Epidemiology of overall and early-onset serrated polyps versus conventional adenomas in a colonoscopy screening cohort

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.     

“双一流”背景下高校理工类中文综合性期刊的发展定位与策略

【目的】 研究高校主办的理工类综合性中文学报在建设“双一流”高校和培育世界一流科技期刊双重背景下的发展定位与策略。【方法】 利用中国知网数据库,统计42所“一流大学”建设高校主办的中文理工类综合性学报近10年(2009—2018年)发文特征与学校建设的“一流学科”之间的相关性。【结果】 “一流大学”建设高校的理工类综合性中文学报学术影响力整体较强,但在“双一流”建设背景下,学报与“双一流”建设的相关性差异较大;针对“一流大学”建设高校的学科优势,提出高校理工类综合性中文学报应该采取增大发文量、调整发文方向和转型为专业刊3种策略。【结论】 培育世界一流科技期刊对高校中文理工类综合性学报提出更高要求,未来高校中文理工类综合性学报的发展定位是培养科研新人、培育新兴学科与交叉学科和服务国家重大发展战略。     

The efficacy of 5-element therapy for senile diabetes with depression: A protocol for a systematic review and meta-analysis

Background:Senile diabetes with depression is a common and frequently-occurring disease, and it is also a difficult and hot point in domestic and international research. However, the efficiency of combination hypoglycemic agents and antidepressants in the treatment of senile diabetes with depression is poor, and new intervention methods are urgently needed. Research shows the 5-element therapy, as a Chinese traditional non-drug intervention, has definite curative effect on the prevention and treatment of various physical and mental diseases. The purpose of this systematic review and meta-analysis is to evaluate the efficacy of 5-element therapy on senile diabetes with depression.Methods:The electronic databases including Pubmed, Embase, Cochrane Library, Web of science, Chinese National Knowledge Infrastructure, Wanfang Database, Sino Med,China Biomedical Literature Database will be searched. The time limit for retrieving studies is from establishment to October 2020 for each database. Randomized controlled clinical trials related to 5-element therapy intervention on senile diabetes with depression will be included. Stata V.13.0 and Review manager 5.3 software will be implemented for data synthesis, sensitivity analysis, subgroup analysis, and the assessment of bias risk. We will use the grading of recommendations assessment, development, and evaluation system to assess the quality of evidence.Results:This study will provide a quantitative and standardized evaluation for the efficacy of 5-element therapy on senile diabetes with depression.Conclusion:This systematic review and meta-analysis will provide the high-quality evidence to assess whether the 5-element therapy has a positive treatment effect for senile diabetes with depression.Registration number:INPLASY2020100081.     

探讨基于近红外脑成像技术的阈下抑郁情志刺激反应机制研究可行性

近红外脑功能成像技术是近几年发展起来用于动态检测脑功能的方法,能够很好地反映抑郁人群认知活动期间大脑有氧代谢的变化,为阈下抑郁研究提供了一个新思路。本研究通过文献综述,结合中医情志理论,在过往研究的基础上基于近红外脑功能成像技术探讨中医情志刺激对阈下抑郁的反应机制,为后期研究提供理论与实践可行性的依据。     

Hazardous Petroleum Sludge-Derived Nitrogen and Oxygen Co-Doped Carbon Material with Hierarchical Porous Structure for High-Performance All-Solid-State Supercapacitors

Rational design and sustainable preparation of high-performance carbonaceous electrode materials are important to the practical application of supercapacitors. In this work, a cost-effective synthesis strategy for nitrogen and oxygen co-doped porous carbon (NOC) from petroleum sludge waste was developed. The hierarchical porous structure and ultra-high surface area (2514.7 m² g⁻¹) of NOC electrode materials could provide an efficient transport path and capacitance active site for electrolyte ions. The uniform co-doping of N and O heteroatoms brought enhanced wettability, electrical conductivity and probably additional pseudo-capacitance. The as-obtained NOC electrodes exhibited a high specific capacitance (441.2 F g⁻¹ at 0.5 A g⁻¹), outstanding rate capability, and cycling performance with inconspicuous capacitance loss after 10,000 cycles. Further, the assembled all-solid-state MnO₂/NOC asymmetrical supercapacitor device (ASC) could deliver an excellent capacitance of 119.3 F g⁻¹ at 0.2 A g⁻¹ under a wide potential operation window of 0–1.8 V with flexible mechanical stability. This ASC device yielded a superior energy density of 53.7 W h kg⁻¹ at a power density of 180 W kg⁻¹ and a reasonable cycling life. Overall, this sustainable, low-cost and waste-derived porous carbon electrode material might be widely used in the field of energy storage, now and into the foreseeable future.     

儿童常见先天性心脏病介入治疗的并发症分析

目的总结儿童先天性心脏病(CHD)介入治疗并发症的发生率,并分析其发生原因。方法回顾性分析2011年1月至2013年12月间2 356例诊断为室间隔缺损(VSD)、房间隔缺损(ASD)、动脉导管未闭(PDA)、肺动脉瓣狭窄(PS),并行介入治疗的0~18岁CHD患儿,在介入治疗中及治疗后发生并发症的情况。结果 2 356例CHD患儿中159例发生并发症,发生率为6.75%;其中VSD组为11.40%(82/719),ASD组为7.50%(51/680),PDA组为3.09%(22/712),PS组为1.63%(4/245)。心律失常发生率为4.41%(102/2 356)。严重并发症发生率为2.71%(64/2 356),VSD组为3.62%(26/719),ASD组为2.21%(15/680),PDA组为2.53%(18/712),PS组为1.63%(4/245);术中严重并发症为0.51%(12/2 356),术后早发严重并发症为1.99%(47/2 356),迟发严重并发症为0.21%(5/2 356)。严重并发症经介入手术治疗0.13%(3/2 356),经外科手术治疗0.64%(15/2 356),经内科保守治疗1.95%(46/2 356);2例死亡,死亡率0.08%。结论 CHD介入治疗的并发症及死亡率低,但仍不容忽视。术前严格掌握适应证,术中按常规操作,术后进行规范的长期随访至关重要。     

PBL和LBL联合教学在骨骼运动系统疾病教学中的效果评价

目的　探讨以问题为基础的学习（problem-based learning,PBL）和传统讲授式教学（lecture-based learning,LBL）在临床医学八年制骨骼运动系统疾病教学中的应用效果。方法　将四川大学华西临床医学院2014级和2015级参与《骨骼运动系统疾病》课程“骨关节炎”教学的临床医学八年制学生分为对照组（60人）和试验组（82人）。对照组采用LBL教学,试验组采用PBL+LBL联合教学。采用问卷调查的方式评价教学效果,包括学习积极性、知识理解程度、思考能力、团队合作能力、实践操作能力、自学能力及师生关系等7个方面,以及对教学满意度的评价。采用SPSS 22.0软件进行t检验和卡方检验。结果　试验组学习积极性[（8.00±1.61） vs. （7.28±1.98）]、知识理解程度[（8.02±1.59） vs. （7.33±1.79）]、思考能力[（8.34±1.66） vs. （7.42±1.90）]、团队合作能力[（8.32±1.76） vs. （6.60±2.79）]、实践操作能力[（7.70±1.69） vs. （6.87±2.57）]、自学能力[（8.05±1.65） vs. （7.35±2.48）]及师生关系（7.96±1.75） vs. （7.25±2.10）]方面优于对照组,差异有统计学意义（P<0.05）。同时,PBL+LBL联合教学组对教学的满意度高于LBL组,差异有统计学意义（P<0.05）。结论　在临床医学八年制《骨骼运动系统疾病》课程“骨关节炎”教学中应用PBL+LBL联合教学,可有效提高学生学习积极性,提升教学质量,获得良好的教学效果。     

益母草注射液联合格丹及欣母沛在前置胎盘剖宫产术后出血中的应用及安全性分析

目的:探讨益母草注射液联合格丹及欣母沛在前置胎盘剖宫产术后出血中的应用及安全性分析。方法:选取2015年7月至2016年10月于我院产科被诊断为前置胎盘及择期行剖宫产分娩的产妇46例,根据产后止血方式的不同分为观察组和对照组,各23例。观察组待胎儿产出后立即注射益母草注射液2 m L+欣母沛250μg于子宫肌层,格丹50 m L冲洗宫腔并保留1 min,对照组注射益母草注射液2 m L+欣母沛250μg于子宫肌层,以0.9%氯化钠注射液50 m L冲洗宫腔并保留1 min。观察2组手术后出血情况及止血效果;检测2组手术前后血红蛋白(Hb)、红细胞计数(RBC)及血浆凝血酶原时间(PT)及凝血酶时间(TT)等凝血相关指标;术后随访42 d,统计产后并发症发生率、不良反应发生率及子宫复旧情况。结果:观察组显效率91.30%,对照组显效率73.91%,2组间显效率差异无统计学意义(P0.05)。观察组术中出血量、术后2 h、24 h阴道出血量、术中输血量均显著低于对照组,差异有统计学意义(P0.05或P0.01)。观察组并发症发生率低于对照组,子宫复旧率高于对照组(P0.05);不良反应发生率2组间比较,差异无统计学意义(P0.05)。与术前比较,术后24 h 2组Hb水平均显著降低(P0.05或P0.01),RBC及PT、TT无明显变化(P0.05);术后24 h观察组RBC、Hb水平均显著高于对照组,差异有统计学意义(P0.01),PT、TT2组间比较,差异无统计学意义(P0.05)。术后随访2组新生儿生长发育均良好。结论:益母草注射液联合格丹及欣母沛在前置胎盘剖宫产术后出血中具有较好的止血效果,降低产妇并发症发生率,且术后子宫恢复良好。     

骨增量技术在口腔种植中的应用进展

种植术区的骨质、骨量是种植手术成败的关键因素之一,临床上常常因为患者缺牙区骨量不足而使得种植医生及患者对种植牙望而却步,随着骨增量技术的发展,使得种植手术的适应证不断扩大,常见的骨增量技术包括骨劈开术、骨挤压术、引导骨再生技术、牵张成骨术、上颌窦提升术及骨移植术等,这些技术的单独及联合应用均不同程度地增加了种植手术的成功率,本文就骨增量技术在牙种植的应用进展作一综述。