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感染、炎症、修复 2023年第3期24卷 139-157页

作者： Sicco A.Bus isabel c.n sacco Matilde Monteiro-Soares Anita Raspovic Joanne Paton Anne Rasmussen Larry A.Lavery Jaap Jvan netten on behalf of the International Working Group on the Diabetic Foot 李恭驰王知李炳辉(译) 李秋许樟荣(审校) Amsterdam UMc University of AmsterdamDepartment of Rehabilitation MedicineAmsterdamthe Netherlands Amster-dam Movement Sciences program Rehabilitation&DevelopmentAmsterdamthe Netherlands Physical Therapy Speech and Occupational Therapy departmentSchool of MedicineUniversity of São PauloSão PauloBrazil Higher School of Health of the Portuguese Red cross LisbonPortugal Department of community Medic.ne Information and Health Decision Sciences(MEDCIDS)Faculty of MedicineUniversity of PortoPortoPortugal RISE@c.nTESIS Faculty of MedicineOporto Uni-versityPortoPortugal Discipline of Podiatry School of Allied HealthHuman Services and SportLa Trobe UniversityMel-bourneVictoriaAustralia School of Health Professions University of PlymouthPlymouthUK Steno Diabetes c.nter copen-hagen HerlevDenmark Department of Plastic Surgery University of Texas Southwestern Medical CenterDallasTexasUSA 不详华中科技大学同济医学院附属协和医院湖北武汉430022 华中科技大学同济医学院附属梨园医院湖北武汉430077 山东省立医院山东济南250021 战略支援部队特色医学中心北京100101

本章是2023年国际糖尿病足工作组(IWGDF)关于糖尿病相关的足溃疡预防的指南,是在2019年版指南基础上的更新。本指南面向临床医生和其他医务人员。我们遵循推荐、评估、发展和评价分级(GRADE)方法,采用患者-干预-比较-结局(PIcO)的方法... 详细信息

本章是2023年国际糖尿病足工作组(IWGDF)关于糖尿病相关的足溃疡预防的指南,是在2019年版指南基础上的更新。本指南面向临床医生和其他医务人员。我们遵循推荐、评估、发展和评价分级(GRADE)方法,采用患者-干预-比较-结局(PIcO)的方法来设计临床问题和关键结局,并进行了包括必要的Meta分析在内的医学科学文献的系统综述,同时撰写了推荐及其理由。这些推荐基于系统综述中证据质量、在没有足够证据的情况下的专家意见、同时考虑干预措施的有益和不良效果,以及患者的偏好、成本、公平性、可行性和适用性的权衡。我们推荐对足溃疡风险较低的糖尿病患者每年进行一次保护性感觉丧失和周围动脉病变的筛查,并对高危患者进行更高频率的筛查以及其他危险因素的筛查。为了预防足溃疡,要对有危险因素的患者进行健康教育,教育其对足部进行适当地自我护理,在没有适当的足部保护的情况下不要行走,并对溃疡前兆进行有效治疗。指导足溃疡中高危风险的糖尿病患者穿着合适、宽松的治疗性鞋类,并考虑指导他们监测足部皮肤温度。开具处方使用治疗性鞋类,这些鞋类在行走时具有缓解足底压力的效果,能够防止足底溃疡复发。推荐足溃疡中低风险人群最好制定一个有监督的足踝运动计划,以减少溃疡风险;就溃疡的风险而言,每天总共增加1000步的负重活动可能是安全的。对于有溃疡前兆的非僵直锤状趾患者,可考虑屈肌腱切断术。我们建议不要用神经松解减压术来预防足溃疡。要对足溃疡中高危的糖尿病患者给予综合足部护理,以预防溃疡复发。贯彻这些推荐有助于医疗专业人员对有足溃疡风险的糖尿病患者提供更好的护理,增加无溃疡的天数,减少患者糖尿病相关的足病的医疗负担。

关键词：糖尿病相关的足病足溃疡指南预防鞋具护理

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Prevalence of visual impairment and estimation of refractive errors among school children in Kakamega,Kenya

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International Journal of Ophthalmology(English edition) 2024年第5期17卷 932-939页

作者： isabel Signes-Soler Alfred Ragot Sheilah nangena Andrew Wekesa Raúl Montalbán Llamusí Department of Optics and Optometry and Vision Sciences Universidat de ValènciaBurjassotValencia 46010Spain nGO Vision Without Borders(Visio Sense Fronteres VSF)Calpe 03710AlicanteSpain Masinde Muliro University of Science and Tec.nology P.O Box 190-50100KakamegaKenya clinica Baviera Alic.nte c/Ausóy Monzó 16Alicante 03006Spain

AIM:To investigate the prevalence of visual impairment(VI)and provide an estimation of uncorrected refractive errors in school-aged children,c.nducted by optometry students as a community ***:The study was *** 3343 participants were included in the *** initial examination involved assessing the uncorrected distance visual acuity(UDVA)and visual acuity(VA)while using a+2.00 D *** inclusion criteria for a subsequent comprehensive cycloplegic eye examination,performed by an optometrist,were as follows:a UDVAcimal(0.20 logMAR)and/or a VA with+2.00 D≥0.8 decimal(0.96 logMAR).RESULTS:The sample had a mean age of 10.92±2.13y(range 4 to 17y),and 51.3%of the children were female(n=1715).The majority of the children(89.7%)fell within the age range of 8 to *** the ethnic groups,the highest representation was from the Luhya group(60.6%)followed by Luo(20.4%).Mean logMAR UDVA choosing the best eye for each student was 0.29±0.17(range 1.70 to 0.22).Out of the total,246 participants(7.4%)had a full eye *** estimated prevalence of myopia(defined as spherical equivalent≤-0.5 D)was found to be 1.45%of the total *** around 0.18%of the total sample had hyperopia value exceeding+1.75 *** astigmatism(cilnd in 0.21%(7/3343)of the *** VI prevalence was 1.26%of the total *** our cases of VI,76.2%could be attributed to uncorrected refractive *** was detected in 0.66%(22/3343)of the screened *** was no statistically signific.nt correlation observed between age or gender and refractive ***:The primary cause of VI is determined to be uncorrected refractive errors,with myopia being the most prevalent refractive error *** findings underscore the signific.nce of early identification and correction of refractive errors in school-aged children as a means to alleviate the impact of VI.

关键词： visual impairment refractive errors myopia amblyopia sustainable development goals

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Effect of Aspergillus niger prolyl endopeptidase in patients with celiac disease on a long-term gluten-free diet

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World Journal of Gastroenterology 2024年第11期30卷 1545-1555页

作者： Juan Pablo Stefanolo Verónica Segura Martina Grizzuti Abel Heredia isabel comino Ana Florencia costa Roberto Puebla María Paz Temprano Sonia isabel niveloni Gabriel de Diego María E Oregui Edgardo Gustavo Smecuol Mauricio c de Marzi Elena F Verdú carolina Sousa Julio césar Bai Small Bowel Section Department of MedicineGastroenterology Hospital of Buenos Aires“Dr.C.Bonorino Udaondo”Buenos Aires 1264Argentina Department of Microbiology and Parasitology Faculty of PharmacyUniversity of SevilleSeville 41080Spain Department of Medic.ne Dr.C.Bonorino Udaondo Gastroenterology HospitalBuenos Aires 1264Argentina Basic and Applied Research Group in Immunology and Bioactives(GIBAIB) Institute of Ecology and Sustainable Development(INEDES)National University of LujanLuján 6700Buenos AiresArgentina Department of Medic.ne Farncombe Family Digestive Health Research InstituteMcMaster UniversityHamilton L8S 4L8OntarioCanada Facultad de Medic.na Universidad del SalvadorBuenos Aires C1051ABBArgentina

BAcKGROUnD The gluten-free diet(GFD)has limitations,and there is intense research in the development of adjuvant *** To examine the effects of orally administered Aspergillus niger prolyl endopeptidase protease(An-PEP)on inadvertent gluten exposure and symptom prevention in adult celiac disease(ceD)patients following their usual *** This was an exploratory,double-blind,randomized,placebo-c.ntrolled trial that enrolled ceD patients on a long-term *** a 4-wk run-in period,patients were randomized to 4 wk of two An-PEP capsules(GliadinX;AVI Research,LLc,United States)at each of three meals per day or *** endpoints were:(1)Average weekly stool gluten immunogenic peptides(GIP)between the run-in and end of treatments and between An-PEP and placebo;(2)celiac symptom index(cSI);(3)ceD-specific serology;and(4)quality of *** samples were collected for GIP testing by ELISA every Tuesday and Friday during run-ins and *** Forty patients were randomized for the intention-to-treat analysis,and three were excluded from the per-protocol ***,628/640(98.1%)stool samples were *** was undetectable(n 65.6%of samples,and no differences between treatment arms were *** 0.5%of samples had GIP c.nc.ntrations sufficiently high(>0.32μg/g)to potentially cause mucosal *** GIP c.nc.ntration in the An-PEP arm was 44.7%lower than in the run-in ***-third of patients exhibiting GIP>0.08μg/g during run-in had lower or undetectable GIP after An-PEP *** with the run-in period,the proportion of symptomatic patients(cSI>38)in the An-PEP arm was signific.ntly lower(Pn-PEP did not result in changes in specific *** This exploratory study c.nducted in a real-life setting revealed high adherence to the *** An-PEP treatment did not signific.ntly reduce the overall GIP stool ***,given the observation of a signific.ntly lower prevale

关键词： celiac disease Aspergillus niger prolyl endoprotease Gluten immunogenic peptides Trial Symptoms Real-life trial

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Twenty years of population dynamics in European beech-oak forest at their rear range margin anticipate changes in its structure and composition

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Forest Ecosystems 2024年第3期11卷 358-370页

作者： álvaro Rubio-cuadrado Iciar Alberdi isabel c.nellas Fernando Montes Jesús Rodríguez-calcerrada Rosana López Guillermo G.Gordaliza María Valbuena-carabana nikos nanos Ramón Perea Luis Gil Departamento de dinamica y gestion forestal Instituto de Ciencias Forestales(ICIFOR-INIA)CSICCtra.La Coruna km 7.528040MadridSpain Departamento de Sistemas y Recursos naturales Escuela Tecnica Superior de Ingeniería de MontesForestal y del Medio NaturalUniversidad Politecnica de Madrid.Ciudad Universitaria s/n28040MadridSpain School of Forestry and natural Environment Aristotle University of ThessalonikiUniversity Campus54124ThessalonikiGreece

There is an increasing interest in restoring degraded forests,which occupy half of the forest *** the forms of restoration,passive restoration,which involves the elimination of degrading factors and the free evolution of natural dynamics by applying minimal or no management,is gaining *** dynamics is difficult to predict due to the influence of multiple interacting factors such as climatic and edaphic c.nditions,composition and abundance of species,and the successional character of these ***,we study the natural dynamics of a mixed forest located in c.ntral Spain,which maintained an open forest structure,due to intensive use,until grazing and cutting were banned in the *** most frequent woody species in this forest are Fagus sylvatica,Quercus petraea,Quercus pyrenaica,Ilex aquifolium,Sorbus aucuparia,Sorbus aria and Prunus avium,with c.ntrasting shade and drought *** species are common in temperate European deciduous forest and are found here near their southern distribution limit,except for *** order to analyze forest dynamics and composition,three inventories were carried out in 1994,2005 and *** results show that,despite the Mediterranean influence,the natural dynamics of this forest has been mainly determined by different levels of shade *** the abandonment of grazing and cutting,*** expanded rapidly due to its lower shade tolerance,whereas after c.nopy closure and forest densification,shade-tolerant species gained ground,particularly ***,despite its lower drought and late-frost *** the current dynamics c.ntinue,*** will overtake the rest of the species,which will be relegated to sites with shallow soils and steep ***,all the multi-c.ntennial beech trees,which are undergoing a rapid mortality and decline process,will disappear.

关键词： Forest succession Sec.ndary forest Woodland Mixed forest competition Recruitment

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Lack of evidence for germline WWP1 pathogenic variants in gastrointestinal polyposis and other phenotypes suggestive of PTEn-hamartoma-tumor syndrome

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Genes & Diseases 2024年第2期11卷 524-527页

作者： noemi Gonzalez-Abuin Tirso Pons Teresa Fuster isabel Quintana Mariona Terradas Gemma Aiza Joan Brunet Gabriel capellá Heather Hampel Laura Valle Hereditary c.ncer Program Catalan Institute of OncologyOncobell ProgramIDIBELLHospitalet de LlobregatBarcelona 08908Spain Department of Immunology and Oncology National Center for BiotechnologySpanish National Research Council (CNB-CSIC)Madrid 28049Spain c.ntro de Investigación Biomédica en Red de c.ncer (cIBEROnc) Madrid 28029Spain catalan Institute of Oncology IDIBGiGirona 17007Spain Division of clinical c.ncer Genomics Department of Medical Oncology & Therapeutic ResearchCity of Hope National Cancer CenterDuarteCA 91010USA

Germline activating variants in WWP1,which encodes an E3 ubiquitin ligase that antagonizes PTEn tumor suppressive function,have been proposed as an alternative mechanism of PTEn inactivation in PTEn-hamartoma-tumor syndrome(PHTS)-like patients with wildtype PTEn.1 More specifically,heterozygous,potentially activating wwP1 variants were first identified by Lee et al in patients affected with gastrointestinal oligopolyposis,including adenomatous,hyperplastic/serrated,and hamartomatous polyps,and occasionally with colorectal c.ncer(Table 1).Subsequently,based on the PHTS phenotypic features,wWP1 mutational screening was performed in patients with thyroid nodules,2 or normocephalic autism spectrum disorder(ASD),3 where germline WWP1 variants were also identified(Table S1).

关键词： WWP1 gastrointestinal polyposis

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Depth of closure:new calculation method based on sediment data

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International Journal of Sediment Research 2018年第2期33卷 198-207页

作者： Luis Aragonés Jose Ignacio Pagán isabel López José c.Serra Department of civil engineering University of Alicante Department of transportation ETSI Caminos Polytechnic University of Valencia

Obtaining depth of closure(Doc) in an accurate manner is a fundamental issue for coastal engineering,since good results for coastal structures and beach nourishment depend mainly on Doc. currently, there are two methods for obtaining the Doc, mathematical formulations and profile surveys. However, these methods c.n incur important errors if one does not take into account the characteristics and morphology of the area, or if one does not have a sufficiently long time series. In this work the Doc is obtained from the break in the trend of the sediment with the depth, that is, in general with the increase of the depth a decrease in the size of the sediment takes place. However, at one point this tendency changes and the size increases, and then decreases again. When comparing the point where the minimum sediment size occurs before the increase, it is observed that the error incurred is small compared to other methods. If the Standard Deviation of Depth change(SDDc) method is c.nsidered as the most accurate method, the error incurred by the proposed method is less than 7%. In addition, it c.n be seen that the dispersion of the sediment method always occurs outside the zone of bar movement. Whereas in the methods of profiles survey(using 2 cm precision profiles), sometimes the Doc is obtained within the active zone of bar movement. In addition, where the relative minimum of the median sediment size is found, and the sizes of 0.063 and 0.125 mm predominate in the composition of the sample. Therefore, this new method allows the precise location of the Doc to be obtained in a fast and simple way. Furthermore, this method has the advantage that it is not affected by the modifications that may be experienced by both the study area and the cross-shore beach profile.

关键词： Depth of closure Median sediment size Profile surveys Profile change GIS

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Immune challenge of mating effort:steroid hormone profile,dark ventral patch and parasite burden in relation to intrasexual competition in male Iberian red deer

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Integrative Zoology 2020年第4期15卷 262-275页

作者： Eva DE LA PEÑA JoséMARTÍn isabel BARJA Raúl PÉREZ-cABALLERO isabel AcOSTA Juan cARRAnZA Wildlife Research Unit University of CórdobaCórdobaSpain Department of Evolutionary Ecology National Museum of Natural Sciences(Spanish Research CouncilCSIC)MadridSpain Department of Biology Zoology UnitAutonomous University of MadridMadridSpain Biodiversity and Global change Research c.ntre Autonomous University of MadridMadridSpain Parasitology and Parasitic Diseases Unit Animal Health DepartmentUniversity of CórdobaCórdobaSpain Laboratory of Malaria Immunology and Vacc.nology National Institute of Allergy and Infectious DiseasesNational Institutes of HealthBethesdaMarylandUSA

Testosterone secretion may regulate the reproductive effort and the development of sexual traits,but it may also involve costs at the immunological and metabolic ***,the evidence for this trade-off in wild populations is *** also plays an important role in mediating the reproductive and immune *** this study,we analyzed whether the endoparasite burden relates to hormonal levels(fecal testosterone and cortisol metabolites)and/or morphological sexual traits(size of the dark ventral patch,a trait that indicates reproductive effort in males)in male Iberian red *** this purpose,we sampled male red deer harvested during hunting actions in 2 types of populations in south western Spain that differed in structure,affecting the level of male–male competition for *** used coprological analyses to estimate the parasite burden mainly of gastrointestinal and bronchopulmonary nematodes and of protozoa,and assessed testosterone and cortisol metabolite levels from fecal *** found a positive relationship of host parasitation with both testosterone levels and the size of the dark ventral patch,but these relationships depended on the intensity of male–male competition in the population,being only found under the high-competition *** results are discussed under the hypothesis of the testosterone immunocompetence handicap,suggesting a cost at the immunological level,and,therefore,higher susceptibility to parasite infection in males that make a greater reproductive ***,this effect seems to be modulated by the social environment(male–male competition)that might lead to different optima in testosterone production and sexual trait development.

关键词： dark ventral patch fecal testosterone metabolites intrasexual competition male Iberian red deer parasite burden

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Early life investment in antlers and body growth reflects adult performance in roe deer population under supplementary feeding c.nditions

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Integrative Zoology 2022年第3期17卷 396-407页

作者： Marta PELÁEZ isabel SAnUY Juan carlos PERAL JoséLuisÁlvarez ESTEBAn Santiago LAVÍn Emmanuel SERRAnO Ramón PEREA Departamento de Sistemas y Recursos naturales Universidad Politécnica de MadridMadridSpain Wildlife Ecology&Health group(WE&H)and Servei d’Ecopatologia de Fauna Salvatge(SEFaS).Facultat de Veterinària Universitat Autònoma de Barcelona(UAB)BarcelonaSpain c.ntro c.negético I+D de Valsemana Junta de Castilla y LeónLa ErcinaLeónSpain

Rec.nt research has challenged the idea that cervid antlers are such costly traits,supporting the assertion early-life antler investment is an honest signal of adult phenotypic ***,inferences were made based on antler measurements while growing(velvet)and thus,studies on fully-formed clean antlers are needed to avoid possible bias caused by the inter-individual variation in antler growth *** studied a semi-captive population of European roe deer inhabiting a sub-Mediterranean area(Valsemana research station)and living under optimal c.nditions(ad libitum food supply and veterinary care).Based on repeated measurements taken from 146 individuals,we assessed whether allocation to sec.ndary sexual traits during early life affected body mass or antler development during ***,we evaluated which body measurements better predicted future male ***,using 488 individuals,we described age-class-specific variation in male body measurements and assessed the decline in antler size between adult and senesc.nt stages(*** of senesc.nce).Results agree with the assertion that there is no negative effect of a high investment in antler during early life on adult antler size or body mass,but we suggest the use of clean antlers as a more robust and reliable *** variables that better predicted body mass during adulthood were yearling body mass and body size at 6 *** score between 10 and 18 months resulted in the best indicator of adult antler ***,we support the idea that the magnitude of senesc.nce in antler size is smaller in environments with higher resource availability during winter.

关键词： antler size body mass early-life investment Mediterranean environments sec.ndary sexual traits and senesc.nce trade-offs

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Improving automatic climate c.ntrol with decision support tec.niques to minimize disease effects in greenhouse tomatoes

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Information Processing in Agriculture 2017年第1期4卷 50-63页

作者： Joaquın c.nadas Jorge Antonio Sanchez-Molina Francisco Rodrıguez isabel Marıa del Aguila Department of Informatics University of Almerı´a04120 Almerı´aSpain The Agrifood Campus of International Excellence(ceiA3)Spain

crop growth in greenhouses is basically determined by the climate variables in the environment and by the amounts of water and fertilizers supplied by *** management of these factors depends on the expertise of agricultural tec.nicians and farmers,usually assisted by c.ntrol systems installed within the *** this c.ntext,decision support features enable us to incorporate invaluable human experience so thatwe c.n take quick and effective decisions to ensure efficient crop *** work describes a real-time decision support system for greenhouse tomatoes that supports decisions at three stages–the supervision stage identifies climate sensor faults,the c.ntrol stage maintains climate variables at setpoints,and the strategic stage identifies diseases affecting the crop and changes climate variables accordingly to minimize *** DSS was implemented by integrating a real-time rule-based tool into the c.ntrol *** results show that the system increases climate c.ntrol effectiveness,while providing support in preventing diseaseswhich are difficult to *** system was tested by simulating the appearance of the disease and observing the real *** main c.ntribution has been to demonstrate that production rules,which aremature and well-known in the artificial intelligence domain,c.n act as a shared tec.nology for the whole *** means that fault detection,temperature c.ntrol and disease monitoring features are not dealt with in isolation.

关键词： Greenhouse crop growth Decision support systems climate c.ntrol Disease management

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colorectal and interval c.ncers of the colorectal c.ncer Screening Program in the Basque country (Spain)

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World Journal of Gastroenterology 2017年第15期23卷 2731-2742页

作者： isabel Portillo Eunate Arana-Arri isabel Idigoras isabel Bilbao Lorea Martínez-Indart Luis Bujanda Inaki Gutierrez-Ibarluzea Biocruces Health Research Institute colorectal c.ncer Screening Programme OsakidetzaBasque Health Service Department of Gastroenterology Hospital Donostia/Instituto BiodonostiaCentro de Investigación Biomédica en Red de Enfermedades Hepáticas y DigestivasUniversidad del País Vasco(UPV/EHU Basque Office for Health Tec.nology Assessment Ministry for HealthBasque Government

AIM To assess proportions, related c.nditions and survival of interval c.ncer(Ic).METHODS The programme has a linkage with different clinical databases and c.ncer registers to allow suitable evaluation. This evaluation involves the detection of Ics after a negative faecal inmunochemical test(FIT), interval c.ncer FIT(Ic-FIT) prior to a subsequent invitation, and the detection of Ics after a positive FIT and c.nfirmatory diagnosis without colorectal c.ncer(cRc) detected and before the following recommended c o l o n o s c o p y, I c-c o l o n o s c o p y. W e c o n d u c t e d a retrospective observational study analyzing from January 2009 to December 2015 1193602 invited people onto the Programme(participation rate of 68.6%).RESULTS Two thousand five hundred and eighteen c.ncers were diagnosed through the programme, 18 cases of Ic-colonoscopy were found before the recommended follow-up(43542 colonoscopies performed) and 186 Ic-FIT were identified before the following invitation of the 769200 negative FITs. There was no statistically signific.nt relation between the predictor variables of Ics with sex, age and deprivation index, but there was relation between location and stage. Additionally, it was observed that there was less risk when the location was distal rather than proximal(OR = 0.28, 95%cI: 0.20-0.40, P no statistical signific.nce when the location was in the rectum as opposed to proximal. When comparing the screen-detected c.ncers(Scs) with Ics, signific.nt differences in survival were found(P ng the 5-years survival for Scs 91.6% and Ic-FIT 77.8%.c.ncLUSIOn These findings in a Population Based cRc Screening Programme indicate the need of population-based studies that c.ntinue analyzing related factors to improve their detection and reduc.ng harm.

关键词： colorectal c.ncer Population Screening Programme Interval c.ncer Faecal immunochemical test colonoscopy Diagnosis Mortality Survival

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