To investigate the clinicopathological features and prognosis of synchronous and metachronous multiple primary colorectal cancer. Patients who underwent operation for synchronous and metachronous colorectal cancer at the colorectal surgery department of Shanghai Changhai Hospital between January 2000 and December 2021 were included. Perioperative indicators were comprehensively compared and included in the survival analyses. In total, 563 patients with synchronous ( n =372) and metachronous ( n =191) colorectal cancer were included. Patients with synchronous colorectal cancer were more likely to have a long onset time, positive carcinoembryonic antigen, advanced TNM stage, large tumor, perineural invasion, p53 high expression, and mismatch repair proficient. Compared with metachronous colorectal cancer, patients with synchronous colorectal cancer showed worse 5-year overall survival (68.6±3.0% vs 81.9±3.5%, P =0.018) and 5-year disease-free survival (61.2±3.1% vs 71.0±3.9%, P =0.022). In the subgroup analysis, segmental resection was an independent risk factor for the long-term outcomes of bilateral synchronous colorectal cancer. Clinicopathological and molecular features were different between synchronous and metachronous colorectal cancer. Patients with synchronous colorectal cancer showed a worse prognosis than those with metachronous colorectal cancer. Bilateral synchronous colorectal cancer requires extended resection to achieve improved long-term outcomes.

Abstract Coronavirus disease 2019 (COVID-19) has affected the quality of sleep for various populations, causing anxiety and depression worldwide. COVID-19–related insomnia (COVIDRI) appears to be more common in certain populations, including females, urban residents and other individuals who reside in high-risk COVID-19–related areas, lack higher socioeconomic and educational levels, have a history of underlying mental illness, have no access to social support and work, or have been mandated for isolation. Among vulnerable populations, pregnant women, adolescents and children are more likely to suffer from anxiety and depression, which leads to irregular sleep-wake cycles and significantly poor sleep quality. Insomnia in COVID-19 patients is associated with decreased immune levels, excessive psychological stress and severe anxiety. The COVIDRI incidence and severity among frontline healthcare workers is high, especially among females and those working in isolation wards and intensive care units. The factors related to COVIDRI for college students during home study are stress from upcoming graduation, disharmonious family relationships and inadaptability to online education. For military personnel, anxiety and depression are the main causes of poor sleep quality. Based on the characteristics of different populations, active Chinese and Western medications, non-drug therapy, psychological counseling and suitable sleep management are vital measures to strengthen immunity, alleviate insomnia and limit recurrence.

Digital transformation is increasingly crucial to the upgrading and sustainable development of China’s manufacturing industry with the rapid development of the digital economy. To study the impact of the digital economy on the sustainable development of the manufacturing industry, this study analyzed the theoretical basis of the digital economy’s impact on the promotion of the sustainable development of the manufacturing industry. Then, based on the panel data of manufacturing sectors in 2002, 2005, 2007, 2010, 2012, 2015, and 2017, empirical tests and mechanism analysis were conducted by means of the two-way fixed effect model and the mediating effect model. The results were as follows: (1) Digital services can significantly improve the industrial performance of the manufacturing industry, while the effect of digital products is nonsignificant; (2) Mechanism analysis revealed that digital services can promote the industrial performance of the manufacturing industry through the intermediary mechanisms of reducing production costs rather than transaction costs; (3) Digital services can also reduce carbon emissions and promote the green development of the manufacturing industry through the intermediary mechanisms of innovation. In conclusion, digital services can promote the sustainable development of China’s manufacturing industry. This paper provides evidence for the integration of the manufacturing industry and the digital economy. Furthermore, it has important implications for the formulation of digital economy policies and the sustainable development of the manufacturing industry.

Retinitis pigmentosa (RP) is a group of inherited retinal disorders characterized by progressive rod and cone photoreceptor degeneration. Changes in retinal vasculature have long been associated with RP. Optical coherence tomography angiography (OCTA) is a novel imaging technology that enables noninvasive visualization of the retinal and choroidal microvasculature. OCTA enables quantification of microvascular changes in the retinal capillary plexus and choriocapillaris, in addition to qualitative feature description. Therefore, OCTA has the potential to become an important tool for better understanding, early detection, progression, and treatment of RP. In this review, we focus on the applications of OCTA in clinical research on RP. We also discuss future improvements in the OCTA technology for RP management. We believe that the advancement of the OCTA technique will ultimately lead to a better understanding of RP and aid in the prevention of visual impairment.

To evaluate the value of the β- d -glucan (BDG) testing of intraocular fluid for the diagnosis of fungal endophthalmitis (FE). Twenty patients (22 eyes) with FE were diagnosed using both culture and nonculture methods. Intraocular fluid was collected for BDG testing, including 22 eyes of FE and 55 eyes of control group. Under different BDG cutoff points as the test-positives, the BDG sensitivity, specificity, positive predictive value, and negative predictive value for FE were analyzed. The BDG testing value was 1,022.78 ± 1,362.40 pg/mL in the FE group, significantly higher than that of the control group (105.0 ± 180.80 pg/mL, P < 0.001). The area under the receiver operating characteristic (ROC) curve was 0.885 (95% confidence interval, 0.793-0.978; P < 0.001). With the prespecified BDG cutoff 107.83 pg/ml as the test-positive, sensitivity was 81.8%, specificity was 87.5%, and the Youden index was 0.693. When the BDG cutoff was depicted as 202.05 pg/mL, sensitivity reduced to 77.3%, specificity increased at 95.8%, and the Youden index reached the highest value of 0.731. β- d -glucan testing of intraocular fluid demonstrated good sensitivity and specificity regarding the diagnosis of FE, which can provide earlier diagnosis to achieve better outcomes.

Breast cancer patients experience a range of disease- and treatment-related symptoms that seriously threaten their quality of life. Virtual reality (VR), an emerging complementary and integrative therapy, has been increasingly applied in clinical practice. However, there is insufficient evidence to support the effectiveness of VR-based interventions on symptom management in breast cancer patients. This article aimed to systematically examine the effects of VR on breast cancer-related symptom management. The PubMed, EMBASE, Cochrane Library, Web of Science, CINAHL, CNKI, Wan Fang, and VIP databases were comprehensively searched for randomized controlled trials (RCTs) and quasi-RCTs published up to April 10, 2021. Studies using VR-based interventions to manage breast cancer-related symptoms were included. Two investigators independently reviewed and extracted data and evaluated methodological quality. RevMan 5.3 was used for meta-analysis, and heterogeneity was evaluated using Higgins' I2 (%) statistic. Eight RCTs and 6 quasi-RCTs with 797 participants were included. Virtual reality-based interventions significantly improved symptoms of anxiety, depression, pain, cognitive function, and shoulder range of motion in breast cancer patients, but no significant improvements in grip and upper extremity function were observed. Virtual reality-based interventions had a positive effect on symptom management for breast cancer patients. Health professionals, especially nurses, can apply VR in clinical practice to reduce symptoms and improve the quality of life of breast cancer patients. More studies are needed to draw higher quality conclusions and explore the best interventions and cost-effectiveness of VR.

A prospective and nonrandomized concurrent controlled trial. To address the early effects of concurrent treatment with vitamin K2 and vitamin D3 on fusion rates in patients who have undergone spinal surgery. Intervertebral pseudarthrosis has been reported after transforaminal lumbar interbody fusion (TLIF) or posterior lumbar interbody fusion (PLIF), especially in patients with osteopenia or osteoporosis. No study has assessed the early effects of concurrent treatment with vitamin K2 and vitamin D3 on fusion rates. Patients with osteopenia or osteoporosis who underwent TLIF or PLIF in our department were included. Patients in the VK2+VD3 group received vitamin K2, vitamin D3, and calcium treatment, whereas subjects in the control group only received calcium and vitamin D3. Spine fusion was evaluated by computed tomography. The Japanese Orthopedic Association Back Pain Evaluation Questionnaire (JOA-BPEQ) and visual analog scale (VAS) were used to assess the clinical and neurological symptoms. Bone mineral density (BMD) and bone metabolism markers were measured for osteoporotic evaluation. Seventy-eight patients were included, and nine patients subsequently discontinued because of 2019-nCoV. At six months postoperatively, complete fusion rates were significantly higher in the VK2+VD3 group than that in the control group (91.18% vs 71.43%, P = 0.036). At six months postoperatively, BMD was increased in the VK2+VD3 group and was higher than that in the control group, although there was no significant difference. At three months postoperatively, a significant increase in procollagen type I amino terminal propeptide (91.81%) and a slight decrease in C-terminal end peptide (8.06%) were observed in the VK2+VD3 group. In both groups, the JOA-BPEQ and VAS scores were significantly improved after spine surgery. Administration of vitamin K2 and vitamin D3 can increase lumbar interbody fusion rates, improve clinical symptoms, promote bone information, and avoid further decline in BMD within six months after TLIF or PLIF.Level of Evidence: 3.

Based on the global urban economic competitiveness data in 2017, this study conducts coupling analyses of the competitiveness indicator system. The comprehensive study on the coupling coordination degree among explanatory indexes of urban economic competitiveness concludes that the city with higher economic competitiveness rankings has a higher degree of coupling coordination (DCC); the city ranked lower in the economic competitiveness has a lower DCC. The cities with higher DCC are mainly those global cities or metropolis known for financial and technological innovations, while cities with bare coupling coordination are mainly in underdeveloped countries in Asia, Africa, and Latin America. Based on the findings, the paper employs a model that combines linear regression and quantile regression to identify the specific driving factors that affect the cities’ competitiveness around the world. Therefore, every city should act according to local conditions, focus on the key drivers of urban development, and address the inadequacies to balance the economic development so as to enhance its competitiveness.

In China, targeted poverty alleviation is a very important objective. By supporting farmers in producing their own goods, the majority of poor individuals have been lifted out of poverty. However, there are still some challenges that must be faced. This chapter presents insights into rural supply chain management development. A generalized blockchain-based supply chain management platform for targeted poverty alleviation is proposed. By taking advantage of blockchain, this platform can effectively help establish trust among participants, turn the supply chain into a trusted supply chain, and enhance the sustainability of poverty alleviation.KeywordsTargeted poverty alleviationSupply chain managementTrust chainSupply chain supervisionBlockchain

Malignant rhabdoid tumor is an aggressive neoplasm commonly arising from the kidney during infancy and childhood. Extrarenal forms of this tumor are relatively rare and have been reported in several extrarenal sites including central nervous system, liver, bladder, vulva, and head and neck. Hereby, we present FDG PET/CT findings of malignant extrarenal rhabdoid tumor originating from the vagina in an 8-year-old girl.