检索结果-南通市图书馆

New clinical trial design in precision medicine:discovery,development and direction

Signal Transduction and Targeted Therapy 2024年第4期9卷 1293-1321页

作者： Xiao-Peng Duan Bao-dong Qin Xiao-dong Jiao ke Liu Zhan Wang Yuan-Sheng Zang Department of Medical Oncology Changzheng HospitalNaval Medical UniversityShanghaiChina

In the era of precision medicine,it has been increasingly recognized that individuals with a certain disease are complex and different from each other.Due to the underestimation of the significant heterogeneity across participants in traditional"one-sizefits-all"trials,patient-centered trials that could provide optimal therapy customization to individuals with specific biomarkers were developed including the basket,umbrella,and platform trial designs under the master protocol framework.In recent years,the successive FDA approval of indications based on biomarker-guided master protocol designs has demonstrated that these new clinical trials are ushering in tremendous opportunities.Despite the rapid increase in the number of basket,umbrella,and platform trials,the current clinical and research understanding of these new trial designs,as compared with traditional trial designs,remains limited.The majority of the research focuses on methodologies,and there is a lack of in-depth insight concerning the underlying biological logic of these new clinical trial designs.Therefore,we provide this comprehensive review of the discovery and development of basket,umbrella,and platform trials and their underlying logic from the perspective of precision medicine.Meanwhile,we discuss future directions on the potential development of these new clinical design in view of the"Precision Pro","Dynamic Precision",and"Intelligent Precision".This review would assist trial-related researchers to enhance the innovation and feasibility of clinical trial designs by expounding the underlying logic,which be essential to accelerate the progression of precision medicine.

关键词： clinical approval successive

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Reinforcement Learning-Based Dynamic Order Recommendation for On-Demand Food Delivery

引用

Tsinghua Science and Technology 2024年第2期29卷 356-367页

作者： Xing Wang Ling Wang Chenxin dong Hao Ren ke Xing Department of Automation Tsinghua UniversityBeijing 100080China School of Mechanical and Automotive Engineering Qingdao Hengxing University of Science and TechnologyQingdao 266100China Meituan Beijing 100015China

On-demand food delivery(OFD)is gaining more and more popularity in modern society.As a kernel order assignment manner in OFD scenario,order recommendation directly influences the delivery efficiency of the platform and the delivery experience of riders.This paper addresses the dynamism of the order recommendation problem and proposes a reinforcement learning solution method.An actor-critic network based on long short term memory(LSTM)unit is designed to deal with the order-grabbing conflict between different riders.Besides,three rider sequencing rules are accordingly proposed to match different time steps of the LSTM unit with different riders.To test the performance of the proposed method,extensive experiments are conducted based on real data from Meituan delivery platform.The results demonstrate that the proposed reinforcement learning based order recommendation method can significantly increase the number of grabbed orders and reduce the number of order-grabbing conflicts,resulting in better delivery efficiency and experience for the platform and riders.

关键词： on-demand food delivery order recommendation reinforcement learning actor-critic network long short term memory

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Balancing act:The dilemma of rapid hyperglycemia correction in diabetes management

引用

World Journal of Diabetes 2024年第2期15卷 129-132页

作者： ke-Xin Zhang Cheng-Xia Kan Xiao-dong Sun Department of Endocrinology and Metabolism Affiliated Hospital of Weifang Medical UniversityWeifang 261031Shandong ProvinceChina

The global diabetes surge poses a critical public health challenge,emphasizing the need for effective glycemic control.However,rapid correction of chronic hyperglycemia can unexpectedly trigger microvascular complications,necessitating a reevaluation of the speed and intensity of glycemic correction.Theories suggest swift blood sugar reductions may cause inflammation,oxidative stress,and neurovascular changes,resulting in complications.Healthcare providers should cautiously approach aggressive glycemic control,especially in long-standing,poorly controlled diabetes.Preventing and managing these complications requires a personalized,comprehensive approach with education,monitoring,and interdisciplinary care.Diabetes management must balance short and longterm goals,prioritizing overall well-being.This editorial underscores the need for a personalized,nuanced approach,focusing on equilibrium between glycemic control and avoiding overcorrection.

关键词： Diabetes Hyperglycemia correction Management Microvascular complications Glucose control

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Evaluating effectiveness and safety of combined percutaneous transhepatic gallbladder drainage and laparoscopic cholecystectomy in acute cholecystitis patients:Meta-analysis

引用

World Journal of Gastrointestinal Surgery 2024年第5期16卷 1407-1419页

作者： Yu Li Wei-ke Xiao Xiao-Jun Li Hui-Yuan dong Department of General Surgery No.942 Hospital of PLAYinchuan 750004Ningxia Hui Autonomous RegionChina

BACKGROUND Acute cholecystitis(AC)is a common disease in general surgery.Laparoscopic cholecystectomy(LC)is widely recognized as the"gold standard"surgical procedure for treating AC.For low-risk patients without complications,LC is the recommended treatment plan,but there is still controversy regarding the treatment strategy for moderate AC patients,which relies more on the surgeon's experience and the medical platform of the visiting unit.Percutaneous transhepatic gallbladder puncture drainage(PTGBD)can effectively alleviate gallbladder inflammation,reduce gallbladder wall edema and adhesion around the gallbladder,and create a"time window"for elective surgery.AIM To compare the clinical efficacy and safety of LC or PTGBD combined with LC for treating AC patients,providing a theoretical basis for choosing reasonable surgical methods for AC patients.METHODS In this study,we conducted a clinical investigation regarding the combined use of PTGBD tubes for the treatment of gastric cancer patients with AC.We performed searches in the following databases:PubMed,Web of Science,EMBASE,Cochrane Library,China National Knowledge Infrastructure,and Wanfang Database.The search encompassed literature published from the inception of these databases to the present.Subsequently,relevant data were extracted,and a meta-analysis was conducted using RevMan 5.3 software.RESULTS A comprehensive analysis was conducted,encompassing 24 studies involving a total of 2564 patients.These patients were categorized into two groups:1371 in the LC group and 1193 in the PTGBD+LC group.The outcomes of the meta-analysis revealed noteworthy disparities between the PTGBD+LC group and the LC group in multiple dimensions:(1)Operative time:Mean difference(MD)=17.51,95%CI:9.53-25.49,P<0.01;(2)Conversion to open surgery rate:Odds ratio(OR)=2.95,95%CI:1.90-4.58,P<0.01;(3)Intraoperative bleeding loss:MD=32.27,95%CI:23.03-41.50,P<0.01;(4)Postoperative hospital stay:MD=1.44,95%CI:0.14-2.73,P=0.03;(5)Overall postoperative compli-cation rate:OR=1.88,95%CI:1.45-2

关键词： Acute cholecystitis Laparoscopic cholecystectomy Percutaneous transhepatic gallbladder drainage Metaanalysis Efficacy

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Age of Information Based User Scheduling and Data Assignment in Multi-User Mobile Edge Computing Networks:An Online Algorithm

引用

China Communications 2024年第5期21卷 153-165页

作者： Ge Yiyang Xiong ke dong Rui Lu Yang Fan Pingyi Qu Gang School of Computer and Information Technology Beijing Jiaotong UniversityBeijing 100044China Engineering Research Center of Network Management Technology for High Speed Railway of Ministry of Education Beijing 100044China Beijing Engineering Research Center of High-speed Railway Broadband Mobile Communications Beijing 100044China Department of Electronic Engineering Tsinghua UniversityBeijing 100084China Beijing National Research Center for Information Science and Technology Tsinghua UniversityBeijing 100084China Department of Electrical and Computer Engineering College ParkMarylandUSA

This paper investigates the age of information(AoI)-based multi-user mobile edge computing(MEC)network with partial offloading mode.The weighted sum AoI(WSA)is first analyzed and derived,and then a WSA minimization problem is formulated by jointly optimizing the user scheduling and data assignment.Due to the non-analytic expression of the WSA w.***.t.the optimization variables and the unknowability of future network information,the problem cannot be solved with known solution methods.Therefore,an online Joint Partial Offloading and User Scheduling Optimization(JPOUSO)algorithm is proposed by transforming the original problem into a single-slot data assignment subproblem and a single-slot user scheduling sub-problem and solving the two sub-problems separately.We analyze the computational complexity of the presented JPO-USO algorithm,which is of O(N),with N being the number of users.Simulation results show that the proposed JPO-USO algorithm is able to achieve better AoI performance compared with various baseline methods.It is shown that both the user’s data assignment and the user’s AoI should be jointly taken into account to decrease the system WSA when scheduling users.

关键词： age of information(aoi) mobile edge computing(mec) user scheduling

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Increased retinal venule diameter as a prognostic indicator for recurrent cerebrovascular events:a prospective observational study

引用

Neural Regeneration Research 2024年第5期19卷 1156-1160页

作者： Ying Zhao Dawei dong Ding Yan Bing Yang Weirong Gui Man ke Anding Xu Zefeng Tan Department of Neurology and Stroke Center the First Affiliated Hospital of Jinan UniversityGuangzhouGuangdong ProvinceChina Clinical Neuroscience Institute the First Affiliated Hospital of Jinan UniversityGuangzhouGuangdong ProvinceChina Department of Neurology the First People’s Hospital of FoshanFoshanGuangdong ProvinceChina

Microvasculature of the retina is considered an alternative marker of cerebral vascular risk in healthy populations.However,the ability of retinal vasculature changes,specifically focusing on retinal vessel diameter,to predict the recurrence of cerebrovascular events in patients with ischemic stroke has not been determined comprehensively.While previous studies have shown a link between retinal vessel diameter and recurrent cerebrovascular events,they have not incorporated this information into a predictive model.Therefore,this study aimed to investigate the relationship between retinal vessel diameter and subsequent cerebrovascular events in patients with acute ischemic stroke.Additionally,we sought to establish a predictive model by combining retinal veessel diameter with traditional risk factors.We performed a prospective observational study of 141 patients with acute ischemic stroke who were admitted to the First Affiliated Hospital of Jinan University.All of these patients underwent digital retinal imaging within 72 hours of admission and were followed up for 3 years.We found that,after adjusting for related risk factors,patients with acute ischemic stroke with mean arteriolar diameter within 0.5-1.0 disc diameters of the disc margin(MAD_(0.5-1.0DD))of≥74.14μm and mean venular diameter within 0.5-1.0 disc diameters of the disc margin(MVD_(0.5-1.0DD))of≥83.91μm tended to experience recurrent cerebrovascular events.We established three multivariate Cox proportional hazard regression models:model 1 included traditional risk factors,model 2 added MAD_(0.5-1.0DD)to model 1,and model 3 added MVD0.5-1.0DD to model 1.Model 3 had the greatest potential to predict subsequent cerebrovascular events,followed by model 2,and finally model 1.These findings indicate that combining retinal venular or arteriolar diameter with traditional risk factors could improve the prediction of recurrent cerebrovascular events in patients with acute ischemic stroke,and that retinal imaging could be a useful and non-invasive method for ide

关键词： acute ischemic stroke arteriolar cerebrovascular events diameter digital retinal imaging microvasculature prediction recurrent retina venular

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

New phenylbutenoids and terpene glycosides from Ginkgo biloba leaves

引用

Chinese Journal of Natural Medicines 2024年第2期22卷 161-170页

作者： SUN Zeshi LIN Shan WU Zhi-Li dong Hong-Yuan XU Xi-ke LI Hui-Liang WANG Jinxin School of Pharmacy Second Military Medical UniversityShanghai 200433China State key Laboratory of New Drug and Pharmaceutical Process Shanghai Institute of Pharmaceutical IndustryChina State Institute of Pharmaceutical IndustryShanghai 201203China

Our continued works on the chemical constituents of Ginkgo biloba(G.biloba)leaves has led to the isolation of two novel phenylbutenoids(1,2),along with five previously unidentified terpene glycosides(3−7).Among them,compounds 1 and 2 represent unique(Z)-phenylbutenoids,3−6 are megastigmane glycosides,and 7 is identified as a rare bilobanone glycoside(Fig.1).This study marks the first reported isolation of phenylbutenoid and bilobanone glycoside from G.biloba.The chemical structures of these compounds were elucidated through extensive spectroscopic analysis,including HR-ESI-MS and various 1D and 2D NMR experiments.Furthermore,the absolute configurations of these molecules were determined using Mosher’s method,ECD experiments,and Cu-KαX-ray crystallographic analyses.

关键词： Ginkgo biloba Phenylbutenoid Megastigmane glycoside Bilobanone glycoside

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Constructing inter-diffusive PtCuNi/WO_(3)interface to enhance the catalytic activity and stability in oxygen reduction

引用

Tungsten 2024年第2期6卷 293-303页

作者： Hao-Zhe Xu dong Li Ying Chen Pin Fang Xiao-Xing ke Olga Demidenko Yu-Jing Li Beijing key Laboratory of Construction Tailorable Advanced Functional Materials and Green Applications Experimental Center of Advanced MaterialsSchool of Materials Science and EngineeringBeijing Institute of TechnologyBeijing 100081China Faculty of Materials and Manufacturing Beijing University of TechnologyBeijing 100124China Scientifi c-Practical Materials Research Centre National Academy of Sciences of Belarus220072 MinskBelarus

Platinum-group-metal-based alloy nanocrystals have been considered as the most effi cient catalysts for oxygen reduction reaction(ORR).However,the poor stability issues limit their further deployment in industrialization.Tungsten oxide(WO_(3))has received attention due to its intrinsic electrochemical stability and proton absorption/desorption capability.In this work,we prepared PtCuNi/WO_(3)/C hybrid catalyst with inter-diff usive alloy/WO_(3)interface on carbon.The catalyst exhibits enhanced activity and stability associated with the WO_(3)content.The characterization results suggest that the increased activity originates from the complementary proton supply of non-stoichiometric H_(x)WO_(3).Moreover,WO_(3)prevents the particle from dissolution and detachment under vigorous electrochemical polarizations.The enhanced stability originates from the electronic interaction established between Pt and W.This work provides new strategies to design high-performance ORR catalysts by taking the merits of WO_(3)。

关键词： Tungsten oxide PtCuNi Interface Electronic interaction

来源：

维普期刊数据库

同方期刊数据库评论

在线全文

学校读者我要写书评

暂无评论

Elucidating the cardioprotective mechanisms of sodium-glucose cotransporter-2 inhibitors beyond glycemic control

引用

World Journal of Diabetes 2024年第2期15卷 137-141页

作者： ke-Xin Zhang Cheng-Xia Kan Fang Han Jing-Wen Zhang Xiao-dong Sun Department of Endocrinology and Metabolism Affiliated Hospital of Weifang Medical UniversityWeifang 261031Shandong ProvinceChina

Sodium-glucose cotransporter-2(SGLT2)inhibitors have emerged as a pivotal intervention in diabetes management,offering significant cardiovascular benefits.Empagliflozin,in particular,has demonstrated cardioprotective effects beyond its glucose-lowering action,reducing heart failure hospitalizations and improving cardiac function.Of note,the cardioprotective mechanisms appear to be independent of glucose lowering,possibly mediated through several mechanisms involving shifts in cardiac metabolism and anti-fibrotic,anti-inflammatory,and anti-oxidative pathways.This editorial summarizes the multifaceted cardiovascular advantages of SGLT2 inhibitors,highlighting the need for further research to elucidate their full therapeutic potential in cardiac care.

关键词： Diabetes Sodium-glucose cotransporter-2 Cardiovascular diseases Empagliflozin

来源：

维普期刊数据库评论

在线全文

维普期刊数据库

学校读者我要写书评

暂无评论

Distribution of Traditional Chinese Medicine syndromes in diabetic kidney disease chronic kidney disease 1-5: a correlation study

引用

Journal of Traditional Chinese Medicine 2024年第3期44卷 572-580页

作者： LI Shuang DUAN Shuwei dong Zheyi QU Yilun LUO Yayong ke Jianghua WANG Conghui PENG Yangzhi ZHOU Xuefeng CHEN Xiangmei Department of Nephrology First Medical Center of Chinese PLA General HospitalNephrology Institute of the Chinese People's Liberation ArmyNational Key Laboratory of Kidney DiseasesNational Clinical Research Center for Kidney DiseasesBeijing Key Laboratory of Kidney Disease Research School of Clinical Medicine Guangdong Pharmaceutical University Basic Medical College Chengdu University of Traditional Chinese Medicine

OBJECTIVE: To analyze the distribution of Traditional Chinese medicine(TCM) syndromes in patients with diabetic kidney disease(DKD) and its related factors.METHODS: We enrolled 435 patients with DKD, who were not undergoing dialysis, admitted to the Department of Nephrology, First Medical Center, Chinese PLA General Hospital from April 2020 to August 2021.Analysis of their TCM syndromes and related factors was carried out.RESULTS: The 435 patients included 109, 117, 86, and 123 chronic kidney disease(CKD) 1-2, CKD3, CKD4, and CKD5 cases, respectively. With the progression of CKD1-5, the proportion of Yin deficiency and dry heat syndrome,and that of Qi and Yin deficiency syndrome showed a downward trend, whereas the proportion of spleen-kidney Yang deficiency, blood deficiency, blood stasis, water stagnation, and phlegm turbidity syndromes showed an upward trend; the differences were statistically significant(P < 0.05). Multivariate logistic regression analysis showed that Yin deficiency and dry heat syndrome was positively correlated with hemoglobin [odds ratio(OR) =1.022, P = 0.005], albumin(OR = 1.058, P = 0.006), and estimated glomerular filtration rate(eGFR)(OR = 1.020,P < 0.001) but negatively correlated with male sex(OR =0.277, P = 0.004). Qi and Yin deficiency syndrome was positively correlated with albumin(OR = 1.056, P < 0.001)and eGFR(OR = 1.008, P = 0.022) but negatively correlated with age(OR = 0.977, P = 0.023). Liver-kidney Yin deficiency syndrome was positively correlated with age(OR = 1.028, P = 0.021) and glycosylated hemoglobin(OR = 1.223, P = 0.007) but negatively correlated with total cholesterol(OR = 0.792, P = 0.006).Spleen-kidney Yang deficiency syndrome was negatively correlated with hemoglobin(OR = 0.977, P < 0.001),albumin(OR = 0.891, P < 0.001), and eGFR(OR = 0.978,P < 0.001) but positively correlated with high density lipoprotein(OR = 3.376, P = 0.001). CONCLUSION: With CKD1-5 progression, TCM syndromes changed from Yin deficiency and dry heat syndrome to syndrome of deficiency of both

关键词： albumins correlation of data diabetic nephropathies glomerular filtration rate hemoglobins syndrome and complex

来源：

同方期刊数据库评论

在线全文

同方期刊数据库

学校读者我要写书评

暂无评论

欢迎您,

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案：

请选择收藏分类：

通借通还

欢迎您,

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

在线全文

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：