Blowup of solution for a reaction diffusion equation with memory and multiple nonlinearities

In this paper, the blow-up of solution for the initial boundary value problem of a class of reaction diffusion equation with memory and multiple nonlinearities is studied. Using a differential inequalities, we obtain sufficient conditions for the blow-up of solutions in a finite time interval under suitable conditions on memory and nonlinearities term and for vanishing initial energy

A Study on the Measurement of the High-quality Development Level of Xiamen's Cultural Tourism Economy

The demand for high-quality products and core technologies in economic transformation and upgrading is growing, and the improvement of residents' living standards also promotes the demand for high-end living products. Restricted by the development level of domestic related industries, these demands have not been well met, resulting in imbalance between supply and demand. This topic measures the high-quality development level of Xiamen's cultural tourism economy, analyzes its development status, compares and draws on the experience of cultural tourism economic development in other regions at home and abroad, and looks for the cultivation path of new growth points of Xiamen's cultural tourism economy, so as to lay a foundation for Xiamen to transform its resource advantages into economic advantages

Comparison of efficacy and safety of general anesthesia alone with those of combined epidural/general anesthesia in Chinese patients with gastric cancer undergoing laparoscopy-assisted tumor resection

Purpose: To compare postoperative opioid consumption, inflammatory response, survival/clinical outcomes and safety profile of epidural combined with general anesthesia (GA) versus GA in stage 1 gastric cancer patients undergoing surgical intervention by laparoscopy.Method: Chinese patients with early-stage gastric cancer undergoing laparoscopic-assisted tumor resection were enrolled and received either epidural combined with general anesthesia (group EA + GA) or general anesthesia only (group GA) in allocation ratio of 1:1. The following efficacy variables were assessed: 1) Pain score was measured on VAS scale; 2) post-operative consumption; 3) Quality of recovery; 4) inflammatory response; and 5) survival outcome. Safety was assessed throughout the study period.Results: Data for 200 subjects were analyzed. Compared to GA alone, combination of EA + GA demonstrate significantly greater reduction in post-operative pain with decrease postoperative opioid consumption. Also, the combination of GA and EA inhibited inflammatory response when compared to patients who received GA only. Moreover, the combination of GA and EA did not demonstrate any clinical benefit in survival outcome, when compared to patients who received GA alone, indicating that GA + EA has no role in improving survival outcome among patients undergoing gastric cancer surgery. Additionally, EA + GA was also associated with a shorter length of hospital stay, compared to GA.Conclusion: Overall, the results favor the use of GA + EA in Chinese patients with early-stage gastric cancer undergoing laparoscopic-assisted tumor resection. GA + EA combination improves immune response by inhibiting the inflammatory response but has no significant effect on survival outcome

Blood biomarkers for new-onset hypertension in midlife women:a nested case-control study

Objective Midlife in women is associated with an increase in prevalence of hypertension. Little is known on the risk factors of new-onset hypertension among middle-aged women. Methods In this nested case-control study, 1,430 women aged 40 to 60 years with repeated physical examinations between 2009 and 2019 were recruited. Data included age, body mass index, blood pressure (BP), and a series of blood biomarkers. Participants with hypertension were divided into two case-control samples: 388 cases with episodic new-onset hypertension (ie, one normal BP at the first visit and one abnormal BP during follow-up) each with two age-matched controls (n = 776) and 151 cases with regular new-onset hypertension (ie, normal BP at the first two visits and abnormal BP at two or more follow-up visits) each with three age-matched controls (n = 453). Multivariable-adjusted logistic regression was used to analyze the data. Results Our data showed very consistent results for episodic and regular new-onset hypertension, respectively, and verified known associations (odds ratio [95% confidence interval], per SD increase) with obesity (body mass index, 1.72 [1.49-1.98] and 1.81 [1.45-2.26]), inflammation (white blood cell count, 1.39 [1.23-1.58] and 1.38 [1.13-1.69]), and metabolic dysregulation (triglycerides, 1.25 [1.09-1.44] and 1.31 [1.08-1.58]; glucose, 1.46 [1.23-1.73] and 1.27 [1.05-1.54]) but, more surprisingly, also revealed positive associations with red blood cell count (1.27 [1.11-1.44] and 1.38 [1.14-1.68]), hemoglobin (1.18 [1.03-1.35] and 1.31 [1.05-1.64]), and platelet count (1.39 [1.20-1.61] and 1.33 [1.09-1.63]). Conclusions In addition to obesity and metabolic dysregulation, increased hemoglobin and counts of platelets, and red and white blood cells are associated with hypertension in this period. Future study may verify whether these associations are causal in nature and whether these variables are useful in risk stratification.</p

Observational and Genetic Evidence for Bidirectional Effects Between Red Blood Cell Traits and Diastolic Blood Pressure

Background: Previous studies have found associations of red blood cell traits (hemoglobin and red blood cell count, RBC) with blood pressure; whether these associations are causal is unknown.Methods: We performed cross-sectional analyses in the Lifelines Cohort Study (n=167,785). Additionally, we performed bidirectional two sample Mendelian randomization (MR) analyses to explore the causal effect of the two traits on systolic (SBP) and diastolic blood pressure (DBP), using genetic instrumental variables regarding hemoglobin and RBC identified in UK Biobank (n=350,475) and International Consortium of Blood Pressure studies for SBP and DBP (n= 757,601).Results: In cross-sectional analyses we observed positive associations with hypertension and blood pressure for both hemoglobin (OR=1.18, 95% CI: 1.16 to 1.20 for hypertension; B=0.11, 95% CI: 0.11 to 0.12 for SBP; B=0.11, 95% CI: 0.10 to 0.11 for DBP, all per SD) and RBC (OR=1.14, 95% CI: 1.12 to 1.16 for hypertension; B=0.11, 95% CI: 0.10 to 0.12 for SBP; B=0.08, 95% CI: 0.08 to 0.09 for DBP, all per SD). MR analyses suggested that higher hemoglobin and RBC cause higher DBP (inverse variance weighted [IVW] B=0.11, 95% CI: 0.07 to 0.16 for hemoglobin; B=0.07, 95% CI: 0.04 to 0.10 for RBC, all per SD). Reverse MR analyses (all per SD) suggested causal effects of DBP on both hemoglobin (B=0.06, 95% CI: 0.03 to 0.09) and RBC (B=0.08, 95% CI: 0.04 to 0.11). No significant effects on SBP were found.Conclusions: Our results suggest bidirectional causal relationships of hemoglobin and RBC with DBP, but not with SBP

Type 2 Diabetes Mellitus and Clinicopathological Tumor Characteristics in Women Diagnosed with Breast Cancer:A Systematic Review and Meta-Analysis

SIMPLE SUMMARY: Female breast cancer continues to be the leading cause of cancer deaths worldwide, and type 2 diabetes mellitus (T2DM) is one of the contributors to the poor prognosis of breast cancer. This raises the issue that T2DM might be associated with aggressive clinicopathological characteristics, which indicate pivotal prognostic values. This study aimed to clarify the differences in breast cancer characteristics at diagnosis between patients with and without pre-existing T2DM. Our meta-analyses showed an increased risk of being diagnosed with a late-stage tumor, large tumor size, and invasive lymph nodes in patients with T2DM. No significant results were observed for grade, estrogen/progesterone receptor, and human epidermal growth factor receptor. These findings indicate an association between T2DM and advanced breast cancer at diagnosis, and suggest that the more active role of breast cancer screening should be further explored for women with T2DM. ABSTRACT: Poor prognosis caused by type 2 diabetes mellitus (T2DM) in women with breast cancer is conferred, while the association between T2DM and breast tumor aggressiveness is still a matter of debate. This study aimed to clarify the differences in breast cancer characteristics, including stage, size, lymph node status, grade, estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (Her2), between patients with and without pre-existing T2DM. PubMed, Embase, and Web of Science were searched for studies from 1 January 2010 to 2 July 2021. Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were pooled by using a random effects model. T2DM was significantly associated with tumor stages III/IV versus cancers in situ and stages I/II (pooled ORs (pOR), 95% CI: 1.19; 1.04–1.36, p = 0.012), tumor size >20 versus ≤20 mm (pOR, 95% CI: 1.18; 1.04–1.35, p = 0.013), and lymph node invasion versus no involvement (pOR, 95% CI: 1.26; 1.05–1.51, p = 0.013). These findings suggest that women with T2DM are at a higher risk of late-stage tumors, large tumor sizes, and invasive lymph nodes at breast cancer diagnosis

HuatuoGPT, towards Taming Language Model to Be a Doctor

In this paper, we present HuatuoGPT, a large language model (LLM) for medical consultation. The core recipe of HuatuoGPT is to leverage both \textit{distilled data from ChatGPT} and \textit{real-world data from doctors} in the supervised fine-tuned stage. The responses of ChatGPT are usually detailed, well-presented and informative while it cannot perform like a doctor in many aspects, e.g. for integrative diagnosis. We argue that real-world data from doctors would be complementary to distilled data in the sense the former could tame a distilled language model to perform like doctors. To better leverage the strengths of both data, we train a reward model to align the language model with the merits that both data bring, following an RLAIF (reinforced learning from AI feedback) fashion. To evaluate and benchmark the models, we propose a comprehensive evaluation scheme (including automatic and manual metrics). Experimental results demonstrate that HuatuoGPT achieves state-of-the-art results in performing medical consultation among open-source LLMs in GPT-4 evaluation, human evaluation, and medical benchmark datasets. It is worth noting that by using additional real-world data and RLAIF, the distilled language model (i.e., HuatuoGPT) outperforms its teacher model ChatGPT in most cases. Our code, data, and models are publicly available at \url{https://github.com/FreedomIntelligence/HuatuoGPT}. The online demo is available at \url{https://www.HuatuoGPT.cn/}

CMB: A Comprehensive Medical Benchmark in Chinese

Large Language Models (LLMs) provide a possibility to make a great breakthrough in medicine. The establishment of a standardized medical benchmark becomes a fundamental cornerstone to measure progression. However, medical environments in different regions have their local characteristics, e.g., the ubiquity and significance of traditional Chinese medicine within China. Therefore, merely translating English-based medical evaluation may result in \textit{contextual incongruities} to a local region. To solve the issue, we propose a localized medical benchmark called CMB, a Comprehensive Medical Benchmark in Chinese, designed and rooted entirely within the native Chinese linguistic and cultural framework. While traditional Chinese medicine is integral to this evaluation, it does not constitute its entirety. Using this benchmark, we have evaluated several prominent large-scale LLMs, including ChatGPT, GPT-4, dedicated Chinese LLMs, and LLMs specialized in the medical domain. It is worth noting that our benchmark is not devised as a leaderboard competition but as an instrument for self-assessment of model advancements. We hope this benchmark could facilitate the widespread adoption and enhancement of medical LLMs within China. Check details in \url{https://cmedbenchmark.llmzoo.com/}