With the rapid development of IoT technology, it is a new trend to combine edge computing with smart medicine in order to better develop modern medicine, avoid the crisis of information "sibling," and meet the requirements of timeliness and computational performance of the massive data generated by edge devices. However, edge computing is somewhat open and prone to security risks, so the security and privacy protection of edge computing systems for smart healthcare is receiving increasing attention. The two groups were compared before and after treatment for blood glucose, blood lipids, blood pressure, renal function, serum advanced glycosylation end products (AGEs) and cyclic adenosine monophosphate (cAMP), serum oxidative stress indicators, and levels of cAMP/PKA signalling pathway-related proteins in peripheral blood mononuclear cells. The results of this study show that the reduction of AGEs, the improvement of oxidative stress, and the regulation of the cAMP/PKA signalling pathway may be associated with a protective effect against early DKD. By introducing the edge computing system and its architecture for smart healthcare, we describe the security risks encountered by smart healthcare in edge computing, introduce the solutions proposed by some scholars to address the security risks, and finally summarize the security protection framework and discuss the specific solutions for security and privacy protection under this framework, which will provide some help for the credible research of smart healthcare edge computing.
Objectives This study aims to summarise the features and trends of thyroid carcinoma in the past two decades in China. Design, setting and participants Clinical data obtained from 10 798 patients treated by thyroidectomy from 1994 to 2015 at the Department of General Surgery of the People’s Liberation Army General Hospital, Beijing, China were retrospectively analysed. Outcome measures Incidence and histopathological features of thyroid cancer were compared and the risk factors for local lymph node metastasis analysed. Results Our data indicated a significant increase in the detection of thyroid cancer (from 16.8% to 69.8%, p < 0.01). Among the 5235 thyroid cancer cases, papillary thyroid carcinoma (PTC) was the most common histotype, accounting for 95.1% of all malignancies over the 22-year period. Among the 4979 PTCs, micro-PTCs (mPTC) with the largest diameter ≤10 mm has gradually become the dominant form, and its percentage in PTCs has increased from 13.3% in the biennial period of 1994–1995 to 51.2% in 2010–2011. Furthermore, the size of the tumour has decreased significantly from 2.3±1.1 cm in 1994 to 1.2±0.9 cm in the largest diameter (p<0.01), while the average age at diagnosis and female dominance remained unchanged during the period. Logistic regression showed that tumour nodules>1 cm and male gender were the main risk factors for local lymph node metastasis (LNM), whereas patients over 45 years had lower risk. Conclusions During the 22-year period, an increased detection of thyroid cancer, particularly mPTC, was found while the occurrence of LNM decreased. Our results suggest that the current preoperative diagnosis and risk stratification are adequate, supporting the published guidelines for the diagnosis of thyroid cancer.
Abstract Background Patients with normoalbuminuria and a reduced estimated glomerular filtration rate (eGFR) account for a considerable proportion of type 2 diabetes patients. The aim of this research was to investigate the epidemiological and clinical characteristics of normoalbuminuric kidney disease in a Chinese population. Methods We included 8131 diabetic patients from a multicenter prospective study in China. Based on eGFR and urinary albumin‐to‐creatinine ratio (UACR), participants were stratified into four groups—normal albuminuria, albuminuria, normoalbuminuria with eGFR < 60 mL/min/1.73 m 2 , and albuminuria with eGFR < 60 mL/min/1.73 m 2 . Clinical parameters and characteristics of patients with normoalbuminuria and eGFR < 60 mL/min/1.73 m 2 were retrospectively analyzed. Results A total of 1060 out of 8131 individuals with diabetes had decreased eGFR (<60 mL/min/1.73 m 2 ). Normoalbuminuria accounted for 63.3% of participants with eGFR < 60 mL/min/1.73 m 2 , and microalbuminuria and macroalbuminuria accounted for 30.1% and 6.3%, respectively. Patients with normoalbuminuria and reduced eGFR were more frequently male, older, and had higher levels of triglycerides than patients with normal albuminuria and eGFR. We also detected a correlation between lower extremity arterial disease, newly diagnosed diabetes, and normoalbuminuria‐reduced eGFR. Compared with participants with both albuminuria and eGFR decline, those with normoalbuminuria had better metabolic indicators, including systolic blood pressure and glycosylated hemoglobin, and shorter diabetes duration. Even in the normal range, UACR has a significant correlation with the risk of eGFR insufficiency. Conclusions Normoalbuminuric renal insufficiency, characterized by male sex, older age, a higher level of triglyceride levels, and a higher risk of lower extremity arterial disease, accounted for a dominant proportion of diabetic patients with eGFR decline.
Long noncoding RNAs (lncRNAs) can regulate the expression of genes at almost every level. The altered expression of lncRNAs was observed in many kinds of cancers. Until recently, few studies have focused on the function of lncRNAs in the context of papillary thyroid carcinoma (PTC).In the current study, we collected seven PTC and nodular goiter tissue samples and explored mRNA and lncRNA expression patterns in these samples by microarray.We observed aberrant expression of 94 lncRNAs and 99 mRNAs in the seven PTC samples as compared to the nodular goiter tissue [fold change (FC) ≥2.0; P<0.01]. To confirm these microarray results, quantitative polymerase chain reaction (q-PCR) was performed to assess the expression of three randomly selected differentially expressed mRNAs and lncRNAs, confirming our microarray findings significantly. We then performed gene ontology (GO) and kyoto encyclopedia of genes and genomes (KEGG) analyses to systematically characterize the twelve significantly differential genes. A co-expression analysis revealed that the lncRNAs n382996, n342483, and n409114 were closely related to the regulation of MT1G, MT1H, and MT1F.In the present study a string of novel lncRNAs associated with PTC were identified. Further study of these lncRNAs should be performed to identify novel target molecules which may improve diagnosis and treatment of PTC.
Abstract Objective The treatment of infantile epileptic spasm syndrome (IESS) aims to achieve spasm control. Current first-line interventions include hormonal therapy (adrenocorticotropic hormone [ACTH] and corticosteroids) and vigabatrin. Despite treatment, the response rate remains at around 40%, with some patients experiencing relapse after initial control. In certain cases, a second course of first-line therapy may be warranted. This study aims to perform a secondary analysis of data from previously published studies by our research group to elucidate factors influencing the efficacy of ACTH when re-administering it after first-line treatment failure. Methods We conducted a retrospective analysis of clinical data from children with IESS who had failed or relapsed following initial first-line therapy and subsequently received ACTH at our institution as a second-line treatment. We examined such variables as etiological classification, interval between treatments, age at first epileptic seizure, radiological findings, and changes in pharmacological treatment modalities to assess their impact on the short-term response to the second administration of first-line therapy. Results Among 128 IESS patients identified, 50 (39.1%) achieved a short-term response. Comparative analysis indicated that responders had a shorter duration since initial first-line therapy (median 1.00 [interquartile range, IQR 0.00, 2.00] vs. 1.75 [IQR 0.50, 3.88] months), were younger at the time of repeated treatment (median 11 [IQR 8, 17] vs. 16 [IQR 10, 24] months, p = 0.008), and were less likely to present with additional seizure types during spasm episodes (12.0% vs. 28.2%, p = 0.030). A multivariate logistic regression model, adjusted for selected variables, revealed that a higher age at the onset of the first epileptic seizure and prior response to first-line therapy were associated with increased odds of achieving a short-term response to subsequent ACTH treatment (odds ratio [OR] = 2.69, 95% confidence interval [CI] = 1.39, 7.23, p = 0.014). Conversely, older age at the time of repeated first-line treatment, older age at the spasm onset, and an etiology of congenital structural anomalies without genetic aberrations were associated with lower odds of a short-term response (OR = 0.85, 95% CI = 0.78, 0.92, p < 0.001; OR = 0.43, 95% CI = 0.16, 0.82, p = 0.032; OR = 0.18, 95% CI = 0.04, 0.69, p = 0.016). Conclusion A subset of children with IESS may benefit from a second trial of ACTH therapy even after initial first-line treatment failure, with over one-third of patients achieving a short-term response. However, patients with congenital structural anomalies without genetic alterations may not be suitable candidates for further ACTH therapy. Additionally, an older age at the first epileptic seizure onset correlates with a higher likelihood of a short-term response, while a later age at spasm onset inversely affects the probability of response. Younger age at the time of ACTH re-treatment may also increase the chances of a short-term response. Consideration for ACTH therapy may be warranted in relapse cases after an initial short-term response to first-line treatment.
Thyroid nodules are very common. Ultrasound (US) and fine needle aspiration (FNA) are both integral in cancer screening. This study investigated the concordance between thyroid nodule sizes measured by US and gross pathologic examination and their relationship with malignancy.A retrospective design was used to select consecutive patients with proven carcinoma of the thyroid. The number and maximum diameter of nodules, rates and types of malignancy, as well as predictors of malignancy were determined.The 10 944 patients examined had 15 283 thyroid nodules, 44.6% of which were malignant. Of the 4449 nodules sampled by FNA and the 8748 not sampled by FNA, 76.5% and 30.5% were malignant, respectively. The sensitivity, specificity, positive and negative predictive values (NPVs), and overall accuracy of FNA based on final pathology were 97.9%, 96.3%, 98.8%, 93.5%, and 97.5%, respectively. Nodule sizes determined by US were comparable with most nodules having either the same size range (n = 2959, 77.7%) or differing only by one size range (n = 770, 20.5%).Thyroid nodule size is inversely related to malignancy risk, as larger nodules have lower malignancy rates. Nodule size estimated by US shows relatively good correlation with final pathologic size. However, thyroid nodules should undergo FNA regardless of size. If the FNA is not benign, nodule size should influence therapeutic decision making.
The Longmen Grottoes is one of the major historical and cultural sites under state protection in China.It is well-known throughout the world for its numerous statues and lifelike exquisite carvings of the niche grottoes.There are also the geothermal water,thermal-spring locality etc.tourism resources within the Longmen Grottoes Scenic Spot.The authors have expounded the lithological features of the grottoes statues carrier,evaluated the water quality features of temperate-hot water and thermal-spring locality,and analysed the present using situation for the tourist resources of the scenic spot.Finally,the authors have put forward the proposal about the further development of tourist resources and suitable protection of scenic spot environment.
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