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农业面源污染 2

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Atypical manifestations of acute coronary syndrome — throat discomfort: a multi-center observational study

《医学前沿（英文）》 2022年 第16卷 第4期   页码 651-658 doi: 10.1007/s11684-021-0859-0

摘要： To present the clinical characteristics and the misdiagnosis rate of acute coronary syndrome manifested primarily as throat discomfort, we conducted a multicentric and retrospective study in the cardiology and otorhinolaryngology departments. Records of patients with primary complaint of throat discomfort, absence of chest pain at onset, and an ultimate diagnosis of acute coronary syndrome, as well as patients with pharyngitis (as controls) were collected from May 2015 to April 2016. The patients’ main manifestations were compared. Logistic regression results showed that chest tightness, dyspnea, perspiring, and exertional throat symptoms were significantly associated with acute coronary syndrome, with odds ratios of 8.3 (95% CI 2.2−31.5), 10.9 (95% CI 1.8−66.9), 25.4 (95% CI 3.6−179.9), and 81.2 (95% CI 13.0−506.7). A total of 25 (56.82%) out of 44 acute coronary syndrome patients, who were first admitted to the otorhinolaryngology department, were misdiagnosed, with a 12% (3/25) mortality rate. Throat discomfort can be the principal manifestation of acute coronary syndrome. Such patients exhibit high misdiagnosis and mortality rates. Exertional throat symptoms, chest tightness, perspiring, and dyspnea were important indicators of acute coronary syndrome in patients whose main complaint was throat discomfort. The awareness of this condition will result in prompt diagnosis and reduce morbidity and mortality.

关键词： acute coronary syndrome (ACS)     throat discomfort (TD)     throat pain     cardiology departments     non-cardiologic physicians    

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Changes in public trust in physicians: empirical evidence from China

Dahai Zhao, Zhiruo Zhang

《医学前沿（英文）》 2019年 第13卷 第4期   页码 504-510 doi: 10.1007/s11684-018-0666-4

摘要： Studies examining the trends in public trust in physicians have provided a considerable amount of valuable policy implications for policymakers compared with cross-sectional studies on this topic in many countries. This study investigated changes in public trust in physicians in China based on two cross-sectional national surveys conducted in 2011 and 2016 and identified the determinants of these changes. The results indicated 83.4% of respondents in 2011 reported trust or strong trust in physicians in China, which decreased to 64.2% by 2016. The results of ordinal logistic regression demonstrated that public trust in physicians in China had decreased significantly from 2011 to 2016 ( <0.001) after adjusting for other independent variables. Self-reported health status, self-rated happiness, and self-identified social class were all associated positively with public trust in physicians in China. The results also confirmed that decreasing public satisfaction with the most recent treatment experience was the major determinant of decreasing public trust in physicians in China. The findings of this study suggest that decreasing public trust in physicians deserves considerable attention from national policymakers and that improving satisfaction with treatment experiences would be the most effective strategy for enhancing public trust in physicians in China.

关键词： trust in physicians     public trust     physician-patient relationship     health system performance    

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Clinical decision-making by the emergency department resident physicians for critically ill patients

null

《医学前沿（英文）》 2012年 第6卷 第1期   页码 89-93 doi: 10.1007/s11684-012-0183-9

摘要：

The application of main methodologies for clinical decision-making by residents in emergency medical practice was assessed, and issues in this area were investigated. The treatments provided to 2 611 critical patients by the Peking Union Medical College Hospital of were analyzed by independent investigators who evaluated the main clinical decision-making processes applied by the hospital residents. The application of decision-making strategies by PG1 and PG3 groups, which means the residents in first year and the third year, were compared. The patients were treated according to pattern recognition (43.0%), hypothetico-deductive reasoning (23.4%), event-driven models (19.3%), and rule-using algorithms (5.9%). A significant difference was found between PG1 and PG3 groups (χ2=498.01, P<0.001). Pattern recognition and hypothetic-deductive methods were the most common techniques applied by emergency physicians in evaluating critically ill patients. The decision-making processes applied by junior and senior residents were significantly different, although neither group adequately applied rule-using algorithms. Inclusion of clinical decision-making in medical curricula is needed to improve decision-making in critical care.

关键词： clinical decision-making     emergency medicine     critically ill patient     resident     methodology    

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Effectively cultivate the next generation of competent Chinese physicians: a perspective from a physician

Zongyu John CHEN,

《医学前沿（英文）》 2010年 第4卷 第4期   页码 473-476 doi: 10.1007/s11684-010-0290-4

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Investigating the effect of online and offline reputation on the provision of online counseling services: A case study of the Internet hospitals in China

《工程管理前沿（英文）》   页码 563-576 doi: 10.1007/s42524-022-0198-0

摘要： The sustainable development of Internet hospitals and e-health platforms relies on the participation of patients and physicians, especially on the provision of health counseling services by physicians. The objective of our study is to explore the factors motivating Chinese physicians to provide online health counseling services from the perspectives of their online and offline reputation. We collect the data of 141029 physicians from 6173 offline hospitals located in 350 cities in China. Based on the reputation theory and previous studies, we incorporate patients’ feedback as physicians’ online reputation and incorporate physicians’ offline professional status as physicians’ offline reputation. Results show that physicians’ online reputation significantly and positively influence their online counseling behaviors, whereas physicians’ offline reputation significantly and negatively influence their online counseling behaviors. We conclude that physician’s online and offline reputations show a competitive and substitute relationship rather than a complementary relationship in influencing physicians to provide online counseling services in Internet hospitals. One possible explanation for the substitute relationship could be the constraints of limited time and effort of physicians.

关键词： Internet hospitals     physicians’ online counseling     online reputation     offline reputation    

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Bevacizumab in combination with pemetrexed and platinum for elderly patients with advanced non-squamousnon-small-cell lung cancer: a retrospective analysis

《医学前沿（英文）》 2022年 第16卷 第4期   页码 610-617 doi: 10.1007/s11684-021-0827-8

摘要： Bevacizumab, an anti-VEGF monoclonal antibody, has significantly improved the clinical outcomes of patients with advanced non-squamous NSCLC (ns-NSCLC). However, the safety and efficacy of bevacizumab for elderly patients with advanced NSCLC require further investigation. Thus, 59 patients were included in the present retrospective study, 22 patients in the bevacizumab plus pemetrexed and platinum (B+PP) group, and 37 patients in the pemetrexed and platinum (PP) group. For the entire cohort of patients, the median OS was 33.3 months, and the 1-year and 2-year overall survival rates were 88.5% and 67.8%, respectively. The median OS and 1-year and 2-year OS rates were 20.5 months, 70.3% and 0%, respectively, in the B+PP group and 33.4 months, 97.0% and 89.4%, respectively, in the PP group (P <0.001). The incidence of grade≥3 adverse events was higher in the B+PP group than in the PP group (27.3% vs. 10.8%, respectively; P=0.204). Univariate and multivariate analyses suggested that the receipt of≥5 cycles of first-line chemotherapy was an independent favorable prognostic factor for OS, whereas the addition of bevacizumab was an unfavorable prognostic factor. With increased toxicities, the addition of bevacizumab to PP does not improve the overall survival of elderly patients with advanced ns-NSCLC.

关键词： bevacizumab     elderly patient     advanced non-small-cell lung cancer     overall survival     toxicity    

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gum or patch treatment for smoking cessation and smoking reduction: a multi-centre study in Chinese physicians

null

《医学前沿（英文）》 2014年 第8卷 第1期   页码 84-90 doi: 10.1007/s11684-014-0311-9

摘要：

In China, around 23% of physicians (41% male, 3% female) currently smoke. Pharmacotherapy for tobacco dependence is available, but is not widely used in China. The purpose of this study was to estimate the effectiveness and the safety on smoking cessation of nicotine gum and nicotine patch in Chinese healthcare professionals. Three hundred regular smokers motivated to quit were recruited from six hospitals in China. All subjects were accepted nicotine replacement therapy, and they could choose nicotine gum (2 mg or 4 mg, depending on baseline smoking level) or nicotine patch (15 mg/16 h) for 12 weeks, with a 12-week follow-up. Limited behavioural support was provided. At Week 24, the 2--24 weeks continuous abstinence rate (verified by expired carbon monoxide) was 17%, the point prevalence abstinence rate (no smoking since the previous visit) was 35%, and 38% of subjects had continuously reduced their daily cigarette consumption by at least 50% versus baseline. Compliance with treatment was good, particularly with patch. No serious adverse event was reported, and most adverse events were mild or moderate. The most common treatment-related adverse events were gastro-intestinal (both gum and patch) and local irritation symptoms. Nicotine patch and gum were well tolerated in Chinese smokers. Abstinence rates were comparable to those previously reported with nicotine replacement therapy, and many smokers who did not quit substantially reduced their cigarette consumption.

关键词： nicotine replacement therapy     smoking cessation     Chinese physicians    

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Error analysis of the parameters for non-coaxial grazing X-ray microscope

ZHAO Lingling, HU Jiasheng, LI Xiang

《机械工程前沿（英文）》 2007年 第2卷 第3期   页码 323-329 doi: 10.1007/s11465-007-0057-z

摘要： A non-coaxial grazing X-ray microscope, consisting of four spherical mirrors, is designed for diagnosis of inertial confinement fusion (ICF). The aberrations and imaging quality of the microscope are analyzed. To acquire excellent imaging quality, suitable tolerances for manufacturing and assembling the microscope are necessary. This paper researches the changes of Gauss parameters and aberrations due to component and subsystem parameters (such as the radius of the mirror, angle between mirrors, grazing angle, object distance, etc.). Here, spot diagrams and modulation transfer function (MTF) are first adopted to quantitatively evaluate the imaging quality of the microscope. Suitable manufacturing tolerances of components and assembly tolerances of the system are established on the basis of the discussion and analysis. A set of non-coaxial grazing X-ray microscopes is manufactured based on the tolerances. In site tests of ICF, the images with high resolution are obtained by the microscope.

关键词： non-coaxial     spherical     manufacturing     necessary     diagnosis    

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Molecular classification of non-small-cell lung cancer: diagnosis, individualized treatment, and prognosis

null

《医学前沿（英文）》 2013年 第7卷 第2期   页码 157-171 doi: 10.1007/s11684-013-0272-4

摘要：

Non-small-cell lung cancer (NSCLC) is the most common cause of premature death among the malignant diseases worldwide. The current staging criteria do not fully capture the complexity of this disease. Molecular biology techniques, particularly gene expression microarrays, proteomics, and next-generation sequencing, have recently been developed to facilitate effectively its molecular classification. The underlying etiology, pathogenesis, therapeutics, and prognosis of NSCLC based on an improved molecular classification scheme may promote individualized treatment and improve clinical outcomes. This review focuses on the molecular classification of NSCLC based on gene expression microarray technology reported during the past decade, as well as their applications for improving the diagnosis, staging and treatment of NSCLC, including the discovery of prognostic markers or potential therapeutic targets. We highlight some of the recent studies that may refine the identification of NSCLC subtypes using novel techniques such as epigenetics, proteomics, or deep sequencing.

关键词： non-small-cell lung cancer     molecular typing     individualized medicine     molecular-targeted therapy     gene expression profiling    

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The world’s first offshore wind power non-desalination of seawater electrolysis for hydrogen production

《能源前沿（英文）》 2023年 第17卷 第3期   页码 317-319 doi: 10.1007/s11708-023-0888-2

摘要： The world’s first offshore wind power non-desalination of seawater electrolysis for hydrogen production successfully tested in Fujian, China

关键词： China     wind power non    

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Identify the contribution of vehicle non-exhaust emissions: a single particle aerosol mass spectrometer

《环境科学与工程前沿（英文）》 2023年 第17卷 第5期 doi: 10.1007/s11783-023-1662-8

摘要：

● A single particle observation was conducted in a high traffic flow road environment.

关键词： Non-exhaust emissions     SPAMS     PMF     Roadside environment    

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A conceptual methodology for simultaneous optimization of water and heat with non-isothermal mixing

Yanlong Hou, Wanni Xie, Zhenya Duan, Jingtao Wang

《化学科学与工程前沿（英文）》 2017年 第11卷 第2期   页码 154-165 doi: 10.1007/s11705-016-1593-z

摘要： A new conceptual methodology is proposed to simultaneously integrate water allocation and energy networks with non-isothermal mixing. This method employs a simultaneous model and includes two design steps. In the first step, the water allocation network (WAN), which could achieve the targets of saving water and energy, is obtained by taking account the temperature factor into the design procedure. The optimized targets of both freshwater and energy are reached at this step which ensures this approach is a simultaneous one. In the second step, based on the obtained WAN, the whole water allocation and heat exchange network (WAHEN) is combined with the non-isothermal mixing to reduce the number of heat exchangers. The thus obtained WAHEN can achieve three optimization targets (minimization of water, energy and the number of heat exchangers). Furthermore, the effectivity of our method has been demonstrated by solving two literature examples.

关键词： simultaneous integration     non-isothermal mixing     multi-target optimization     water and energy networks    

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FULL TIME-SPACE GOVERNANCE STRATEGY AND TECHNOLOGY FOR CROPLAND NON-POINT POLLUTION CONTROL IN CHINA

《农业科学与工程前沿（英文）》 2023年 第10卷 第4期   页码 593-606 doi: 10.15302/J-FASE-2023522

摘要：

Ensuring food safety while reducing agricultural non-point source pollution is quite challenging, especially in developing and underdeveloped countries. Effective systematic strategies and comprehensive technologies need to be developed for agricultural non-point source pollution control at the watershed scale to improve surface water quality. In this review, a proposal is made for a full time-space governance strategy that prioritizes source management followed by endpoint water pollution control. The 4R chain technology system is specifically reviewed, including source reduction, process retention, nutrient reuse and water restoration. The 4R chain technology system with the full time-space governance strategy was applied at the scale of an administrative village and proved to be a feasible solution for reducing agricultural non-point source pollution in China. In the future, a monitoring system needs to be established to trace N and P transport. Additionally, new smart fertilizer and intelligent equipment need to be developed, and relevant governance standards and supportive policies need to be set to enhance the efficacy of agricultural non-point source pollution control.

关键词： 4R chain technology system     agricultural non-point source pollution     case study     full time-space governance strategy    

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Effect of non-uniform illumination on performance of solar thermoelectric generators

Ershuai YIN, Qiang LI, Yimin XUAN

《能源前沿（英文）》 2018年 第12卷 第2期   页码 239-248 doi: 10.1007/s11708-018-0533-7

摘要： Solar thermoelectric generators (STEGs) are heat engines which can generate electricity from concentrated sunlight. The non-uniform illumination caused by the optical concentrator may affect the performance of solar thermoelectric generators. In this paper, a three-dimensional finite element model of solar thermoelectric generators is established. The two-dimensional Gaussian distribution is employed to modify the illumination profiles incident on the thermoelectric generator. Six non-uniformities of solar illumination are investigated while keeping the total energy constant. The influences of non-uniform illumination on the temperature distribution, the voltage distribution, and the maximum output power are respectively discussed. Three thermoelectric generators with 32, 18 and 8 pairs of thermocouples are compared to investigate their capability under non-uniform solar radiation. The result shows that the non-uniformity of the solar illumination has a great effect on the temperature distribution and the voltage distribution. Central thermoelectric legs can achieve a larger temperature difference and generate a larger voltage than peripheral ones. The non-uniform solar illumination will weaken the capability of the TE generator, and the maximum output power decrease by 1.4% among the range of non-uniformity studied in this paper. Reducing the number of the thermoelectric legs for non-uniform solar illumination can greatly increase the performance of the thermoelectric generator.

关键词： solar thermoelectric generators     non-uniform solar illumination     performance evaluation     solar energy    

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标题 作者 时间 类型 操作

Atypical manifestations of acute coronary syndrome — throat discomfort: a multi-center observational study

期刊论文

Changes in public trust in physicians: empirical evidence from China

Dahai Zhao, Zhiruo Zhang

期刊论文

Clinical decision-making by the emergency department resident physicians for critically ill patients

null

期刊论文

Effectively cultivate the next generation of competent Chinese physicians: a perspective from a physician

Zongyu John CHEN,

期刊论文

Investigating the effect of online and offline reputation on the provision of online counseling services: A case study of the Internet hospitals in China

期刊论文

Bevacizumab in combination with pemetrexed and platinum for elderly patients with advanced non-squamousnon-small-cell lung cancer: a retrospective analysis

期刊论文

gum or patch treatment for smoking cessation and smoking reduction: a multi-centre study in Chinese physicians

null

期刊论文

Error analysis of the parameters for non-coaxial grazing X-ray microscope

ZHAO Lingling, HU Jiasheng, LI Xiang

期刊论文

Molecular classification of non-small-cell lung cancer: diagnosis, individualized treatment, and prognosis

null

期刊论文

The world’s first offshore wind power non-desalination of seawater electrolysis for hydrogen production

期刊论文

周波：Do Energy Subsidies Occupy Fiscal and Household Non-Energy Expenditures?（2020年7月12日）

2022年06月10日

会议视频

Identify the contribution of vehicle non-exhaust emissions: a single particle aerosol mass spectrometer

期刊论文

A conceptual methodology for simultaneous optimization of water and heat with non-isothermal mixing

Yanlong Hou, Wanni Xie, Zhenya Duan, Jingtao Wang

期刊论文

FULL TIME-SPACE GOVERNANCE STRATEGY AND TECHNOLOGY FOR CROPLAND NON-POINT POLLUTION CONTROL IN CHINA

期刊论文

Effect of non-uniform illumination on performance of solar thermoelectric generators

Ershuai YIN, Qiang LI, Yimin XUAN

期刊论文