With the increasing incidence of obesity and metabolic syndrome worldwide,concomitant nonalcoholic fatty liver disease(NAFLD)in patients with chronic hepatitis B(CHB)has become highly prevalent.The risk of dual etiolo...With the increasing incidence of obesity and metabolic syndrome worldwide,concomitant nonalcoholic fatty liver disease(NAFLD)in patients with chronic hepatitis B(CHB)has become highly prevalent.The risk of dual etiologies,outcome,and mechanism of CHB with concomitant NAFLD have not been fully characterized.In this review,we assessed the overlapping prevalence of metabolic disorders and CHB,assessed the risk of advanced fibrosis/hepatocellular carcinoma in CHB patients concomitant with NAFLD,and discussed the remaining clinical issues to be addressed in the outcome of such patients.We also explored the possible roles of hepatitis B virus in the development of steatosis and discussed difficultiesof histological evaluation.For CHB patients,it is important to address concomitant NAFLD through lifestyle management and disease screening to achieve better prognoses.The assessment of progressive changes and novel therapies for CHB patients concomitant with NAFLD deserve further research.展开更多
BACKGROUND:Hospital mortality rates are higher among patients with sepsis-associated acute kidney injury(SA-AKI)than among patients with sepsis.However,the pathogenesis underlying SA-AKI remains unclear.We hypothesize...BACKGROUND:Hospital mortality rates are higher among patients with sepsis-associated acute kidney injury(SA-AKI)than among patients with sepsis.However,the pathogenesis underlying SA-AKI remains unclear.We hypothesized that the source of infection affects development of SA-AKI.We aim to explore the relationship between the anatomical source of infection and outcome in patients with SA-AKI.METHODS:Between January 2013 and January 2018,113 patients with SA-AKI admitted to our Emergency Center were identifi ed and divided into two groups:those with pulmonary infections and those with other sources of infection.For each patient,we collected data from admission until either discharge or death.We also recorded the clinical outcome after 90 days for the discharged patients.RESULTS:The most common source of infection was the lung(52/113 cases,46%),followed by gastrointestinal(GI)(25/113 cases,22.1%)and urinary(22/113,19.5%)sources.Our analysis showed that patients with SA-AKI had a significantly worse outcome(30/52 cases,P<0.001)and poorer kidney recovery(P=0.015)with pulmonary sources of infection than those infected by another source.Data also showed that patients not infected by a pulmonary source more likely experienced shock(28/61 cases,P=0.037).CONCLUSION:This study demonstrated that the source of infection infl uenced the outcome of SA-AKI patients in an independent manner.Lung injury may influence renal function in an asyet undetermined manner as the recovery of kidney function was poorer in SA-AKI patients with a pulmonary source of infection.展开更多
Background:Although concomitant nonalcoholic steatohepatitis(NASH)is common in chronic hepatitis B(CHB),the impact of viral factors on NASH and the outcome of CHB patients concomitant with NASH remain unclear.We aimed...Background:Although concomitant nonalcoholic steatohepatitis(NASH)is common in chronic hepatitis B(CHB),the impact of viral factors on NASH and the outcome of CHB patients concomitant with NASH remain unclear.We aimed to investigate the outcomes of NASH in CHB patients receiving antiviral treatment.Methods:In the post-hoc analysis of a multicenter trial,na?ve CHB patients receiving 72-week entecavir treatment were enrolled.We evaluated the biochemical,viral and histopathological responses of these patients.The histopathological features of NASH were also evaluated,using paired liver biopsies at baseline and week 72.Results:A total of 1000 CHB patients were finally enrolled for analysis,with 18.2%of whom fulfilling the criteria of NASH.A total of 727 patients completed entecavir antiviral treatment and received the second biopsy.Serum HBe Ag loss,HBe Ag seroconversion and HBV-DNA undetectable rates were similar between patients with or without NASH(P>0.05).Among patients with NASH,the hepatic steatosis,ballooning,lobular inflammation scores and fibrosis stages all improved during follow-up(all P<0.001),46%(63/136)achieved NASH resolution.Patients with baseline body mass index(BMI)≥23 kg/m2(Asian criteria)[odds ratio(OR):0.414;95%confidence interval(95%CI):0.190-0.899;P=0.012]and weight gain(OR:0.187;95%CI:0.050-0.693;P=0.026)were less likely to have NASH resolution.Among patients without NASH at baseline,22(3.7%)developed NASH.Baseline BMI≥23 kg/m2(OR:12.506;95%CI:2.813-55.606;P=0.001)and weight gain(OR:5.126;95%CI:1.674-15.694;P=0.005)were predictors of incident NASH.Conclusions:Lower BMI and weight reduction but not virologic factors determine NASH resolution in CHB.The value of weight management in CHB patients during antiviral treatment deserves further evaluation.展开更多
The Jiangmen Underground Neutrino Observatory(JUNO)is a large liquid scintillator detector designed to explore many topics in fundamental physics.In this study,the potential of searching for proton decay in the p→νK...The Jiangmen Underground Neutrino Observatory(JUNO)is a large liquid scintillator detector designed to explore many topics in fundamental physics.In this study,the potential of searching for proton decay in the p→νK^(+)mode with JUNO is investigated.The kaon and its decay particles feature a clear three-fold coincidence signature that results in a high efficiency for identification.Moreover,the excellent energy resolution of JUNO permits suppression of the sizable background caused by other delayed signals.Based on these advantages,the detection efficiency for the proton decay via p→νK^(+)is 36.9%±4.9%with a background level of 0.2±0.05(syst)±0.2(stat)events after 10 years of data collection.The estimated sensitivity based on 200 kton-years of exposure is 9.6×1033 years,which is competitive with the current best limits on the proton lifetime in this channel and complements the use of different detection technologies.展开更多
The chemical stoichiometry on the surface of superconducting δ-NbN thin films is of great importance for their application.Here,we fabricated the δ-NbN thin films on SiO2/Si substrate by DC sputtering method.The fil...The chemical stoichiometry on the surface of superconducting δ-NbN thin films is of great importance for their application.Here,we fabricated the δ-NbN thin films on SiO2/Si substrate by DC sputtering method.The film was characterized using X-ray diffraction(XRD) and atomic force microscopy(AFM).Transport properties were measured to reveal the field dependent superconducting transition temperature.Both XRD and electrical measurement show high crystallinity of δ-NbN phase.A homogeneous and smooth surface morphology was measured by AFM.Auger electron spectroscopy(AES) was applied to analyze the composition along the depth of the film.The evolution of Auger peak profile,heights and nitride stoichiometry at the film surface is discussed.The current study provides a more thorough understanding of complex chemical compositions of δ-NbN thin films.展开更多
目的评估1型糖尿病(type I diabetes mellitus, T1DM)患者血尿酸、尿微量白蛋白、肾小球滤过率,探讨T1DM患者血尿酸与糖尿病肾病的关系。方法纳入2017—2018年在北京协和医院内分泌科住院的64例诊断明确的T1DM患者,收集详细的人口学资料...目的评估1型糖尿病(type I diabetes mellitus, T1DM)患者血尿酸、尿微量白蛋白、肾小球滤过率,探讨T1DM患者血尿酸与糖尿病肾病的关系。方法纳入2017—2018年在北京协和医院内分泌科住院的64例诊断明确的T1DM患者,收集详细的人口学资料,人体测量学指标,以及血脂、血糖、C肽、血尿酸、血肌酐、尿微量白蛋白、尿肌酐等指标,计算尿微量清蛋白与肌酐的比值(albumin to creatinine ratio,ACR)、肾小球滤过率,通过Pearson相关性分析、多元线性回归探讨血尿酸与ACR及肾小球滤过率的关系。结果 64例T1DM患者中,男性占37.5%,中位年龄为38.5岁,中位糖尿病病程为4年,平均糖化血红蛋白为9.2%。Pearson相关分析发现,血尿酸与ACR呈正相关(r=0.397,P=0.001),与估算的肌酐清除率呈负相关(r=-0.449,P<0.001)。在多元线性回归中通过逐步回归法构建回归方程发现,血尿酸每增加一个标准差,ACR升高1.2倍(P=0.001),估算的肾小球滤过率下降15.764ml/(min·1.73m^2)(P<0.001)。结论血尿酸是T1DM患者ACR升高、肾小球滤过率下降的独立危险因素。展开更多
The Jiangmen Underground Neutrino Observatory(JUNO)features a 20 kt multi-purpose underground liquid scintillator sphere as its main detector.Some of JUNO's features make it an excellent location for^8B solar neut...The Jiangmen Underground Neutrino Observatory(JUNO)features a 20 kt multi-purpose underground liquid scintillator sphere as its main detector.Some of JUNO's features make it an excellent location for^8B solar neutrino measurements,such as its low-energy threshold,high energy resolution compared with water Cherenkov detectors,and much larger target mass compared with previous liquid scintillator detectors.In this paper,we present a comprehensive assessment of JUNO's potential for detecting^8B solar neutrinos via the neutrino-electron elastic scattering process.A reduced 2 MeV threshold for the recoil electron energy is found to be achievable,assuming that the intrinsic radioactive background^(238)U and^(232)Th in the liquid scintillator can be controlled to 10^(-17)g/g.With ten years of data acquisition,approximately 60,000 signal and 30,000 background events are expected.This large sample will enable an examination of the distortion of the recoil electron spectrum that is dominated by the neutrino flavor transformation in the dense solar matter,which will shed new light on the inconsistency between the measured electron spectra and the predictions of the standard three-flavor neutrino oscillation framework.IfDelta m^(2)_(21)=4.8times10^(-5);(7.5times10^(-5))eV^(2),JUNO can provide evidence of neutrino oscillation in the Earth at approximately the 3sigma(2sigma)level by measuring the non-zero signal rate variation with respect to the solar zenith angle.Moreover,JUNO can simultaneously measureDelta m^2_(21)using^8B solar neutrinos to a precision of 20% or better,depending on the central value,and to sub-percent precision using reactor antineutrinos.A comparison of these two measurements from the same detector will help understand the current mild inconsistency between the value of Delta m^2_(21)reported by solar neutrino experiments and the KamLAND experiment.展开更多
Background and Aims:Nonalcoholic fatty liver disease(NAFLD)is associated with metabolic disorders.This study aimed to explore the role of metabolic disorders in screening advanced fibrosis in NAFLD patients.Methods:A ...Background and Aims:Nonalcoholic fatty liver disease(NAFLD)is associated with metabolic disorders.This study aimed to explore the role of metabolic disorders in screening advanced fibrosis in NAFLD patients.Methods:A total of 246 histologically-proven NAFLD patients were enrolled across 14 centers.We compared the severity of fibrosis in patients with different components of metabolic disorders.Based on standard noninvasive tests and metabolic disorders,we developed new algorithms to identify advanced fibrosis.Results:Metabolic syndrome(MetS)was frequent in NAFLD patients(133/246,54%).Patients with MetS had a higher proportion of significant fibrosis(p=0.014)and higher LSM values(9.2 kPa,vs.7.4 kPa,p=0.002)than those without MetS.Patients with more metabolic disorders had higher fibrosis stages(p=0.017).Reduced highdensity lipoprotein cholesterol(odds ratio[OR]:2.241,95%confidence interval[CI]:1.004–5.002,p=0.049)and raised fasting glucose(OR:4.500,95%CI:2.083–9.725,p<0.001)were significantly associated with advanced fibrosis.Using these two metabolic disorders as a screening tool,a sensitivity,specificity and accuracy of 92%,81%and 83%was achieved,respectively.With the new algorithms combining metabolic disorders with noninvasive measurements,the number of patients requiring liver biopsy was reduced,especially in combination with the Fibrosis-4 score and metabolic disorders(36%to 17%,p<0.001).In addition,this stepwise algorithm could achieve a high accuracy(85%)and high negative predictive value(93%).Conclusions:Metabolic disorders should be taken into consideration in the diagnosis of advanced fibrosis.With further validation and investigation,new algorithms could be recommended in primary care units to spare patients from unnecessary referral and liver biopsies.展开更多
Background and Aims:Nonalcoholic fatty liver disease,now renamed metabolic dysfunction-associated fatty liver disease(MAFLD),is common in obese patients.Intragastric balloon(IGB),an obesity management tool with low co...Background and Aims:Nonalcoholic fatty liver disease,now renamed metabolic dysfunction-associated fatty liver disease(MAFLD),is common in obese patients.Intragastric balloon(IGB),an obesity management tool with low complication risk,might be used in MAFLD treatment but there is still unexplained heterogeneity in results across studies.Methods:We conducted a systematic search of 152 citations published up to September 2020.Meta-analyses,stratified analyses,and meta-regression were performed to evaluate the efficacy of IGB on homeostasis model assessment of insulin resistance(HOMA-IR),alanine aminotransferase(ALT),aspartate aminotransferase(AST),and gamma-glutamyl transpeptidase(GGT),and to identify patients most appropriate for IGB therapy.Results:Thirteen observational studies and one randomized controlled trial met the inclusion criteria(624 participants in total).In the overall estimate,IGB therapy significantly improved the serum markers change from baseline to follow-up[HOMA-IR:1.56,95%confidence interval(CI)=1.16–1.95;ALT:11.53 U/L,95%CI=7.10–15.96;AST:6.79 U/L,95%CI=1.69–11.90;GGT:10.54 U/L,95%CI=6.32–14.75].In the stratified analysis,there were trends among participants with advanced age having less change in HOMA-IR(1.07 vs.1.82).The improvement of insulin resistance and liver biochemistries with swallowable IGB therapy was no worse than that with endoscopic IGB.Multivariate meta-regression analyses showed that greater HOMA-IR loss was predicted by younger age(p=0.0107).Furthermore,effectiveness on ALT and GGT was predicted by basal ALT(p=0.0004)and GGT(p=0.0026),respectively.Conclusions:IGB is effective among the serum markers of MAFLD.Younger patients had a greater decrease of HOMA-IR after IGB therapy.展开更多
基金Supported by National Key Research and Development Program of China,No.2017YFC0908903National Natural Science Foundation of China,No.81873565 and No.81900507.
文摘With the increasing incidence of obesity and metabolic syndrome worldwide,concomitant nonalcoholic fatty liver disease(NAFLD)in patients with chronic hepatitis B(CHB)has become highly prevalent.The risk of dual etiologies,outcome,and mechanism of CHB with concomitant NAFLD have not been fully characterized.In this review,we assessed the overlapping prevalence of metabolic disorders and CHB,assessed the risk of advanced fibrosis/hepatocellular carcinoma in CHB patients concomitant with NAFLD,and discussed the remaining clinical issues to be addressed in the outcome of such patients.We also explored the possible roles of hepatitis B virus in the development of steatosis and discussed difficultiesof histological evaluation.For CHB patients,it is important to address concomitant NAFLD through lifestyle management and disease screening to achieve better prognoses.The assessment of progressive changes and novel therapies for CHB patients concomitant with NAFLD deserve further research.
基金supported by the National Natural Science Foundation of China(81873947)Hospital Development center(SHDC120161)
文摘BACKGROUND:Hospital mortality rates are higher among patients with sepsis-associated acute kidney injury(SA-AKI)than among patients with sepsis.However,the pathogenesis underlying SA-AKI remains unclear.We hypothesized that the source of infection affects development of SA-AKI.We aim to explore the relationship between the anatomical source of infection and outcome in patients with SA-AKI.METHODS:Between January 2013 and January 2018,113 patients with SA-AKI admitted to our Emergency Center were identifi ed and divided into two groups:those with pulmonary infections and those with other sources of infection.For each patient,we collected data from admission until either discharge or death.We also recorded the clinical outcome after 90 days for the discharged patients.RESULTS:The most common source of infection was the lung(52/113 cases,46%),followed by gastrointestinal(GI)(25/113 cases,22.1%)and urinary(22/113,19.5%)sources.Our analysis showed that patients with SA-AKI had a significantly worse outcome(30/52 cases,P<0.001)and poorer kidney recovery(P=0.015)with pulmonary sources of infection than those infected by another source.Data also showed that patients not infected by a pulmonary source more likely experienced shock(28/61 cases,P=0.037).CONCLUSION:This study demonstrated that the source of infection infl uenced the outcome of SA-AKI patients in an independent manner.Lung injury may influence renal function in an asyet undetermined manner as the recovery of kidney function was poorer in SA-AKI patients with a pulmonary source of infection.
基金supported by grants from the National Major Special Project for the Prevention and Treatment of Major Infectious Diseases:AIDS and viral hepatitis(2013ZX10005002,2018ZX10725506)the National Key Research and Development Program(2017YFC0908903)。
文摘Background:Although concomitant nonalcoholic steatohepatitis(NASH)is common in chronic hepatitis B(CHB),the impact of viral factors on NASH and the outcome of CHB patients concomitant with NASH remain unclear.We aimed to investigate the outcomes of NASH in CHB patients receiving antiviral treatment.Methods:In the post-hoc analysis of a multicenter trial,na?ve CHB patients receiving 72-week entecavir treatment were enrolled.We evaluated the biochemical,viral and histopathological responses of these patients.The histopathological features of NASH were also evaluated,using paired liver biopsies at baseline and week 72.Results:A total of 1000 CHB patients were finally enrolled for analysis,with 18.2%of whom fulfilling the criteria of NASH.A total of 727 patients completed entecavir antiviral treatment and received the second biopsy.Serum HBe Ag loss,HBe Ag seroconversion and HBV-DNA undetectable rates were similar between patients with or without NASH(P>0.05).Among patients with NASH,the hepatic steatosis,ballooning,lobular inflammation scores and fibrosis stages all improved during follow-up(all P<0.001),46%(63/136)achieved NASH resolution.Patients with baseline body mass index(BMI)≥23 kg/m2(Asian criteria)[odds ratio(OR):0.414;95%confidence interval(95%CI):0.190-0.899;P=0.012]and weight gain(OR:0.187;95%CI:0.050-0.693;P=0.026)were less likely to have NASH resolution.Among patients without NASH at baseline,22(3.7%)developed NASH.Baseline BMI≥23 kg/m2(OR:12.506;95%CI:2.813-55.606;P=0.001)and weight gain(OR:5.126;95%CI:1.674-15.694;P=0.005)were predictors of incident NASH.Conclusions:Lower BMI and weight reduction but not virologic factors determine NASH resolution in CHB.The value of weight management in CHB patients during antiviral treatment deserves further evaluation.
基金supported by the Chinese Academy of Sciencesthe National Key R&D Program of China+22 种基金the CAS Center for Excellence in Particle PhysicsWuyi Universitythe Tsung-Dao Lee Institute of Shanghai Jiao Tong University in Chinathe Institut National de Physique Nucléaire et de Physique de Particules (IN2P3) in Francethe Istituto Nazionale di Fisica Nucleare (INFN) in Italythe Italian-Chinese collaborative research program MAECI-NSFCthe Fond de la Recherche Scientifique (F.R.S-FNRS)FWO under the "Excellence of Science-EOS" in Belgiumthe Conselho Nacional de Desenvolvimento Científico e Tecnològico in Brazilthe Agencia Nacional de Investigacion y Desarrollo in Chilethe Charles University Research Centrethe Ministry of Education,Youth,and Sports in Czech Republicthe Deutsche Forschungsgemeinschaft (DFG)the Helmholtz Associationthe Cluster of Excellence PRISMA+ in Germanythe Joint Institute of Nuclear Research (JINR)Lomonosov Moscow State University in Russiathe joint Russian Science Foundation (RSF)National Natural Science Foundation of China (NSFC) research programthe MOST and MOE in Taiwan,Chinathe Chulalongkorn UniversitySuranaree University of Technology in Thailandthe University of California at Irvine in USA
文摘The Jiangmen Underground Neutrino Observatory(JUNO)is a large liquid scintillator detector designed to explore many topics in fundamental physics.In this study,the potential of searching for proton decay in the p→νK^(+)mode with JUNO is investigated.The kaon and its decay particles feature a clear three-fold coincidence signature that results in a high efficiency for identification.Moreover,the excellent energy resolution of JUNO permits suppression of the sizable background caused by other delayed signals.Based on these advantages,the detection efficiency for the proton decay via p→νK^(+)is 36.9%±4.9%with a background level of 0.2±0.05(syst)±0.2(stat)events after 10 years of data collection.The estimated sensitivity based on 200 kton-years of exposure is 9.6×1033 years,which is competitive with the current best limits on the proton lifetime in this channel and complements the use of different detection technologies.
基金supported in part by the Ministry of Science and Technology (MOST) of China (No. 2018YFE0202700)the National Natural Science Foundation of China (Grants No.12004251,12104302,12104303)+3 种基金the Natural Science Foundation of Shanghai (Grant No.20ZR1436100)the Science and Technology Commission of Shanghai Municipality,the start-up funding from ShanghaiTech UniversityBeijing National Laboratory for Condensed Matter Physicsthe Interdisciplinary Program of Wuhan National High Magnetic Field Center (WHMFC202124)。
文摘The chemical stoichiometry on the surface of superconducting δ-NbN thin films is of great importance for their application.Here,we fabricated the δ-NbN thin films on SiO2/Si substrate by DC sputtering method.The film was characterized using X-ray diffraction(XRD) and atomic force microscopy(AFM).Transport properties were measured to reveal the field dependent superconducting transition temperature.Both XRD and electrical measurement show high crystallinity of δ-NbN phase.A homogeneous and smooth surface morphology was measured by AFM.Auger electron spectroscopy(AES) was applied to analyze the composition along the depth of the film.The evolution of Auger peak profile,heights and nitride stoichiometry at the film surface is discussed.The current study provides a more thorough understanding of complex chemical compositions of δ-NbN thin films.
文摘目的评估1型糖尿病(type I diabetes mellitus, T1DM)患者血尿酸、尿微量白蛋白、肾小球滤过率,探讨T1DM患者血尿酸与糖尿病肾病的关系。方法纳入2017—2018年在北京协和医院内分泌科住院的64例诊断明确的T1DM患者,收集详细的人口学资料,人体测量学指标,以及血脂、血糖、C肽、血尿酸、血肌酐、尿微量白蛋白、尿肌酐等指标,计算尿微量清蛋白与肌酐的比值(albumin to creatinine ratio,ACR)、肾小球滤过率,通过Pearson相关性分析、多元线性回归探讨血尿酸与ACR及肾小球滤过率的关系。结果 64例T1DM患者中,男性占37.5%,中位年龄为38.5岁,中位糖尿病病程为4年,平均糖化血红蛋白为9.2%。Pearson相关分析发现,血尿酸与ACR呈正相关(r=0.397,P=0.001),与估算的肌酐清除率呈负相关(r=-0.449,P<0.001)。在多元线性回归中通过逐步回归法构建回归方程发现,血尿酸每增加一个标准差,ACR升高1.2倍(P=0.001),估算的肾小球滤过率下降15.764ml/(min·1.73m^2)(P<0.001)。结论血尿酸是T1DM患者ACR升高、肾小球滤过率下降的独立危险因素。
基金This work was supported by the Chinese Academy of Sciences,the National Key R&D Program of China,the CAS Center for Excellence in Particle Physics,the Joint Large Scale Scientific Facility Funds of the NSFC and CAS,Wuyi University,and the Tsung-Dao Lee Instiute of Shanghai Jiao Tong University in China,the In stiut National de Physique Nucleaire et de Physique de Particules(IN2P3)in France,the Istituto Nazionale di Fisica Nucleare(INFN)in Italy,the Fond de la Recherche Scintifique(F.R.S-FNRS)and FWO under the"Excellence of Science-EOS"in Belgium,the Conselho Nacional de Desenvolvimento Cientificoce Tecnologico in Brazil,the Agencia Nacional de Investigacion y Desrrollo in Chile,the Charles University Research Centre and the Ministry of Education,Youth,and Sports in Czech Republic,the Deutsche Forschungsgemeinschaft(DFG),the Helmholtz Association,and the Cluster of Exellence PRISMA+in Germany,the Joint Institute of Nuclear Research(JINR),Lomonosov Moscow State University,and Russian Foundation for Basic Research(RFBR)in Russia,the MOST and MOE in Taiwan,the Chu-lalongkorm University and Suranaree University of Technology in Thailand,and the University of aliformia at Irvine in USA.
文摘The Jiangmen Underground Neutrino Observatory(JUNO)features a 20 kt multi-purpose underground liquid scintillator sphere as its main detector.Some of JUNO's features make it an excellent location for^8B solar neutrino measurements,such as its low-energy threshold,high energy resolution compared with water Cherenkov detectors,and much larger target mass compared with previous liquid scintillator detectors.In this paper,we present a comprehensive assessment of JUNO's potential for detecting^8B solar neutrinos via the neutrino-electron elastic scattering process.A reduced 2 MeV threshold for the recoil electron energy is found to be achievable,assuming that the intrinsic radioactive background^(238)U and^(232)Th in the liquid scintillator can be controlled to 10^(-17)g/g.With ten years of data acquisition,approximately 60,000 signal and 30,000 background events are expected.This large sample will enable an examination of the distortion of the recoil electron spectrum that is dominated by the neutrino flavor transformation in the dense solar matter,which will shed new light on the inconsistency between the measured electron spectra and the predictions of the standard three-flavor neutrino oscillation framework.IfDelta m^(2)_(21)=4.8times10^(-5);(7.5times10^(-5))eV^(2),JUNO can provide evidence of neutrino oscillation in the Earth at approximately the 3sigma(2sigma)level by measuring the non-zero signal rate variation with respect to the solar zenith angle.Moreover,JUNO can simultaneously measureDelta m^2_(21)using^8B solar neutrinos to a precision of 20% or better,depending on the central value,and to sub-percent precision using reactor antineutrinos.A comparison of these two measurements from the same detector will help understand the current mild inconsistency between the value of Delta m^2_(21)reported by solar neutrino experiments and the KamLAND experiment.
基金This study was funded by Sanofi(China)Investment Co.,Ltdthe National Key R&D Program of China(No.2017YFC090890).
文摘Background and Aims:Nonalcoholic fatty liver disease(NAFLD)is associated with metabolic disorders.This study aimed to explore the role of metabolic disorders in screening advanced fibrosis in NAFLD patients.Methods:A total of 246 histologically-proven NAFLD patients were enrolled across 14 centers.We compared the severity of fibrosis in patients with different components of metabolic disorders.Based on standard noninvasive tests and metabolic disorders,we developed new algorithms to identify advanced fibrosis.Results:Metabolic syndrome(MetS)was frequent in NAFLD patients(133/246,54%).Patients with MetS had a higher proportion of significant fibrosis(p=0.014)and higher LSM values(9.2 kPa,vs.7.4 kPa,p=0.002)than those without MetS.Patients with more metabolic disorders had higher fibrosis stages(p=0.017).Reduced highdensity lipoprotein cholesterol(odds ratio[OR]:2.241,95%confidence interval[CI]:1.004–5.002,p=0.049)and raised fasting glucose(OR:4.500,95%CI:2.083–9.725,p<0.001)were significantly associated with advanced fibrosis.Using these two metabolic disorders as a screening tool,a sensitivity,specificity and accuracy of 92%,81%and 83%was achieved,respectively.With the new algorithms combining metabolic disorders with noninvasive measurements,the number of patients requiring liver biopsy was reduced,especially in combination with the Fibrosis-4 score and metabolic disorders(36%to 17%,p<0.001).In addition,this stepwise algorithm could achieve a high accuracy(85%)and high negative predictive value(93%).Conclusions:Metabolic disorders should be taken into consideration in the diagnosis of advanced fibrosis.With further validation and investigation,new algorithms could be recommended in primary care units to spare patients from unnecessary referral and liver biopsies.
基金This study was supported by the National Key R&D Program of China(2017YFC0908903)National Natural Science Foundation of China(81873565,81900507)Shanghai Leading Talent Plan 2017,Innovative Research Team of High-Level Local Universities in Shanghai,and Hospital Funded Clinical Research,Clinical Research Unit,Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine(17CSK04).
文摘Background and Aims:Nonalcoholic fatty liver disease,now renamed metabolic dysfunction-associated fatty liver disease(MAFLD),is common in obese patients.Intragastric balloon(IGB),an obesity management tool with low complication risk,might be used in MAFLD treatment but there is still unexplained heterogeneity in results across studies.Methods:We conducted a systematic search of 152 citations published up to September 2020.Meta-analyses,stratified analyses,and meta-regression were performed to evaluate the efficacy of IGB on homeostasis model assessment of insulin resistance(HOMA-IR),alanine aminotransferase(ALT),aspartate aminotransferase(AST),and gamma-glutamyl transpeptidase(GGT),and to identify patients most appropriate for IGB therapy.Results:Thirteen observational studies and one randomized controlled trial met the inclusion criteria(624 participants in total).In the overall estimate,IGB therapy significantly improved the serum markers change from baseline to follow-up[HOMA-IR:1.56,95%confidence interval(CI)=1.16–1.95;ALT:11.53 U/L,95%CI=7.10–15.96;AST:6.79 U/L,95%CI=1.69–11.90;GGT:10.54 U/L,95%CI=6.32–14.75].In the stratified analysis,there were trends among participants with advanced age having less change in HOMA-IR(1.07 vs.1.82).The improvement of insulin resistance and liver biochemistries with swallowable IGB therapy was no worse than that with endoscopic IGB.Multivariate meta-regression analyses showed that greater HOMA-IR loss was predicted by younger age(p=0.0107).Furthermore,effectiveness on ALT and GGT was predicted by basal ALT(p=0.0004)and GGT(p=0.0026),respectively.Conclusions:IGB is effective among the serum markers of MAFLD.Younger patients had a greater decrease of HOMA-IR after IGB therapy.
