BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is a cause of acute-onchronic liver failure(ACLF).AIM To investigate the risk factors of ACLF within 1 year after TIPS in patients with cirrhosis and const...BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is a cause of acute-onchronic liver failure(ACLF).AIM To investigate the risk factors of ACLF within 1 year after TIPS in patients with cirrhosis and construct a prediction model.METHODS In total,379 patients with decompensated cirrhosis treated with TIPS at Nanjing Drum Tower Hospital from 2017 to 2020 were selected as the training cohort,and 123 patients from Nanfang Hospital were included in the external validation cohort.Univariate and multivariate logistic regression analyses were performed to identify independent predictors.The prediction model was established based on the Akaike information criterion.Internal and external validation were conducted to assess the performance of the model.RESULTS Age and total bilirubin(TBil)were independent risk factors for the incidence of ACLF within 1 year after TIPS.We developed a prediction model comprising age,TBil,and serum sodium,which demonstrated good discrimination and calibration in both the training cohort and the external validation cohort.CONCLUSION Age and TBil are independent risk factors for the incidence of ACLF within 1 year after TIPS in patients with decompensated cirrhosis.Our model showed satisfying predictive value.展开更多
Extracellular amyloid beta(Aβ) plaques are main pathological feature of Alzheimer’s disease.However,the specific type of neuro ns that produce Aβ peptides in the initial stage of Alzheimer’s disease are unknown.In...Extracellular amyloid beta(Aβ) plaques are main pathological feature of Alzheimer’s disease.However,the specific type of neuro ns that produce Aβ peptides in the initial stage of Alzheimer’s disease are unknown.In this study,we found that 5-hydroxytryptamin receptor 3A subunit(HTR3A) was highly expressed in the brain tissue of transgenic amyloid precursor protein and presenilin-1 mice(an Alzheimer’s disease model) and patients with Alzheimer’s disease.To investigate whether HTR3A-positive interneurons are associated with the production of Aβ plaques,we performed double immunostaining and found that HTR3A-positive interneurons were clustered around Aβ plaques in the mouse model.Some amyloid precursor protein-positive or β-site amyloid precursor protein cleaving enzyme-1-positive neurites near Aβ plaques were co-localized with HTR3A interneurons.These results suggest that HTR3A-positive interneurons may partially contribute to the generation of Aβ peptides.We treated 5.0-5.5-month-old model mice with tro pisetron,a HTR3 antagonist,for 8 consecutive weeks.We found that the cognitive deficit of mice was partially reversed,Aβ plaques and neuroinflammation we re remarkably reduced,the expression of HTR3 was remarkably decreased and the calcineurin/nuclear factor of activated T-cell 4 signaling pathway was inhibited in treated model mice.These findings suggest that HTR3A interneurons partly contribute to generation of Aβ peptide at the initial stage of Alzheimer’s disease and inhibiting HTR3 partly reve rses the pathological changes of Alzheimer’s disease.展开更多
BACKGROUND The validation of various risk scores in elderly patients with comorbid atrial fibrillation(AF)and acute coron-ary syndrome(ACS)has not been reported.The present study compared the predictive performance of...BACKGROUND The validation of various risk scores in elderly patients with comorbid atrial fibrillation(AF)and acute coron-ary syndrome(ACS)has not been reported.The present study compared the predictive performance of existing risk scores in patients.these METHODS A total of 1252 elderly patients with AF and ACS comorbidities(≥65 years old)were consecutively enrolled from January 2015 to December 2019.All patients were followed up for one year.The predictive performance of risk scores in predict-bleeding and thromboembolic events was calculated and compared.ing RESULTS During the 1-year follow-up,183(14.6%)patients had thromboembolic events,198(15.8%)patients had BARC class≥2 bleeding events,and 61(4.9%)patients had BARC class≥3 bleeding events.For the BARC class≥3 bleeding events,discrimina-tion of the existing risk scores was low to moderate,PRECISE-DAPT(C-statistic:0.638,95%CI:0.611-0.665),ATRIA(C-statistic:0.615,95%CI:0.587-0.642),PARIS-MB(C-statistic:0.612,95%CI:0.584-0.639),HAS-BLED(C-statistic:0.597,95%CI:0.569-0.624)and CRUSADE(C-statistic:0.595,95%CI:0.567-0.622).However,the calibration was good.PRECISE-DAPT showed a higher in-tegrated discrimination improvement(IDI)than PARIS-MB,HAS-BLED,ATRIA,and CRUSADE(P<0.05)and the best decision curve analysis(DCA).For thromboembolic events,the discrimination of GRACE(C-statistic:0.636,95%CI:0.608-0.662)was higher than CHA2DS2-VASc(C-statistic:0.612,95%CI:0.584-0.639),OPT-CAD(C-statistic:0.602,95%CI:0.574-0.629)and PARIS-CTE(C-statistic:0.595,95%CI:0.567-0.622).The calibration was good.Compared to OPT-CAD and PARIS-CTE,the IDI of the GRACE score slightly improved(P<0.05).However,NRI analysis showed no significant difference.DCA showed that the clinical practic-of thromboembolic risk scores was similar.ability CONCLUSIONS The discrimination and calibration of existing risk scores in predicting 1-year thromboembolic and bleeding events were unsatisfactory in elderly patients with comorbid AF and ACS.PRECISE-DAPT showed higher IDI and DCA than other risk score展开更多
We study the contain men t cont rol problem for high-order het erogeneous nonlinear multi-age nt systems under distributed event-triggered schemes.To achieve the containment control objective and reduce communication ...We study the contain men t cont rol problem for high-order het erogeneous nonlinear multi-age nt systems under distributed event-triggered schemes.To achieve the containment control objective and reduce communication consumption among agents,a distributed event-triggered control scheme is proposed by applying the backstepping method,Lyapunov functional approach,and neural networks.Then,the results are extended to the self-triggered control case to avoid continuous monitoring of state errors.The developed protocols and triggered rules ensure that the output for each follower converges to the convex hull spanned by multi-leader signals within a bounded error.In addition,no agent exhibits Zeno behavior.Two numerical simulations are finally presen ted to verify the correctness of the obtained results.展开更多
目的探讨自我管理模式在初诊糖尿病患者中的应用效果。方法将140例初诊糖尿病患者随机分为观察组和对照组,各70例。对照组给予常规糖尿病护理,观察组在此基础上实施糖尿病自我管理模式。观察两组患者出院时、出院后3、6个月的生存质量...目的探讨自我管理模式在初诊糖尿病患者中的应用效果。方法将140例初诊糖尿病患者随机分为观察组和对照组,各70例。对照组给予常规糖尿病护理,观察组在此基础上实施糖尿病自我管理模式。观察两组患者出院时、出院后3、6个月的生存质量、自我管理行为及生化指标水平。结果出院后3、6个月,两组患者的生理功能、心理功能、社会关系及治疗情况评分均显著降低,且观察组出院后6个月的上述评分均显著低于对照组(P<0.05)。出院后3、6个月,两组的SDSCA评分均显著升高,且观察组高于对照组(P<0.05)。出院后3、6个月,两组的FBG、2 h PBG、HbA1c水平及BMI均显著降低,且观察组均显著低于对照组(P<0.05)。结论对初诊糖尿病患者开展自我管理模式干预,可有效控制血糖,提高患者生存质量。展开更多
We propose and realize a new optical state selection method on a cesium atomic fountain clock by applying a two-laser 3-3'optical pumping configuration to spin polarize atoms.The atoms are prepared in|F=3,mF=0>...We propose and realize a new optical state selection method on a cesium atomic fountain clock by applying a two-laser 3-3'optical pumping configuration to spin polarize atoms.The atoms are prepared in|F=3,mF=0>clock state with optical pumping directly after being launched up,followed by a pushing beam to push away the atoms remaining in the|F=4>state.With a state selection efficiency exceeding 92%,this optical method can substitute the traditional microwave state selection,and helps to develop a more compact physical package.A Ramsey fringe has been achieved with this optical state selection method,and a contrast of 90%is obtained with a full width half maximum of 0.92 Hz.The short-term frequency stability of 6.8×10^(-14)(τ/s)^(-1/2) is acquired.In addition,the number of detected atoms is increased by a factor of 1.7 with the optical state selection.展开更多
基金the Special Fund for Clinical Research of Nanjing Drum Tower Hospital,No.2021-LCYJ-PY-01.
文摘BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)is a cause of acute-onchronic liver failure(ACLF).AIM To investigate the risk factors of ACLF within 1 year after TIPS in patients with cirrhosis and construct a prediction model.METHODS In total,379 patients with decompensated cirrhosis treated with TIPS at Nanjing Drum Tower Hospital from 2017 to 2020 were selected as the training cohort,and 123 patients from Nanfang Hospital were included in the external validation cohort.Univariate and multivariate logistic regression analyses were performed to identify independent predictors.The prediction model was established based on the Akaike information criterion.Internal and external validation were conducted to assess the performance of the model.RESULTS Age and total bilirubin(TBil)were independent risk factors for the incidence of ACLF within 1 year after TIPS.We developed a prediction model comprising age,TBil,and serum sodium,which demonstrated good discrimination and calibration in both the training cohort and the external validation cohort.CONCLUSION Age and TBil are independent risk factors for the incidence of ACLF within 1 year after TIPS in patients with decompensated cirrhosis.Our model showed satisfying predictive value.
基金supported by the Notional Natural Science Foundation of China,Nos.81371213 and 8107098 7the Natural Science Foundation of Shanghai,No.21ZR1468400 (all to QLY)。
文摘Extracellular amyloid beta(Aβ) plaques are main pathological feature of Alzheimer’s disease.However,the specific type of neuro ns that produce Aβ peptides in the initial stage of Alzheimer’s disease are unknown.In this study,we found that 5-hydroxytryptamin receptor 3A subunit(HTR3A) was highly expressed in the brain tissue of transgenic amyloid precursor protein and presenilin-1 mice(an Alzheimer’s disease model) and patients with Alzheimer’s disease.To investigate whether HTR3A-positive interneurons are associated with the production of Aβ plaques,we performed double immunostaining and found that HTR3A-positive interneurons were clustered around Aβ plaques in the mouse model.Some amyloid precursor protein-positive or β-site amyloid precursor protein cleaving enzyme-1-positive neurites near Aβ plaques were co-localized with HTR3A interneurons.These results suggest that HTR3A-positive interneurons may partially contribute to the generation of Aβ peptides.We treated 5.0-5.5-month-old model mice with tro pisetron,a HTR3 antagonist,for 8 consecutive weeks.We found that the cognitive deficit of mice was partially reversed,Aβ plaques and neuroinflammation we re remarkably reduced,the expression of HTR3 was remarkably decreased and the calcineurin/nuclear factor of activated T-cell 4 signaling pathway was inhibited in treated model mice.These findings suggest that HTR3A interneurons partly contribute to generation of Aβ peptide at the initial stage of Alzheimer’s disease and inhibiting HTR3 partly reve rses the pathological changes of Alzheimer’s disease.
基金supported by the National Clinical Research Center for Geriatric Diseases(No.NCRCGPLAGH-20190003)the Chinese Cardiovascular Health Alliance-Advanced Fund(No.2019-CCAACCESS-054).
文摘BACKGROUND The validation of various risk scores in elderly patients with comorbid atrial fibrillation(AF)and acute coron-ary syndrome(ACS)has not been reported.The present study compared the predictive performance of existing risk scores in patients.these METHODS A total of 1252 elderly patients with AF and ACS comorbidities(≥65 years old)were consecutively enrolled from January 2015 to December 2019.All patients were followed up for one year.The predictive performance of risk scores in predict-bleeding and thromboembolic events was calculated and compared.ing RESULTS During the 1-year follow-up,183(14.6%)patients had thromboembolic events,198(15.8%)patients had BARC class≥2 bleeding events,and 61(4.9%)patients had BARC class≥3 bleeding events.For the BARC class≥3 bleeding events,discrimina-tion of the existing risk scores was low to moderate,PRECISE-DAPT(C-statistic:0.638,95%CI:0.611-0.665),ATRIA(C-statistic:0.615,95%CI:0.587-0.642),PARIS-MB(C-statistic:0.612,95%CI:0.584-0.639),HAS-BLED(C-statistic:0.597,95%CI:0.569-0.624)and CRUSADE(C-statistic:0.595,95%CI:0.567-0.622).However,the calibration was good.PRECISE-DAPT showed a higher in-tegrated discrimination improvement(IDI)than PARIS-MB,HAS-BLED,ATRIA,and CRUSADE(P<0.05)and the best decision curve analysis(DCA).For thromboembolic events,the discrimination of GRACE(C-statistic:0.636,95%CI:0.608-0.662)was higher than CHA2DS2-VASc(C-statistic:0.612,95%CI:0.584-0.639),OPT-CAD(C-statistic:0.602,95%CI:0.574-0.629)and PARIS-CTE(C-statistic:0.595,95%CI:0.567-0.622).The calibration was good.Compared to OPT-CAD and PARIS-CTE,the IDI of the GRACE score slightly improved(P<0.05).However,NRI analysis showed no significant difference.DCA showed that the clinical practic-of thromboembolic risk scores was similar.ability CONCLUSIONS The discrimination and calibration of existing risk scores in predicting 1-year thromboembolic and bleeding events were unsatisfactory in elderly patients with comorbid AF and ACS.PRECISE-DAPT showed higher IDI and DCA than other risk score
基金Project supported by the National Natural Science Foundation of China(Nos.61873128 and 61673219)the Jiangsu Key Research and Development Plan,China(No.BE2018004-3)。
文摘We study the contain men t cont rol problem for high-order het erogeneous nonlinear multi-age nt systems under distributed event-triggered schemes.To achieve the containment control objective and reduce communication consumption among agents,a distributed event-triggered control scheme is proposed by applying the backstepping method,Lyapunov functional approach,and neural networks.Then,the results are extended to the self-triggered control case to avoid continuous monitoring of state errors.The developed protocols and triggered rules ensure that the output for each follower converges to the convex hull spanned by multi-leader signals within a bounded error.In addition,no agent exhibits Zeno behavior.Two numerical simulations are finally presen ted to verify the correctness of the obtained results.
文摘目的探讨自我管理模式在初诊糖尿病患者中的应用效果。方法将140例初诊糖尿病患者随机分为观察组和对照组,各70例。对照组给予常规糖尿病护理,观察组在此基础上实施糖尿病自我管理模式。观察两组患者出院时、出院后3、6个月的生存质量、自我管理行为及生化指标水平。结果出院后3、6个月,两组患者的生理功能、心理功能、社会关系及治疗情况评分均显著降低,且观察组出院后6个月的上述评分均显著低于对照组(P<0.05)。出院后3、6个月,两组的SDSCA评分均显著升高,且观察组高于对照组(P<0.05)。出院后3、6个月,两组的FBG、2 h PBG、HbA1c水平及BMI均显著降低,且观察组均显著低于对照组(P<0.05)。结论对初诊糖尿病患者开展自我管理模式干预,可有效控制血糖,提高患者生存质量。
基金Project supported by the National Natural Science Foundation of China(Grant No.11873044).
文摘We propose and realize a new optical state selection method on a cesium atomic fountain clock by applying a two-laser 3-3'optical pumping configuration to spin polarize atoms.The atoms are prepared in|F=3,mF=0>clock state with optical pumping directly after being launched up,followed by a pushing beam to push away the atoms remaining in the|F=4>state.With a state selection efficiency exceeding 92%,this optical method can substitute the traditional microwave state selection,and helps to develop a more compact physical package.A Ramsey fringe has been achieved with this optical state selection method,and a contrast of 90%is obtained with a full width half maximum of 0.92 Hz.The short-term frequency stability of 6.8×10^(-14)(τ/s)^(-1/2) is acquired.In addition,the number of detected atoms is increased by a factor of 1.7 with the optical state selection.
