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Open access

Fang Ren, Louis Simonson and Zhixin Pan

Abstract

This study presents an interpretation system model of geoheritage to facilitate the understanding of geoscience knowledge by the common lay person. Interpretation system construction is crucial to geoparks and is a shared value. The improvement of the effectiveness of geoheritage interpretation is still under exploration. Therefore, the interpretation systems of two global geoparks in China are outlined and compared with the interpretation system in Zion National Park in the United States. From lessons and experiences, this paper suggests utilizing geotourism as a complete contextual communication system, in which a geopark (source) delivers information about its unique cultural and natural values to target tourists (receivers) through tourism activities (channels). The communication effect of geotourism is monitored by feedback from tourists through the post-travel surveys or activities. We expect that this model will provide a better interpretation of geoheritage with a new perspective.

Open access

Qing Fang, Zeping Tong, Liang Ren and Ao Liu

Abstract

Price decision is studied in a risk-averse retailer-dominated dual-channel supply chain, which consisting of one manufacturers and one retailer with both off-line and on-line channels. Firstly, two mean-variance models in centralized and decentralized supply chain are established. Secondly, the optimal solutions under the two decision modes are compared and analyzed. The results shows that the price of dual-channel of retailer decreased with the increase of retailers’ risk- aversion coefficient and the standard deviation of the fluctuation of market demand, while the wholesale price changes is on the contrary; in addition, when the market demand is greater than a certain value, the prices of dual channel are correspondingly higher in decentralized supply chain than in centralized supply chain, and vice versa. In addition, when the retailer’s risk aversion is in a certain interval, the expected utility of the whole supply chain is greater in centralized supply chain than in decentralized decision, and vice versa. Finally, a numerical example is given to verify the above conclusions.

Open access

Yao-ren Hu, Hua-dong Yan, Guo-sheng Gao, Cheng-liang Zhu and Ji-fang Cheng

Abstract

Objective To investigate the efficiency of pegylated interferon α therapy for patients with HBeAg-positive chronic hepatitis B (CHB) and explore whether liver histopathological features and other factors might influence HBeAg seroconversion.

Methods Total of 80 HBeAg-positive CHB patients who received liver puncture were treated with pegylated interferon α once a week for 48 weeks. The rate of HBeAg seroconversion was determined after therapy, and the factors influencing HBeAg seroconversion were analyzed.

Results The rate of HBeAg seroconversion was 30.00% at the end of treatment. The rate of HBeAg seroconversion gradually increased with the elevation of liver inflammatory activity (χ2 = 9.170, P = 0.027). But liver fibrosis has little correlation with the rate of HBeAg seroconversion (χ2 = 5.917, P = 0.116). Except HBeAg, other baseline indexes including gender, age, serum ALT and serum HBV DNA 1evels had no statistical difference between the patients with HBeAg seroconversion and the patients without HBeAg seroconversion. By binary logistic regression analysis, liver inflammation and HBeAg were influencing factors for HBeAg seroconversion.

Conclusions Pegylated interferon α therapy induces a higher rate of HBeAg seroconversion in HBeAg-positive chronic hepatitis B patients with severe liver inflammation, so the liver biopsies should be performed in time.

Open access

Fang Wang, Xin Huang, Liang Wen, Jiang-biao Gong, Hao Wang, Gu Li, Ren-ya Zhan and Xiao-feng Yang

Abstract

Background: The Marshall computed tomography (CT) system for classification of traumatic brain injury (TBI) includes the most important independent prognostic variables except for traumatic subarachnoid hemorrhage (tSAH).

Objectives: To evaluate the prognostic effect of tSAH on different injury types based on the Marshall CT system.

Methods: We performed a retrospective study. All patients with severe closed head injury admitted from February 2011 to July 2012 were included. Their scans were classified into two groups: localized injury and diffuse injury using the Marshall classification. Outcomes were compared between patients with tSAH and those without tSAH among the two groups.

Results: Ninety-six patients were included in this study. Seventy-two (75%) were found to have tSAH, and outcomes significantly negatively correlated with tSAH in both localized injury and diffused injury groups.

Conclusions: tSAH had an important effect on the patients’ outcome. Although the Marshall classification includes important independent prognostic variables, tSAH should also be added.

Open access

Yong-jian Ji, Wan-hua Ren, Fei-fei Li, Jian-ting Fang, Xi-zhen Sun and Cheng-yong Qin

Abstract

Objective To investigate the quantitation of hepatitis B e antigen (HBeAg) at week 24 in predicting the efficacy of pegylated-interferon alfa-2a (Peg-IFN-α 2a) in HBeAg-positive chronic hepatitis B (CHB) patients at week 48 and to find a useful predictor for treatment efficacy and investigate individualized treatment of antiviral therapy.

Methods Ninety-six HBeAg-positive CHB patients with detectable HBeAg who were treated with Peg-IFN-α 2a were enrolled in this trial. They were categorized into 3 groups according to the changes of HBeAg in week 24: HBeAg decline > 2 log10 group (group A), HBeAg decline between 1 1og10 - 2 log10 (group B), HBeAg decline < 1 log10 group (group C), and group C was randomly distributed into C1 and C2. The patients in group A, group B, and group C1 continued the original therapy and the patients in group C2 were given lamivudine plus Peg-IFN-α 2a for 24 weeks. At week 48, the treatment efficacy and hepatitis B virus covalently closed circular DNA (HBV cccDNA) in liver biopsies were analyzed.

Results At week 48, mean reduction of serum HBV DNA: group A: 5.8 log10 copies/ml, group B: 3.8 log10 copies/ml, group C1: 2.8 log10 copies/ml, group C2: 5.7 log10 copies/ml, the reduction of HBV DNA in group A was greater than groups B and C1 (P < 0.01), that in group C1 was greater than group C2 (P < 0.01), the difference between groups B and C1 had no statistical significance (P = 0.19). Mean reduction of HBeAg: group A: 2.7 log10S/CO, group B: 1.9 log10S/CO, group C1: 0.9 log10S/CO, group C2: 1.5 log10S/CO, the difference among groups A, B and C1 and between groups C1 and C2 were statistically significant (P < 0.01). At week 48, HBV DNA undetectable rate in group A, group B, group C1 and group C2 were 87.5%, 34.5%, 17.4% and 81.9%, respectively, the rate in group A was greater than groups B and C1 (P < 0.01),that in group C1 was greater than group C2 (P < 0.01). HBeAg seroconversion rate were 75.0%, 24.1%, 13.0% and 22.7%, respectively, that in group A was greater than groups B and C1 (P < 0.01). Group A had lower cccDNA in liver tissue than group B and group C1 (P < 0.01). The difference of HBV cccDNA between groups B and C1 and that between groups C1 and C2 had no statistical significance.

Conclusions HBeAg decline > 2 log10 at week 24 in Peg-IFN-α 2a-treated hepatitis B patients suggested a better efficacy at week 48; HBeAg decline < 2 log10 at week 24 suggests a worse efficacy at week 48, the combined therapy of Peg-IFN-α and lamivudine could improve the clinical responses. The change of quantitative of HBeAg at week 24 may be used as a predictor of treatment effects at week 48.

Open access

Jiang-Biao Gong, Liang Wen, Ren-Ya Zhan, Heng-Jun Zhou, Fang Wang, Gu Li and Xiao-Feng Yang

Abstract

Background: Decompressing craniectomy (DC) is an important method for the management of severe traumatic brain injury (TBI).

Objective: To analyze the effect of prophylactic DC within 24 hours after head trauma TBI.

Methods: Seventy-two patients undergoing prophylactic DC for severe TBI were included in this retrospective study. Both of the early and late outcomes were studied and the prognostic factors were analyzed.

Results: In this series, cumulative death in the first 30 days after DC was 26%, and 28 (53%) of 53 survivors in the first month had a good outcomes. The factors including Glasgow Coma Score (GCS) score at admission, whether the patient had an abnormal pupil response and whether the midline shift was greater than 5 mm were most important prognostic factors for the prediction of death in the first 30 days and the final outcome at 6 months after DC.

Conclusion: Prophylactic DC plays an important role in the management of highly elevated ICP, especially when other methods of reduction of ICP are unavailable.

Open access

Xin Liu, Yongfeng Ren, Chengqun Chu and Wei Fang

Abstract

This paper presents a simple DFT-based golden section searching algorithm (DGSSA) for the single tone frequency estimation. Because of truncation and discreteness in signal samples, Fast Fourier Transform (FFT) and Discrete Fourier Transform (DFT) are inevitable to cause the spectrum leakage and fence effect which lead to a low estimation accuracy. This method can improve the estimation accuracy under conditions of a low signal-to-noise ratio (SNR) and a low resolution. This method firstly uses three FFT samples to determine the frequency searching scope, then – besides the frequency – the estimated values of amplitude, phase and dc component are obtained by minimizing the least square (LS) fitting error of three-parameter sine fitting. By setting reasonable stop conditions or the number of iterations, the accurate frequency estimation can be realized. The accuracy of this method, when applied to observed single-tone sinusoid samples corrupted by white Gaussian noise, is investigated by different methods with respect to the unbiased Cramer-Rao Low Bound (CRLB). The simulation results show that the root mean square error (RMSE) of the frequency estimation curve is consistent with the tendency of CRLB as SNR increases, even in the case of a small number of samples. The average RMSE of the frequency estimation is less than 1.5 times the CRLB with SNR = 20 dB and N = 512.

Open access

Rui-Fang Zhu, Hong-Xia Ren, Xiu-Juan Wang, Chi-Chen Zhang, Qi Yu, Zhi-Guang Duan and Shi-Fan Han

Abstract

As nursing becomes a first-level discipline, the central focus of the development process of nursing science is the independent exploration of the future path of nursing care. Although many countries have made efforts to develop nursing as an independent discipline, no remarkable advancement has been achieved due to the incorrect understanding of the relationship between nursing and medicine and the improper comprehension of other factors involved in the process of nursing reform. Teaching and practicing nursing also face many problems. Based on our understanding of the relationship between nursing and medicine and through a careful analysis of the existing problems in the current nursing discipline, this paper provides some insights into the future directions of nursing development by exploring the independently developing nursing discipline in foreign countries.

Open access

Jiancheng Wang, Nengtai Ouyang, Long Qu, Tengfei Lin, Xianglin Zhang, Yaren Yu, Chongfei Jiang, Liling Xie, Liping Wang, Zhigui Wang, Shuzhen Ren, Shizhi Chen, Jiang Huang, Fang Liu, Weiqing Huang and Xianhui Qin

Abstract

Background and Objectives

The Chinese population typically has inadequate folate intake and no mandatory folic acid fortification. Methylenetetrahydrofolate reductase (MTHFR) and methionine synthase reductase (MTRR) are the two key regulatory enzymes in the folate/homocysteine (Hcy) metabolism. Hcy has been implicated in the pathogenesis of cardiovascular disease. We conducted a meta-analysis to assess whether the MTHFR gene A1298C and the MTRR gene A66G polymorphisms affect Hcy levels in the Chinese population.

Methods

This analysis included 13 studies with Hcy levels reported as one of the study measurements. Summary estimates of weighted mean differences and 95% confidence intervals (CIs) were obtained using random-effect models.

Results

Overall, there were no significant differences in Hcy concentrations between participants with the MTHFR 1298 CC (12 trials, n = 129), AA (n = 2166; β, −0.51 μmol/L; 95%CI: −2.14, 1.11; P = 0.53), or AC genotype (n = 958; β, 0.55 μmol/L; 95%CI: −0.72, 1.82; P = 0.40). Consistently, compared to those with the MTRR 66 GG genotype (6 trials, n = 156), similar Hcy concentrations were found in participants with the AA (n = 832; β, −0.43 μmol/L; 95%CI: −1.04, 0.17; P = 0.16) or AG (n =743; β, −0.57 μmol/L; 95%CI: −1.46, 0.31; P = 0.21) genotype. Similar results were observed for the dominant and recessive models.

Conclusions

Neither the MTHFR A1298C polymorphism nor the MTRR A66G polymorphism affects Hcy levels in the Chinese population.