新疆54家居室装修后不同季节的室内空气污染状况调查

目的 研究新疆居室装修后室内空气中甲醛、TVOC和氡浓度,以及不同季节甲醛和TVOC浓度的变化趋势.方法 在乌鲁木齐市和哈密市随机选择了新装修的54户居民家庭,监测装修后居室空气中甲醛、TVOC和氡的浓度,在3个月和6个月后对第1次所监测的用户进行2次甲醛和TVOC的回访监测.结果 监测居室刚装修完工时、3个月和6个月后的室内空气甲醛浓度总体均值分别为0.154 mg/m3,0.064 mg/m3和0.115 mg/m3,超标率分别是70.4%,11.1%和59.3%(F=10.11,P＜0.01);居室刚装修完工时,室内空气中TVOC浓度总体均值为881.6ug/m3,超标率66.7%,装修3个月和6个月之后,TVOC浓度总体均值在国家标准之下,无超标户;装修之后的氡均低于国家标准,无超标户.结论 监测的新装修房屋的主要污染物为甲醛,室内的微小气候和通风状况对室内甲醛的浓度有明显影响,干燥炎热的季节和冬季取暖期是甲醛明显的释放期,甲醛超标比较严重.TVOC挥发速度快,初装修时超标严重,但一般经过2～3个月时间的释放,大都能远低于国家标准,TVOC的浓度随装修的时间而逐步下降,与季节和温度等因素关系不大.     

Role of adjuvant chemoradiotherapy and chemotherapy in patients with resected gallbladder carcinoma: a multi-institutional analysis (KROG 19-04)

Objective:The effectiveness of adjuvant treatments for resected gallbladder carcinoma (GBC) has remained unclear due to lack of randomized controlled trials; thus, the aim of present study was to evaluate the role of adjuvant treatments, including chemoradiotherapy (CRT) and/or chemotherapy (CTx), in patients with resected GBC.Methods:A total of 733 GBC patients who received curative-intent surgical resection were identified in a multi-institutional database. Of 733 patients, 372 (50.8%) did not receive adjuvant treatment, whereas 215 (29.3%) and 146 (19.9%) received adjuvant CTx and CRT, respectively. The locoregional recurrence-free survival (LRFS), recurrence-free survival (RFS), and overall survival (OS) of the adjuvant treatment groups were compared according to tumor stage (stage II vs. stage III–IV).Results:In stage II disease (n = 381), the 5-year LRFS, RFS, and OS were not significantly different among the no-adjuvant therapy, CTx, and CRT groups, and positive resection margin, presence of perineural invasion, and Nx classification were consistently associated with worse LRFS, RFS, and OS in the multivariate analysis (P < 0.05). For stage III–IV (n = 352), the CRT group had significantly higher 5-year LRFS, RFS, and OS than the no-adjuvant therapy and CTx groups (67.8%, 45.2%, and 56.9%; 37.9%, 28.8%, and 35.4%; and 45.0%, 30.0%, and 45.7%, respectively) (P < 0.05).Conclusions:CRT has value as adjuvant treatment for resected GBC with stage III–IV disease. Further study is needed for stage II disease with high-risk features.     

不同MMP mRNA和ADAMTS mRNA表达与椎间盘退行性变性程度的相关性

目的 探讨不同金属蛋白酶（MMP）和解聚蛋白样金属蛋白酶（ADAMTS）的mRNA表达与椎间盘退行性变性（简称退变）程度的相关性。方法 选取行手术治疗的椎间盘退变患者160例,依据磁共振成像（MRI）检查结果,采用Pfirrmann分级将所有患者分为Ⅰ级组（30例）、Ⅱ级组（32例）、Ⅲ级组（35例）、Ⅳ级组（33例）和Ⅴ级组（30例）。检测所有患者髓核组织中MMP-1 mRNA、MMP-3 mRNA、MMP-9mRNA、MMP-13mRNA、ADAMTS-1mRNA、ADAMTS-4mRNA、ADAMTS-5mRNA、白细胞介素（IL）-1αmRNA、IL-1βmRNA、IL-6 mRNA和IL-8 mRNA的相对表达量。采用Spearman相关分析评估各项指标与Pfirrmann分级的相关性。采用Pearson相关分析评估各项指标之间的相关性。结果 Ⅳ级组和Ⅴ级组MMP-3mRNA、MMP-9mRNA、IL-1αmRNA和IL-1βmRNA相对表达量显著高于Ⅰ级组、Ⅱ级组和Ⅲ级组（P<0.05）,且Ⅰ级组、Ⅱ级组、Ⅲ级组依次升高（P<0.05）。Ⅲ级组、Ⅳ级组和Ⅴ级组A...     

Venous Thromboembolism Risk in Asian Patients with Inflammatory Bowel Disease: A Population-Based Nationwide Inception Cohort Study

Background/AimsInflammatory bowel disease (IBD) is associated with the occurrence of venous thromboembolism (VTE). However, to date, there have been few studies on the risk of VTE in Asian IBD patients. We aimed to estimate the incidence of VTE in Asian IBD patients and to determine if IBD is related to increased VTE risk.MethodsWe performed a population-based cohort study between 2004 and 2015 using Korean National Health Insurance data. IBD and VTE were defined by ICD-10 codes. Incidence rates of VTE were calculated among patients with IBD and among age- and sex-matched controls. Hazard ratios were estimated using Cox regression with adjustment for multiple variables. We performed additional analyses stratifying by age, sex, Charlson comorbidity index (CCI) score, and disease type.ResultsAmong the 45,037 patients with IBD (IBD cohort) and 133,019 matched controls (non-IBD cohort) included in our analysis, 411 IBD patients and 641 controls developed VTE. The IBD cohort had a higher incidence rate ratio and risk of VTE than the non-IBD cohort (incidence rate ratio 1.92 and hazard ratio 1.93). Older age, female sex, higher CCI scores, cardiovascular disease, chronic kidney disease, use of steroids, and hospitalization were significant risk factors for VTE in patients with IBD.ConclusionsThe IBD patients in this study were approximately two times more likely to develop VTE than the non-IBD individuals. Our findings support the need for thromboprophylaxis in Asian IBD patients with various factors that further increase the risk of VTE.     

Triple Therapy-Based on Tegoprazan,a New Potassium-Competitive Acid Blocker,for First-Line Treatment of Helicobacter pylori Infection: A Randomized,Double-Blind,Phase III,Clinical Trial

Background/AimsWe examined the efficacy and safety of tegoprazan as a part of first-line triple therapy for Helicobacter pylori eradication.MethodsA randomized, double-blind, controlled, multicenter study was performed to evaluate whether tegoprazan (50 mg)-based triple therapy (TPZ) was noninferior to lansoprazole (30 mg)-based triple therapy (LPZ) (with amoxicillin 1 g and clarithromycin 500 mg; all administered twice daily for 7 days) for treating H. pylori. The primary endpoint was the H. pylori eradication rate. Subgroup analyses were performed according to the cytochrome P450 (CYP) 2C19 genotype, the minimum inhibitory concentration (MIC) of amoxicillin and clarithromycin, and underlying gastric diseases.ResultsIn total, 350 H. pylori-positive patients were randomly allocated to the TPZ or LPZ group. The H. pylori eradication rates in the TPZ and LPZ groups were 62.86% (110/175) and 60.57% (106/175) in an intention-to-treat analysis and 69.33% (104/150) and 67.33% (101/150) in a per-protocol analysis (non-inferiority test, p=0.009 and p=0.013), respectively. Subgroup analyses according to MICs or CYP2C19 did not show remarkable differences in eradication rate. Both first-line triple therapies were well-tolerated with no notable differences.ConclusionsTPZ is as effective as proton pump inhibitor-based triple therapy and is as safe as first-line H. pylori eradication therapy but does not overcome the clarithromycin resistance of H. pylori in Korea (ClinicalTrials.gov identifier {"type":"clinical-trial","attrs":{"text":"NCT03317223","term_id":"NCT03317223"}}NCT03317223).     

基于人群的身体活动水平与脑卒中发病风险的队列研究

目的:探讨≥40岁成年人身体活动水平对脑卒中发病的影响。方法:通过宁波市2015年具有人群代表性的成年人慢性病监测调查获得身体活动和人口特征基线数据,利用2015-2019年宁波市慢性病监测信息协同管理系统获得脑卒中发病数据,将数据库进行匹配形成队列。身体活动按照每周身体活动量（METs）分为低、中等和高强度身体活动。...     

Growth and Gastrointestinal Tolerance in Healthy Term Infants Fed Milk-Based Infant Formula Supplemented with Five Human Milk Oligosaccharides (HMOs): A Randomized Multicenter Trial

Background: Five of the most abundant human milk oligosaccharides (HMOs) in human milk are 2′-fucosyllactose (2′-FL), 3-fucosyllactose (3-FL), lacto-N-tetraose (LNT), 3′-sialyllactose (3′-SL) and 6′-sialyllactose (6′-SL). Methods: A randomized, double-blind, controlled parallel feeding trial evaluated growth in healthy term infants fed a control milk-based formula (CF; n = 129), experimental milk-based formula (EF; n = 130) containing five HMOs (5.75 g/L; 2′-FL, 3-FL, LNT, 3′-SL and 6′-SL) or human milk (HM; n = 104). Results: No significant differences (all p ≥ 0.337, protocol evaluable cohort) were observed among the three groups for weight gain per day from 14 to 119 days (D) of age, irrespective of COVID-19 or combined non-COVID-19 and COVID-19 periods. There were no differences (p ≥ 0.05) among the three groups for gains in weight and length from D14 to D119. Compared to the CF group, the EF group had more stools that were soft, frequent and yellow and were similar to the HM group. Serious and non-serious adverse events were not different among groups, but more CF-fed infants were seen by health care professionals for illness from study entry to D56 (p = 0.044) and D84 (p = 0.028) compared to EF-fed infants. Conclusions: The study demonstrated that the EF containing five HMOs supported normal growth, gastrointestinal (GI) tolerance and safe use in healthy term infants.     

Research on Hyperparameter Optimization of Concrete Slump Prediction Model Based on Response Surface Method

In this paper, eight variables of cement, blast furnace slag, fly ash, water, superplasticizer, coarse aggregate, fine aggregate and flow are used as network input and slump is used as network output to construct a back-propagation (BP) neural network. On this basis, the learning rate, momentum factor, number of hidden nodes and number of iterations are used as hyperparameters to construct 2-layer and 3-layer neural networks respectively. Finally, the response surface method (RSM) is used to optimize the parameters of the network model obtained previously. The results show that the network model with parameters obtained by the response surface method (RSM) has a better coefficient of determination for the test set than the model before optimization, and the optimized model has higher prediction accuracy. At the same time, the model is used to evaluate the influencing factors of each variable on slump. The results show that flow, water, coarse aggregate and fine aggregate are the four main influencing factors, and the maximum influencing factor of flow is 0.875. This also provides a new idea for quickly and effectively adjusting the parameters of the neural network model to improve the prediction accuracy of concrete slump.     

血管内超声引导下应用药物涂层球囊治疗左前降支慢性完全闭塞病变处合并心肌桥1例

<正>患者男,57岁,胸痛1月余、加重20余天;外院因“冠状动脉造影示右冠状动脉（right coronary artery,RCA）远端闭塞、左前降支（left anterior descending branch,LAD）中段闭塞”而“考虑慢性完全闭塞（chronic total occlusion,CTO）”并予“开通RCA远端”;7年前曾因“脑血管畸形、蛛网膜下腔出血”接受“脑血管栓塞”治疗。