Objective To discuss the present status and progress of clinical research on recurrence of gastric cancer after surgery, including patterns, clinicopathologic factors, prognosis, detection, diagnosis, prevention, and ...Objective To discuss the present status and progress of clinical research on recurrence of gastric cancer after surgery, including patterns, clinicopathologic factors, prognosis, detection, diagnosis, prevention, and treatment strategies. Data sources The data used in this review were mainly from PubMed articles published in English from 2000 to August 2011. The search terms were ＂gastric cancer＂ and ＂recurrence＂. Study selection Articles were selected if they involved clinicopathologic factors, detection methods, and treatment strategies of recurrence of gastric cancer. Results Peritoneal recurrence is the most common pattern in recurrence of gastric cancer. The main risk factors for recurrence of gastric cancer are tumor stage, including depth of tumor invasion and lymph node metastasis, and Borrmann classification. The prognosis of patients with recurrence is very poor, especially patients with peritoneal recurrence. Systemic chemotherapy is still the main treatment method for patients with recurrent cancer. If complete resection can be accomplished, some benefits may be obtained from surgery for recurrence. However, standard treatment for patients with recurrence has not yet been established. Conclusions Early detection and diagnosis of recurrence is quite crucial for treatment and prognosis. The optimal therapeutic strategy for recurrence should be based on a multidisciplinary assessment and the patient＇s individual state and should involve combined therapy.展开更多
Background The relationship between inflammation and delirium remains to be determined.The purposes of this study were to investigate the association between serum interleukin-6 levels and the occurrence of delirium i...Background The relationship between inflammation and delirium remains to be determined.The purposes of this study were to investigate the association between serum interleukin-6 levels and the occurrence of delirium in elderly patients after major noncardiac surgery.Methods A total of 338 elderly patients （60 years of age and over） undergoing major noncardiac surgery were enrolled.Blood samples were obtained before anesthesia and in the first postoperative morning and serum interleukin-6 concentrations were measured.Delirium was assessed twice daily by the confusion assessment method for the Intensive Care Unit during the first three postoperative days.Survival analyses were performed to assess the relationship between the serum IL-6 level and the occurrence of postoperative delirium.Results Postoperative delirium occurred in 14.8% （50 of 338） of patients.High serum interleukin-6 levelsafter surgery were significantly associated with increased risk of the occurrence of postoperative delirium （hazard ratio 1.514,95% confidence interval 1.155-1.985,P=0.003）.Other independent predictors of delirium included increasing age,poor preoperative New York Heart Association classification,low preoperative Mini-Mental State Examination score,and high total postoperative Visual Analogue Scale pain score.Patients who developed delirium had a prolonged hospital stay after surgery.Conclusions Delirium is a frequent complication in elderly patients after noncardiac surgery.High serum interleukin-6 level after surgery is associated with increased risk of the occurrence of postoperative delirium.展开更多
Li metal is considered one of the most promising candidates for the anode material in high-energy-density Li-ion batteries. However, the dendritic growth of Li metal during the plating/stripping process can severely r...Li metal is considered one of the most promising candidates for the anode material in high-energy-density Li-ion batteries. However, the dendritic growth of Li metal during the plating/stripping process can severely reduce Coulombic efficiency and cause safety problems, which is a key issue limiting the application of Li metal anodes. Herein, we present a novel strategy for dendrite-free deposition of Li by modifying the Cu current collector with a three-dimensional carbon nanofiber （CNF） network. Owing to the large surface area and high conductivity of the CNF network, Li metal is inserted into and deposited onto the CNF directly, and no dendritic Li metal is observed, leaving a flat Li metal surface. With Li metal as the counter electrode for Li deposition, an average Coulombic efficiency of 99.9% was achieved for more than 300 cycles, at large current densities of 1.0 and 2.0 mA·cm^-2, and with a high Li loading of 1 mAh·cm^-2. The scalability of the preparation method and the impressive results achieved here demonstrate the potential for the application of our design to the future development of dendrite-free Li metal anodes.展开更多
AIM: To study liver cell apoptosis caused by the toxicity of selenium and observe the alteration of choline compounds using in vitro 9.4T high resolution magnetic resonance spectroscopy. METHODS: Twenty male Wistar ra...AIM: To study liver cell apoptosis caused by the toxicity of selenium and observe the alteration of choline compounds using in vitro 9.4T high resolution magnetic resonance spectroscopy. METHODS: Twenty male Wistar rats were randomly divided into two groups. The rats in the treatment group were intraperitoneally injected with sodium selenite and the control group with distilled water. All rats were sacrifi ced and the livers were dissected. 1H-MRS data were collected using in vitro 9.4T high resolution magnetic resonance spectrometer. Spectra were processed using XWINNMR and MestRe-c 4.3. HE and TUNEL staining was employed to detect and confi rm the change of liver cells. RESULTS: Good 1H-MR spectra of perchloric acid extract from liver tissue of rats were obtained. The conventional metabolites were detected and assigned. Concentrations of different ingredient choline compounds in treatment group vs control group were as follows: total choline compounds,5.08 ± 0.97 mmol/L vs 3.81 ± 1.16 mmol/L (P = 0.05); and free choline,1.07 ± 0.23 mmol/L vs 0.65 ± 0.20 mmol/L (P = 0.00). However,there was no statistical signif icance between the two groups. The hepatic sinus and cellular structure of hepatic cells in treatmentgroup were abnormal. Apoptosis of hepatic cells was confi rmed by TUNEL assay. CONCLUSION: High dose selenium compounds can cause the rat liver lesion and induce cell apoptosis in vivo. High resolution 1H-MRS in vitro can detect diversified metabolism. The changing trend for different ingredient of choline compounds is not completely the same at early period of apoptosis.展开更多
Diabetic kidney disease(DKD) is the most common cause of chronic kidney disease, leading to end-stage renal disease and cardiovascular disease. The overall number of patients with DKD will continue to increase in para...Diabetic kidney disease(DKD) is the most common cause of chronic kidney disease, leading to end-stage renal disease and cardiovascular disease. The overall number of patients with DKD will continue to increase in parallel with the increasing global pandemic of type 2 diabetes. Based on landmark clinical trials, DKD has become preventable by controlling conventional factors, including hyperglycemia and hypertension, with multifactorial therapy; however, the remaining risk of DKD progression is still high. In this review, we show the importance of targeting remission/regression of microalbuminuria in type 2 diabetic patients, which may protect against the progression of DKD and cardiovascular events. To achieve remission/regression of microalbuminuria, several steps are important, including the early detection of microalbuminuria with continuousscreening, targeting HbA1c < 7.0% for glucose control, the use of renin angiotensin system inhibitors to control blood pressure, the use of statins or fibrates to control dyslipidemia, and multifactorial treatment. Reducing microalbuminuria is therefore an important therapeutic goal, and the absence of microalbuminuria could be a pivotal biomarker of therapeutic success in diabetic patients. Other therapies, including vitamin D receptor activation, uric acid-lowering drugs, and incretin-related drugs, may also be promising for the prevention of DKD progression.展开更多
AIM To assess the efficacy and safety of fibrin sealant for closure of mucosal penetration at the cardia during peroral endoscopic myotomy(POEM).METHODS Twenty-four patients who underwent POEM and experienced mucosal ...AIM To assess the efficacy and safety of fibrin sealant for closure of mucosal penetration at the cardia during peroral endoscopic myotomy(POEM).METHODS Twenty-four patients who underwent POEM and experienced mucosal injury of the cardia during the procedure were retrospectively identified. Of the 24 patients, 21 had mucosal penetration and 3 had only slight mucosal damage without penetration. The 21 patients with mucosal penetration received fibrin sealant for closure at the site of penetration. Penetration-related characteristics, treatment, and recovery were reviewed for all 21 patients to assess the efficacy and safety of fibrin sealant for closure of mucosal penetration at the cardia. Clinical data, including general characteristics, procedure-related parameters, Eckardt scores, lower esophageal sphincter pressures (LESP), and esophagogastroduodenoscopy(EGD) results, were analyzed to determine their influence on treatment success after mucosal penetration during POEM.RESULTS All 21 patients had a solitary mucosal penetration in the cardia (12 in esophageal region of the cardia, 9 in the stomach region of the cardia, and 1 in both the esophageal and stomach regions). Twelve had ahole-like penetration and 9 had a linear penetration. For those with a hole-like penetration, the mean size was 0.14 cm2 (0.02-0.32 cm2). For those with a linear penetration, the median size was 0.37 cm (0.10-1.00 cm). Closure of the mucosal penetration using fibrin sealant was performed successfully in all 21 patients(two patients required 5 m L fibrin sealant, and the remaining 19 patients required 2.5 mL). Two patients had a nasogastric tube placed for five days after POEM; the remaining 19 patients were kept fasting for 3 d. All 21 patients were discharged after a median of 5 d(range: 5-7 d) postoperatively. During a median 42 mo (range: 9-62 mo) follow-up, all 21 patients with a mucosal penetration successfully healed without the occurrence of infection, ulcer, or esophagitis. Furthermore, the median LESP decreased from 31.9 mm H展开更多
AIM:To evaluate the adequacy of surgical treatment of T2 gallbladder carcinoma(GBCa)according to tumor spread in the subserosal layer. METHODS:A series of 84 patients with GBCa were treated at Saga University Hospital...AIM:To evaluate the adequacy of surgical treatment of T2 gallbladder carcinoma(GBCa)according to tumor spread in the subserosal layer. METHODS:A series of 84 patients with GBCa were treated at Saga University Hospital,Japan between April 1989 and October 2008.The tumor stage was graded according to the TNM staging for GBCa from the American Joint Committee on Cancer Manual 6th edition. Tumor staging revealed 30 patients with T2 tumors.T2 GBCa was divided into three groups histologically by the extent of tumor spread in the subserosal layer,using a score of ss minimum(ss min),ss medium(ss med)or ss massive(ss mas). RESULTS:For ss min GBCa,there was no positive pathological factor and patient survival was satisfactory with simple cholecystectomy,with or without extra-he- patic bile duct resection.For ss med GBCa,some pathological factors,h-inf(hepatic infiltration),ly(lymphatic invasion)and n(lymph node metastasis),were positive. For ss mas GBCa,there was a high incidence of positive pathological factors.The patient group with extra-hepatic bile duct resection with D2 lymph node dissection (BDR with D2)and those with S4a5 hepatectomy had significantly better survival rates.CONCLUSION:We suggest that radical surgery is not necessary for ss min GBCa,and partial hepatectomy and BDR are necessary for both ss med and ss mas GBCa.展开更多
目的评估人工全髋关节置换术（total hip arthroplasty，THA）治疗髋关节骨性强直的效果。方法自1987年8月～1998年2月，36例（38髋）行转换THA，平均术前融合时间20年1个月；平均随访8年11个月。结果Harris评分由（68．7±7．2）...目的评估人工全髋关节置换术（total hip arthroplasty，THA）治疗髋关节骨性强直的效果。方法自1987年8月～1998年2月，36例（38髋）行转换THA，平均术前融合时间20年1个月；平均随访8年11个月。结果Harris评分由（68．7±7．2）分提高到（87±6．1）分；髋关节总活动度增加180．7°±14．5°。关节疼痛缓解率为93．3％；平均肢体短缩由4．1cm降到1．6cm；人工关节存活率为86．8％。X线片示髋臼骨溶解6例，髋臼杯松动2例，股骨骨溶解4例，股骨柄松动1例。结论骨性强直的髋关节转换THA，可以缓解周围关节疼痛、增加髋关节的活动度、改善双下肢不等长和矫正髋关节畸形，提高生活质量。髋关节功能与臀中肌力量的恢复直接关联。展开更多
Obejctives To study mitogen activated protein kinase (MAPKs) activation in fibroblast like synoviocytes (FLS) of rheumatoid arthritis (RA) under the stimulation of IL 1β, and to elucidate the role of protein tyro...Obejctives To study mitogen activated protein kinase (MAPKs) activation in fibroblast like synoviocytes (FLS) of rheumatoid arthritis (RA) under the stimulation of IL 1β, and to elucidate the role of protein tyrosine kinase (PTK) in the activation of MAPKs Methods Primary cultures of RA FLS were used Western blot was applied to examine transient changes in protein tyrosine phosphorylation status and MAPKs activation in RA FLS stimulated with IL 1β at various doses, and over different periods Genistein, the specific PTK inhibitor, was used to evaluate the inhibitory role in activation of MAPKs by IL 1β Results IL 1β transiently increased protein tyrosine phosphorylation, and activated the MAPKs cascades (mainly ERK 2, JNK 2 and P 38 ) in RA FLS There was no obvious difference in MAPKs activation among different doses of IL 1β (1?IU/ml,10?IU/ml, 100?IU/ml), but the peak activation of ERK 2, JNK 2 and P 38 took place at 5?min, 15?min and 1?min, respectively, after stimulation with IL 1β The activation of ERK 2 was inhibited by genistein, but the inhibitory role on that of JNK and P 38 was relatively weak Conclusions During signal transduction of IL 1β in RA FLS, tyrosine phosphorylation was increased transiently, the MAPKs cascade was activated in a few minutes, and there was heterogenicity in the activation among three subfamily members PTK had a role in the activation of ERK, but had weak effects on that of JNK and P 38展开更多
The supersonic ejector-diffuser system with a second throat was simulated using CFD. A fully implicit finite volume scheme was applied to solve the axisymmetric Navier-Stokes equations and a standard k-E turbulence mo...The supersonic ejector-diffuser system with a second throat was simulated using CFD. A fully implicit finite volume scheme was applied to solve the axisymmetric Navier-Stokes equations and a standard k-E turbulence model was used to close the governing equations. The flow field in the supersonic ejectordiffuser system was investigated by changing the ejector throat area ratio and the secondary mass flow ratio at a fixed operating pressure ratio of 10. A convergent-divergent nozzle with a design Mach number of 2.11 was selected to give the supersonic operation of the ejector-diffuser system. For the constant area mixing tube the secondary mass flow seemed not to significantly change the flow field in the ejector-diffuser systems. It was, however, found that the flow in the ejector-diffuser systems having the second throat is strongly dependent on the secondary mass flow.展开更多
Objective:To investigate the effects of co-transfection of miR-520c-3p and miR-132 on proliferation and apoptosis of hepatocellular carcinoma Huh7.Methods:Hepatocellular carcinoma Huh7 was cultured in vitro and lipido...Objective:To investigate the effects of co-transfection of miR-520c-3p and miR-132 on proliferation and apoptosis of hepatocellular carcinoma Huh7.Methods:Hepatocellular carcinoma Huh7 was cultured in vitro and lipidosome was used to transfect miR-520c-3p and miR-132 respectively or together.The effects of transfection of miR-520c-3p and miR-132 on proliferation and apoptosis of Huh7 were detected by CCK8 and Annexin V staining and flow cytometry,and the expression level of the targeted gene of over-expressed miR-520c-3p and miR-132 was determined by Western blot and realtime PCR.Results:Compared with the control group,the proliferation ability of Huh7 of the single transfected and co-transfected miR-520c-3p and miR-132 decreased significantly,and the apoptosis ratio increased distinctly(P<0.05).Besides,the affect of the co-transfection group was better than that of the single transfection group.The protein levels of GPC3(Glypican-3) and YAP(Yes-associated protein),the target genes transfected only by miR-520c-3p and miR-132,respectively,reduced obviously(P<0.05),which was similar with the co-infected cells,but cells transfected by miR-132 only showed a decrease of YAP.Conclusions:The co-transfection of miR-520c-3p and miR-132 can target-regulate the expression of GPC3 and YAP,enhance the exhibition effect on proliferation of hepatocellular carcinoma Huh7 and induce cell apoptosis synergistically.展开更多
To investigate the relation of two different mutations to the outcome of partial external biliary diversion (PEBD) in severe bile salt export pump (BSEP) deficiency. METHODSMutations in the gene encoding BSEP leading ...To investigate the relation of two different mutations to the outcome of partial external biliary diversion (PEBD) in severe bile salt export pump (BSEP) deficiency. METHODSMutations in the gene encoding BSEP leading to severe BSEP deficiency in two unrelated patients were identified by genomic sequencing. Native liver biopsies and transiently transfected human embryonic kidney (HEK) 293 cells expressing either wild-type or mutated BSEP were subjected to immunofluorescence analysis to assess BSEP transporter localization. Bile acid profiles of patient and control bile samples were generated by ultra-performance liquid chromatography-tandem mass spectrometry. Wild-type and mutant BSEP transport of [<sup>3</sup>H]-labeled taurocholate (TC) and taurochenodeoxycholate (TCDC) was assessed by vesicular transport assays. RESULTSA girl (at 2 mo) presented with pruritus, jaundice and elevated serum bile salts (BS). PEBD stabilized liver function and prevented liver transplantation. She was heterozygous for the BSEP deletion p.T919del and the nonsense mutation p.R1235X. At the age of 17 years relative amounts of conjugated BS in her bile were normal, while total BS were less than 3% as compared to controls. An unrelated boy (age 1.5 years) presenting with severe pruritus and elevated serum BS was heterozygous for the same nonsense and another missense mutation, p.G1032R. PEBD failed to alleviate pruritus, eventually necessitating liver transplantation. BS concentration in bile was about 5% of controls. BS were mainly unconjugated with an unusual low amount of chenodeoxycholate derivatives (< 5%). The patients’ native liver biopsies showed canalicular BSEP expression. Both BSEP p.T919del and p.G1032R were localized in the plasma membrane in HEK293 cells. In vitro transport assays showed drastic reduction of transport by both mutations. Using purified recombinant BSEP as quantifiable reference, per-molecule transport rates for TC and TCDC were determined to be 3 and 2 BS molecules per wild-type BSEP transporter per minute,展开更多
The present work reports a sensitive and selective fluorescent sensor for the detection of mercury ion, Hg（II）, by hybridizing carbon nanodots （C-dots） and gold nanoclusters （Au NCs） through intrinsic interactio...The present work reports a sensitive and selective fluorescent sensor for the detection of mercury ion, Hg（II）, by hybridizing carbon nanodots （C-dots） and gold nanoclusters （Au NCs） through intrinsic interactions of the two components. The C-dots serve as the reference signal and the Au NCs as the reporter. This method employs the specific high affinity metallophilic Hg2^-Au＋ interactions which can greatly quench the red fluorescence of Au NCs, while the blue fluorescence of C-dots is stable against Hg（II）, leading to distinct ratiometric fluorescence changes when exposed to Hg（II）. A limit of detection of 28 nM for Hg（II） in aqueous solution was estimated. Thus we applied the sensor for the detection of Hg（II） in real water samples including tap water, lake water and mineral water samples with good results. We further demonstrated that a visual chemical sensor could be manufactured by immobilizing the nanohybrid probe on a cellulose acetate circular filter paper. The paper-based sensor immediately showed a distinct fluorescence color evolution from pink to blue after exposure to a drop of the Hg（II） solution展开更多
Additive manufacturing(AM) has been increasingly used in production. Because of its rapid growth, the efficiency and robustness of AM-based product development processes should be improved. Artificial intelligence(AI)...Additive manufacturing(AM) has been increasingly used in production. Because of its rapid growth, the efficiency and robustness of AM-based product development processes should be improved. Artificial intelligence(AI) is a powerful tool that has outperformed humans in numerous complex tasks. AI-enabled intelligent agents can reduce the workforce required to scale up AM production and achieve higher resource utilization efficiency. This study provides an introduction of AI techniques. Then,the current development of AI-enabled AM product development is investigated. Existing intelligent agents are used for problems in product design, process design and production stages. Based on the review, current research gaps and future research directions are identified. To guide future development of more efficient and comprehensive intelligent agents, a smart AM framework based on cloud-edge computing is proposed. Global consideration can be realized in the cloud environment, and a fast response can be achieved at the edge nodes.展开更多
Objective Triple-negative breast cancer(TNBC)poses a significant challenge for treatment efficacy.CD8+T cells,which are pivotal immune cells,can be effectively analyzed for differential gene expression across diverse ...Objective Triple-negative breast cancer(TNBC)poses a significant challenge for treatment efficacy.CD8+T cells,which are pivotal immune cells,can be effectively analyzed for differential gene expression across diverse cell populations owing to rapid advancements in sequencing technology.By leveraging these genes,our objective was to develop a prognostic model that accurately predicts the prognosis of patients with TNBC and their responsiveness to immunotherapy.Methods Sample information and clinical data of TNBC were sourced from The Cancer Genome Atlas and METABRIC databases.In the initial stage,we identified 67 differentially expressed genes associated with immune response in CD8+T cells.Subsequently,we narrowed our focus to three key genes,namely CXCL13,GBP2,and GZMB,which were used to construct a prognostic model.The accuracy of the model was assessed using the validation set data and receiver operating characteristic(ROC)curves.Furthermore,we employed various methods,including Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway,immune infiltration,and correlation analyses with CD274(PD-L1)to explore the model's predictive efficacy in immunotherapeutic responses.Additionally,we investigated the potential underlying biological pathways that contribute to divergent treatment responses.Results We successfully developed a model capable of predicting the prognosis of patients with TNBC.The areas under the curve(AUC)values for the 1-,3-,and 5-year survival predictions were 0.618,0.652,and 0.826,respectively.Employing this risk model,we stratified the samples into high-and low-risk groups.Through KEGG enrichment analysis,we observed that the high-risk group predominantly exhibited enrichment in metabolism-related pathways such as drug and chlorophyll metabolism,whereas the low-risk group demonstrated significant enrichment in cytokine pathways.Furthermore,immune landscape analysis revealed noteworthy variations between(PD-L1)expression and risk scores,indicating that our model effectively predicted the response of p展开更多
Cotton has enormous economic potential providing high-quality protein,oil,and fibre.A large increase in cotton output is necessary due to the world’s changing climate and constantly expanding human population.In the ...Cotton has enormous economic potential providing high-quality protein,oil,and fibre.A large increase in cotton output is necessary due to the world’s changing climate and constantly expanding human population.In the past,conventional breeding techniques were used to introduce genes into superior cotton cultivars to increase production and to improve quality.The disadvantages of traditional breeding techniques are their time-consuming,reliance on genetic differences that are already present,and considerable backcrossing.To accomplish goals in a short amount of time,contemporary plant breeding techniques,in particular modern genome editing technologies(GETs),can be used.Numerous crop improvement initiatives have made use of GETs,such as zinc-finger nucleases,transcription-activator-like effector nucleases,clustered regularly interspaced palindromic repeats(CRISPR),and CRISPR-associated proteins systems(CRISPR/Cas)-based technologies.The CRISPR/Cas system has a lot of potential because it combines three qualities that other GETs lack:simplicity,competence,and adaptability.The CRISPR/Cas mechanism can be used to improve cotton tolerance to biotic and abiotic stresses,alter gene expression,and stack genes for critical features with little possibility of segregation.The transgene clean strategy improves CRISPR acceptability addressing regulatory issues associated with the genetically modified organisms(GMOs).The research opportunities for using the CRISPR/Cas system to address biotic and abiotic stresses,fibre quality,plant architecture and blooming,epigenetic changes,and gene stacking for commercially significant traits are highlighted in this article.Furthermore,challenges to use of CRISPR technology in cotton and its potential for the future are covered in detail.展开更多
This paper presents an effective and efficient combination of feature extraction and multi-class classifier for motion classification by analyzing the surface electromyografic(sEMG) signals. In contrast to the existin...This paper presents an effective and efficient combination of feature extraction and multi-class classifier for motion classification by analyzing the surface electromyografic(sEMG) signals. In contrast to the existing methods,considering the non-stationary and nonlinear characteristics of EMG signals,to get the more separable feature set,we introduce the empirical mode decomposition(EMD) to decompose the original EMG signals into several intrinsic mode functions(IMFs) and then compute the coefficients of autoregressive models of each IMF to form the feature set. Based on the least squares support vector machines(LS-SVMs) ,the multi-class classifier is designed and constructed to classify various motions. The results of contrastive experiments showed that the accuracy of motion recognition is improved with the described classification scheme. Furthermore,compared with other classifiers using different features,the excellent performance indicated the potential of the SVM techniques embedding the EMD-AR kernel in motion classification.展开更多
基金This study was supported by the National Natural Science Foundation of China （No. 81172368） and the Capital Clinical Application Research Foundation （No. ZI 11107058811047）.
文摘Objective To discuss the present status and progress of clinical research on recurrence of gastric cancer after surgery, including patterns, clinicopathologic factors, prognosis, detection, diagnosis, prevention, and treatment strategies. Data sources The data used in this review were mainly from PubMed articles published in English from 2000 to August 2011. The search terms were ＂gastric cancer＂ and ＂recurrence＂. Study selection Articles were selected if they involved clinicopathologic factors, detection methods, and treatment strategies of recurrence of gastric cancer. Results Peritoneal recurrence is the most common pattern in recurrence of gastric cancer. The main risk factors for recurrence of gastric cancer are tumor stage, including depth of tumor invasion and lymph node metastasis, and Borrmann classification. The prognosis of patients with recurrence is very poor, especially patients with peritoneal recurrence. Systemic chemotherapy is still the main treatment method for patients with recurrent cancer. If complete resection can be accomplished, some benefits may be obtained from surgery for recurrence. However, standard treatment for patients with recurrence has not yet been established. Conclusions Early detection and diagnosis of recurrence is quite crucial for treatment and prognosis. The optimal therapeutic strategy for recurrence should be based on a multidisciplinary assessment and the patient＇s individual state and should involve combined therapy.
文摘Background The relationship between inflammation and delirium remains to be determined.The purposes of this study were to investigate the association between serum interleukin-6 levels and the occurrence of delirium in elderly patients after major noncardiac surgery.Methods A total of 338 elderly patients （60 years of age and over） undergoing major noncardiac surgery were enrolled.Blood samples were obtained before anesthesia and in the first postoperative morning and serum interleukin-6 concentrations were measured.Delirium was assessed twice daily by the confusion assessment method for the Intensive Care Unit during the first three postoperative days.Survival analyses were performed to assess the relationship between the serum IL-6 level and the occurrence of postoperative delirium.Results Postoperative delirium occurred in 14.8% （50 of 338） of patients.High serum interleukin-6 levelsafter surgery were significantly associated with increased risk of the occurrence of postoperative delirium （hazard ratio 1.514,95% confidence interval 1.155-1.985,P=0.003）.Other independent predictors of delirium included increasing age,poor preoperative New York Heart Association classification,low preoperative Mini-Mental State Examination score,and high total postoperative Visual Analogue Scale pain score.Patients who developed delirium had a prolonged hospital stay after surgery.Conclusions Delirium is a frequent complication in elderly patients after noncardiac surgery.High serum interleukin-6 level after surgery is associated with increased risk of the occurrence of postoperative delirium.
文摘Li metal is considered one of the most promising candidates for the anode material in high-energy-density Li-ion batteries. However, the dendritic growth of Li metal during the plating/stripping process can severely reduce Coulombic efficiency and cause safety problems, which is a key issue limiting the application of Li metal anodes. Herein, we present a novel strategy for dendrite-free deposition of Li by modifying the Cu current collector with a three-dimensional carbon nanofiber （CNF） network. Owing to the large surface area and high conductivity of the CNF network, Li metal is inserted into and deposited onto the CNF directly, and no dendritic Li metal is observed, leaving a flat Li metal surface. With Li metal as the counter electrode for Li deposition, an average Coulombic efficiency of 99.9% was achieved for more than 300 cycles, at large current densities of 1.0 and 2.0 mA·cm^-2, and with a high Li loading of 1 mAh·cm^-2. The scalability of the preparation method and the impressive results achieved here demonstrate the potential for the application of our design to the future development of dendrite-free Li metal anodes.
基金The National Natural Science Foundation of China,No.30570480
文摘AIM: To study liver cell apoptosis caused by the toxicity of selenium and observe the alteration of choline compounds using in vitro 9.4T high resolution magnetic resonance spectroscopy. METHODS: Twenty male Wistar rats were randomly divided into two groups. The rats in the treatment group were intraperitoneally injected with sodium selenite and the control group with distilled water. All rats were sacrifi ced and the livers were dissected. 1H-MRS data were collected using in vitro 9.4T high resolution magnetic resonance spectrometer. Spectra were processed using XWINNMR and MestRe-c 4.3. HE and TUNEL staining was employed to detect and confi rm the change of liver cells. RESULTS: Good 1H-MR spectra of perchloric acid extract from liver tissue of rats were obtained. The conventional metabolites were detected and assigned. Concentrations of different ingredient choline compounds in treatment group vs control group were as follows: total choline compounds,5.08 ± 0.97 mmol/L vs 3.81 ± 1.16 mmol/L (P = 0.05); and free choline,1.07 ± 0.23 mmol/L vs 0.65 ± 0.20 mmol/L (P = 0.00). However,there was no statistical signif icance between the two groups. The hepatic sinus and cellular structure of hepatic cells in treatmentgroup were abnormal. Apoptosis of hepatic cells was confi rmed by TUNEL assay. CONCLUSION: High dose selenium compounds can cause the rat liver lesion and induce cell apoptosis in vivo. High resolution 1H-MRS in vitro can detect diversified metabolism. The changing trend for different ingredient of choline compounds is not completely the same at early period of apoptosis.
基金Supported by A Grant from Novo Nordisk Pharma,to Kitada MA Grant-in-Aid for Scientific Research(C)to Kitada M,No.24591218+4 种基金A Grant for Promoted Research from Kanazawa Medical University to Kitada M,No.S2012-4A Grant-in-Aid for Scientific Research(B)to Koya D,No.25282028A Grant-in-Aid for Challenging Exploratory Research to Koya D,No.25670414A grant for Specially Promoted Research from Kanazawa Medical University to Koya D,No.SR2012-06the 4th Annual Research Award Grant of the Japanese Society of Anti-Aging Medicine,to Koya D
文摘Diabetic kidney disease(DKD) is the most common cause of chronic kidney disease, leading to end-stage renal disease and cardiovascular disease. The overall number of patients with DKD will continue to increase in parallel with the increasing global pandemic of type 2 diabetes. Based on landmark clinical trials, DKD has become preventable by controlling conventional factors, including hyperglycemia and hypertension, with multifactorial therapy; however, the remaining risk of DKD progression is still high. In this review, we show the importance of targeting remission/regression of microalbuminuria in type 2 diabetic patients, which may protect against the progression of DKD and cardiovascular events. To achieve remission/regression of microalbuminuria, several steps are important, including the early detection of microalbuminuria with continuousscreening, targeting HbA1c < 7.0% for glucose control, the use of renin angiotensin system inhibitors to control blood pressure, the use of statins or fibrates to control dyslipidemia, and multifactorial treatment. Reducing microalbuminuria is therefore an important therapeutic goal, and the absence of microalbuminuria could be a pivotal biomarker of therapeutic success in diabetic patients. Other therapies, including vitamin D receptor activation, uric acid-lowering drugs, and incretin-related drugs, may also be promising for the prevention of DKD progression.
文摘AIM To assess the efficacy and safety of fibrin sealant for closure of mucosal penetration at the cardia during peroral endoscopic myotomy(POEM).METHODS Twenty-four patients who underwent POEM and experienced mucosal injury of the cardia during the procedure were retrospectively identified. Of the 24 patients, 21 had mucosal penetration and 3 had only slight mucosal damage without penetration. The 21 patients with mucosal penetration received fibrin sealant for closure at the site of penetration. Penetration-related characteristics, treatment, and recovery were reviewed for all 21 patients to assess the efficacy and safety of fibrin sealant for closure of mucosal penetration at the cardia. Clinical data, including general characteristics, procedure-related parameters, Eckardt scores, lower esophageal sphincter pressures (LESP), and esophagogastroduodenoscopy(EGD) results, were analyzed to determine their influence on treatment success after mucosal penetration during POEM.RESULTS All 21 patients had a solitary mucosal penetration in the cardia (12 in esophageal region of the cardia, 9 in the stomach region of the cardia, and 1 in both the esophageal and stomach regions). Twelve had ahole-like penetration and 9 had a linear penetration. For those with a hole-like penetration, the mean size was 0.14 cm2 (0.02-0.32 cm2). For those with a linear penetration, the median size was 0.37 cm (0.10-1.00 cm). Closure of the mucosal penetration using fibrin sealant was performed successfully in all 21 patients(two patients required 5 m L fibrin sealant, and the remaining 19 patients required 2.5 mL). Two patients had a nasogastric tube placed for five days after POEM; the remaining 19 patients were kept fasting for 3 d. All 21 patients were discharged after a median of 5 d(range: 5-7 d) postoperatively. During a median 42 mo (range: 9-62 mo) follow-up, all 21 patients with a mucosal penetration successfully healed without the occurrence of infection, ulcer, or esophagitis. Furthermore, the median LESP decreased from 31.9 mm H
文摘AIM:To evaluate the adequacy of surgical treatment of T2 gallbladder carcinoma(GBCa)according to tumor spread in the subserosal layer. METHODS:A series of 84 patients with GBCa were treated at Saga University Hospital,Japan between April 1989 and October 2008.The tumor stage was graded according to the TNM staging for GBCa from the American Joint Committee on Cancer Manual 6th edition. Tumor staging revealed 30 patients with T2 tumors.T2 GBCa was divided into three groups histologically by the extent of tumor spread in the subserosal layer,using a score of ss minimum(ss min),ss medium(ss med)or ss massive(ss mas). RESULTS:For ss min GBCa,there was no positive pathological factor and patient survival was satisfactory with simple cholecystectomy,with or without extra-he- patic bile duct resection.For ss med GBCa,some pathological factors,h-inf(hepatic infiltration),ly(lymphatic invasion)and n(lymph node metastasis),were positive. For ss mas GBCa,there was a high incidence of positive pathological factors.The patient group with extra-hepatic bile duct resection with D2 lymph node dissection (BDR with D2)and those with S4a5 hepatectomy had significantly better survival rates.CONCLUSION:We suggest that radical surgery is not necessary for ss min GBCa,and partial hepatectomy and BDR are necessary for both ss med and ss mas GBCa.
文摘目的评估人工全髋关节置换术（total hip arthroplasty，THA）治疗髋关节骨性强直的效果。方法自1987年8月～1998年2月，36例（38髋）行转换THA，平均术前融合时间20年1个月；平均随访8年11个月。结果Harris评分由（68．7±7．2）分提高到（87±6．1）分；髋关节总活动度增加180．7°±14．5°。关节疼痛缓解率为93．3％；平均肢体短缩由4．1cm降到1．6cm；人工关节存活率为86．8％。X线片示髋臼骨溶解6例，髋臼杯松动2例，股骨骨溶解4例，股骨柄松动1例。结论骨性强直的髋关节转换THA，可以缓解周围关节疼痛、增加髋关节的活动度、改善双下肢不等长和矫正髋关节畸形，提高生活质量。髋关节功能与臀中肌力量的恢复直接关联。
基金ThestudywassupportedbythegrantfromtheNationalNaturalScienceFundationofChina (No 39730 430 )
文摘Obejctives To study mitogen activated protein kinase (MAPKs) activation in fibroblast like synoviocytes (FLS) of rheumatoid arthritis (RA) under the stimulation of IL 1β, and to elucidate the role of protein tyrosine kinase (PTK) in the activation of MAPKs Methods Primary cultures of RA FLS were used Western blot was applied to examine transient changes in protein tyrosine phosphorylation status and MAPKs activation in RA FLS stimulated with IL 1β at various doses, and over different periods Genistein, the specific PTK inhibitor, was used to evaluate the inhibitory role in activation of MAPKs by IL 1β Results IL 1β transiently increased protein tyrosine phosphorylation, and activated the MAPKs cascades (mainly ERK 2, JNK 2 and P 38 ) in RA FLS There was no obvious difference in MAPKs activation among different doses of IL 1β (1?IU/ml,10?IU/ml, 100?IU/ml), but the peak activation of ERK 2, JNK 2 and P 38 took place at 5?min, 15?min and 1?min, respectively, after stimulation with IL 1β The activation of ERK 2 was inhibited by genistein, but the inhibitory role on that of JNK and P 38 was relatively weak Conclusions During signal transduction of IL 1β in RA FLS, tyrosine phosphorylation was increased transiently, the MAPKs cascade was activated in a few minutes, and there was heterogenicity in the activation among three subfamily members PTK had a role in the activation of ERK, but had weak effects on that of JNK and P 38
文摘The supersonic ejector-diffuser system with a second throat was simulated using CFD. A fully implicit finite volume scheme was applied to solve the axisymmetric Navier-Stokes equations and a standard k-E turbulence model was used to close the governing equations. The flow field in the supersonic ejectordiffuser system was investigated by changing the ejector throat area ratio and the secondary mass flow ratio at a fixed operating pressure ratio of 10. A convergent-divergent nozzle with a design Mach number of 2.11 was selected to give the supersonic operation of the ejector-diffuser system. For the constant area mixing tube the secondary mass flow seemed not to significantly change the flow field in the ejector-diffuser systems. It was, however, found that the flow in the ejector-diffuser systems having the second throat is strongly dependent on the secondary mass flow.
基金supported by Supported by Education Department of Hubei Province science and technology research project(NO.B2015230)Applied Fundamental Research Project of Wuhan Municipal Science and Technology Bureau(Grant No.2015061701011630)+1 种基金Medical Scientific Research Project of Health and Familly Planning Commission of Wuhan Municipality(Grant No.WX16E12)the fourth batch of "Hanyang Talent Associate Program"
文摘Objective:To investigate the effects of co-transfection of miR-520c-3p and miR-132 on proliferation and apoptosis of hepatocellular carcinoma Huh7.Methods:Hepatocellular carcinoma Huh7 was cultured in vitro and lipidosome was used to transfect miR-520c-3p and miR-132 respectively or together.The effects of transfection of miR-520c-3p and miR-132 on proliferation and apoptosis of Huh7 were detected by CCK8 and Annexin V staining and flow cytometry,and the expression level of the targeted gene of over-expressed miR-520c-3p and miR-132 was determined by Western blot and realtime PCR.Results:Compared with the control group,the proliferation ability of Huh7 of the single transfected and co-transfected miR-520c-3p and miR-132 decreased significantly,and the apoptosis ratio increased distinctly(P<0.05).Besides,the affect of the co-transfection group was better than that of the single transfection group.The protein levels of GPC3(Glypican-3) and YAP(Yes-associated protein),the target genes transfected only by miR-520c-3p and miR-132,respectively,reduced obviously(P<0.05),which was similar with the co-infected cells,but cells transfected by miR-132 only showed a decrease of YAP.Conclusions:The co-transfection of miR-520c-3p and miR-132 can target-regulate the expression of GPC3 and YAP,enhance the exhibition effect on proliferation of hepatocellular carcinoma Huh7 and induce cell apoptosis synergistically.
基金Supported by the German -Research Foun-dation-through the Clin-ical Research Group KFO217“Hepatobiliary tran-sport an-d liver diseases”the Collaborative Research Cen-tre 974“Commun-ication-an-d Systemic Relevan-ce in-Liver Damage an-d Regen-eration-”
文摘To investigate the relation of two different mutations to the outcome of partial external biliary diversion (PEBD) in severe bile salt export pump (BSEP) deficiency. METHODSMutations in the gene encoding BSEP leading to severe BSEP deficiency in two unrelated patients were identified by genomic sequencing. Native liver biopsies and transiently transfected human embryonic kidney (HEK) 293 cells expressing either wild-type or mutated BSEP were subjected to immunofluorescence analysis to assess BSEP transporter localization. Bile acid profiles of patient and control bile samples were generated by ultra-performance liquid chromatography-tandem mass spectrometry. Wild-type and mutant BSEP transport of [<sup>3</sup>H]-labeled taurocholate (TC) and taurochenodeoxycholate (TCDC) was assessed by vesicular transport assays. RESULTSA girl (at 2 mo) presented with pruritus, jaundice and elevated serum bile salts (BS). PEBD stabilized liver function and prevented liver transplantation. She was heterozygous for the BSEP deletion p.T919del and the nonsense mutation p.R1235X. At the age of 17 years relative amounts of conjugated BS in her bile were normal, while total BS were less than 3% as compared to controls. An unrelated boy (age 1.5 years) presenting with severe pruritus and elevated serum BS was heterozygous for the same nonsense and another missense mutation, p.G1032R. PEBD failed to alleviate pruritus, eventually necessitating liver transplantation. BS concentration in bile was about 5% of controls. BS were mainly unconjugated with an unusual low amount of chenodeoxycholate derivatives (< 5%). The patients’ native liver biopsies showed canalicular BSEP expression. Both BSEP p.T919del and p.G1032R were localized in the plasma membrane in HEK293 cells. In vitro transport assays showed drastic reduction of transport by both mutations. Using purified recombinant BSEP as quantifiable reference, per-molecule transport rates for TC and TCDC were determined to be 3 and 2 BS molecules per wild-type BSEP transporter per minute,
文摘The present work reports a sensitive and selective fluorescent sensor for the detection of mercury ion, Hg（II）, by hybridizing carbon nanodots （C-dots） and gold nanoclusters （Au NCs） through intrinsic interactions of the two components. The C-dots serve as the reference signal and the Au NCs as the reporter. This method employs the specific high affinity metallophilic Hg2^-Au＋ interactions which can greatly quench the red fluorescence of Au NCs, while the blue fluorescence of C-dots is stable against Hg（II）, leading to distinct ratiometric fluorescence changes when exposed to Hg（II）. A limit of detection of 28 nM for Hg（II） in aqueous solution was estimated. Thus we applied the sensor for the detection of Hg（II） in real water samples including tap water, lake water and mineral water samples with good results. We further demonstrated that a visual chemical sensor could be manufactured by immobilizing the nanohybrid probe on a cellulose acetate circular filter paper. The paper-based sensor immediately showed a distinct fluorescence color evolution from pink to blue after exposure to a drop of the Hg（II） solution
基金supported by the National Natural Science Foundation of China (Grant No. 51890885)the Natural Science Foundation of Zhejiang Province (Grant No. LY19E050019)。
文摘Additive manufacturing(AM) has been increasingly used in production. Because of its rapid growth, the efficiency and robustness of AM-based product development processes should be improved. Artificial intelligence(AI) is a powerful tool that has outperformed humans in numerous complex tasks. AI-enabled intelligent agents can reduce the workforce required to scale up AM production and achieve higher resource utilization efficiency. This study provides an introduction of AI techniques. Then,the current development of AI-enabled AM product development is investigated. Existing intelligent agents are used for problems in product design, process design and production stages. Based on the review, current research gaps and future research directions are identified. To guide future development of more efficient and comprehensive intelligent agents, a smart AM framework based on cloud-edge computing is proposed. Global consideration can be realized in the cloud environment, and a fast response can be achieved at the edge nodes.
基金supported by Joint Funds for the Innovation of Science and Technology,Fujian Province[Grant number:2020Y9039]Fujian Provincial Health Technology Project[Grant number:2022GGA032].
文摘Objective Triple-negative breast cancer(TNBC)poses a significant challenge for treatment efficacy.CD8+T cells,which are pivotal immune cells,can be effectively analyzed for differential gene expression across diverse cell populations owing to rapid advancements in sequencing technology.By leveraging these genes,our objective was to develop a prognostic model that accurately predicts the prognosis of patients with TNBC and their responsiveness to immunotherapy.Methods Sample information and clinical data of TNBC were sourced from The Cancer Genome Atlas and METABRIC databases.In the initial stage,we identified 67 differentially expressed genes associated with immune response in CD8+T cells.Subsequently,we narrowed our focus to three key genes,namely CXCL13,GBP2,and GZMB,which were used to construct a prognostic model.The accuracy of the model was assessed using the validation set data and receiver operating characteristic(ROC)curves.Furthermore,we employed various methods,including Kyoto Encyclopedia of Genes and Genomes(KEGG)pathway,immune infiltration,and correlation analyses with CD274(PD-L1)to explore the model's predictive efficacy in immunotherapeutic responses.Additionally,we investigated the potential underlying biological pathways that contribute to divergent treatment responses.Results We successfully developed a model capable of predicting the prognosis of patients with TNBC.The areas under the curve(AUC)values for the 1-,3-,and 5-year survival predictions were 0.618,0.652,and 0.826,respectively.Employing this risk model,we stratified the samples into high-and low-risk groups.Through KEGG enrichment analysis,we observed that the high-risk group predominantly exhibited enrichment in metabolism-related pathways such as drug and chlorophyll metabolism,whereas the low-risk group demonstrated significant enrichment in cytokine pathways.Furthermore,immune landscape analysis revealed noteworthy variations between(PD-L1)expression and risk scores,indicating that our model effectively predicted the response of p
文摘Cotton has enormous economic potential providing high-quality protein,oil,and fibre.A large increase in cotton output is necessary due to the world’s changing climate and constantly expanding human population.In the past,conventional breeding techniques were used to introduce genes into superior cotton cultivars to increase production and to improve quality.The disadvantages of traditional breeding techniques are their time-consuming,reliance on genetic differences that are already present,and considerable backcrossing.To accomplish goals in a short amount of time,contemporary plant breeding techniques,in particular modern genome editing technologies(GETs),can be used.Numerous crop improvement initiatives have made use of GETs,such as zinc-finger nucleases,transcription-activator-like effector nucleases,clustered regularly interspaced palindromic repeats(CRISPR),and CRISPR-associated proteins systems(CRISPR/Cas)-based technologies.The CRISPR/Cas system has a lot of potential because it combines three qualities that other GETs lack:simplicity,competence,and adaptability.The CRISPR/Cas mechanism can be used to improve cotton tolerance to biotic and abiotic stresses,alter gene expression,and stack genes for critical features with little possibility of segregation.The transgene clean strategy improves CRISPR acceptability addressing regulatory issues associated with the genetically modified organisms(GMOs).The research opportunities for using the CRISPR/Cas system to address biotic and abiotic stresses,fibre quality,plant architecture and blooming,epigenetic changes,and gene stacking for commercially significant traits are highlighted in this article.Furthermore,challenges to use of CRISPR technology in cotton and its potential for the future are covered in detail.
基金Project (No. 2005CB724303) supported by the National Basic Re-search Program (973) of China
文摘This paper presents an effective and efficient combination of feature extraction and multi-class classifier for motion classification by analyzing the surface electromyografic(sEMG) signals. In contrast to the existing methods,considering the non-stationary and nonlinear characteristics of EMG signals,to get the more separable feature set,we introduce the empirical mode decomposition(EMD) to decompose the original EMG signals into several intrinsic mode functions(IMFs) and then compute the coefficients of autoregressive models of each IMF to form the feature set. Based on the least squares support vector machines(LS-SVMs) ,the multi-class classifier is designed and constructed to classify various motions. The results of contrastive experiments showed that the accuracy of motion recognition is improved with the described classification scheme. Furthermore,compared with other classifiers using different features,the excellent performance indicated the potential of the SVM techniques embedding the EMD-AR kernel in motion classification.
