Background China is one of the countries that set the goal to eliminate mother-to-child transmission (EMTCT) of syphilis by a target date. Active screening for syphilis among pregnant women, followed by effective treatment of maternal syphilis, is critical for achieving the goal. The China health authority issued national implementation protocols to guide EMTCT practice in health facilities. Methods Within a cohort of infants born to mothers infected with syphilis, we obtained the data of regimens used for treatment of maternal syphilis from the National Information System of Prevention of Mother-to-Child Transmission of HIV, Syphilis and Hepatitis B, and analysed the physician’s treatment behaviour and its associated factors in a public hospital in Suzhou of China. Results A total of 450 pregnant women who were positive for treponemal or non-treponemal antibody, or had previous infection with syphilis were included into the study for analysis. Of them, 260 (57.8%) were positive for both treponemal and non-treponemal antibodies (syphilis seropositivity), and 353 (78.4%) were treated for syphilis according to the protocol in which 123 (34.8%) were treated with two courses. Non-adherence to treatment recommended by the protocol for maternal syphilis was significantly associated with antenatal visits in the third trimester (AOR 6.65, 95% CI 2.20–20.07, P = 0.001), being positive only for a treponemal test (AOR 5.34, 95% CI 3.07–9.29, P < 0.001) or having a syphilis infection before the pregnancy (AOR 2.05, 95% CI 1.14–3.69, P = 0.017), whereas the uptake of treatment for two treatment courses was associated with attending antenatal care in 2020 or before (AOR 3.49, 95% CI 1.89–6.42, P < 0.001), being positive for treponemal and non-treponemal tests (AOR 5.28, 95% CI 2.78–10.06, P < 0.001) or having non-treponemal antibody titre of ≥1:8 (AOR 3.71, 95% CI 1.77–7.78, P = 0.001). Conclusions Implementation of the current recommendation to offer a universal treatment for syphilis among all pregnant women who are shown to be positive for a treponemal test alone is challenging in some clinical settings in China.
Endoscopic antireflux therapy is widely used in clinical practice. Peroral endoscopic cardial constriction (PECC), antireflux mucosal intervention (ARMI), and radiofrequency ablation (RF) possess analogous antireflux mechanisms. This comprehensive systematic review and meta-analysis aimed to evaluate and compare the safety and effectiveness of antireflux therapy during endoscopic cardia peripheral tissue scar formation (ECSF) procedures. We comprehensively searched the Web of Science, PubMed, Embase, China National Knowledge Infrastructure, and Wan-Fang databases for articles published from January 1990 to January 2024. Network meta-analysis (NMA) was used to assess the outcomes, with outcome metrics including the Gastroesophageal Reflux Questionnaire (GERD-Q) score, proton pump inhibitor discontinuation rate, pH <4.2 percent acid reflux time (AET), lower esophageal pressure (LES pressure), DeMeester score, adverse events, and patient satisfaction. Twenty studies involving 1219 patients were included. PECC was significantly superior to RF in lowering the patients’ postoperative GERD-Q scores(MD = -2.34, 95% confidence interval (CI): [-3.02, -1.66]), augmentation of LES pressures(MD = 3.22, 95% CI: [1.21, 5.23]), and having a lower incidence of serious adverse events. ARMI was preferable to PECC (MD = -2.87, 95% CI [-4.23, -1.51])and RF (MD = -1.12, 95% CI [-1.79, -0.54]) in reducing the AET percentage, but was not as effective as PECC in lowering GERD-Q scores(MD = -1.50, 95% CI [-2.47, -0.53]). The incidence of adverse effects was less than 10% for all interventions, with most of them mildly self-resolving. Each ECSF procedure resulted in a favorable outcome in patients with GERD. Considering the safety and efficacy of treatment, PECC was the most favorable choice among ECSF procedures.
Endoscopic submucosal dissection (ESD) is currently the standard therapy for superficial esophageal cancer (SEC). However, postoperative mucosal defects often lead to esophageal stricture. Although steroid application is effective prophylaxis, the efficacy and safety of various steroid administration modes remain unclear. Thus, this study aimed to evaluate the efficacy and safety of different steroid administrations for SEC patients after ESD.
Objective
To observe the clinical efficacy of surgical operation combined with photodynamic therapy for plantar warts.
Methods
From July 2017 to June 2018, 16 patients with plantar warts were enrolled in the Department of Dermatology, the Fifth People's Hospital of Suzhou City. The enrolled patients aged 10 to 42 years, including 12 males and 4 females, with a course of 4 to 15 month, and a total of 47 plantar warts. The plantar warts was removed by surgical operation and bipolar coagulation, followed by the photodynamic treatment with 5-aminolevulinic acid for 3 to 4 times with an interval of 7-10 days.
Results
Eleven patients showed complete clearance after operation and three times photodynamic treatments, and the other 5 patients underwent 2 operations and four times photodynamic treatments. 47 plantar warts in 16 patients were disappeared completely during 6-month post-treatment follow up. The plantar warts clearance rate was 100%, and the skin texture still presented. In addition to local mild erythematous, pain and burning sensation presented after surgery, but no adverse reactions such as infection, ulcers and obvious scars occurred.
Conclusions
Surgery combined with 5-aminolevulinic acid photodynamic therapy is a favorable treatment for plantar warts.
Key words:
Metatarsus; Warts; Surgical procedures; Photodynamic therapy; Aminolevulinic acid
Due to the critical influence on combustion, extensive research has been carried out to deepen the understanding of diesel spray evolution. However, for the greater share of land-based diesel engines, most of the studies have focused on the injectors with small nozzle diameter and rare studies can be found on marine diesel engines, which has a larger mass flow rate and longer injection duration with large nozzle diameter. In this study, the influence of injection pressure, ambient temperature, ambient density and nozzle diameter on spray morphology for medium speed marine diesel engine injectors (with nozzle diameter up to 0.53 mm) were investigated under various non-reacting but evaporative conditions. The experiments were performed via a highly enhanced constant volume chamber (highest temperature of 900 K and highest pressure of 8 MPa) with an optical window diameter of 205 mm. Liquid and vapor penetration of sprays were recorded by Mie-scattering and schlieren optical configurations respectively. Results show that the vapor penetration velocity is mainly affected by injection pressure. Ambient temperature has the most significant effect on liquid penetration length, but less effect can be found on the vapor penetration velocity. Given the obvious deviation from heavy duty engine sprays, the empirical correlations for liquid penetration length and vapor spray evolution are updated to fit the spray characteristics of medium speed marine diesel engine injectors, which is helpful to understand the spray behavior for large nozzle diameter injector under marine diesel engine conditions.
The technology development tendency of internal combustion engine is analyzed as attending the 24th CIMAC. Some point of view is given on the participation of CIMAC in diesel circles of China.
Heterotopic gastric mucosa in the upper esophagus (HGMUE) is considered to be accompanied by pharyngolaryngeal symptoms, whereas the association strength between HGMUE and pharyngolaryngeal symptoms remains controversial. This study assessed the strength of the association between HGMUE and pharyngolaryngeal symptoms using a meta-analytic approach. PubMed, Embase, Web of Science, and CNKI databases were searched for relevant articles published between January 2010 and January 2024. The pharyngolaryngeal symptoms of chronic cough, dysphagia, hoarseness, and globus in patients with HGMUE were summarized. The pooled odds ratio (OR) and 95% confidence interval (CI) were calculated using a random-effects model. The exploratory analyses were also performed, including sensitivity and subgroup analyses. A total of 17 observational studies (1 cohort study and 16 cross-sectional studies) with 626,369 patients (2414 HGMUE patients and 623,955 non-HGMUE patients) were included in the meta-analysis. HGMUE was significantly associated with an elevated incidence of chronic cough (OR: 3.36; 95% CI 1.25–9.01; P = 0.02), dysphagia (OR: 1.58; 95% CI 1.12–2.25; P = 0.01), hoarseness (OR: 4.13; 95% CI 1.47–11.56; P = 0.007), and globus (OR: 2.41; 95% CI: 1.43–4.04, P < 0.001). The association between HGMUE and the risk of dysphagia was found to be potentially influenced by study design, sample size, country, and diagnostic method, whereas the association between HGMUE with the risk of globus was potentially affected by the study design and country. HGMUE was significantly associated with chronic cough, dysphagia, hoarseness, and globus. HGMUE should be taken into consideration for patients with pharyngolaryngeal symptoms.
Due to the critical influence on combustion, a lot of efforts has been put into the understanding of diesel spray evolution. However, for the bigger share of vehicle engines, most of the studies have focused on the injectors with small nozzle diameter and rare studies are focused on the marine diesel engines, which has a larger mass flow rate and longer injection duration. In this paper, the influence of injection pressure, ambient temperature, ambient density and nozzle diameter on spray morphology for medium speed marine diesel engine injectors (with nozzle diameter up to 0.53mm) have been investigated under various non-reacting but evaporative conditions. The experiments were performed via a highly enhanced constant volume chamber with an optical window diameter of 205 mm, and the liquid and vapor penetration were recorded by Mie scattering and schlieren optical configurations respectively. The experimental results show that the vapor spray tip velocity is mainly affected by injection pressure at the start of injection. Among these factors, ambient temperature has a most significant effect on liquid penetration length, but less effect can be found on the spray tip behavior. Given the obvious deviation from heavy duty engines, both for liquid penetration length and vapor spray evolution, the empirical correlations are updated to fit the spray characteristics of medium speed marine diesel engine injectors.
'/%3e%3cuse xlink:href='%23a' transform='rotate(23.036 .093 25.536)'/%3e%3cuse xlink:href='%23a' transform='rotate(45.87 1.273 16.18)'/%3e%3cuse xlink:href='%23a' transform='rotate(69.945 .996 12.078)'/%3e%3cuse xlink:href='%23a' transform='rotate(20.66 -19.689 31.932)'/%3e%3c/svg%3e)