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Understanding the spatial distribution of dead pine trees (DPTs) in mountainous areas is vital for diseased wood cleanup and the prediction of pine wilt disease. The study induced a deep learning (...

Isosorbide-5-mononitrate (5-ISMN), an organic nitrate vasodilator, has been widely used worldwide to prevent angina pectoris for more than two decades. A simple and sensitive high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS/MS) method was developed and validated for the determination of 5-ISMN in human plasma. 13C6-5-ISMN is an internal standard, and 5-ISMN was extracted from human plasma (50 µL) with ethyl acetate (200 µL) by a simple liquid-liquid extraction method. The chromatographic separation was carried out on LC-20A (Shimadzu, Japan) using an analytical column ZORBAX XDB-C18 (4.6 × 50 mm, 5 µm), coupled with API 4000 tandem mass spectrometers in a multiple reaction monitoring (MRM) mode. The mobile phase was composed of acetonitrile (organic phase A) and 2 mM ammonium acetate in water (aqueous phase B) with an isocratic elution of A/B = 90 : 10 (v/v). The total run time was 3.5 min with a small injection volume (5 µL). This method was fully validated in every aspect of selectivity, linearity, accuracy, precision, matrix effect, extraction recovery, and different stabilities. It was proved that the calibration standards within the 5.00–1000 ng/mL concentration range were linear. The lower limit of quantification was 5.00 ng/mL for 5-ISMN. The intrabatch and interbatch accuracy (RE) ranged from −8.8% to 7.1% with precision between 2.4% and 6.6%. The mean values of 5-ISMN extraction recovery and matrix effect were 87.0% and 102.0%, respectively. The fully validated method was successfully applied for a bioequivalence clinical trial of oral 20 mg 5-ISMN tablets in healthy Chinese subjects.

Proton pump inhibitors (PPIs) are the main drugs for the treatment of reflux esophagitis. Previous studies have indicated ilaprazole to be safer and more effective in treating duodenal ulcers as compared with omeprazole. Being a novel PPI, ilaprazole may be used in the treatment of reflux esophagitis. The purpose of this study was to evaluate the safety and efficacy of ilaprazole tablets in the treatment of reflux esophagitis. This study used a randomized, double-blind, multi-center, active-comparison design. The patients were randomly divided into an ilaprazole group (10 mg once daily and 15 mg once daily) and an esomeprazole group (40 mg once daily). Both the groups were treated for 8 weeks. Heartburn and reflux symptoms prior to treatment, and 4 and 8 weeks after the treatment were assessed. Gastroscopy was performed after 4 and 8 weeks. The healing rate after 4 weeks treatment was compared. If esophagitis was healed at the end of 4 weeks, patients did not undergo gastroscopy at the end of 8 weeks. Three hundred and twenty-five patients were enrolled in this study. The 4-week full analysis set (per-protocol set) healing rates in the esomeprazole 40-mg group, the ilaprazole 10-mg group, and the ilaprazole 15-mg group were: 71.43 % (78.89 %), 81.31 % (86.73 %), and 71.70 % (81.40 %), respectively, p = 0.1595 (0.4122); the 8-week healing rates were 84.76 % (93.33 %), 88.79 % (94.90 %), and 85.85 % (97.67 %), respectively, p = 0.6689 (0.4049). Drug-related adverse events rate were 10.48 %, 14.02 %, and 15.09 %, respectively, in the three groups (p = 0.6114). The efficacy and safety of ilaprazole (10 mg/day, 15 mg/day) in treating reflux esophagitis was similar to esomeprazole (40 mg/day). Ilaprazole (10 mg/day) has a smaller dosage, hence it should be considered more in clinical uses. Trial registration: ClinicalTrials.gov NCT01107938.

Ilaprazole is a novel proton pump inhibitor that provides effective and long lasting inhibition of intragastric acid secretion. The objectives of this study were to investigate the pharmacokinetics, pharmacodynamics, and safety of intravenous ilaprazole after multiple administrations in healthy Chinese subjects. This was an open-label and multiple-dose clinical study. Ten healthy Chinese subjects received 10 mg ilaprazole infusion once daily for 5 days. Helicobacter pylori status was examined. Blood samples were collected and intragastric pH was recorded for 24 h. Safety was assessed throughout the study. There was no accumulation after multiple administrations. The mean steady-state half-life and clearance were comparable to those following single administration. Ilaprazole provided sustainable and significant intragastric pH control in terms of percentage time at pH >4, pH >6 within 24 h and mean 24-h pH values. The pH value within 24 h was affected by Helicobacter pylori infection in subjects with continuous infusion. Intravenous ilaprazole was safe and there were no serious adverse events. Intravenous ilaprazole provided stable pharmacokinetics and pharmacodynamics at a dose of 10 mg once daily for 5 days, and was well tolerated in healthy subjects.

OBJECTIVE: To explore the value of baseline serum alkaline phosphatase (ALP) for predicting 2-year fracture in patients with chronic kidney disease (CKD) on maintenance dialysis. METHODS: A total of 139 patients with CKD undergoing maintenance dialysis in our hospital were enrolled in this study. According to the median serum ALP level, the patients were divided into high ALP and low ALP groups. The demographic and clinical data of the patients including dialysis duration, serum calcium level, serum phosphorus level, and serum intact parathyroid hormone level were recorded, and their bone mineral density of the femur and the lumbar spine was measured using dual energy X-ray absorptiometry. The patients were followed up for 2 years and fracture events were recorded. The risk factors of fracture were analyzed using logistic regression analysis, and their predictive value for fracture was analyzed using receiver-operating characteristic (ROC) curve. RESULTS: The mean baseline serum ALP level was 132.55±167.68 U/L in these patients, significantly higher than that in the normal population (t=2.816, P=0.006). Baseline serum ALP level was negatively correlated with the bone mineral density of the lumbar spine (r=-0.203, P=0.006) and the femur (r=-0.196, P=0.021). Fractures occurred in 21 (15.1%) of the patients during the 2-year follow-up, and the fracture rate was significantly higher in patients with high ALP levels. Logistic regression analysis identified serum ALP level as an independent risk factor of fracture (OR: 1.010, P=0.001, 95%CI: 1.004-1.016). The areas under the ROC curve were 0.900 and 0.768 for serum ALP level and intact parathyroid hormone level in predicting 2-year fractures, respectively. CONCLUSION: Serum ALP may serve as a good indicator for predicting 2-year fractures in patients with CKD on maintenance dialysis.

Laparoscopic experience and relevant reports about PD catheter emplacement in Chinese patients are seldom. In this study, we described our experience with advanced laparoscopy for PD catheter implantation in Chinese patients. There were one hundred and thirty Chinese patients accepted advanced laparoscopic approach for PD catheter emplacement in this study. Six of 26 patients with prior abdominal operations had abdominal adhesion, while six of 104 patients without prior abdominal surgeries showed abdominal adhesion. Operation time required 10 to 180 minutes. During a mean follow-up time of 26.46 months, the catheter complications were shown as outflow obstruction (n = 6, 4.62%), pericatheter leaking (n = 3, 2.31%), hydrocele of tunica vaginalis (n = 1, 0.77% in all), and umbilical hernia (n = 2, 1.54%). Cumulative revision-free survival probability for catheter loss from mechanical complications at 8 years was 0.95. During the postoperative follow-up ranged between 6 and 106 months, 98 patients (75.38%) were still on CAPD, 17 patients (13.08%) died, 8 patients (6.15%) were transferred to hemodialysis, 6 patients (4.62%) received kidney transplantation, and 1 patient (0.77%) showed improved renal function. These results showed that PD catheter placement with advanced laparoscopy is a safe and effective approach in Chinese patients with or without prior abdominal surgeries.

The concept of ecosystem services (ES) has become mainstreamed in environmental planning and management recently, and with that various tools for quantifying ecosystem services have emerged. However, designing the tools for integrated assessment and optimization of multiple ES has become a challenging task. In order to promote the efficiency of ecosystem planning and management, we develop a spatial decision support tool named SAORES, which provides a platform for exploratory scenario analysis and optimal planning design, rather than ES assessment. SAORES is formed with four modules: the scenario development module, the integrated ecosystem service model base, the ecosystem service trade-off analysis module, and the multi-objective spatial optimization module based on NSGA-II. Using SAORES, we make a case study on the Yangou catchment of the Loess Plateau, China. Based on impact assessment of the Grain to green program (GTGP), we optimize the farmland retiring planning, involving multiple objectives which include the eco-compensation and the key ES. The integrated assessment shows that, the aim of the GTGP, the water and soil retention are prominent improved. Optimization for GTGP provides a series of optimal solutions, which are better than other single optimized solutions, and are twice the cost-effectiveness of the actual situation. SAORES, as a decision support tool, can improve the scenario analysis and multi-objective optimal planning design for ecosystem management and planning. The case study demonstrates the potential and effectiveness of SAORES and spatial multi-objective optimization model for ecosystem service management, especially in the Loess Plateau.

Aim Angiotensin receptor antagonists (ARBs) and anti-oxidants reduce urinary protein excretion and delay progression of immunoglobulin A (IgA) nephropathy. We investigated the efficacy and safety of probucol (an anti-oxidant) combined with valsartan (an ARB) on the progression of IgA nephropathy. Methods Patients with IgA nephropathy (n = 69) were recruited from five centres and randomly assigned to a treatment group (750 mg/day probucol plus 160 mg/day valsartan) or a control group (160 mg/day valsartan) and were followed for 3 years. Results At baseline, the two groups in any measured clinical information were comparable. The primary endpoint (doubling serum creatinine) showed no significant difference between the two groups during 3-year follow-up. The secondary endpoint (50% reduction in 24-h urinary protein) occurred in 23 patients in the treatment group and 20 patients in the control group. The time to the secondary end-point was shorter in the treatment group than the control group (8.13 months vs 19.63 months, P = 0.019). However, at the 3-year follow-up, the 24-h urinary protein levels were not significantly different from the baseline levels (P = 0.99 and P = 0.66, respectively). At the 1-year follow-up, plasma cholesterol in the treatment group was markedly lower than in the control group (4.12 ± 1.28 vs 5.03 ± 1.01, P = 0.02). Conclusion Kidney function remained stable and there was no significant difference in two group patients. Probucol combined with valsartan led to a more rapid decrease of 24-h urinary protein excretion than valsartan alone. However, the long-term effect needs further investigation.

The new proton pump inhibitor (PPI), ilaprazole performed better at the dose of 10 mg/d relative to 5 or 20 mg/d in a previous phase II trial. A larger phase III trial was carried out to confirm the efficacy and safety of ilaprazole (10 mg/d) compared with omeprazole (20 mg/d) and provide some characteristics of the relationship between ilaprazole metabolism and CYP2C19 for later studies.Patients with at least one endoscopically diagnosed active duodenal ulcer (DU) were enrolled in a multicenter, randomized, double-blind, positive controlled trial and then assigned randomly to the ilaprazole group (10 mg/d) or the omeprazole group (20 mg/d) with a sample allocation ratio 2:1. The course of treatment was 4 weeks.ClinicalTrials.gov registration number: NCT00952978.The primary endpoint was endoscopically diagnosed ulcer healing rate at week 4. Symptom relief was evaluated as a secondary endpoint by graded scores. Safety and tolerability were evaluated on basis of clinical assessments. In addition, blood samples were collected at baseline for CYP2C19 genotypes identification.Efficacy analyses were based on 494 patients. At week 4, the ulcer healing rates were 93.0% in ilaprazole group and 90.8% in omeprazole group (rate difference: 2.2%; 95% confidence interval: -2.8% to 7.2%). No obvious variation of healing rate on different CYP2C19 genotypes was found in ilaprazole group. The majority of patients (80%) became asymptomatic after treatment. Incidences of adverse drug reactions were similar between ilaprazole group and omeprazole group (8.5% vs. 11.5%).Ilaprazole (10 mg/d) is as effective as omeprazole (20 mg/d) in the treatment of DU with similar side effects. The efficacy of ilaprazole is not affected by CYP2C19 polymorphisms.

To investigate the efficacy and safety of a new proton pump inhibitor (PPI), ilaprazole (IY-81149) in the treatment of duodenal ulcers and provide some characteristics of the dose-response relationship for later studies.PPIs have been used therapeutically for many years, and shown great efficacy in accelerating ulcer healing. Currently researches are focused on more potent PPIs. Some preclinical studies have shown that ilaprazole might be such a new substitute.235 patients with at least 1 endoscopically diagnosed active duodenal ulcer were enrolled in a randomized trial. Patients were randomized into 4 groups (5, 10, and 20 mg/d ilaprazole, with 20 mg/d omeprazole as positive control) and treated for up to 4 weeks. Forty patients accepted continuous 24-hour pH measurements after the fifth dose. The primary endpoint was ulcer healing rate at week 4.The efficacy analyses were based on 235 patients. At week 4, 86.4%, 93.1%, 86.4%, and 89.8% patients treated with 5 mg ilaprazole, 10 mg ilaprazole, 20 mg ilaprazole, and 20 mg omeprazole once daily, respectively had ulcers healed (P=0.59). The majority of patients (70%) became asymptomatic after 4 weeks treatment. Both drugs with stipulated dosages exhibited similar efficacy and safety profiles. Gastric acid suppression increased with increasing dose of ilaprazole in pH study.Ilaprazole is as tolerable, safe, and efficacious as omeprazole in the treatment of duodenal ulcers, especially at a lower dose (10 mg/d ilaprazole vs. 20 mg/d omeprazole). (ClinicalTrials.gov ID: NCT00953381).

Keywords: urban sustainable development; entropy method; coordination index; sustainable development level Abstract. Urban city plays important roles in the development of urban China. It is of highly strategic significance to evaluate the urban sustainable development level. In this paper, an assessment indicator system was designed composing of 4 first-level indicators and 20 second-level indicators. The entropy method was employed to calculate the development index of economic, social, resource and environmental subsystems, coordination index and sustainable development level of Xicheng District in Beijing during 2004-2013. An increase trend for sustainable development level was observed, from 0.30 in 2004 to 0.67 in 2013. The coordination index fluctuated with the best performance of 0.82 in 2007 and worst performance of 0.36 in 2004. The percentage of economic, social, resource and environmental subsystems was 20.03%, 40.53%, 18.13% and 21.31% respectively, and the sustainability index of social, economic and resource showed an increase trend during the past ten years.

Angiotensin receptor antagonists (ARBs) and anti-oxidants reduce urinary protein excretion and delay progression of immunoglobulin A (IgA) nephropathy. We investigated the efficacy and safety of probucol (an anti-oxidant) combined with valsartan (an ARB) on the progression of IgA nephropathy.Patients with IgA nephropathy (n = 69) were recruited from five centres and randomly assigned to a treatment group (750 mg/day probucol plus 160 mg/day valsartan) or a control group (160 mg/day valsartan) and were followed for 3 years.At baseline, the two groups in any measured clinical information were comparable. The primary endpoint (doubling serum creatinine) showed no significant difference between the two groups during 3-year follow-up. The secondary endpoint (50% reduction in 24-h urinary protein) occurred in 23 patients in the treatment group and 20 patients in the control group. The time to the secondary end-point was shorter in the treatment group than the control group (8.13 months vs 19.63 months, P = 0.019). However, at the 3-year follow-up, the 24-h urinary protein levels were not significantly different from the baseline levels (P = 0.99 and P = 0.66, respectively). At the 1-year follow-up, plasma cholesterol in the treatment group was markedly lower than in the control group (4.12 ± 1.28 vs 5.03 ± 1.01, P = 0.02).Kidney function remained stable and there was no significant difference in two group patients. Probucol combined with valsartan led to a more rapid decrease of 24-h urinary protein excretion than valsartan alone. However, the long-term effect needs further investigation.

Kidney injury associated with lymphocytic leukemia (CLL) is typically caused by direct tumor infiltration which occasionally results in acute renal failure. Glomerular involvement presenting as proteinuria or even nephrotic syndrome is exceptionally rare. Here we report a case of 54-year-old male CLL patient with nephrotic syndrome and renal failure. The lymph node biopsy confirmed that the patients had CLL with remarkable immunoglobulin light chain amyloid deposition. The renal biopsy demonstrated the concurrence of AL amyloidosis and neoplastic infiltration. Combined treatment of fludarabine, cyclophosphamide and rituximab resulted in remission of CLL, as well as the renal disfunction and nephrotic syndrome, without recurrence during a 12-month follow-up. To our knowledge, this is the first case of CLL patient showing the nephrotic syndrome and acute renal failure caused by AL amyloidosis and neoplastic infiltration. Though AL amyloidosis caused by plasma cell dyscrasia usually responses poorly to chemotherapy, this patient exhibited a satisfactory clinical outcome due to successful inhibition of the production of amylodogenic light chains by combined chemotherapy. Virtual Slides The virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2479639195566762.

Background As the transmission of many other parasitic diseases, the transmission of schistosomiasis is a complex process governed by natural, socio-economic factors and human life style. Based on the life cycle of Schistosoma j aponicum , some models have been developed. However, the human–environment interaction, especially through agricultural activities, has not been explicitly modeled in previous efforts. Objective To understand the effect of agricultural land use and other social economic factors on schistosomiasis transmission by explicitly including agricultural land use, human water contact behaviors, feces processing, and control strategies in a multi-level agent based model. Methods We proposed a spatially explicit agent-based schistosomiasis transmission model and describe its design and implementation. We chose one endemic village near Xichang, China to construct a virtual environment with the “patch”. We modeled the behaviors (water contact, feces contamination and disease control) of various agents (villages, households and individuals) in the environment and predicted the potential infection risk of human and snails in space and time with consideration of socio-economic and human behavioral factors. Results We obtained simulation results based on different scenarios of schistosomiasis control involving two dominant types of land use and four types of control measures. We also compared the effect of different timing on chemotherapy treatment. Conclusions The scheme for multi-level agent simulation including human–environment interaction behaviors in schistosomiasis transmission is a useful framework for assessment of different control strategies.

Geographic space, as the arena within which all of the natural and social processes occur, and time, have become key research components of social science for the past two decades. However, most GIS software packages lack the predictive and analytic capabilities for complex problems, such as spatial statistical methods and spatial modeling. Meanwhile, the spatio-temporally explicit representation of complex, heterogeneous and dynamic geographic data sets is a particularly challenging issue. Many efforts have been made in developing tools for effective representation of health data, spatio-temporal analysis of the data, and the dynamic process simulation of disease transmission. To meet this demand, we attempted to develop a tool for integrating spatio-temporal analysis, simulation and representation of health data and processes. In this paper, we will introduce some methods for spatial temporal data analysis and their applications in public health. We'll describe the conceptual model of spatial temporal process simulation and the process-oriented spatio-temporal data model adopted in the tool we developed. After that, we'll present the framework of our integrated research toolkit, and demonstrate how to conduct analysis, modeling, and simulation with this software. Finally, we will discuss some issues for future studies.