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Efficacy and safety of transvaginal mesh repair in a cohort with a minimum of 10-year follow-up

Science China(Life Sciences) 2024年第5期67卷 1061-1068页

作者： Zhibo Zhang Jianbin Guo Weijie Tian Ye Zhang Yuelun Zhang tianshu Sun Jiali Duan Xinmiao Bao Yuan Wang Yang Ye Qianqian Gao Honghui Shi Abraham Nick Morse Juan chen Lan Zhu Departmentof Obstetrics and Gynecology Peking Union MedicalCollege HospitalChinese Academyof Medical Sciences&Peking Union MedicalCollegeNational Clinical Research Center for Obstetricand Gynecologic DiseasesBeijing 100730China Department of Gynecology Guizhou Provincial People’s HospitalMedical College of Guizhou UniversityGuiyang 550002China Department of Obstetrics and Gynecology The First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450000China Medical Research Center Peking Union Medical College HospitalChinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Medical Doctor Program Chinese Academy of Medical Sciences&Peking Union Medical CollegeBeijing 100730China Department of Pathology Peking Union Medical College HospitalBeijing 100730China Tufts University School of Medicine Boston MA 02111USA

Although transvaginal mesh(TVM)repair is no longer used in some countries,long-term outcomes after TVM surgery are of great importance globally.However,reports with follow-up>10 years are limited.Thus,this study aimed to report outcomes in a prospective cohort with at least 10 years of follow-up.Women with stageⅢ–Ⅳsymptomatic prolapse were approached consecutively from 2008 to 2013 at one tertiary hospital.The main outcome measure was symptomatic failure.Secondary outcomes included anatomic failure,recurrence,patient satisfaction,complications,and reoperation.The Kaplan-Meier curve was used to estimate the cumulative failure rate.Of the 121 patients enrolled in the study,103(85.1%)completed a median follow-up of 11 years.The estimated probability rates of symptomatic and anatomic failure were 17.6%and 8.8%in 11 years,respectively.The estimated incidence of symptomatic failure increased by 8.2%between 5 and 11 years;however,the corresponding rate for anatomic failure was 3.7%.The most common complication was vaginal mesh exposure,and its estimated probability increased from 19.3%to 28.4%from 5 to 11 years,respectively.Office trimming resolved 80.0%of vaginal exposures.These patients did not report decreased overall satisfaction.Patients with vaginal mesh exposure requiring>3 office procedures or mesh removal in the operating room(5.8%by 11 years)had lower satisfaction rates(P<0.01)and were defined as having severe mesh exposure.The rates of postoperative pain,reoperation,and Patient Global Impression of Improvement≥2 were 2.5%,3.3%,and 94.2%,respectively.The results of this study implied that TVM treatment gradually increased the symptomatic failure rate but provided durable anatomical support of the vaginal wall.Vaginal mesh exposure was common in women who were largely not sexually active;however,80%of the cases could be managed in the outpatient clinic,which did not affect patient satisfaction.

关键词： complication efficacy long-term follow-up pelvic organ prolapse safety transvaginal mesh

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基于自注意力机制和多尺度输入输出的医学图像分割算法

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计算机科学 2024年第2期51卷 135-141页

作者：丁天舒陈媛媛四川大学计算机学院成都610065

更精细化的糖尿病性视网膜病变眼底图像分割结果,可以更好地辅助医生进行诊断。大规模高分辨率的分割数据集的出现,为更精细化的分割提供了有利条件。基于U-Net的主流分割网络,使用基于局部运算的卷积操作进行像素预测时无法充分挖掘全... 详细信息

更精细化的糖尿病性视网膜病变眼底图像分割结果,可以更好地辅助医生进行诊断。大规模高分辨率的分割数据集的出现,为更精细化的分割提供了有利条件。基于U-Net的主流分割网络,使用基于局部运算的卷积操作进行像素预测时无法充分挖掘全局信息,网络模型采用单输入单输出的结构,难以获取多尺度特征信息。为了最大程度地利用现有的大规模高分辨率的眼底图像病灶分割数据集,实现更精细化的分割,需要设计更好的分割方法。文中基于自注意力机制和多尺度输入输出结构对U-Net进行改造,提出了一种新的分割网络SAM-Net,用自注意力模块代替传统卷积模块,增大网络获取全局信息的能力,引入多尺度输入和多尺度输出结构,使网络更容易获取多尺度特征信息。使用图片切片方法来缩小模型的输入尺寸,防止神经网络模型因为输入图片像素过大而导致训练难度增大。最终在IDRiD数据集和FGADR数据集上进行实验,结果表明,SAM-Net可以达到比其他方法更优的性能。

关键词： U-Net 自注意力机制糖尿病性视网膜病变分割神经网络

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Associations of sleeping patterns and isotemporal substitution of other behavior with the prevalence of CKD in Chinese adults

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Frontiers of Medicine 2024年第2期18卷 303-314页

作者： Yi Ding Xiaoli Xu Zhuojun Xin Qiuyu Cao Jiaojiao Huang Xianglin Wu Yanan Huo Qin Wan Yingfen Qin Ruying Hu Lixin Shi Qing Su Xuefeng Yu Li Yan Guijun Qin Xulei Tang Gang chen Min Xu Tiange Wang Zhiyun Zhao Zhengnan Gao Guixia Wang Feixia Shen Zuojie Luo Li chen Qiang Li Zhen Ye Yinfei Zhang Chao Liu Youmin Wang Tao Yang Huacong Deng Lulu chen tianshu Zeng Jiajun Zhao Yiming Mu Shengli Wu Yuhong chen Jieli Lu Weiqing Wang Guang Ning Yu Xu Yufang Bi Mian Li Department of Endocrine and Metabolic Diseases Shanghai Institute of Endocrine and Metabolic DiseasesRuijin HospitalShanghai Jiao Tong University School of MedicineShanghai200025China Shanghai National Clinical Research Center for Metabolic Diseases Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of ChinaShanghai Key Laboratory for Endocrine TumorState Key Laboratory of Medical GenomicsRuijin HospitalShanghai Jiao Tong University School of MedicineShanghai200025China Jiangxi Provincial People’s Hospital Affiliated to Nanchang UniversityNanchang330000China Department of Endocrinology The Affiliated Hospital of Southwest Medical UniversityLuzhou646000China Department of Endocrinology The First Affiliated Hospital of Guangxi Medical UniversityNanning530000China Zhejiang Provincial Center for Disease Control and Prevention Hangzhou310000China Department of Endocrinology Affiliated Hospital of Guiyang Medical UniversityGuiyang550000China Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai200000China Tongji Hospital Tongji Medical CollegeHuazhong University of Science and TechnologyWuhan430000China Sun Yat-sen Memorial Hospital Sun Yat-sen UniversityGuangzhou510000China Department of Endocrinology The First Affiliated Hospital of Zhengzhou UniversityZhengzhou450000China Department of Endocrinology The First Hospital of Lanzhou UniversityLanzhou730000China Fujian Provincial Hospital Fujian Medical UniversityFuzhou350000China Dalian Municipal Central Hospital Affiliated of Dalian Medical UniversityDalian116000China Department of Endocrinology The First Hospital of Jilin UniversityChangchun130000China Department of Endocrinology The First Affiliated Hospital of Wenzhou Medical UniversityWenzhou325000China Qilu Hospital of Shandong University Jinan250000China Department of Endocrinology The Second Affiliated Hospital of Harbin Medical UniversityHarbin150000China Department of Endocrinology Cen

Studies have found a U-shaped relationship between sleep duration and chronic kidney disease(CKD)risk,but limited research evaluated the association of reallocating excessive sleep to other behavior with CKD.We included 104538 participants from the nationwide cohort of the Risk Evaluation of Cancers in Chinese Diabetic Individuals:A Longitudinal Study,with self-reported time of daily-life behavior.Using isotemporal substitution models,we found that substituting 1 h of sleeping with sitting,walking,or moderate-to-vigorous physical activity was associated with a lower CKD prevalence.Leisure-time physical activity displacement was associated with a greater prevalence reduction than occupational physical activity in working population.In stratified analysis,a lower CKD prevalence related to substitution toward physical activity was found in long sleepers.More pronounced correlations were observed in long sleepers with diabetes than in those with prediabetes,and they benefited from other behavior substitutions toward a more active way.The U-shaped association between sleep duration and CKD prevalence implied the potential effects of insufficient and excessive sleep on the kidneys,in which the pernicious link with oversleep could be reversed by time reallocation to physical activity.The divergence in the predicted effect on CKD following time reallocation to behavior of different domains and intensities and in subpopulations with diverse metabolic statuses underlined the importance of optimizing sleeping patterns and adjusting integral behavioral composition.

关键词： sleep physical activity chronic kidney disease isotemporal substitution behavioral pattern

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Understanding unusually high levels of peroxyacetyl nitrate(PAN) in winter in Urban Jinan,China

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Journal of Environmental Sciences 2018年第9期30卷 249-260页

作者： Lu Liu Xinfeng Wang Jianmin chen Likun Xue Wenxing Wang Liang Wen Dandan Li tianshu chen Environment Research Institute School of Environmental Science and EngineeringShandong University Shanghai Key Laboratory of Atmospheric Particle Pollution and Prevention Department of Environmental Science and EngineeringInstitute of Atmospheric SciencesFudan University Institute for Climate and Global Change Research School of Atmospheric SciencesNanjing University

Peroxyacetyl nitrate （PAN）, as a major secondary pollutant, has gained increasing worldwide attentions, but relevant studies in China are still quite limited. During winter of 2015 to summer of 2016, the ambient levels of PAN were measured continuously by an automatic gas chromatograph equipped with an electron capture detector （GC-ECD） analyzer at an urban site in Jinan （China）, with related parameters including concentrations of 03, NO, NO2, PM2.5, HONO, the photolysis rate constant of NO2 and meteorological factors observed concurrently. The mean and maximum values of PAN concentration were （1.89 ± 1.42） and 9.61 ppbv respectively in winter, and （2.54 ± 1.44） and 13.47 ppbv respectively in summer. Unusually high levels of PAN were observed during severe haze episodes in winter, and the formation mechanisms of them were emphatically discussed, Study showed that high levels of PAN in winter were mainly caused by local accumulation and strong photochemical reactions during haze episodes, while mass transport played only a minor role. Accelerated photochemical reactions （compared to winter days without haze） during haze episodes were deduced by the higher concentrations but shorter lifetimes of pAN, which was further supported by the sufficient solar radiation in the photolysis band along with the high concentrations of precursors （NO2, VOCs） and HONO during haze episodes. In addition, significant PAN accumulation during calm weather of haze episodes was verified by meteorological data.

关键词： Peroxyacetyl nitrate Winter Haze episodes North China Plain

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Dual-enzyme-propelled unbounded DNA walking nanomachine for intracellular imaging of lowly expressed microRNA

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Nano Research 2019年第5期12卷 1055-1060页

作者： tianshu chen Yaoyao chen Huinan chen Fan Zhang Qianqian Zhang Guifang chen Xiaoli Zhu Center for Molecular Recognition and Biosensing School of Life SciencesShanghai UniversityShanghai 200444China Institute of Biomedical Engineering School of Communication and Information EngineeringShanghai UniversityShanghai 200444China Department of Bioengineering University of WashingtonSeattleWA 98195USA

Despite the progress on the analysis of miRNA either in vitro or in vivo,intracellular imaging of lowly expressed microRNA remains a challenge.Here we develop a novel dual-enzyme-propelled DNA walking nanomachine,which is tailored to accomplish this mission.The nanomachine is constructed with nanoparticles-loaded DNA tracks,on which the targeted miRNA working as a single-foot DNA walker can move autonomously under the catalysis of two cooperative enzymes.Cleavage of the DNA tracks like a "burnt-bridge" mechanism is thereafter triggered,resulting in an amplified fluorescent signal.After the comprehensive study and optimization of the DNA nanomachine,miR-892b,a significantly down-regulated miRNA in breast cancer cells,is selected as a model target.Sensitivity detection in vitro is achieved with a superior detection limit of 4 pM.While being delivered into cells,the DNA nanomachine is available for the imaging of the lowly expressed microRNA,which is totally missing using the conventional fluorescence in situ hybridization (FISH) method.Up-regulation or down-regulation of the miRNA by exogenous regulatory factors can be also well evaluated.This DNA nanomachine provides a competitive approach for the analysis of miRNA,and has the potential to be extended to some other biomolecules.

关键词： DNA walker nanomachine microRNA nanoparticles imaging analysis

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基于故障行波差异性的柔性直流输电线路纵联保护

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中国电机工程学报 2024年第7期44卷 2616-2627,I0009页

作者：贾科姚昆鹏刘子奕陈淼李再男毕天姝新能源电力系统国家重点实验室(华北电力大学) 北京市昌平区102206 国网天津市电力公司高压分公司天津市河北区300232

柔性直流输电对解决大规模新能源的消纳问题具有重要意义,其中行波保护是保障系统安全的关键。然而采用行波幅值比较判据区内外故障的保护对故障前、反行波幅值关系分析并不严谨,行波反射关系式仅在复频域下成立,若将此关系推广到时域... 详细信息

柔性直流输电对解决大规模新能源的消纳问题具有重要意义,其中行波保护是保障系统安全的关键。然而采用行波幅值比较判据区内外故障的保护对故障前、反行波幅值关系分析并不严谨,行波反射关系式仅在复频域下成立,若将此关系推广到时域中可能影响保护的动作性能,给系统安全埋下隐患。针对这一问题,该文首先从理论上分析行波幅值比较式方向纵联保护的不足,并从区内故障验证出保护失效的边界。为具体揭示故障前、反行波的差异性,该文定量分析电压反行波与电流行波在一定时间内的极性,进而提出一种采用多点均值的电压行波方向识别判据并构成纵联保护。大量仿真结果表明,所提保护能够快速、可靠地识别线路区内外故障,具有较强的耐受过渡电阻能力与抗干扰能力。

关键词：柔性直流输电行波差异性多点均值纵联保护

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Visualized and cascade-enhanced gene silencing by smart DNAzyme-graphene nanocomplex

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Nano Research 2020年第8期13卷 2165-2174页

作者： Lingjie Ren Xiaoxia chen Chang Feng Lei Ding Xiaomin Liu tianshu chen Fan Zhang Yanli Li Zhongliang Ma Bo Tian Xiaoli Zhu Center for Molecular Recognition and Biosensing School of Life SciencesShanghai UniversityShanghai200444China School of Medical Shanghai UniversityShanghai200444China Lab for Noncoding RNA and Cancer School of Life SciencesShanghai UniversityShanghai200444China State Key Laboratory of Oncogenes and Related Genes Shanghai Cancer InstituteRen Ji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai200032China

BCL-2 gene as well as its products is recognized as a promising target for the molecular targeted therapy of tumors.However,due to certain defense measures of tumor cells,the therapeutic effect based on the gene silencing of BCL-2 is greatly reduced.Here we fabricate a smart response nucleic acid therapeutic that could silence the gene effectively through a dual-targeted and cascade-enhanced strategy.In brief,nano-graphene oxide(GO),working as a nano-carrier,is loaded with a well-designed DNAzyme,which can target and silence the BCL-2 mRNA.Furthermore,upon binding with the BCL-2 mRNA,the enzymatic activity of the DNAzyme can be initiated,cutting a substrate oligonucleotide to produce an anti-nucleolin aptamer AS1411.Nucleolin,a nucleolar phosphoprotein,is known as a stabilizer of BCL-2 mRNA.Via binding and inactivating the nucleolin,AS1411 can destabilize BCL-2 mRNA.By this means of simultaneously targeting mRNA and its stabilizer in an integrated system,effective silencing of the BCL-2 gene of tumor cells is achieved at both the cellular and in vivo levels.After being dosed with this nucleic acid therapeutic and without any chemotherapeutics,apoptosis of tumor cells at the cellular level and apparent shrinkage of tumors in vivo are observed.By labeling a molecular beacon on the substrate of DNAzyme,visualization of the enzymatic activity as well as the tumor in vivo can be also achieved.Our work presents a pure bio-therapeutic strategy that has positive implications for enhancing tumor treatment and avoiding side effects of chemotherapeutics.

关键词： BCL-2 gene gene silencing DNAzyme graphene oxide AS1411

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行为改变技术分类法第一版(BCTTv1)汉化及应用

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中华行为医学与脑科学杂志 2024年第2期33卷 172-176页

作者：仲学锋陈天舒王筱婷安徽医科大学卫生管理学院合肥230032 Centre for Behaviour Change University College LondonLondon WC1E 7HB

行为改变技术分类法第一版(behavior change techniques taxonomy v1, BCTTv1)是使用最广泛的行为改变技术分类, 它提供了一系列共享的、标准化的术语来识别行为干预的有效成分。本文对BCTTv1进行翻译汉化, 形成BCTTv1汉化版。BCTTv1由9... 详细信息

行为改变技术分类法第一版(behavior change techniques taxonomy v1, BCTTv1)是使用最广泛的行为改变技术分类, 它提供了一系列共享的、标准化的术语来识别行为干预的有效成分。本文对BCTTv1进行翻译汉化, 形成BCTTv1汉化版。BCTTv1由93个行为改变技术组成, 按层次结构分为16组, 每组包含3~11个行为改变技术, 并对每项行为改变技术进行命名、定义、解释和举例。本文还简述行为改变技术在行为干预研究中的应用, 为推动行为改变干预方法和技术在中国的应用和推广提供参考依据。

关键词：行为改变技术分类法研究汉化应用

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地震和高铁共同作用下桩网复合地基振动特性

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噪声与振动控制 2024年第1期44卷 7-14页

作者：高广运潘天舒耿建龙陈少杰同济大学地下建筑工程系上海200092 同济大学岩土及地下工程教育部重点实验室上海200092

为研究地震和高铁列车荷载共同作用下桩网复合地基振动特性,通过建立轨道-路堤-桩网复合地基三维有限元计算模型,分别与实测数据和一维波动理论对比验证模型的正确性。通过对比不同荷载工况下地面位移和加速度时频振动曲线,分析地震和... 详细信息

为研究地震和高铁列车荷载共同作用下桩网复合地基振动特性,通过建立轨道-路堤-桩网复合地基三维有限元计算模型,分别与实测数据和一维波动理论对比验证模型的正确性。通过对比不同荷载工况下地面位移和加速度时频振动曲线,分析地震和高铁两动载共同作用时不同车速下桩网复合地基时频振动特性,研究桩体模量对桩网复合地基减震效果的影响。研究表明,Hollister地震荷载和高铁荷载共同作用下,距轨道中心1 m处地面振动位移由地震荷载主导,地面振动加速度由列车荷载主导;20 Hz以下地面低频振动由高铁和地震荷载共同控制,地面高频振动主要由列车荷载控制。Lytle Creek地震荷载和高铁荷载共同作用下,桩网复合地基地面振动位移和加速度峰值均大于高铁荷载单独作用下的值;增加桩体模量对高铁荷载单独作用和两动载共同作用下桩网复合地基地面振动均有减振效果,但两动载共同作用下增加桩体模量对地面减振效果比高铁荷载单独作用下弱。

关键词：振动与波地震荷载高铁荷载桩网复合地基桩体模量地面振动

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基于XGBoost-SHAP模型的太湖流域居民生态补偿支付意愿影响因素研究

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水利经济 2024年第2期42卷 44-50页

作者：邓梦华张天舒陈军飞河海大学商学院江苏南京211100 河海大学江苏长江保护与高质量发展研究基地江苏南京210098 常州市工业大数据挖掘与知识管理重点实验室江苏常州213200

在对太湖流域居民生态补偿支付意愿调查的基础上,基于可解释机器学习模型XGBoost-SHAP分析了居民生态补偿支付意愿的影响因素,并比较了有支付意愿和没有支付意愿居民之间影响因素的差异。结果表明:影响太湖流域居民生态补偿支付意愿最... 详细信息

在对太湖流域居民生态补偿支付意愿调查的基础上,基于可解释机器学习模型XGBoost-SHAP分析了居民生态补偿支付意愿的影响因素,并比较了有支付意愿和没有支付意愿居民之间影响因素的差异。结果表明:影响太湖流域居民生态补偿支付意愿最重要的3个因素为学历、收入和生态环境保护意愿;单个居民之间的支付意愿影响因素呈现一定的差异,尤其是有支付意愿和没有支付意愿居民之间的影响因素差异显著;总体而言,增强居民生态环境保护意识和加大生态补偿政策的宣传可以提升流域居民参与生态补偿的意愿。

关键词：生态补偿支付意愿 XGBoost SHAP 可解释机器学习太湖流域

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