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Validation of the Institute Mutualiste Montsouris system for the stratification of laparoscopic liver resections:an international multicenter study 认领 引用
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作者 Alessandro Mazzotta David Fuks +71 位作者 Olivier Soubrane Hwee-Leong Tan Nicholas L.Syn Safi Dokmak Salvatore Gruttadauria Federica Cipriani Giuseppe Zimmitti Mohammad Alzoubi Atsushi Sugioka Olivier Scatton Paulo Herman Yufu Peng Marco V.Marino Roland S.Croner Vincenzo Mazzaferro Adrian K.H.Chiow Iswanto Sucandy Arpad Ivanecz Sung-Hoon Choi Jae Hoon Lee Mikel Gastaca Marco Vivarelli Felice Giuliante Andrea Ruzzenente Chee-Chien Yong Mengqiu Yin Constantino Fondevila Mikhail Efanov Zenichi Morise Fabrizio Di Benedetto Raffaele Brustia Raffaele Dalla Valle Ugo Boggi David Geller Andrea Belli Riccardo Memeo Alejandro Mejia James O.Park Fernando Rotellar Gi-Hong Choi Ricardo Robles-Campos Kiyoshi Hasegawa Yoshikuni Kawaguchi Xiaoying Wang Robert P.Sutcliffe Johann Pratschke Eric C.H.Lai Charing C.N.Chong Mathieu D’Hondt Kazuteru Monden Santiago Lopez-Ben T.Peter Kingham Rong Liu Alessandro Ferrero Giuseppe Maria Ettorre Daniel Cherqui Xiao Liang Go Wakabayashi Roberto I.Troisi Tan-To Cheung Motokazu Sugimoto Ho-Seong Han Tran Cong duy Long Wanguang Zhang Yonggang Wei Davit L.Aghayan Bjorn Edwin Kuo-Hsin Chen Mohammad Abu Hilal Luca Aldrighetti Brian K.P.Goh International Robotic and Laparoscopic Liver Resection Study Group Investigators 《Hepatobiliary Surgery and Nutrition》 SCIE 2026年第1期44-59,共16页
Background:The Institut Mutualiste Montsouris(IMM)3-level complexity classification has been validated for laparoscopic liver resection(LLR)in several studies with small sample size.However,it has not been well-valida... Background:The Institut Mutualiste Montsouris(IMM)3-level complexity classification has been validated for laparoscopic liver resection(LLR)in several studies with small sample size.However,it has not been well-validated in large studies down to the individual procedure type.Hence,in order to address current limitations in the studies validating the IMM complexity classification,we performed an international multicenter study to validate the IMM complexity classification across its three complexity levels and the categorization of the 11 distinct procedure types.Methods:A retrospective cohort study of 22,252 patients undergoing LLR across 64 centers worldwide between 2005 and 2021 was performed.Baseline characteristics and perioperative outcomes were analyzed across the three difficulty levels and 11 procedure types of the IMM complexity classification.Results:A total of 14,765 patients were included in our final analysis.The main indications for LLR in our study was hepatocellular carcinoma or intrahepatic cholangiocarcinoma(n=7,781,52.7%)followed by liver metastasectomy(n=3,911,26.5%).In terms of underlying liver pathology,5,127(34.7%)cases had cirrhosis,and 1,214(8.3%)had portal hypertension.Perioperative outcomes including operative time,open conversion rate,intraoperative blood loss,need for intraoperative blood transfusion,need for Pringle’s application,length of stay,postoperative morbidity,major postoperative morbidity and 90-day mortality all demonstrated a significant increasing trend with increasing IMM complexity grades(P<0.001).These trends remained significant following adjustment for baseline characteristics(P<0.001).Notably,when examining the 11 LLR procedure types,all procedures within each IMM complexity grade were individually higher than all procedures in the preceding complexity grade for operative time,blood loss,length of stay,postoperative morbidity and major postoperative morbidity.Conclusions:The three IMM complexity grades were well associated with LLR complexity as determined by key surrogate perioperative measures.Our findings also supported the categorization of the 11 distinct LLR procedures into the three complexity levels. 展开更多
关键词 Laparoscopic liver resection(LLR) Iwate criteria validation international multicenter study perioperative outcomes
Genomic sequencing as a key primary recommendation for neonatal hyperbilirubinemia:a population-based multicenter study 认领 引用
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作者 Dabin Huang Xia Gu +10 位作者 Weizhong Li Hongying Mi Haiquan Zeng Guiying Zhuang Sitao Li Congcong Shi Tao Wei Wei Zhou Xin Xiao Wenhao Zhou Hu Hao 《Journal of Genetics and Genomics》 SCIE CAS CSCD 2026年第3期467-475,共9页
Genetic variations are risk factors for neonatal hyperbilirubinemia(NHB),a common cause of infant hospitalization in the first postnatal week,but their contribution and long-term impacts remain unclear.This population... Genetic variations are risk factors for neonatal hyperbilirubinemia(NHB),a common cause of infant hospitalization in the first postnatal week,but their contribution and long-term impacts remain unclear.This population-based multicenter study enrolls 1780 hospitalized NHB newborns and 38,158 genetically screened newborns across 20 hospitals(2019-2022).Excluding cases with clear clinical causes,977 NHB cases are categorized into genetic variation-positive and-negative groups.Results show significantly higher NHB-related gene variants(81.63%vs.65.62%)and positive variation rates(36.29%vs.9.4%)in NHB cases than in the general newborn population(all P<0.001).Among the 977 NHB cases,325(33.3%)have positive variants,with higher rates of severe hyperbilirubinemia(16.9%vs.9.7%,P=0.001),prolonged jaundice(36.3%vs.27.6%,P=0.005),and cholestasis/hypercholanaemia(23.7%vs.14.7%,P<0.001)in the positive group.Cumulative genetic variants in bilirubin metabolism pathways exhibit dosedependent associations with increased risks of complications.Long-term follow-up reveals that UGT1A1 variants prolong jaundice up to one month,while severe SLC10A1 variants cause persistent cholestasis/hypercholanaemia beyond nine months.This large-scale evidence highlights genetic factors as key NHB determinants,with implications for neonatal care protocols to integrate genetic testing and establish longterm surveillance for variant carriers. 展开更多
关键词 Neonatal hyperbilirubinemia Jaundice polygene metabolic disorder Genetic variations Prolonged jaundice Multicenter observational study
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Divergent lymphocyte associations with depression severity and case status in first-episode,drug-naive adolescents:A multicenter study 认领 引用
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作者 Xi-Wang Fan Jia-Zhe Hou +7 位作者 Yi-Zhe Wang Ming-Lin Gao Ying Shen Dai Jian Qin Zhou Jing Yang Hui Zhao Li-Juan Zhang 《World Journal of Psychiatry》 SCIE 2026年第7期368-379,共12页
BACKGROUND Adolescent major depressive disorder(MDD)imposes an increasingly severe global health burden.Current diagnosis relies predominantly on subjective symptom reporting.Adolescents exhibit a unique immunobiologi... BACKGROUND Adolescent major depressive disorder(MDD)imposes an increasingly severe global health burden.Current diagnosis relies predominantly on subjective symptom reporting.Adolescents exhibit a unique immunobiological landscape,characterized by immune signatures that differ from those of adults.This feature may enable development of an immunopsychiatric framework for adolescent depression.AIM To investigate whether routinely measured peripheral immune parameters could both identify depression and reflect its severity in treatment-naive adolescents.METHODS We employed a two-stage,multicenter design.In stage I,a cross-sectional sample of 2115 first-episode,drug-naive adolescents with MDD was recruited from three regional centers in China.Associations between peripheral immune parameters and derived ratios with depression severity were assessed by the Self-Rating Depression Scale,with sex-stratified analyses.In stage II,a case-control study enrolled 41 adolescents with MDD and 41 controls.Multivariable logistic regression and receiver operating characteristic analyses were performed to evaluate the discriminatory capacity of candidate immune indicators.RESULTS Compared with healthy peers,adolescents with MDD had significantly lower lymphocyte counts[odds ratio(OR)=0.27,95%confidence interval(CI):0.13-0.57]and lymphocyte-to-monocyte ratio(LMR;OR=0.72,95%CI:0.56-0.92).Paradoxically,within the MDD group,higher lymphocyte count(OR=1.10,95%CI:1.01-1.22)and LMR(OR=1.06,95%CI:1.01-1.13)were independently associated with greater depression severity,an effect most accentuated in female participants(OR=1.17,95%CI:1.01-1.35).receiver operating characteristic analyses confirmed moderate discriminative accuracy for lymphocyte count[area under the curve(AUC)=0.76,95%CI:0.66-0.87]and LMR(AUC=0.70,95%CI:0.59-0.81).A composite model integrating age,sex,and key immune parameters achieved good discrimination(bootstrap-corrected AUC=0.79,95%CI:0.73-0.82).CONCLUSION Our findings reveal a bidirectional immunological pattern in adolescent MDD:Reduced lymphocyte count supports diagnostic identification,while elevated levels correlate with greater illness severity.These results support a stage-dependent immunopsychiatric model and lend support to precision mental health strategies in youth. 展开更多
关键词 Adolescent depression Lymphocyte count Lymphocyte-to-monocyte ratio Peripheral immunity Severity Multicenter study
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Deep learning radiomics of elastography for diagnosing compensated advanced chronic liver disease:an international multicenter study 认领 引用 被引量：2
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作者 Xue Lu Haoyan Zhang +22 位作者 Hidekatsu Kuroda Matteo Garcovich Victor de Ledinghen Ivica Grgurević Runze Linghu Hong Ding Jiandong Chang Min Wu Cheng Feng Xinping Ren Changzhu Liu Tao Song Fankun Meng Yao Zhang Ye Fang Sumei Ma Jinfen Wang Xiaolong Qi Jie Tian Xin Yang Jie Ren Ping Liang Kun Wang 《Visual Computing for Industry,Biomedicine,and Art》 EI 2025年第1期288-300,共13页
Accurate,noninvasive diagnosis of compensated advanced chronic liver disease(cACLD)is essential for effective clinical management but remains challenging.This study aimed to develop a deep learning-based radiomics mod... Accurate,noninvasive diagnosis of compensated advanced chronic liver disease(cACLD)is essential for effective clinical management but remains challenging.This study aimed to develop a deep learning-based radiomics model using international multicenter data and to evaluate its performance by comparing it to the two-dimensional shear wave elastography(2D-SWE)cut-off method covering multiple countries or regions,etiologies,and ultrasound device manufacturers.This retrospective study included 1937 adult patients with chronic liver disease due to hepatitis B,hepatitis C,or metabolic dysfunction-associated steatotic liver disease.All patients underwent 2D-SWE imaging and liver biopsy at 17 centers across China,Japan,and Europe using devices from three manufacturers(SuperSonic Imagine,General Electric,and Mindray).The proposed generalized deep learning radiomics of elastography model integrated both elastographic images and liver stiffness measurements and was trained and tested on stratified internal and external datasets.A total of 1937 patients with 94722D-SWE images were included in the statistical analysis.Compared to 2D-SWE,the model achieved a higher area under the receiver operating characteristic curve(AUC)(0.89 vs 0.83,P=0.025).It also achieved a highly consistent diagnosis across all subanalyses(P values:0.21–0.91),whereas 2D-SWE exhibited different AUCs in the country or region(P<0.001)and etiology(P=0.005)subanalyses but not in the manufacturer subanalysis(P=0.24).The model demonstrated more accurate and robust performance in noninvasive cACLD diagnosis than 2D-SWE across different countries or regions,etiologies,and manufacturers. 展开更多
关键词 Deep learning Elastography International multicenter study Compensated advanced chronic liver disease
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Development and Validation of a Postoperative Recurrence Prediction Model for Pancreatic Cancer: A Multicenter Study 认领 引用
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作者 Jinzhi Li Yong Chen 《Journal of Cancer Therapy》 2025年第1期38-50,共13页
Background: Pancreatic cancer is one of the most lethal malignancies, with postoperative recurrence severely affecting patient survival and prognosis. This study aims to develop and validate a clinical prediction mode... Background: Pancreatic cancer is one of the most lethal malignancies, with postoperative recurrence severely affecting patient survival and prognosis. This study aims to develop and validate a clinical prediction model for postoperative recurrence in pancreatic cancer patients, incorporating multiple preoperative, intraoperative, and postoperative factors to assist clinical decision-making. Methods: A retrospective study was conducted on 216 patients who underwent surgical treatment for pancreatic malignancy at the First Affiliated Hospital of Chongqing Medical University between January 2015 and January 2023. An independent external validation cohort of 76 patients from the Second Affiliated Hospital of Chongqing Medical University was used to validate the model. Seven independent risk factors for postoperative recurrence were identified through univariate and multivariate Cox regression analyses. The model’s performance was evaluated using the concordance index (C-index) and ROC curves, and its accuracy and clinical value were assessed using calibration curves and decision curve analysis (DCA). Results: The predictive model demonstrated good discriminatory power, with a C-index of 0.72 in the training cohort and 0.66 in the validation cohort. The ROC curves for predicting recurrence at 3, 6, and 12 months postoperatively showed AUC values ranging from 0.72 to 0.83, indicating strong predictive value. Calibration curves and DCA confirmed the model’s accuracy and clinical utility. Conclusion: This study successfully developed and validated a clinical prediction model that incorporates seven independent risk factors for postoperative recurrence in pancreatic cancer. The model provides a useful tool for predicting recurrence risk, aiding in the identification of high-risk patients, and informing clinical decision-making. 展开更多
关键词 Pancreatic Cancer Multicenter Study Recurrence Prediction Model
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A Multicenter Study of Viral Aetiology of Community-Acquired Pneumonia in Hospitalized Children in Chinese Mainland 认领 引用 被引量：30
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作者 Yun Zhu Baoping Xu +16 位作者 Changchong Li Zhimin Chen Ling Cao Zhou Fu Yunxiao Shang Aihuan Chen Li Deng Yixiao Bao Yun Sun Limin Ning Shuilian Yu Fang Gu Chunyan Liu Ju Yin Adong Shen Zhengde Xie Kunling Shen 《Virologica Sinica》 SCIE CAS CSCD 2021年第6期1543-1553,共11页
Community-acquired pneumonia(CAP) is one of the leading causes of morbidity and mortality in children worldwide.In this study,we aimed to describe the aetiology of viral infection of pediatric CAP in Chinese mainland.... Community-acquired pneumonia(CAP) is one of the leading causes of morbidity and mortality in children worldwide.In this study,we aimed to describe the aetiology of viral infection of pediatric CAP in Chinese mainland.During November2014 to June 2016,the prospective study was conducted in 13 hospitals.The hospitalized children under 18 years old who met the criteria for CAP were enrolled.The throat swabs or nasopharyngeal aspirates(NPAs) were collected which were then screened 18 respiratory viruses using multiplex PCR assay.Viral pathogens were present in 56.6%(1539/2721) of the enrolled cases,with the detection rate of single virus in 39.8% of the cases and multiple viruses in 16.8% of the cases.The most frequently detected virus was respiratory syncytial virus(RSV)(15.2%,414/2721).The highest detection rate of virus was in <6-month-age group(70.7%,292/413).RSV,human metapneumovirus(HMPV),human parainfluenza viruses(HPIVs) and influenza B virus(Flu B) showed the similar prevalence patterns both in north and south China,but HPIVs,Flu A,human bocavirus(HBoV),human adenovirus(HAdV) and human coronaviruses(HCoVs) showed the distinct circulating patterns in north and south China.Human enterovirus/human rhinovirus(HEV/HRV)(27.6%,27/98),HBoV(18.4%,18/98),RSV(16.3%,16/98) and HMPV(14.3%,14/98) were the most commonly detected viruses in severe pneumonia cases with single virus infection.In conclusion,viral pathogens are frequently detected in pediatric CAP cases and may therefore play a vital role in the aetiology of CAP.RSV was the most important virus in hospitalized children with CAP in Chinese mainland. 展开更多
关键词 Children Community-acquired pneumonia Multicenter study Viral aetiology Multiplex PCR assay
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Development and Validation of an Automatic Ultrawide-Field Fundus Imaging Enhancement System for Facilitating Clinical Diagnosis:A Cross-Sectional Multicenter Study 认领 引用 被引量：2
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作者 Qiaoling Wei Zhuoyao Gu +19 位作者 Weimin Tan Hongyu Kong Hao Fu Qin Jiang Wenjuan Zhuang Shaochi Zhang Lixia Feng Yong Liu Suyan Li Bing Qin Peirong Lu Jiangyue Zhao Zhigang Li Songtao Yuan Hong Yan Shujie Zhang Xiangjia Zhu Jiaxu Hong Chen Zhao Bo Yan 《Engineering》 SCIE EI CAS CSCD 2024年第10期179-188,共10页
In ophthalmology,the quality of fundus images is critical for accurate diagnosis,both in clinical practice and in artificial intelligence(AI)-assisted diagnostics.Despite the broad view provided by ultrawide-field(UWF... In ophthalmology,the quality of fundus images is critical for accurate diagnosis,both in clinical practice and in artificial intelligence(AI)-assisted diagnostics.Despite the broad view provided by ultrawide-field(UWF)imaging,pseudocolor images may conceal critical lesions necessary for precise diagnosis.To address this,we introduce UWF-Net,a sophisticated image enhancement algorithm that takes disease characteristics into consideration.Using the Fudan University ultra-wide-field image(FDUWI)dataset,which includes 11294 Optos pseudocolor and 2415 Zeiss true-color UWF images,each of which is rigorously annotated,UWF-Net combines global style modeling with feature-level lesion enhancement.Pathological consistency loss is also applied to maintain fundus feature integrity,significantly improving image quality.Quantitative and qualitative evaluations demonstrated that UWF-Net outperforms existing methods such as contrast limited adaptive histogram equalization(CLAHE)and structure and illumination constrained generative adversarial network(StillGAN),delivering superior retinal image quality,higher quality scores,and preserved feature details after enhancement.In disease classification tasks,images enhanced by UWF-Net showed notable improvements when processed with existing classification systems over those enhanced by StillGAN,demonstrating a 4.62%increase in sensitivity(SEN)and a 3.97%increase in accuracy(ACC).In a multicenter clinical setting,UWF-Net-enhanced images were preferred by ophthalmologic technicians and doctors,and yielded a significant reduction in diagnostic time((13.17±8.40)s for UWF-Net enhanced images vs(19.54±12.40)s for original images)and an increase in diagnostic accuracy(87.71%for UWF-Net enhanced images vs 80.40%for original images).Our research verifies that UWF-Net markedly improves the quality of UWF imaging,facilitating better clinical outcomes and more reliable AI-assisted disease classification.The clinical integration of UWF-Net holds great promise for enhancing diagnostic processes and patient care in ophthalmology. 展开更多
关键词 Ultrawide-field imaging Fundus photography Image enhancement algorithm Artificial intelligence Multicenter study Artificial intelligence-assisted diagnostics Diagnostic accuracy
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Current treatment paradigm and survival outcomes among patients with newly diagnosed multiple myeloma in China:a retrospective multicenter study 认领 引用 被引量：9
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作者 Huishou Fan Weida Wang +6 位作者 Ya Zhang Jianxiang Wang Tao Cheng Lugui Qiu Xin Wang Zhongjun Xia Gang An 《Cancer Biology & Medicine》 SCIE CAS CSCD 2023年第1期77-87,共11页
Objective:Evidence on the prognostic value of autologous stem cell transplantation(ASCT)and minimal residual disease(MRD)dynamics of patients with newly diagnosed multiple myeloma(NDMM)in China is limited.Our objectiv... Objective:Evidence on the prognostic value of autologous stem cell transplantation(ASCT)and minimal residual disease(MRD)dynamics of patients with newly diagnosed multiple myeloma(NDMM)in China is limited.Our objective in the current study was to understand the current care paradigm and outcomes of these patients.Methods:This longitudinal cohort study used historical data from three top-tier hematologic disease care hospitals that contributed to the National Longitudinal Cohort of Hematological Diseases-Multiple Myeloma.Treatment regimens[proteasome inhibitor(PI)-,immunomodulatory drug(IMiD)-,PI+IMiD-based,and conventional],post-induction response,ASCT and MRD status,and survival outcomes[progression-free survival(PFS)and overall survival(OS)]were evaluated.Results:In total,454 patients with NDMM were included(median age,57 years;59.0%males)with a median follow-up of 58.7 months.The overall response rate was 91.0%,83.9%,90.6%,and 60.9%for PI-,IMiD-,PI+IMiD-based,and conventional regimens,respectively.Patients with ASCT during first-line therapy(26.2%)had a longer PFS and OS than patients who did not receive ASCT[median PFS,42.9 vs.21.2 months,P<0.001;median OS,not reached(NR)vs.65.8 months,P<0.001].The median OS was NR,71.5,and 56.6 months among patients with sustained MRD negativity,loss of MRD negativity,and persistent MRD,respectively(P<0.001).Multivariate analysis revealed that the lactic dehydrogenase level,International Staging System stage,extra-medullary disease,and upfront ASCT were independent factors in predicting OS among NDMM patients.Conclusions:Our study showed that novel agent-based regimens,first-line ASCT,and sustained MRD negativity were associated with a superior outcome for patients with NDMM in China(Identifier:NCT04645199). 展开更多
关键词 Multiple myeloma autologous stem cell transplantation minimal residual disease survival outcomes multicenter study
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Rapid screening for Klinefelter syndrome with a simple high-resolution melting assay: a multicenter study 认领 引用 被引量：7
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作者 Dong-Mei Fu Yu-Lin Zhou +6 位作者 Jing Zhao Ping HU Zheng-Feng Xu3 Shi-Ming Lv Jun-Jie HU Zhong-Min Xia Qi-Wei Guo 《Asian Journal of Andrology》 SCIE CAS CSCD 2018年第4期349-354,共6页
Klinefelter syndrome （KS） is the set of symptoms that result from the presence of an extra X chromosome in males. Postnatal population-based KS screening will enable timely diagnosis of this common chromosomal disea... Klinefelter syndrome （KS） is the set of symptoms that result from the presence of an extra X chromosome in males. Postnatal population-based KS screening will enable timely diagnosis of this common chromosomal disease, providing the opportunity for early intervention and therapy at the time point when they are most effective and may prevent later symptoms or complications. Therefore, through this study, we introduced a simple high-resolution melting （HRM） assay for KS screening and evaluated its clinical sensitivity and specificity in three medical centers using 1373 clinical blood samples. The HRM assay utilized a single primer pair to simultaneously amplify specific regions in zinc finger protein, X-linked （ZFX） and zinc finger protein, Y-linked （ZFY）. In cases of KS, the ratios of ZFX/ZFYare altered compared to those in normal males. As a result, the specific melting profiles differ and can be differentiated during data analysis. This HRM assay displayed high analytical specificity over a wide range of template DNA amounts （5 ng-50 ng） and reproducibility, high resolution for detecting KS mosaicism, and high clinical sensitivity （100%） and specificity （98.1%）. Moreover, the HRM assay was rapid （2 h per run）, inexpensive （0.2 USD per sample）, easy to perform and automatic, and compatible with both whole blood samples and dried blood spots. Therefore, this HRM assay is an ideal postnatal population-based KS screening tool that can be used for different age groups. 展开更多
关键词 high-resolution melting Klinefelter syndrome multicenter study postnatal population-based screening
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Male reproductive function before and after the adjustment of the COVID-19 prevention policy:a multicenter study in China 认领 引用
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作者 Jian-Zheng Li Han Wu +6 位作者 Li Wang Yun-Shan Wang Feng Kong Long-Qiao Cao Ming Liang Xiong Wang Ming-Zhen Yuan 《Asian Journal of Andrology》 SCIE CAS CSCD 2024年第3期308-314,共7页
At the end of 2022,the adjustment of the coronavirus disease 2019(COVID-19)pandemic control policy in China resulted in alarge-scale increase in public infection.To compare the fertility parameters of male patients be... At the end of 2022,the adjustment of the coronavirus disease 2019(COVID-19)pandemic control policy in China resulted in alarge-scale increase in public infection.To compare the fertility parameters of male patients before and after the adjustments ofthe COVID-19 pandemic control policy in China,we collected data on patients’medical histories and laboratory examinations ontheir first visits between June 2022 and March 2023 in five different hospitals.Data were divided into five groups according tothe timeline of the policy adjustment.The data we collected from male patients included semen quality and serum reproductivehormone levels,and intergroup comparisons were made using the Mann–Whitney U and Chi-square tests.In total,16784 casesunderwent regular semen analysis,11180 had sperm morphology assessments,and 7200 had reproductive hormone analyses.Thedata showed declining trends in semen volume,sperm motility,and the progressive sperm motility rate after the policy adjustment.Subgroup comparison revealed an initial decrease and gradual recovery in progressive motility rate.Sperm morphology analysisshowed increased neck and tail abnormalities after the policy adjustment.No significant change in hormone levels was observed.Following the adjustment of the COVID-19 prevention policy in China,a decline in sperm motility and morphology was observed.This trend may gradually recover over 2 months.After the policy adjustment,reproductive hormone levels were relatively stablethroughout,except for an increase in luteinizing hormone(LH).These changes in semen parameters suggest that the policyadjustment had a short-to medium-term impact on male reproductive function. 展开更多
关键词 COVID-19 multicenter study reproduction SARS-CoV-2 semen analysis
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Hybrid argon plasma coagulation for the treatment of Barrett’s esophagus:A prospective,multicenter study 认领 引用
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作者 Dong Wang Yan Chen +8 位作者 Feng Ji Jian-Wei Hu Ping-Hong Zhou Shu-Chang Xu Ying Chen Li-Ping Ye Guo-Liang Ye Rui Li Zhao-Shen Li 《World Journal of Clinical Cases》 SCIE 2024年第19期3866-3872,共7页
BACKGROUND The incidence of Barrett’s esophagus(BE)in China is lower compared to the Western populations.Hence,studies conducted in the Chinese population has been limited.The current treatment options available for ... BACKGROUND The incidence of Barrett’s esophagus(BE)in China is lower compared to the Western populations.Hence,studies conducted in the Chinese population has been limited.The current treatment options available for BE treatment includes argon plasma coagulation(APC),radiofrequency ablation and cryoablation,all with varying degrees of success.AIM To determine the efficacy and safety of HybridAPC in the treatment of BE.METHODS The study cohort consisted of patients with BE who underwent HybridAPC ablation treatment.These procedures were performed by seven endoscopists from different tertiary hospitals.The duration of the procedure,curative rate,complications and recurrent rate by 1-year follow-up were recorded.RESULTS Eighty individuals were enrolled for treatment from July 2017 to June 2020,comprising of 39 males and 41 females with a median age of 54 years(range,30 to 83 years).The technical success rate of HybridAPC was 100%and the overall curative rate was 98.15%.No severe complications occurred during the operation.BE cases were classified as short-segment BE and long-segment BE.Patients with short-segment BE were all considered cured without complications.Thirty-six patients completed the one-year follow-up without recurrence.Twenty-four percent had mild dysplasia which were all resolved with one post-procedural treatment.The mean duration of the procedure was 10.94±6.52 min.CONCLUSION Treatment of BE with HybridAPC was found to be a simple and quick procedure that is safe and effective during the short-term follow-up,especially in cases of short-segment BE.This technique could be considered as a feasible alternative ablation therapy for BE. 展开更多
关键词 Barrett’s esophagus Hybrid argon plasma coagulation Ablation treatment Prospective study Multicenter study
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Clinical and economic impact of infliximab one-hour infusion protocol in patients with inflammatory bowel diseases:A multicenter study 认领 引用
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作者 Anna Viola Giuseppe Costantino +6 位作者 Antonino Carlo Privitera Fabrizio Bossa Angelo Lauria Laurino Grossi Maria Beatrice Principi Nicola Della Valle Maria Cappello 《World Journal of Gastrointestinal Pharmacology and Therapeutics》 2017年第2期131-136,共6页
AIM To assess the impact of short infliximab(IFX)infusion on hospital resource utilization and costs.METHODS All inflammatory bowel diseases(IBD)patients who received IFX 1 h infusion from March 2007 to September 2014... AIM To assess the impact of short infliximab(IFX)infusion on hospital resource utilization and costs.METHODS All inflammatory bowel diseases(IBD)patients who received IFX 1 h infusion from March 2007 to September 2014 in eight centers from Southern Italy were included in the analysis.Demographic,clinical and infusion related data were collected.The potential benefits related to the short infusion protocol were assessed both in terms of time saving and increased infusion unit capacity.In addition,indirect patient-related cost savings were evaluated.RESULTS One hundred and twenty-five patients were recruited(64 with ulcerative colitis and 61 with Crohn's disease).Median duration of disease was of 53 mo and mean age of pts at diagnosis was of 34 years(SD:±13).Adverse infusion reactions were reported in less than 4%both before and after short infusion.The total number of infusions across the selected centers was of 2501(30.5%short infusions).In the analyzed cohort,1143 h were saved(762 in the infusion and 381 in observation phases)through the rapid IFX infusion protocol.This time saving(-15%compared to the standard protocol in infusion phase)represents,from the hospital perspective,an opportunity to optimize infusion unit capacity by allocating the saved time in alternative cost-effective treatments.This is the case of opportunity cost that represents the value of forgone benefit which could be obtained from a resource in its next-best alternative use.Hence,an extra hour of infusion in the case of standard 2-h IFX represents a loss in opportunity to provide other cost effective services.The analysis showed that the short infusion increased the infusion units capacity up to 50%on days when the IFX infusions were scheduled(infusion phase).Furthermore,the analysis showed that the short IFX infusion protocol leads to time savings also in the post-infusion phase(observation)leading to a time saving of 10%on average among the analyzed centers.Finally,the short infusion protocol has been demonstrated to lead to indirect cost savings of€138/patient(average-€17.300 on the whole cohort).CONCLUSION A short IFX infusion protocol can be considered time and cost saving in comparison to the standard infusion protocol both from the hospital's perspective,as it contributes to increase infusion units capacity,and the patients'perspective,as it reduces indirect costs and the impact of treatment on everyday life and work productivity. 展开更多
关键词 Infliximab One-hour infusion Cost savings Economic impact Multicenter study
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Screening of Class 1 and Class 2 Integrons in Clinical Isolates of Pseudomonas aeruginosa Collected from Seven Hospitals in Turkey:A Multicenter Study 认领 引用
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作者 Aysegul Copur Cicek Aysegul Saral +9 位作者 Azer Ozad Duzgun Zeynep Cizmeci Tuba Kayman Pervin Ozlem Balci Tuba Dal Mehmet Firat Yelda Yazici Metin Sancaktar Osman Birol Ozgumus Cemal Sandalli 《Open Journal of Medical Microbiology》 2013年第4期227-233,共7页
Pseudomonas aeruginosa is one of the leading nosocomial pathogens worldwide, and their infections are difficult to treat due to acquired resistance to many antibiotics. This study aimed to detect class 1 and 2 integro... Pseudomonas aeruginosa is one of the leading nosocomial pathogens worldwide, and their infections are difficult to treat due to acquired resistance to many antibiotics. This study aimed to detect class 1 and 2 integrons and antibiotic susceptibility of clinical isolates of P. aeruginosa. Two hundred and five P. aeruginosa strains were collected from the seven general state hospitals in Turkey. They were characterized by antimicrobial susceptibility testing, screened for class 1 and class 2 integrons, and evaluated for the association between antibiotic resistance phenotypes and the presence of integrons. intI gene was amplified in 10 isolates (4.87%) by PCR and in seven isolates of them (70%) were found different gene cassettes. The aadA gene integrated into the class 1 integrons was most frequently found and it was followed by aac genes and blaOXA family genes. Sequence analysis of variable regions of the class 1 integrons showed five gene cassette arrays;aadA1(99%), aac(3)-Id(82%)-orf-aac(3”)-Ia(99%), aac(3)-Ie(83%)-blaoxa10(100%)- aadA1 (100%), aadA6(99%, 100%), aac(6’)-I(97%)-orf-aadA2(99%). No class 2 integron was detected. This study is the first multicenter study for class 1 integrons and it indicates the low rate of presence of class 1 gene cassette in P. aeruginosa. 展开更多
关键词 Pseudomonas aeruginosa Antibiotic Resistance Class 1 Integron AadA Multicenter Study
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Machine learning-based diagnosis of uterine myomas and sarcomas using tumor-educated platelet transcriptomics:a retrospective multicenter study 认领 引用
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作者 Xudong Liu Roujie Huang +27 位作者 Hua Yang Yu Dong Lei Li Zhe Li Jia Zeng Qingxia Zhang Yun Liu Lei Zhang Yidi Ma Lin Zhang Weijie Tian Yan You Yaqian Li Tianshu Sun Xiaoyue Zhao Wei Liu Le Dang Zhibo Zhang Lei Li Ran Chen Yining Zhao Yiming Liang Baochen Du Qijun Xu Xuwo Ji Yuxing Dai Han Liang Lan Zhu 《Science Bulletin》 SCIE EI CAS CSCD 2026年第1期60-63,共4页
Uterine myomas are the most prevalent benign gynecological tumors,affecting over 70%of women[1].They are often associated with significant morbidity,including anemia and infertility.In contrast,uterine sarcomas,althou... Uterine myomas are the most prevalent benign gynecological tumors,affecting over 70%of women[1].They are often associated with significant morbidity,including anemia and infertility.In contrast,uterine sarcomas,although rare,are highly malignant,with a five-year survival rate of 50%-55%in early stages and a stark decline to 8%-12%in advanced stages[2],[3]. 展开更多
关键词 uterine sarcomas uterine myomas benign gynecological tumorsaffecting diagnosis retrospective multicenter study tumor educated platelets machine learning transcriptomics
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Clinical efficacy of optimized drug treatment for acute type A aortic dissection:insights from a multicenter retrospective cohort study 认领 引用
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作者 Shi-Pan Wang Hai-Yang Li +6 位作者 Yin-Fan Zhu Hao-Tian Wu Dong-Jie Li Yuan-Fei Zhao Lu Dai Wen-Jian Jiang Hong-Jia Zhang 《Military Medical Research》 SCIE CAS CSCD 2026年第3期507-510,共4页
Dear Editor,Acute aortic dissection(AAD)refers to the tearing of the aortic intima,with high-pressure blood flowing into the media.It can be classified into Stanford type A and type B according to whether the ascendin... Dear Editor,Acute aortic dissection(AAD)refers to the tearing of the aortic intima,with high-pressure blood flowing into the media.It can be classified into Stanford type A and type B according to whether the ascending aorta is involved.Acute type A aortic dissection(ATAAD)is a life-threatening cardiovascular disease with high mortality rates(approximately 50%and 1%–2% per hour)within the first 48 h[1]. 展开更多
关键词 Multicenter study Optimized drug treatment(ODP) Acute type A aortic dissection(ATAAD) Clinical prognosis
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Management and complication investigation among breast cancer patients undergoing immediate implant-based breast reconstruction:A Chinese multicenter study(CSBrS-012) 认领 引用
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作者 Ling Li Ang Zheng +3 位作者 Feng Jin Baoliang Guo Bo Chen Chinese Society of Breast Surgery 《Chinese Medical Journal》 SCIE CAS CSCD 2026年第5期770-772,共3页
To the Editor:Immediate implant-based breast reconstruction(IBBR)has become the primary option for postmastectomy reconstruction.[1]A retrospective study was conducted to investigate the current management status and ... To the Editor:Immediate implant-based breast reconstruction(IBBR)has become the primary option for postmastectomy reconstruction.[1]A retrospective study was conducted to investigate the current management status and complications of patients with breast cancer who underwent immediate IBBR after mastectomy in China through a questionnaire survey.The study was approved by the Ethics Committee of the First Hospital of China Medical University(No.[2024]579).This questionnaire contains two parts:(Ⅰ)Overview of the participating hospitals and the overall situation of breast reconstruction surgeries performed from January 1,2022,to May 31,2022.(Ⅱ)Details of immediate IBBR surgery at each hospital.The data collection cutoff date was December 12,2023,with a median follow-up of 17 months.The detailed questionnaire and flowchart summarizing the research design and patient selection process can be found in the supplementary document and Supplementary Figure 1,http://gffzz7970c142aa3c4dfah0bk066npqqxv6u6v.ffgz.tsg.suse.edu.cn/CM9/C693.Statistical significance was set at P<0.05.Theχ2test,Fisher’s exact test,and logistic regression were used. 展开更多
关键词 ethics committee immediate implant based breast reconstruction breast reconstruction ibbr questionnaire survey breast cancer postmastectomy reconstruction multicenter study complications
A multicenter study on the impact of treatment times on anxiety and depression in patients with Helicobacter pylori infection 认领 引用
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作者 CHEN Meihong 《China Medical Abstracts(Internal Medicine)》 2026年第1期37-37,共1页
Objective To evaluate the impact of treatment times on the anxiety and depression in patients with Helicobacter pylori(HP) infection.Methods This study was a multicenter and cross-sectional survey.From May 2023 to May... Objective To evaluate the impact of treatment times on the anxiety and depression in patients with Helicobacter pylori(HP) infection.Methods This study was a multicenter and cross-sectional survey.From May 2023 to May2024,a total of 206 patients with HP infection who visited the Department of Gastroenterology of the First Affiliated Hospital with Nanjing Medical University,the Third Affiliated Hospital of Nanjing Medical University and Mufu Mountain Community Health care Center of Gulou District were enrolled.All the patients were divided into refractory group (≥2 times of treatment)and non-refractory group (<2 times of treatment). 展开更多
关键词 helicobacter pylori infection depression evaluate impact treatment times helicobacter pylori hp treatment times multicenter study anxiety depression anxiety
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Endoscopic transparent cap assisted hemostasis:A multicenter retrospective cohort study 认领 引用
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作者 Ömer Küçükdemirci Talat Ayyildiz +3 位作者 Berk Bas Hasan Eruzun Nisa Efe Ahmet Bektas 《World Journal of Gastroenterology》 SCIE CAS 2026年第15期36-45,共10页
BACKGROUND Non-variceal upper gastrointestinal bleeding(NVUGIB)remains a common and potentially life-threatening emergency despite advances in endoscopic therapy.Endoscopic transparent caps(CAPs)have been proposed to ... BACKGROUND Non-variceal upper gastrointestinal bleeding(NVUGIB)remains a common and potentially life-threatening emergency despite advances in endoscopic therapy.Endoscopic transparent caps(CAPs)have been proposed to enhance lesion visualization and procedural stability,but their effect on clinical outcomes is uncertain.AIM To evaluate whether CAP use during therapeutic endoscopy influences hemostatic efficacy and short-term outcomes in NVUGIB.METHODS A total of 206 patients who underwent emergency endoscopic hemostasis between 2021 and 2025 at six tertiary centers in Türkiye were included.Patients were divided into CAP-assisted(n=67)and non-CAP(n=139)groups.Baseline characteristics,comorbidities,Glasgow-Blatchford and Rockall scores,hemostatic methods,and clinical outcomes were analyzed.Multivariable linear regression identified independent predictors of post-admission transfusion requirement and hospital length of stay(LOS).RESULTS Baseline demographic and clinical variables were comparable between groups.CAP was more often used in hemodynamically unstable patients.The CAP group required a greater number of hemostatic techniques(2.66±1.00 vs 2.14±0.87;P<0.001),with higher use of Ankaferd Blood Stopper and argon plasma coagulation,but received fewer post-admission transfusions(14.8%vs 33.8%;P=0.006)and a lower transfusion volume(0.44±1.13 U vs 0.91±1.31 U;P=0.012).Mortality,intensive-care need,and LOS did not differ significantly.CAP use independently predicted reduced transfusion volume(β=-0.47,P=0.010),whereas higher Charlson Comorbidity index and intensive care unit admission predicted longer LOS.CONCLUSION CAP-assisted endoscopy may improve procedural efficiency and hemostatic control in NVUGIB,reducing transfusion requirements without affecting mortality or hospitalization.Prospective randomized trials are warranted to validate these findings and clarify CAP’s role in standardized bleeding management. 展开更多
关键词 Non-variceal upper gastrointestinal bleeding Endoscopic hemostasis Transparent cap Hemostatic efficacy Transfusion requirement Charlson Comorbidity index Multicenter retrospective study
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Gut microbial characteristics of the damp-heat constitution:a population-based multicenter cross-sectional study 认领 引用 被引量：4
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作者 LI Tianxing ZHU Linghui +9 位作者 WANG Xueke TANG Jun YANG Lingling PANG Guoming LI Huang WANG Liying DONG Yang ZHAO Shipeng LI Yingshuai LI Lingru 《Journal of Traditional Chinese Medicine》 SCIE CAS CSCD 2025年第1期140-151,共12页
OBJECTIVE:To investigate the difference in gut microbiota between population with damp-heat constitution(DHC)and balanced constitution(BC).METHODS:A multi-centered cross-sectional casecontrol study was conducted,which... OBJECTIVE:To investigate the difference in gut microbiota between population with damp-heat constitution(DHC)and balanced constitution(BC).METHODS:A multi-centered cross-sectional casecontrol study was conducted,which included 249 participants with damp-heat constitution or balanced constitution.Baseline information of participants was collected,and stool samples were collected for gut microbiota analysis.Principal coordinate analysis,linear discriminant analysis effect size analysis,receiver operating characteristic,random forest model,and phylogenetic investigation of communities by reconstruction of unobserved states methods were used to reveal the relationship between gut microbiota and the damp-heat constitution.RESULTS:Compared to those in the BC group,the richness and diversity of the microbiota,specifically those of several short-chain fatty acid producing genera such as Barnesiella,Coprobacter,and Butyricimonas,were significantly decreased in the DHC group.Regarding biological functions,flavonoid biosynthesis,propanoate metabolism,and nucleotide sugar metabolism were suppressed,while arachidonic acid metabolism and glutathione metabolism were enriched in the DHC group.Finally,a classifier based on the microbiota was constructed to discriminate between the DHC and BC populations.CONCLUSION:The gut microbiota of the DHC population exhibits significantly reduced diversity and is closely related to inflammation,metabolic disorders,and liver steatosis,which is consistent with clinical observations,thus serving as a potential diagnostic tool for traditional Chinese medicine constitution discrimination. 展开更多
关键词 damp-heat constitution balanced constitution Traditional Chinese medicine constitution microbiota inflammatory PICRUSt multicenter study cross-sectional studies
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Clinical,Microbiological,and Antibiotic Treatment Characteristics of Bacterial Infections in Patients with Liver Cirrhosis in China:A Multicenter Study 认领 引用 被引量：3
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作者 Xiuding Zhang Haoda Weng +39 位作者 Qinzhi Deng Min Deng Xuwei Wu Zuxiong Huang Shourong Liu Rui Wu Chunlian Ma Yao Xu Jianfeng Zhong Jie Yang Yinxia Wu Huajiang Shen Feng Ding Fang Wang Xuezhen Zhai Chunxian Peng Haotang Ren Jie Jin Xiangfei Xu Xiaofei Li Xiaoting Ye Guoqing Qian Shuilin Sun Xuebing Yao Haifeng Miao Qianggu Xiao Shaoheng Ye Qing Zhang Xinyi Xu Xia Yu Yue Yu Yan Lan Huilan Tu Xianbin Xu Xinrong Zhang Rui Huang Xiaohan Qian Qiao Yang Jifang Sheng Yu Shi 《Journal of Clinical and Translational Hepatology》 SCIE CSCD 2025年第8期644-654,共11页
Background and Aims:Epidemiological data on bacterial infections in cirrhosis in China remain limited.Therefore,we aimed to conduct a multicenter study to investigate the characteristics and outcomes of patients with ... Background and Aims:Epidemiological data on bacterial infections in cirrhosis in China remain limited.Therefore,we aimed to conduct a multicenter study to investigate the characteristics and outcomes of patients with cirrhosis and bacterial infections in China.Methods:We retrospectively enrolled 1,438 hospitalized adult patients with cirrhosis and bacterial or fungal infections from 24 hospitals across China between January 2018 and September 2024.Data on demographics,clinical features,microbiology,treatment,and outcomes were collected.Results:A total of 1,783 infection episodes were recorded,including 1,668 first infections and 115 second infections.Most infections were community-acquired(86.6%).Pneumonia was the most common infection type(26.7%),followed by spontaneous bacterial peritonitis(19.5%)and spontaneous bacteremia(14.1%).Among 754 pathogens isolated from 620 patients,Klebsiella pneumoniae(20.1%)was nearly as common as Escherichia coli(21.7%).Multidrug-resistant(MDR)organisms accounted for 41.0%of(20.1%)was nearly as common as Escherichia coli(21.7%).Multidrug-resistant(MDR)organisms accounted for 41.0%of all isolates,with extended-spectrum p-lactamase-producing Escherichia coli being the most prevalent MDR strain(8.9%of patients).Adherence to empirical antibiotic treatment guidelines from the European Association for the Study of the Liver was significantly lower in this cohort compared to the global study(21.5%vs.61.2%,P<0.001),accompanied by a lower clinical resolution rate(63.5%vs.79.8%,P<0.001).Conclusions:The clinical and microbiological characteristics of bacterial infections in patients with cirrhosis in China differ substantially from those reported in other regions.These findings highlight the need for region-specific management and prevention strategies,particularly in light of the changing microbiological landscape,high MDR prevalence,and suboptimal antibiotic practices. 展开更多
关键词 Bacterial infections Epidemiology Multidrug resistance Cirrhosis Antibiotics Multicenter study
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