Search

Objective. To analyze the interaction of positive coping style and quality of life (QoL) between survivors of pancreatic cancer and their family caregivers based on the Conceptual Framework of Caring Experience of Cancer Family and Actor-Partner Interdependence Model (APIM). Methods. This study adopted a cross-sectional design that selected 200 pairs of survivors of pancreatic cancer and their family caregivers hospitalized in the First and Second Affiliated Hospitals of Nanjing Medical University from August 2020 to February 2021. Survivors of pancreatic cancer and their family caregivers completed Simple Coping Style Questionnaire and 12-item Short-Form Health Survey, whose results successfully built an APIM model. Results. The spousal relationship was the most common type of dyadic relationship. Family caregivers had higher levels of positive coping and QoL than cancer survivors. In terms of actor effects, the positive coping style of both survivors and caregivers significantly affected individual total scores of QoL and personal physical and psychological dimensions of QoL. As for the partner effects, the positive coping style of both survivors and caregivers significantly impacted their partners' total QoL scores and the positive coping style of survivors significantly impacted their caregivers' psychological level of QoL. Conclusions. The positive coping style of survivors of pancreatic cancer affects both their own QoL and their partner's QoL. Examining mutual effects between coping styles and QoL among survivors and their informal caregivers is an essential first step in providing comprehensive and cooperative care. The study has been reviewed by the Chinese Clinical Trial Registry, and registration information has been sent to the central database of the World Health Organization International Clinical Trial Registration Platform for global retrieval. This trial is registered with ChiCTR2300074087. [ABSTRACT FROM AUTHOR]

Using deep learning-based object detection algorithms for landslide hazards detection is very popular and effective. However, most existing algorithms are designed for landslides in a specific geographical range. This paper constructs a set of landslide detection models YOLOX-Pro, based on the improved YOLOX (You Only Look Once) target detection model to address the poor detection of complex mixed landslides. Wherein the VariFocal is used to replace the binary cross entropy in the original classification loss function to solve the uneven distribution of landslide samples and improve the detection recall; the coordinate attention (CA) mechanism is added to enhance the detection accuracy. Firstly, 1200 historical landslide optical remote sensing images in thirty-eight areas of China were extracted from Google Earth to create a mixed sample set for landslide detection. Next, the three attention mechanisms were compared to form the YOLOX-Pro model. Then, we tested the performance of YOLOX-Pro by comparing it with four models: YOLOX, YOLOv5, Faster R-CNN, and Single Shot MultiBox Detector (SSD). The results show that the YOLOX-Pro(m) has significantly improved the detection accuracy of complex and small landslides than the other models, with an average precision (AP0.75) of 51.5%, APsmall of 36.50%, and ARsmall of 49.50%. In addition, optical remote sensing images of a 12.32 km 2 group-occurring landslides area located in Mibei village, Longchuan County, Guangdong, China, and 750 Unmanned Aerial Vehicle (UAV) images collected from the Internet were also used for landslide detection. The research results proved that the proposed method has strong generalization and good detection performance for many types of landslides, which provide a technical reference for the broad application of landslide detection using UAV. [ABSTRACT FROM AUTHOR]

Background: Different levels of telemedicine systems have been built across China. To share high-quality medical resources and conduct centralized management of telemedicine systems, a regional telemedicine system (RTS) (such as a provincial level system) has been developed to integrate with small-scale telemedicine systems. Although the established systems offer integration services, they are tightly coupled systems, and not easily integrated with new systems. Meanwhile, with the increasing of input/output, it is difficult for them to run with high scalability, considering the cost of architecture redesign and further development. This article presents the design and implementation of regional integration system through a study in Henan, China, mainly aimed to integrate with heterogeneous small-scale telemedicine systems and provide high efficiency. Methods: A provincial telemedicine system and some city-level telemedicine systems have already been established. The provincial system has been built to act as a regional integration system to connect city-level systems. Adopting message-based technology, the provincial system achieves high availability and high scalability, respectively, through LevelDB + ZooKeeper and multicast. Results: The system achieved the centralized management of established telemedicine systems without restructuring their framework, improving high availability of RTS when one ActiveMQ service node in a group failed, and it did not negatively influence normal business logic when adding a new service node. At the same time, two "Master" state ActiveMQ service nodes provided services simultaneously, which enable the RTS to achieve high scalability. Conclusions: The message-based regional integration system enriched the RTS with high availability, easy extensibility, and provided a convenient way to integrate new small-scale telemedicine systems. [ABSTRACT FROM AUTHOR]

Air pollution contributes substantially to global health burdens; however, less is known about pollution patterns in China and whether they differ from those elsewhere. We evaluated temporal and spatial heterogeneity of air pollution in Lanzhou, an urban Chinese city (April 2009-December 2012), and conducted a systematic review of literature on air pollution and health in Lanzhou. Average levels were 141.5, 42.3, and 47.2 μg/m for particulate matter with an aerodynamic diameter ≤10 μm (PM), NO, and SO, respectively. Findings suggest some seasonality, particularly for SO, with higher concentrations during colder months relative to warmer months, although a longer time frame of data is needed to evaluate seasonality fully. Correlation coefficients generally declined with distance between monitors, while coefficients of divergence increased with distance. However, these trends were not statistically significant. PM levels exceeded Chinese and other health-based standards and guidelines. The review identified 13 studies on outdoor air pollution and health. Although limited, the studies indicate that air pollution is associated with increased risk of health outcomes in Lanzhou. These studies and the high air pollution levels suggest potentially serious health consequences. Findings can provide guidance to future epidemiological studies, monitor placement programs, and air quality policies. [ABSTRACT FROM AUTHOR]

This article examines developments in the legal framework intended to entrench and protect equal rights for women. The author then considers the reasons, legal and practical, why the ideals set out in the legislation fail far short in practice. The author also discusses a practical program in which she has been involved that has been undertaken to educate citizens and officials at the local level about accepting and, more important, embracing the principles set out in the Law of the PRC on the Protection of the Rights and Interests of Women. [ABSTRACT FROM AUTHOR]

Naoqingzhiming, whose active ingredient is echinacoside, is the first new Class I natural medicine approved for clinical trials for the therapeutic potential of vascular dementia in China. We report randomized, double-blind, placebo-controlled trials to evaluate the safety, tolerability and pharmacokinetics of single ascending doses of Naoqingzhiming tablet after oral administration in healthy Chinese subjects. The single ascending dose of Naoqingzhiming tablet (180–2160 mg) were well tolerated in all enrolled subjects, without serious adverse events and adverse events leading to withdrawal from the study. The most common drug-related treatment-emergent adverse events were elevated blood bilirubin and serum uric acid. No clinically significant findings were found in the physical examinations, vital signs or electrocardiograms. After single-dose administration of Naoqingzhiming tablet, echinacoside was absorbed with a T max at 1.25–1.75 h and declined with a t 1/2 of 2.42–3.33 h. However, the proportionality coefficients for C max , AUC 0−t and AUC 0-∞ of echinacoside were not fully contained in the pre-defined 90 % CI criterion (0.91–1.09). As a result, the dose proportionality could not be concluded statistically within the dosage range of this study. Overall, the safety profile and PK properties support further development and use of Naoqingzhiming in vascular dementia. • Naoqingzhiming, a new Class I natural medicine, has therapeutic potential for VaD. • Naoqingzhiming was generally well tolerated during the single ascending dose period. • Safety and PK properties of Naoqingzhiming support its further clinical trials. [ABSTRACT FROM AUTHOR]

Objective: To assess the safety and efficacy of antimicrobial peptide PL-5 (Peceleganan) spray in the treatment of wound infections., Background: Antimicrobial peptide PL-5 spray is a novel topical antimicrobial agent., Methods: We conducted a multicenter, open-label, randomized, controlled phase IIb clinical trial to evaluate the efficacy and safety of PL-5 spray, as compared with silver sulfadiazine, in patients with skin wound infections. The primary efficacy outcome was the clinical efficacy rate on the first day after ending the treatment (D8). The secondary efficacy outcome was the clinical efficacy rate on the fifth day posttreatment (D5), the bacteria clearance rate, and the overall efficacy rate at the mentioned 2 time points. The safety outcomes included adverse reactions and pharmacokinetic analysis posttreatment., Results: A total of 220 patients from 27 hospitals in China were randomly assigned to 4 groups. On D8, the efficacy rate was 100.0%, 96.7%, 96.7% for the 1‰ PL-5, 2‰ PL-5, 4‰ PL-5 groups, respectively, as compared with 87.5% for the control group. The efficacy rate among the 4 groups was significantly different ( P <0.05). On D5, the efficacy rate was 100.0%, 93.4%, 98.3% for the 1‰ PL-5, 2‰ PL-5, 4‰ PL-5 groups, respectively, as compared with 82.5% for the control group. The efficacy rate among the 4 groups was significantly different ( P <0.05). The blood concentration of PL-5 was not detectable in pharmacokinetic analysis. No severe adverse event related to the application of PL-5 was reported., Conclusions: Antimicrobial peptide PL-5 spray is safe and effective for the treatment of skin wound infections., Trial Registration: ChiCTR2000033334., Competing Interests: The authors report no conflicts of interest., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc.)

Background: China has a high burden of hepatocellular carcinoma, and hepatitis B virus (HBV) infection is the main causative factor. Patients with hepatocellular carcinoma have a poor prognosis and a substantial unmet clinical need. The phase 2-3 ORIENT-32 study aimed to assess sintilimab (a PD-1 inhibitor) plus IBI305, a bevacizumab biosimilar, versus sorafenib as a first-line treatment for unresectable HBV-associated hepatocellular carcinoma., Methods: This randomised, open-label, phase 2-3 study was done at 50 clinical sites in China. Patients aged 18 years or older with histologically or cytologically diagnosed or clinically confirmed unresectable or metastatic hepatocellular carcinoma, no previous systemic treatment, and a baseline Eastern Cooperative Oncology Group (ECOG) performance status of 0 or 1 were eligible for inclusion. In the phase 2 part of the study, patients received intravenous sintilimab (200 mg every 3 weeks) plus intravenous IBI305 (15 mg/kg every 3 weeks). In the phase 3 part, patients were randomly assigned (2:1) to receive either sintilimab plus IBI305 (sintilimab-bevacizumab biosimilar group) or sorafenib (400 mg orally twice daily; sorafenib group), until disease progression or unacceptable toxicity. Randomisation was done using permuted block randomisation, with a block size of six, via an interactive web response system, and stratified by macrovascular invasion or extrahepatic metastasis, baseline α-fetoprotein, and ECOG performance status. The primary endpoint of the phase 2 part of the study was safety, assessed in all patients who received at least one dose of study drug. The co-primary endpoints of the phase 3 part of the study were overall survival and independent radiological review committee (IRRC)-assessed progression-free survival according to Response Evaluation Criteria in Solid Tumors (RECIST) version 1.1 in the intention-to-treat population. The study is registered with ClinicalTrials.gov, NCT03794440. The study is closed to new participants and follow-up is ongoing for long-term outcomes., Findings: Between Feb 11, 2019 and Jan 15, 2020, we enrolled 595 patients: 24 were enrolled directly into the phase 2 safety run-in and 571 were randomly assigned to sintilimab-bevacizumab biosimilar (n=380) or sorafenib (n=191). In the phase 2 part of the trial, 24 patients received at least one dose of the study drug, with an objective response rate of 25·0% (95% CI 9·8-46·7). Based on the preliminary safety and activity data of the phase 2 part, in which grade 3 or worse treatment-related adverse events occurred in seven (29%) of 24 patients, the randomised phase 3 part was started. At data cutoff (Aug 15, 2020), the median follow-up was 10·0 months (IQR 8·5-11·7) in the sintilimab-bevacizumab biosimilar group and 10·0 months (8·4-11·7) in the sorafenib group. Patients in the sintilimab-bevacizumab biosimilar group had a significantly longer IRRC-assessed median progression-free survival (4·6 months [95% CI 4·1-5·7]) than did patients in the sorafenib group (2·8 months [2·7-3·2]; stratified hazard ratio [HR] 0·56, 95% CI 0·46-0·70; p<0·0001). In the first interim analysis of overall survival, sintilimab-bevacizumab biosimilar showed a significantly longer overall survival than did sorafenib (median not reached [95% CI not reached-not reached] vs 10·4 months [8·5-not reached]; HR 0·57, 95% CI 0·43-0·75; p<0·0001). The most common grade 3-4 treatment-emergent adverse events were hypertension (55 [14%] of 380 patients in the sintilimab-bevacizumab biosimilar group vs 11 [6%] of 185 patients in the sorafenib group) and palmar-plantar erythrodysaesthesia syndrome (none vs 22 [12%]). 123 (32%) patients in the sintilimab-bevacizumab biosimilar group and 36 (19%) patients in the sorafenib group had serious adverse events. Treatment-related adverse events that led to death occurred in six (2%) patients in the sintilimab-bevacizumab biosimilar group (one patient with abnormal liver function, one patient with both hepatic failure and gastrointestinal haemorrhage, one patient with interstitial lung disease, one patient with both hepatic faliure and hyperkalemia, one patient with upper gastrointestinal haemorrhage, and one patient with intestinal volvulus) and two (1%) patients in the sorafenib group (one patient with gastrointestinal haemorrhage and one patient with death of unknown cause)., Interpretation: Sintilimab plus IBI305 showed a significant overall survival and progression-free survival benefit versus sorafenib in the first-line setting for Chinese patients with unresectable, HBV-associated hepatocellular carcinoma, with an acceptable safety profile. This combination regimen could provide a novel treatment option for such patients., Funding: Innovent Biologics., Translation: For the Chinese translation of the abstract see Supplementary Materials section., Competing Interests: Declaration of interests ZR has received honoraria as an advisor from Innovent Biologics, AstraZeneca, F Hoffmann-La Roche, and Merck Sharp & Dohme. YY, MC, YW. and HZ are employees of Innovent Biologics. All other authors declare no competing interests., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: Different levels of telemedicine systems have been built across China. To share high-quality medical resources and conduct centralized management of telemedicine systems, a regional telemedicine system (RTS) (such as a provincial level system) has been developed to integrate with small-scale telemedicine systems. Although the established systems offer integration services, they are tightly coupled systems, and not easily integrated with new systems. Meanwhile, with the increasing of input/output, it is difficult for them to run with high scalability, considering the cost of architecture redesign and further development. This article presents the design and implementation of regional integration system through a study in Henan, China, mainly aimed to integrate with heterogeneous small-scale telemedicine systems and provide high efficiency., Methods: A provincial telemedicine system and some city-level telemedicine systems have already been established. The provincial system has been built to act as a regional integration system to connect city-level systems. Adopting message-based technology, the provincial system achieves high availability and high scalability, respectively, through LevelDB + ZooKeeper and multicast., Results: The system achieved the centralized management of established telemedicine systems without restructuring their framework, improving high availability of RTS when one ActiveMQ service node in a group failed, and it did not negatively influence normal business logic when adding a new service node. At the same time, two "Master" state ActiveMQ service nodes provided services simultaneously, which enable the RTS to achieve high scalability., Conclusions: The message-based regional integration system enriched the RTS with high availability, easy extensibility, and provided a convenient way to integrate new small-scale telemedicine systems.

In order to analyze the major factors contributing to malnutrition of children aged under five at 40 inspective spots, a cluster method was used and four patterns were set up in this study. Multiple logistic regression was applied in each pattern to identify the most important factor. The results showed that the problem of child malnutrition in urban areas has been solved, but the problem in rural is still severe. The attributable risk of education level of mother, breast feeding and water supply were the major factors contributing to the nutrition status of children and therefore, the synthetical measures should be take for improving the nutrition status of children.