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Multimodality management for chronic subdural hematoma in China: protocol and characteristics of an ambidirectional, nationwide, multicenter registry study

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中华神经外科杂志(英文) 2024年第2期10卷 1-10页

作者： Liu Tao Zhao Zhihao Huang Jinhao Zhu Xide Chen Weiliang Lin Kun Yu Yunhu Li Zhanying Fan Yibing Liu mingqi Nie Meng Liu Xuanhui Gao Chuang Quan Wei Qian Yu Wu Chenrui Yuan Jiangyuan Wu Di Lv Chuanxiang Dong Shiying mi liang Tian Yu Tian Ye Zhang Jianning Jiang Rongcai Department of Neurosurgery Tianjin Medical University General Hospital Tianjin China ministry of Education Tianjin Neurological Institute Key Laboratory of Post Neuro-injury Neuro-repair and Regeneration in Central Nervous System Tianjin Medical University General Hospital Tianjin China Department of Neurosurgery Linyi People’s Hospital Shandong China Department of Neurosurgery Haining People’s Hospital Zhejiang China Department of Neurosurgery Fujian Provincial Hospital Fujian China Department of Clinical Research Center for Neurological Disease the People’s Hospital of HongHuaGang District of ZunYi Guizhou China Department of Neurosurgery Kailuan General Hospital Hebei China Department of Neurosurgery Tianjin First Central Hospital Tianjin China Department of Neurosurgery The First Hospital of Jilin University Changchun China

Background Despite its prevalence, there is ongoing debate regarding the optimal management strategy for chronic subdural hematoma (CSDH), reflecting the variability in clinical presentation and treatment outcomes. This ambidirectional, nationwide, multicenter registry study aims to assess the efficacy and safety of multimodality treatment approaches for CSDH in the Chinese population.Methods/design A multicenter cohort of CSDH patients from 59 participating hospitals in mainland China was enrolled in this study. The treatment modalities encompassed a range of options and baseline demographics, clinical characteristics, radiographic findings, and surgical techniques were documented. Clinical outcomes, including hematoma resolution, recurrence rates, neurological status, and complications, were assessed at regular intervals during treatment, 3 months, 6 months, 1 year, and 2 years follow-up.Result Between March 2022 and August 2023, a comprehensive cohort comprising 2173 individuals who met the criterion was assembled across 59 participating clinical sites. Of those patients, 81.1% were male, exhibiting an average age of 70.12 ± 14.53 years. A historical record of trauma was documented in 48.0% of cases, while headache constituted the predominant clinical presentation in 58.1% of patients. The foremost surgical modality employed was the burr hole (61.3%), with conservative management accounting for 25.6% of cases. Notably, a favorable clinical prognosis was observed in 88.9% of CSDH patients at 3 months, and the recurrence rate was found to be 2.4%.Conclusion This registry study provides critical insights into the multimodality treatment of CSDH in China, offering a foundation for advancing clinical practices, optimizing patient management, and ultimately, improving the quality of life for individuals suffering from this challenging neurosurgical condition.Trial registration ChiCTR2200057179

关键词： Chronic subdural hematoma Multimodality therapy Outcome Recurrence

Establishment and validation of an adherence prediction system for lifestyle interventions in non-alcoholic fatty liver disease

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World Journal of Gastroenterology 2024年第10期30卷 1393-1404页

作者： ming-Hui Zeng Qi-Yu Shi liang Xu Yu-Qiang mi Clinical School of the Second People’s Hospital Tianjin Medical UniversityTianjin 300192China Department of Gastroenterology Cangzhou People’s HospitalCangzhou 061000Hebei ProvinceChina Department of Hepatology Tianjin Second People’s HospitalTianjin 300192China Tianjin Research Institute of Liver Diseases Tianjin 300192China

BACKGROUND Non-alcoholic fatty liver disease(NAFLD)is the most common liver disease worldwide,affecting about 1/4th of the global population and causing a huge global economic burden.To date,no drugs have been approved for the treatment of NAFLD,making the correction of unhealthy lifestyles the principle method of treatment.Identifying patients with poor adherence to lifestyle correction and attempting to improve their adherence are therefore very important.AIM To develop and validate a scale that can rapidly assess the adherence of patients with NAFLD to lifestyle interventions.METHODS The Exercise and Diet Adherence Scale(EDAS)was designed based on com-pilation using the Delphi method,and its reliability was subsequently evaluated.Demographic and laboratory indicators were measured,and patients completed the EDAS questionnaire at baseline and after 6 months.The efficacy of the EDAS was evaluated in the initial cohort.Subsequently,the efficacy of the EDAS was internally verified in a validation cohort.RESULTS The EDAS consisted of 33 items in six dimensions,with a total of 165 points.Total EDAS score correlated significantly with daily number of exercise and daily reduction in calorie intake(P500 kacl/d),(sensitivity/specificity was 100.0%/75.8%),while patients score below 97 could nearly rule out the possibility of daily exercise(sensitivity/specificity was 89.5%/44.4%).Total EDAS scores≥116,97-115,and<97 points were indicative of good,average,and poor adherence,respectively,to diet and exercise recommendations.CONCLUSION The EDAS can reliably assess the adherence of patients with NAFLD to lifestyle interventions and have clinical application in this population.

关键词： Fatty liver Lifestyle intervention Behavioral change Patient adherence Compliance

Full-Scale Isogeometric Topology Optimization of Cellular Structures Based on Kirchhoff-Love Shells

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Computer Modeling in Engineering & Sciences 2024年第6期139卷 2479-2505页

作者： mingzhe Huang mi Xiao liang Gao mian Zhou Wei Sha Jinhao Zhang State Key Lab of Intelligent Manufacturing Equipment and Technology Huazhong University of Science and TechnologyWuhan430074China

Cellular thin-shell structures are widely applied in ultralightweight designs due to their high bearing capacity and strength-to-weight ratio.In this paper,a full-scale isogeometric topology optimization(ITO)method based on Kirchhoff-Love shells for designing cellular tshin-shell structures with excellent damage tolerance ability is proposed.This method utilizes high-order continuous nonuniform rational B-splines(NURBS)as basis functions for Kirchhoff-Love shell elements.The geometric and analysis models of thin shells are unified by isogeometric analysis(IGA)to avoid geometric approximation error and improve computational accuracy.The topological configurations of thin-shell structures are described by constructing the effective density field on the controlmesh.Local volume constraints are imposed in the proximity of each control point to obtain bone-like cellular structures.To facilitate numerical implementation,the p-norm function is used to aggregate local volume constraints into an equivalent global constraint.Several numerical examples are provided to demonstrate the effectiveness of the proposed method.After simulation and comparative analysis,the results indicate that the cellular thin-shell structures optimized by the proposed method exhibit great load-carrying behavior and high damage robustness.

关键词： Cellular thin-shell structures isogeometric analysis full-scale topology optimization Kirchhoff–Love shells

Direct-acting antivirals failed to reduce the incidence of hepatocellular carcinoma occurrence in hepatitis C virus associated cirrhosis: A real-world study

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World Journal of Hepatology 2024年第1期16卷 41-53页

作者： Xue-Mei Tao ming-Hui Zeng You-Fei Zhao Jia-Xin Han Yu-Qiang mi liang Xu Clinical School of the Second People’s Hospital Tianjin Medical UniversityTianjin 300192China Department of Hepatology Tianjin Second People’s HospitalTianjin 300192China Department of Hepatology Tianjin Research Institute of Liver DiseasesTianjin 300192China

BACKGROUND Direct-acting antivirals(DAAs)revolutionized the treatment of chronic hepatitis C virus(HCV)-associated disease achieving high rates of sustained virological response(SVR).However,whether DAAs can reduce the occurrence of hepatocellular carcinoma(HCC)in patients with HCV-associated cirrhosis who are at high risk have not been concluded.AIM To investigate the effect of DAAs on the occurrence of HCC in patients with HCVassociated cirrhosis after achieving SVR.METHODS Of 427 inpatients with HCV-associated cirrhosis were enrolled in Tianjin Second People's Hospital from January 2014 to April 2020.118 patients weren’t received antiviral treatment with any reasons named non-antiviral treatment group,and 236 patients obtained from the 309 DAAs treatment patients according to the propensity score matching named DAAs treatment group.Demographic information and laboratory data were collected from baseline and the following up.Kaplan-Meier curve and Log-Rank test were used to compare the incidence and cumulative incidence of HCC between the two groups.Cox proportional risk regression was used to re-evaluate the risk factors for HCC.RESULTS HCC incidence was 4.68/100PY(95%CI,3.09-6.81)in the DAAs treatment group,while it was 3.00/100PY(95%CI,1.50-5.37)in the non-antiviral treatment group,and the relative risk was 1.82(95%CI,0.93-3.53,P>0.05).The incidence of HCC at 12,24,36 and 48 months was 3.39%,6.36%,8.47%and 10.17%in the DAAs treatment group,and it was 0%,0%,3.39%and 9.32%in the non-antiviral treatment group,respectively.Age>58[hazard ratio(HR)=1.089;95%CI,1.033-1.147;P=0.002]and liver stiffness measurement>27.85 kPa(HR=1.043;95%CI,1.022-1.065;P=0.000)were risk factors for HCC in all patients(n=427),and DAAs treatment didn’t show protective efficacy.CONCLUSION DAAs treatment seems failed to reduce the incidence of HCC occurrence in HCV-associated cirrhosis in 48 months,and even increased the incidence of HCC in 36 months.

关键词： Direct-acting antivirals Sustained viral response Cirrhosis Hepatocellular carcinoma Risk factor

Efficacy and safety of Huzhang Granule,a compound Chinese herbal medicine,for acute gouty arthritis:A double-blind,randomized controlled trial

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Journal of Integrative Medicine 2024年第3期22卷 270-278页

作者： Hao Wang Si-ting Chen Xiao-jie Ding Le Kuai liang Hua Xin Li Yi-fei Wang ming Zhang Bin Li Rui-ping Wang mi Zhou Department of Dermatology Yueyang Hospital of Integrated Traditional Chinese and Western MedicineShanghai University of Traditional Chinese MedicineShanghai 200437China Institute of Dermatology Shanghai Academy of Traditional Chinese MedicineShanghai 201203China Department of Dermatology the Affiliated Hospital of Jiangxi University of Chinese MedicineNanchang 330000Jiangxi ProvinceChina Shanghai Skin Disease Hospital School of MedicineTongji UniversityShanghai 200443China Institute of Dermatology School of MedicineTongji UniversityShanghai 200443China

Background:Acute gouty arthritis(AGA)is an inflammatory joint disease with a high prevalence.Typical medical interventions,including nonsteroidal anti-inflammatory drugs,colchicine and glucocorticoids,can have serious adverse reactions.Huzhang Granule(HZG),a compound Chinese herbal medicine,has been used to treat AGA for more than 30 years with satisfactory effects and no significant adverse reactions.However,the efficacy and safety of HZG in AGA patients remains unknown.Objective:The present investigation was designed to examine the efficacy and safety profile of HZG in managing AGA patients.Design,setting,participants and interventions:The current study was conducted as a noninferiority,randomized controlled clinical trial on 180 eligible enrolled participants.Participants were randomly assigned into the HZG and etoricoxib groups.Treatments were administered for 5 d,during which the HZG group received HZG and placebo etoricoxib,while the etoricoxib group received etoricoxib and placebo HZG in the same ratio(1:1).Main outcome measures:The primary outcome was pain experienced by the patient in the gout-afflicted joint from days 2 to 5 of the treatment window.The pain level was measured via a visual analogue scale,ranging from 0 mm to 100 mm.The secondary outcomes comprised joint tenderness and swelling,reduction of inflammatory biomarkers,and the patient’s and investigator’s global evaluations of therapeutic response.Results:The mean reduction in pain was-51.22 mm(95%confidence interval[CI],[-53.42,-49.03]mm)for the HZG and-52.00 mm(95%CI,[-54.06,-49.94]mm)for the etoricoxib groups.The mean difference between the two groups was 0.78 mm(95%CI,[-2.25,3.81]mm).All additional efficacy endpoints,covering decreased inflammation and pain relief,yielded compelling proof of noninferiority.Patients in the HZG group exhibited a comparatively lower rate of adverse events compared to those in the etoricoxib group(4.44%vs 13.33%;P≤0.05).Conclusion:HZG and etoricoxib groups demonstrated similar levels of analgesic effectiveness

关键词： Acute gouty arthritis Huzhang Granule Randomized controlled trial Blind

Meter-Scale Thin-Walled Structure with Lattice Infill for Fuel Tank Supporting Component of Satellite:Multiscale Design and Experimental Verification

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工程与科学中的计算机建模(英文) 2024年第1期138卷 201-220页

作者： Xiaoyu Zhang Huizhong Zeng Shaohui Zhang Yan Zhang mi Xiao Liping Liu Hao Zhou Hongyou Chai liang Gao Beijing Key Laboratory of Lightweight Multi-Functional Composite Materials and Structures Beijing Institute of TechnologyBeijing100081China Beijing Key Laboratory of Intelligent Space Robotic Systems Technology and Applications Beijing Institute of Spacecraft System EngineeringChina Academy of Space TechnologyBeijing100094China Key Laboratory of Metallurgical Equipment and Control Technology Ministry of EducationWuhan University of Science and TechnologyWuhan430081China State Key Laboratory of Digital Manufacturing Equipment and Technology Huazhong University of Science and TechnologyWuhan430074China

Lightweight thin-walled structures with lattice infill are widely desired in satellite for their high stiffness-to-weight ratio and superior buckling strength resulting fromthe sandwich effect.Such structures can be fabricated bymetallic additive manufacturing technique,such as selective laser melting(SLM).However,the maximum dimensions of actual structures are usually in a sub-meter scale,which results in restrictions on their appliance in aerospace and other fields.In this work,a meter-scale thin-walled structure with lattice infill is designed for the fuel tank supporting component of the satellite by integrating a self-supporting lattice into the thickness optimization of the thin-wall.The designed structure is fabricated by SLM of AlSi10Mg and cold metal transfer welding technique.Quasi-static mechanical tests and vibration tests are both conducted to verify the mechanical strength of the designed large-scale lattice thin-walled structure.The experimental results indicate that themeter-scale thin-walled structure with lattice infill could meet the dimension and lightweight requirements of most spacecrafts.

关键词： Thin-walled structure lattice infill supporting component selective laser melting satellite

Total body water percentage and 3rd space water are novel risk factors for training-related lower extremity muscle injuries in young males

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Chinese Journal of Traumatology 2024年第3期27卷 168-172页

作者： liang Chen Ke-Xing Jin Jing Yang Jun-Jjie Ouyang Han-Gang Chen Si-Ru Zhou Xiao-Qing Luo mi Liu liang Kuang Yang-Li Xie Yan Hu Lin Chen Zhen-Hong Ni Xiao-Lan Du Department of Orthopedic Daping HospitalArmy Medical UniversityChongqing400042China Department of Rehabilitation Medicine Daping HospitalArmy Medical UntiversityChongqing400042China Department of Wound Repair and Rehabilitation Medicine Center of Bone Metabolism and RepairLaboratory for Prevention and Rehabilitation of Training InjuriesState Key Laboratory of Trouma and Chemical Poisoning.Trauma CenterResearch Instiute of SurgeryDaping HospitalArmy Medical UniversityChongqing.400042China War Trouma Medical Center Daping HospitalArmy Medical UniversilyChongqing400042.China Department of military Basic Training and Arny Management Army Health Service Training BaseArmy Medical UniversityChongqing400042China Department of Army Occupational Disease Laboratory for Prevention and Rehabilitation of Training lnjuriesState Key Laboratory of Trauma and Chemical PoisoningResearch Institute of SurgeryDaping HospitalArmy Medical UniversiryChongqing400042.China

Purpose:To identify the risk factors for training-related lower extremity muscle injuries in young males by a non-invasive method of body composition analysis.Methods:A total of 282 healthy young male volunteers aged 18-20 years participated in this cohort study.Injury location,degree,and injury rate were adjusted by a questionnaire based on the overuse injury assessment methods used in epidemiological studies of sports injuries.The occurrence of training injuries is monitored and diagnosed by physicians and treated accordingly.The body composition was measured using the BodyStat QuadScan 4000 multifrequency Bio-impedance system at 5,50,100 and 200 kHz to obtain 4 impedance values.The Shapiro-Wilk test was used to check whether the data conformed to a normal distribution.Data of normal distribution were shown as mean±SD and analyzed by t-test,while those of non-normal distribution were shown as median(Q1,Q3)and analyzed by Wilcoxon rank sum test.The receiver operator characteristic curve and logistic regression analysis were performed to investigate risk factors for developing training-related lower extremity injuries and accuracy.Results:Among the 282 subjects,78(27.7%)developed training injuries.Lower extremity training injuries revealed the highest incidence,accounting for 23.4%(66 cases).These patients showed higher percentages of lean body mass(p=0.001),total body water(TBW,p=0.006),extracellular water(p=0.020)and intracellular water(p=0.010)as well as a larger ratio of basal metabolic rate/total weight(p=0.006),compared with those without lower extremity muscle injuries.On the contrary,the percentage of body fat(p=0.001)and body fat mass index(p=0.002)were lower.Logistic regression analysis showed that TBW percentage>65.35%(p=0.050,odds ratio=3.114)and 3rd space water>0.95%(p=0.045,odds ratio=2.342)were independent risk factors for lower extremity muscle injuries.Conclusion:TBW percentage and 3rd space water measured with bio-impedance method are potential risk factors for predicting the incidence of lower

关键词： Body composition Training injuries Lower extremity Bio-impedance

SARS-CoV-2 breakthrough infections following inactivated vaccine vaccination induce few neutralizing antibodies against the currently emerging Omicron XBB variants

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Virologica Sinica 2024年第1期39卷 173-176页

作者： Fan Shen Chun liang Cui-Xian Yang Ying Lu An-Qi Li Ying Duan mi Zhang c Ren-Rong Tian a Xing-Qi Dong Yong-Tang Zheng Wei Pang Key Laboratory of Bioactive Peptides of Yunnan Province/Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research in Common DiseasesKunming Institute of ZoologyChinese Academy of SciencesKunming650223China University of Chinese Academy of Sciences Beijing100049China Yunnan Provincial Infectious Disease Hospital Kunming650399China Department of Pathogen Biology and Immunology Faculty of Basic Medical ScienceKunming Medical UniversityKunming650500China

Dear Editor,COVID-19 inactivated vaccines have been extensively administered inChina.However,the majority of the Chinese population has experiencedbreakthrough infections from SARS-CoV-2 ancestral,Delta or Omicronvariants over the past three years,particularly during the wave of Omicron BA.5 and BA.7 variants at the end of 2022(Zhu et al.,2023).Subsequently,new Omicron variants,such as BQ.1,BQ.1.1,XBB,XBB.1/XBB.1.9,and XBB.1.5/XBB.1.9.1,are emerging in China(Yueetal.,2023;Zhu et al.,2023).Therefore,it is an urgentneed and a publichealth imperative to assess the extent of the immunoprotection established in this population.

关键词： breakthrough neutral Omi

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法理学视阈下的生态文明法治

云南民族大学学报（哲学社会科学版） 2024年第3期41卷 110-118页

作者：米良北京外国语大学法学院北京100089

党的十八大以来,习近平总书记对生态文明建设作出一系列重要论述,提出“人与自然生命共同体”理念,强调人与自然关系在新高度上的辩证统一关系,让人类对人与自然之间关系的认识达到了一个全新的高度。“生态文明”成为我国的治国方略写... 详细信息

党的十八大以来,习近平总书记对生态文明建设作出一系列重要论述,提出“人与自然生命共同体”理念,强调人与自然关系在新高度上的辩证统一关系,让人类对人与自然之间关系的认识达到了一个全新的高度。“生态文明”成为我国的治国方略写进了宪法,标志着“生态法治”成为我国法治一项新的重要内容。“生态法治”已经成为我国法治的一个重要价值理念,成为我国社会主义法治所要追求的目标之一,是我国社会主义法治思想的升级进步。它把此前“保护环境”的制度规范上升到“法理价值”的哲学层面,从而将对我国整个法律体系带来根本性的影响。从法理学的角度阐释“生态法治”,可以丰富我国法学理论的内容,还能为“生态法治”建设提供理论指导。

关键词：法理学生态文明生态法治