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简介：摘要：煤缝接和充满煤的地区的形成是在煤累积过程的一系列因素的综合结果。煤累积系统是煤累积因素的建筑上的聚集。它能被分类进4个层次：全球煤累积超级系统，煤累积领域大系统，煤累积盆系统，和煤缝接或煤缝接设定分系统。煤累积进程是一个开、动态、灰的系统，并且是同时有象聚集的如此的性质的一个系统，关联，全部，面向目的，层次，和环境适应性。在这份报纸，我们作为一个系统拿煤累积过程学习煤缝接和充满煤的地区的起源；并且我们将讨论煤累积过程的系统的分析的方法论。作为一个例子，Ordos煤盆被调查阐明煤累积系统分析的方法的应用程序。

简介：AbstractBackground:Historically sinonasal malignancies were always addressed via open craniofacial surgery for an oncologic resection. Increasingly esthesioneuroblastomas are excised using an exclusively endoscopic approach, however, the rarity of this disease limits the availability of long-term and large scale outcomes data.Objective:The primary objective is to evaluate the treatment modalities used and the overall survival of patients with esthesioneuroblastoma managed with exclusively endoscopic surgery.Methods:In accordance with PRISMA guidelines, PubMed was queried to identify studies describing outcomes associated with endoscopic management of esthesioneuroblastomas.Results:Forty-four out of 2462 articles met inclusion criteria, totaling 399 patients with esthesioneuroblastoma treated with an exclusively endoscopic approach. Seventy-two patients (18.0%) received adjuvant chemotherapy and 331 patients (83.0%) received postoperative radiation therapy. The average age was 50.6 years old (range 6-83). Of the 399 patients, 57 (16.6%) were Kadish stage A, 121 (35.2%) were Kadish stage B, 145 (42.2%) were Kadish stage C, and 21 (6.1%) were Kadish stage D. Pooled analysis demonstrated that 66.0% of patients had Hyams histologic Grade Ⅰ or Ⅱ, while 34.0% of patients had Grade Ⅲ or Ⅳ disease. Negative surgical margins were achieved in 86.9% of patients, and recurrence was identified in 10.3% of patients. Of those with 5-year follow-up, reported overall survival was 91.1%.Conclusion:Exclusively endoscopic surgery for esthesioneuroblastoma is performed for a wide range of disease stages and grades, and the majority of these patients are also treated with adjuvant chemotherapy or radiation therapy. Reported overall recurrence rate is 10.3% and 5-year survival is 91.1%.

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简介：AbstractNew discoveries based on genetic and epigenetic evidence have significantly expanded the understanding of diffuse gliomas. Molecular biomarkers detected in diffuse gliomas are not only potential targets for radiotherapy, chemotherapy, and immunotherapy, but are also able to guide surgical treatment. Previous studies have suggested that the optimal extent of resection of diffuse gliomas varies according to the expression of specific molecular biomarkers. However, the specific guiding role of these biomarkers in the resection of diffuse gliomas has not been systemically analyzed. This review summarizes several critical molecular biomarkers of tumorigenesis and progression in diffuse gliomas and discusses different strategies of tumor resection in the context of varying genetic expression. With ongoing study and advances in technology, molecular biomarkers will play a more important role in glioma resection and maximize the survival benefit from surgery for diffuse gliomas.

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简介：Background:InJapan,studiesonacupuncturetherapyforrespiratorydiseasehaverarelybeenreported.Additionally,mostofthereportsaredifficultforoverseasresearcherstoaccessbecausetheyarewritteninJapaneseandcannotbelocatedusingMedline.Purpose:ToreviewstudiesonacupunctureandmoxibustiontherapyforrespiratorydiseaseconductedinJapan.Datasources:Theresultsofaliteraturesearchusing'IgakuChuoZasshiWeb'andtheMedicalOnlineLibrary,bothofwhichareJapanesedatabases,coveringtheperiodbetween1979and2006.Studyselection:Thisstudyreviewedreferencescitedinretrieveddocumentsand

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简介：在季风发行量上与亚洲夏天季风和他们的影响的预言联系的风地的系统的错误在这份报纸被学习了。每天运作的分析和预报(直到day-5)预报的中等范围天气(NCMRWF)的国家中心，印度在为时期6月的亚洲夏天季风领域上，1995的7月和8月为目的被成为使用。与低级流动联系的系统的错误描出，在贸易的力量的减小弯屈导致在印度洋上生气赤道的流动以及西的流动变弱。上面的水平误差意味着在回来流动的强度西藏的反气旋和减小变弱进南部的半球。进一步，这些错误随预报时期的增加表示成长趋势。除了动能预算学期的一般低估，模型预报没能代表短暂旋涡。预报显示在旋涡的变换的增加的趋势意味着动能。这些错误使衰弱有预报时期的增加的亚洲夏天季风循环。关键词季风-系统的错误-动能预算作者对为提供数据和计算设备执行现在的学习的NCMRWF感激。

简介：Thispaperputsforwardtheconceptoflandusestructureoptimizationunderspacetimecouplingthroughanalyzingthesystematiccharacteristicoflandusestructureoptimization.Itmainlyexpoundstheconstructionoflandusestructureoptimizationmodelatdifferentlevels.Lastly,thispaperexplainsthepracticablenessoflandusestructureoptimizationundersystematicframeworkthroughtheexampleofQionghaicity.

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简介：Thenaturalmeasureofacertainareainphasespaceisdefinedfirstly.Onthebasisofnaturalmeasure,theexpressionofLyapunovexponentbasedonunstableperiodicorbits(UPOs)ofchaoticsystemsisdeducedfromtheoreticalaspect.Then,bymeansoftheinherentrelationbetweenUPOsandsystematicLyapunovexponent,thetransitionalmechanismandrouteofchaoticsystemsfromlow-dimensionalchaostohigh-dimensionalchaosareexplained.Intheend,anovelmethodforcomputingsystematicLyapunovexponentsbasedonUPOsisproposed.Itscomputingprocedureisalsosummarized.ThechaoticsystemdescribedbyHenonmapistakenasexample.ThroughcalculatingtheLypunovexponentsofthissystem,validityofthesuggestedmethodisverified.

简介：AbstractImportance:The prevalence and characteristics of short stature (SS) among children in China should be assessed to provide guidance for planning and implementation of nationwide public health policies. Thus far, there have been no accurate estimates of the prevalence of SS in China.Objective:To analyze the prevalence of SS among children in China and to explore the influences of sex, area, age, study year, and study site on prevalence rates.Methods:Relevant literature was identified by searching the following databases: PubMed, Embase, The Cochrane Library, Chinese Biomedical Literature, China Knowledge Resource Integrated, WeiPu, and WanFang databases. Meta-analysis was carried out using STATA 11.2.Results:This meta-analysis included 39 studies with 348 326 Chinese participants; the studies covered 20 provinces, municipalities, and autonomous regions. The pooled prevalence of SS was 3.2% (95% confidence interval [CI], 2.6%-3.7%; I2 = 99.8%). The prevalence of SS in boys and girls were 3.1% (95% CI, 2.5%-3.7%) and 3.2% (95% CI, 2.6%-3.9%), respectively. The sex difference was not statistically significant (P > 0.05). The prevalence of SS was higher in rural areas than in urban areas (4.7% [95% CI, 3.6%-5.8%] vs. 2.8% [95% CI, 2.2%-3.4%]; P < 0.001). The prevalence of SS was higher in West China (5.2%; 95% CI, 4.4%-6.0%) than in Northeast China (0.6%; 95% CI, 0.3%-0.8%), East China (2.3%; 95% CI, 1.9%-2.8%), or Central China (2.9%; 95% CI, 1.9%-3.9%).Interpretation:The prevalence of SS among children was higher in western and rural areas of China. Close attention to children’s growth and development is needed to prevent the occurrence of SS.

简介：AbstractBackground:Meniere’s disease (MD) is an idiopathic disorder of the inner ear, which manifests as cochleo-vestibular dysfunction. Hearing loss will progress to a profound levelin a subset of patients with MD, and vestibular interventions can independently cause loss of hearing. The aim of this study was to systematically review the published literature describing the safety and efficacy of CI in patients with MD.Materials and methods:A systematic literature review was conducted in accordance PRISMA guidelines to identify articles that assessed at least one functional outcome in patients with MD who underwent CI. Demographic information, disease history, MD symptoms, outcomes measures, and complications related to CI were extracted from included studies.Results:In total, 17 studies were included, and 182 patients with MD underwent CI. The weighted-mean age was 61.9 years (range 27-85). Study objective and methodology varied, and there was significant heterogeneity in CI outcome measures reported. In total, 179 (98.3%) of 182 patients reported objective improvements in at least one hearing metric after CI. A total of 69 patients (37.9%) reported vertigo or severe dizziness prior to CI, compared to 22 patients (15.4%) postoperatively. Two studies reported significant reductions in postoperative Tinnitus Handicap Inventory score (THI). Quality of life assessments varied between studies. Complications rates were low with only nine patients (4.9%) reporting a serious CI-related complication.Conclusions:This systematic review evaluated 17 studies describing the safety and efficacy of CI in patients with MD and encountered many challenges due to small sample sizes, and heterogeneity in study design and outcomes measured. Despite these limitations, this study of 182 patients is to the best of our knowledge the largest systematic review evaluating the safety and efficacy of CI in MD. The results of this study support the need for a standardized approach to evaluating outcomes of CI in patients with MD in future studies.

简介：AbstractObjective:To comprehensively review the recent published literature to characterize current trends of burnout and well-being among otolaryngology trainees.Methods:Study design: systematic review and meta-analysis. A comprehensive literature review from 2000 to 2021 of studies related to otolaryngology resident burnout and well-being, as well as the general topic of well-being among surgical residents was completed. All included studies were summarized qualitatively. For the quantitative analysis, only articles reporting a Maslach burnout inventory (MBI), modified MBI or Mini-Z-Burnout assessment were included.Results:Twenty-five articles were included in the qualitative summary and nine articles in the quantitative analysis. In the qualitative summary, trainees were reported to have increased levels of distress and emotional hardening compared to attending otolaryngologists. Total hours worked per week and female gender were associated with worsened well-being. Residency program strategies to improve trainee well-being include program-sponsored wellness activities, dedicated wellness champions, and assistance with clerical burden. Implementation of protected nonclinical time has been shown to decrease burnout and increase well-being among trainees. Moreover, formal trainee mentorship programs have also been shown to reduce trainee burnout and stress. In the quantitative analysis, rates of trainee burnout ranged from 29.7% to 86% with an overall trend towards reduced rates of burnout from 2006 to 2021. Utilizing a weighted average, the overall burnout among otolaryngology residents was 58.6%.Conclusions:Rates of burnout remain high among otolaryngology trainees. Implementing formal mentorship programs and providing protected time during regular work hours appear to be effective tools to improve resident well-being.

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