均能反应不同产地栽培滇重楼的化学成分差异,在中级数据融合中,基于VIP和SPA提取的特征变量建立的模型正确率均大于94%。相较于中级数据融合,低级数据融合模型得到了最为满意的结果,其预测集分类正确率达到100%。结论 根据近红外和中红外数据建立的低级数据融合PLS-DA模型,能够用于栽培滇重楼的产地鉴别分析。  相似文献   
9.
The COVID-19 pandemic caused by the SARS-CoV-2 virus has significantly disrupted and burdened the diagnostic workup and delivery of care, including transfusion, to cancer patients across the globe. Furthermore, cancer patients suffering from solid tumors or hematologic malignancies were more prone to the infection and had higher morbidity and mortality than the rest of the population. Major signaling pathways have been identified at the intersection of SARS-CoV-2 and cancer cells, often leading to tumor progression or alteration of the tumor response to therapy. The reactivation of oncogenic viruses has also been alluded to in the context and following COVID-19. Paradoxically, certain tumors responded better following the profound infection-induced immune modulation. Unveiling the mechanisms of the virus-tumor cell interactions will lead to a better understanding of the pathophysiology of both cancer progression and virus propagation. It would be challenging to monitor, through the different cancer registries, retrospectively, the response of patients who have been previously exposed to the virus in contrast to those who have not contracted the infection.  相似文献   
10.
Obstructive sleep apnea (OSA) is a sleep disorder common among patients with type 2 diabetes (T2D). The aim of this quality improvement project was to increase identification and referral for sleep study for individuals with T2D at moderate to high risk for OSA. Pre- and post-intervention patient samples were analyzed to compare the number of referrals for sleep study. Results demonstrated that none of the patients pre-intervention were referred for sleep study compared with 77% of patients post-intervention. This project demonstrated implementing an evidence-based tool to screen patients with T2D for OSA leads to higher rates of detection and referral.  相似文献   
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