简介：AbstractBackground:Despite almost two decades of well-funded and comprehensive response efforts by the Chinese Government, human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) remains a major problem in China. Yet, few studies have recently examined long-term trends in HIV/AIDS prevalence, incidence, and mortality at the national level. This study aimed to determine the prevalence, incidence, and mortality trends for HIV/AIDS over the past 28 years in China.Methods:We conducted a descriptive, epidemiological, secondary analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017 data. To evaluate trends in prevalence, incidence, and mortality over the study period from 1990 to 2017, we calculated values for annual percentage change (APC) and corresponding 95% confidence intervals (CIs) using joinpoint regression analysis.Results:A significant increase in HIV/AIDS prevalence was observed for 1990 to 2009 (APC: 10.7; 95% CI: 10.4, 11.0; P < 0.001), and then remained stable for 2009 to 2017 (APC: 0.7; 95% CI: -0.3, 1.7; P = 0.1). A significant increase in HIV incidence was also observed for 1990 to 2005 (APC: 13.0; 95% CI: 12.6, 13.4; P < 0.001), and then a significant decrease was detected for 2005 to 2017 (APC: -6.5; 95% CI: -7.0, -6.1; P < 0.001). A significant increase in AIDS-related mortality rate was detected for 1990 to 2004 (APC: 10.3; 95% CI: 9.3, 11.3; P < 0.001), followed by a period of stability for 2004 to 2013 (APC: 1.3; 95% CI: -0.7, 3.3; P = 0.2), and then another significant increase for 2013 to 2017 (APC: 15.3; 95% CI: 8.7, 22.2; P < 0.001).Conclusions:Although prevalence has stabilized and incidence has declined, AIDS-related mortality has risen sharply in recent years. These findings suggest more must be done to bring people into treatment earlier, retain them in treatment more effectively, actively seek to reenter them in treatment if they dropout, and improve the quality of treatment and care regimens.

简介：AbstractPurpose:The triage and initial care of injured patients and a subsequent right level of care is paramount for an overall outcome after traumatic injury. Early recognition of patients is an important case of such decision-making with risk of worse prognosis. This article is to answer if clinical and paraclinical signs can predict the critical conditions of injured patients after traumatic injury resuscitation.Methods:The study included 1107 trauma patients, 16 years and older. The patients were trauma victims of Levels I and II triage and admitted to the Rajaee (Emtiaz) Trauma Hospital, Shiraz, in 2014-2015. The cross-industry process for data mining methodology and modeling was used for assessing the best early clinical and paraclinical variables to predict the patients' prognosis. Five modeling methods including the support vector machine, K-nearest neighbor algorithms, Bagging and Adaboost, and the neural network were compared by some evaluation criteria.Results:Learning algorithms can predict the deterioration of injured patients by monitoring the Bagging and SVM models with 99% accuracy. The most-fitted variables were Glasgow Coma Scale score, base deficit, and diastolic blood pressure especially after initial resuscitation in the algorithms for overall outcome predictions.Conclusion:Data mining could help in triage, initial treatment, and further decision-making for outcome measures in trauma patients. Clinical and paraclinical variables after resuscitation could predict short-term outcomes much better than variables on arrival. With artificial intelligence modeling system, diastolic blood pressure after resuscitation has a greater association with predicting early mortality rather than systolic blood pressure after resuscitation. Artificial intelligence monitoring may have a role in trauma care and should be further investigated.

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简介：AbstractIntroduction:Neuroblastoma (NB) is the most common extracranial solid tumor among children. The 5-year event-free survival rate for high-risk (HR) NB is still poor, especially for patients with advanced NB with MYCN gene amplification. Chimeric antigen receptor T (CAR-T) cell therapy is a new treatment for HR-NB.Case presentation:A 55-month-old boy with stage IV HR-NB received 4th-generation CAR-T cells that target disialoganglioside GD2, as consolidation maintenance treatment after intensive chemotherapy, surgery, and autologous stem-cell transplantation. As of February 2019, his CAR-T follow-up time was 37.5 months, indicating prolonged survival. Cranial MRI and ultrasound showed no mass; 123I-metaiodobenzylguanidine (123I-MIBG) scan was negative.Conclusion:GD2-CAR-T cells may be an effective treatment option for NB patients with MYCN amplification.

简介：摘要BACKGROUNDCorona Virus Disease-2019 (COVID-19) pandemic is quickly spreading, putting under heavy stress health systems worldwide and especially Intensive Care Units (ICU). Rehabilitation Units have a crucial role in reducing disability in order to reintroduce patients in the community.OBJECTIVETo characterize pulmonary function and disability status and to propose an early rehabilitation protocol in a cohort of post-acute COVID-19 patients admitted to an Italian Rehabilitation Unit.METHODSDemographic, anamnestic and clinical characteristics, laboratory exams and medical imaging findings were collected for the entire cohort. Outcome measures evaluated at the admission in Rehabilitation Unit were: type of respiratory supports needed, fraction of inspired oxygen (FIO2), partial pressure of oxygen (PaO2), FIO2/PaO2, Barthel Index (BI), modified Medical Research Council (mMRC) Dyspnoea Scale, and 6-Minute Walking Test (6-MWT). Furthermore, we proposed an early rehabilitation protocol for COVID-19 patients based on baseline FiO2.RESULTSWe included 32 post-acute COVID-19 patients (22 male and 10 female), mean aged 72.6±10.9 years. BI was 45.2±27.6, with patients in need of higher FIO2 (≥ 40%) showing lower values: 39.6±25.7 vs 53.3±29.3. All patients had grade 4 or 5 on the mMRC Dyspnoea Scale. Only 14 COVID-19 patients were able to walk (43.7%). 6-MWT was feasible in 6 (18.8%) patients with a mean distance of 45.0±100.6 meters.CONCLUSIONSTaken together, our findings suggest that post-acute COVID-19 patients suffered from dyspnoea and shortness of breath even for minimal activities, with a resulting severe disability, and only a few of them were able to perform 6-MWT with poor results. An early rehabilitation protocol was proposed according to the baseline conditions of the patients.

简介：BACKGROUND:Intracerebralhemorrhage(ICH)andcoronaryheartdisease(CHD)havethesamepathologicalbase,atherosclerosis,andthesimilarriskfactors,suchassmoking,drinking,hypertension,hyperlipemia,diabetesmellitus,etc;butthedistributionsoftwodiseasesareverydifferentinthepopulations.Thismayberelatedtotheexposureofriskfactorsanddifferenteffectsofriskfactorsontwodiseases.OBJECTIVE:ToanalyzethedistributiondifferenceofriskfactorsforICHandCHDinthepopulationsofTongliaocityofNeiMonggolAutonomousRegion.DESIGN:Retrospectiveanalysis.SETTING:SchoolofRadiationMedicineandPublicHealth,SoochowUniversity;TongliaoHospital,NeiMonggolAutonomousRegion.PARTICIPANTS:Randomsamplingwasusedtoselect6hospitalsfrom10hospitalsaffiliatedtoTongliaoCityofNeiMonggolAutonomousRegion.Totally1672medicalrecordsofpatientswithICHand2195medicalrecordsofpatientswithCHDadmittedtoDepartmentofNeurologyandDepartmentofCardiovascularInternalMedicineofabove-mentioned6hospitalsbetweenJanuary2003andDecember2005werecollectedaccordingtotheinvestigationneed.METHODS:Thesubjects,whosemedicalrecordswereinvolved,wereperformedretrospectiveanalysiswithpre-preparedquestionnaire'StrokeandCoronaryHeartDiseaseEpidemiologicQuestionnaire'.Themaincontentsincluded:①Socialdemographycondition:Thedistributionsofgender,age,nationality,etc.②Previoushistoryofdisease:hypertension,diabetesmellitus,etc.③Relatedriskfactors:systolicbloodpressure,diastolicbloodpressure,totalcholesterol,triglyceride,high-densitylipoproteincholesterol,low-densitylipoproteincholesterol,smoking,drinkingandglucose(GLU).ThedatabaseofEpidatawastransformedtoSPSSdatabase.Single-andmultiple-factornon-conditionalLogisticregressionanalysiswereperformedonthedata,andORvalueand95%CIwerecalculated.Thedistributiondifferencesofriskfactorsfortwodiseaseswerecompared