Nanomaterials-mediated lysosomal regulation:a robust protein-clearance approach for the treatment of Alzheimer’s disease

Alzheimer’s disease is a debilitating,progressive neurodegenerative disorder characterized by the progressive accumulation of abnormal proteins,including amyloid plaques and intracellular tau tangles,primarily within the brain.Lysosomes,crucial intracellular organelles responsible for protein degradation,play a key role in maintaining cellular homeostasis.Some studies have suggested a link between the dysregulation of the lysosomal system and pathogenesis of neurodegenerative diseases,including Alzheimer’s disease.Restoring the normal physiological function of lysosomes hold the potential to reduce the pathological burden and improve the symptoms of Alzheimer’s disease.Currently,the efficacy of drugs in treating Alzheimer’s disease is limited,with major challenges in drug delivery efficiency and targeting.Recently,nanomaterials have gained widespread use in Alzheimer’s disease drug research owing to their favorable physical and chemical properties.This review aims to provide a comprehensive overview of recent advances in using nanomaterials(polymeric nanomaterials,nanoemulsions,and carbon-based nanomaterials)to enhance lysosomal function in treating Alzheimer’s disease.This review also explores new concepts and potential therapeutic strategies for Alzheimer’s disease through the integration of nanomaterials and modulation of lysosomal function.In conclusion,this review emphasizes the potential of nanomaterials in modulating lysosomal function to improve the pathological features of Alzheimer’s disease.The application of nanotechnology to the development of Alzheimer’s disease drugs brings new ideas and approaches for future treatment of this disease.

Biomaterials-based anti-inflammatory treatment strategies for Alzheimer's disease

The current therapeutic drugs for Alzheimer's disease only improve symptoms,they do not delay disease progression.Therefo re,there is an urgent need for new effective drugs.The underlying pathogenic factors of Alzheimer's disease are not clear,but neuroinflammation can link various hypotheses of Alzheimer's disease;hence,targeting neuroinflammation may be a new hope for Alzheimer's disease treatment.Inhibiting inflammation can restore neuronal function,promote neuro regeneration,reduce the pathological burden of Alzheimer's disease,and improve or even reverse symptoms of Alzheimer's disease.This review focuses on the relationship between inflammation and various pathological hypotheses of Alzheimer's disease;reports the mechanisms and characteristics of small-molecule drugs(e.g.,nonsteroidal anti-inflammatory drugs,neurosteroids,and plant extracts);macromolecule drugs(e.g.,peptides,proteins,and gene therapeutics);and nanocarriers(e.g.,lipid-based nanoparticles,polymeric nanoparticles,nanoemulsions,and inorganic nanoparticles)in the treatment of Alzheimer's disease.The review also makes recommendations for the prospective development of anti-inflammatory strategies based on nanocarriers for the treatment of Alzheimer's disease.

New indices to balanceα-diversity against tree size inequality

The number and composition of species in a community can be quantified withα-diversity indices,including species richness(R),Simpson’s index(D),and the Shannon-Wiener index(H΄).In forest communities,there are large variations in tree size among species and individu-als of the same species,which result in differences in eco-logical processes and ecosystem functions.However,tree size inequality(TSI)has been largely neglected in studies using the available diversity indices.The TSI in the diameter at breast height(DBH)data for each of 99920 m×20 m forest census quadrats was quantified using the Gini index(GI),a measure of the inequality of size distribution.The generalized performance equation was used to describe the rotated and right-shifted Lorenz curve of the cumulative proportion of DBH and the cumulative proportion of number of trees per quadrat.We also examined the relationships ofα-diversity indices with the GI using correlation tests.The generalized performance equation effectively described the rotated and right-shifted Lorenz curve of DBH distributions,with most root-mean-square errors(990 out of 999 quadrats)being<0.0030.There were significant positive correlations between each of threeα-diversity indices(i.e.,R,D,and H’)and the GI.Nevertheless,the total abundance of trees in each quadrat did not significantly influence the GI.This means that the TSI increased with increasing spe-cies diversity.Thus,two new indices are proposed that can balanceα-diversity against the extent of TSI in the com-munity:(1−GI)×D,and(1−GI)×H’.These new indices were significantly correlated with the original D and H΄,and did not increase the extent of variation within each group of indices.This study presents a useful tool for quantifying both species diversity and the variation in tree sizes in forest communities,especially in the face of cumulative species loss under global climate change.

A New Merged Product Reveals Precipitation Features over Drylands in China

Due to the considerable uncertainties inherent in the datasets describing the spatiotemporal distributions of precipitation in the drylands of China,this study presents a new merged monthly precipitation product with a spatial resolution of approximately 0.2°×0.2°during 1980–2019.The newly developed precipitation product was validated at different temporal scales(e.g.,monthly,seasonally,and annually).The results show that the new product consistently aligns with the spatiotemporal distributions reported by the Chinese Meteorological Administration Land Data Assimilation System(CLDAS)product and Multi-Source Weighted Ensemble Precipitation(MSWEP).The merged product exhibits exceptional quality in describing the drylands of China,with a bias of–2.19 mm month^(–1)relative to MSWEP.In addition,the annual trend of the merged product(0.09 mm month^(–1)yr^(−1))also closely aligns with that of the MSWEP(0.11 mm month^(–1)yr^(−1))during 1980–2019.The increasing trend indicates that the water cycle and wetting process intensified in the drylands of China during this period.In particular,there was an increase in wetting during the period from 2001–2019.Generally,the merged product exhibits potential value for improving our understanding of the climate and water cycle in the drylands of China.

Bird’s-eye view of recycled solid wastes in road engineering

Recent trends in road engineering have explored the potential of incorporating recycled solid wastes into infrastructures that including pavements,bridges,tunnels,and accessory structures.The utilization of solid wastes is expected to offer sustainable solutions to waste recycling while enhancing the performance of roads.This review provides an extensive analysis of the recycling of three main types of solid wastes for road engineering purposes:industrial solid waste,infrastructure solid waste,and municipal life solid waste.Industrial solid wastes suitable for road engineering generally include coal gangue,fly ash,blast furnace slag,silica fume,and steel slag,etc.Infrastructure solid wastes recycled in road engineering primarily consist of construction&demolition waste,reclaimed asphalt pavements,and recycled cement concrete.Furthermore,recent exploration has extended to the utilization of municipal life solid wastes,such as incinerated bottom ash,glass waste,electronics waste,plastic waste,and rubber waste in road engineering applications.These recycled solid wastes are categorized into solid waste aggregates,solid waste cements,and solid waste fillers,each playing distinct roles in road infrastructure.Roles of solid waste acting aggregates,cements,and fillers in road infrastructures were fully investigated,including their pozzolanic properties,integration effects to virgin materials,modification or enhancement solutions,engineering performances.Utilization of these materials not only addresses the challenge of waste management but also offers environmental benefits aiming carbon neutral and contributes to sustainable infrastructure development.However,challenges such as variability in material properties,environmental impact mitigation,secondary pollution to environment by leaching,and concerns regarding long-term performance need to be further addressed.Despite these challenges,the recycled solid wastes hold immense potential in revolutionizing road construction practices and fostering environmental stewardship.This review delves into a bird’seye view of the utilization of recycled solid wastes in road engineering,highlighting advances,benefits,challenges,and future prospects.

132例晚期非小细胞肺癌胸腔积液EGFR基因突变检测结果及其临床意义:一项来自单中心的回顾性研究

背景与目的恶性胸腔积液表皮生长因子受体(epidermal growth factor receptor,EGFR)基因突变检测缺乏病理质控,导致对检测结果解释及指导临床EGFR酪氨酸激酶抑制剂(tyrosine kinase inhibitor,TKI)使用造成困惑。因此,提出质控标准,并按此标准进行胸水EGFR突变检测尤为重要。本研究拟回顾性分析按照严格病理质控标准进行的胸水沉渣切片EGFR基因突变检测结果以及据此结果指导EGFR-TKIs治疗的疗效。方法回顾性分析中国医学科学院北京协和医院病理科2012年1月-2018年6月收到的胸腔积液标本的患者临床资料,其中具有临床资料相对完整,且按照制定的质控标准进行了胸水沉渣石蜡包埋切片EGFR基因突变检测的患者132例。根据EGFR基因突变检测结果,分为阳性组和阴性组,比较不同组别使用EGFR-TKIs的疗效。结果胸腔积液经离心后,沉渣石蜡包埋、切片,HE染色后镜下观察,若肿瘤细胞数目≥100个,即满足病理质控标准,可用于后续EGFR基因突变检测。132例患者中,72例(54.5%)患者胸水中检出EGFR基因突变。72例突变阳性患者中,69例患者使用了EGFR-TKIs。60例EGFR突变阴性患者中,仅15例使用EGFR-TKIs。EGFR突变阳性组的疾病控制率(disease control rate,DCR)为95.8%,中位无疾病进展生存时间(progression-free survival,PFS)为11个月;EGFR突变阴性组的DCR为0%,中位PFS为1个月,两组患者DCR和PFS均有显著差异(P<0.05)。结论经病理质控的胸水沉渣包埋切片可用于EGFR基因突变检测,其结果可指导临床EGFR-TKIs使用。

血清microRNA-122a、microRNA-124a及microRNA-125b对脓毒症休克并发肝损伤早期诊断及预后评估的临床价值

目的探讨microRNA-122a(miR-122a)、microRNA-124a(miR-124a)及microRNA-125b(miR-125b)对脓毒症休克合并肝损伤的早期诊断及预后评估的临床价值。方法选取2016年12月-2019年2月沧州市中心医院急诊重症监护室收治的254例脓毒症休克患者作为研究对象。将患者分为肝损伤组和无肝损伤组。肝损伤组按肝损伤严重程度分为轻、中、重度肝损伤组。肝损伤组根据28 d转归分为存活组和死亡组。选取同期该院健康体检者40例作为对照组。采用RT-PCR测定血清miR-122a、miR-124a及miR-125b的相对表达量,并绘制受试者工作特征曲线分析其对脓毒症休克合并肝损伤的早期诊断价值。采用二元Logistic回归法分析影响脓毒症休克合并肝损伤患者预后的危险因素。结果肝损伤组急性生理学和慢性健康状况评估Ⅱ(APACHEⅡ)评分、序贯器官衰竭估计(SOFA)评分、28 d后的病死率及降钙素原(PCT)高于无肝损伤组(P<0.05),重度肝损伤组APACHEⅡ评分、SOFA评分、28 d后的病死率及PCT高于轻度、中度肝损伤组(P<0.05),肝损伤组、无肝损伤组血清miR-122a、miR-124a及miR-125b相对表达量均高于对照组(P <0.05),重度肝损伤组血清miR-122a、miR-124a及miR-125b相对表达量高于轻、中度肝损伤组(P <0.05),血清miR-122a、miR-124a及miR-125b诊断脓毒症休克合并肝损伤的AUC分别为:0.796(95%CI:0.728,0.854)、0.771(95%CI:0.701,0.832)和0.784(95%CI:0.715,0.840),死亡组治疗28 d后APACHEⅡ评分、SOFA评分、PCT、乳酸、肝损伤严重程度,血清miR-122a、miR-124a及miR-125b相对表达量高于存活组(P<0.05)。肝损伤严重程度[OR=5.396(95%CI:2.024,9.631)]、APACHEⅡ评分[OR=4.565(95%CI:1.965,7.323)]、SOFA评分[OR=4.623(95%CI:2.538,6.835)]和miR-122a[OR=2.818(95%CI:1.082,5.726)]是影响脓毒症休克合并肝损伤患者预后的危险因素。结论血清miR-122a、miR-124a及miR-125b可作为脓毒症休克患者合并肝损伤早期诊断的新型生物标志物,且miR-122a对脓毒症休克合并肝损伤患者的预后评估有一定的临床价值。

泰它西普在IgA肾病和狼疮性肾炎中的研究进展

B淋巴细胞刺激因子(BLys)及其同源物增殖诱导配体(APRIL)在自身免疫性肾病发病机制中起着重要作用。泰它西普是通过重组DNA技术将BLys受体TACI胞外特定的可溶部分与人IgG1 Fc段融合的蛋白,可以阻断BLys和APRIL与其细胞膜受体(TACI、BR3、BCMA)之间的相互作用,从而实现阻断BLys和APRIL的生物学作用。该文阐述了泰它西普的作用机制及其在IgA肾病、狼疮性肾炎中的疗效及其安全性和耐受性,提示泰它西普为临床治疗自身免疫性肾病提供了新的思路和方向。

富马酸二甲酯对肾草酸钙结石大鼠肾功能和氧化应激的影响及其机制研究

目的基于p38丝裂原活化蛋白激酶(MAPK)信号通路,探讨富马酸二甲酯对肾草酸钙结石大鼠肾功能及氧化应激的影响及其作用机制。方法将30只SPF级SD雄性大鼠随机分为对照组、模型组、富马酸二甲酯组,每组10只。其中模型组、富马酸二甲酯组大鼠腹腔注射0.25%L-羟脯氨酸2.5 kg/(kg·d)复制肾草酸钙结石大鼠模型。富马酸二甲酯组大鼠腹腔注射富马酸二甲酯25 mg/(kg·d),连续28 d,对照组、模型组同时腹腔注射等量生理盐水。采用全自动生化分析仪检测大鼠尿蛋白、尿钙,以及血肌酐水平;HE染色检测大鼠肾组织草酸钙晶体形成情况;试剂盒检测血清超氧化物歧化酶(SOD)活性、丙二醛(MDA)及活性氧簇(ROS)水平;Western bloting检测大鼠肾组织p38 MAPK通路蛋白相对表达量。结果与对照组比较,模型组和富马酸二甲酯组大鼠肾组织SOD活性降低,草酸钙晶体含量、尿蛋白、尿钙、血肌酐及肾组织MDA、ROS水平,p-JNK、p-p38蛋白相对表达量升高(P<0.05);但富马酸二甲酯组大鼠SOD活性高于模型组(P<0.05),肾组织草酸钙晶体含量、尿蛋白、尿钙、血肌酐,肾组织MDA、ROS水平,p-JNK、p-p38蛋白相对表达量低于模型组(P<0.05)。结论富马酸二甲酯可能通过抑制p38 MAPK通路活化,抑制肾脏组织氧化应激反应,从而抑制肾草酸钙结石形成,进而保护肾功能。

Research on the Reform Strategy of University Education Management from the Perspective of Innovative Education

With the advent of the knowledge economy era and the acceleration of globalization,the demand for talent in society has gradually become innovative.The traditional mode of university education management has become difficult to adapt to the requirements of the new era.Therefore,it is urgent to reform university education management from the perspective of innovative education.This article aims to explore the inherent relationship between innovative education and education management,analyze the current situation and existing problems of university education management,and propose strategies for reforming university education management,providing references for universities to cultivate innovative talents.

大学生信息素养影响因素及培养策略研究——基于三维重叠空间的分析

构建教育与人力资源强国对大学生信息素养培养提出更高要求,因此探索大学生信息素养影响因素并提供合适的培养策略,对提高大学生信息素养具有重要意义。文章通过对调查数据进行结构方程模型和三维重叠空间分析发现:大学生学习兴趣、自我效能感、自主学习能力显著正向影响信息素养;学习积极特质在学习动机特质和信息素养之间存在完全中介作用;在高信息素养群体与低信息素养群体的重叠空间中,低分群体更有潜力培养为高信息素养者。文章最后提出从改善大学生学习积极特质、改进学习动机特质、针对三维重叠空间中的低分群体等方面提升大学生信息素养水平的策略和建议。

Patterns of antiemetic prophylaxis for chemotherapy-induced nausea and vomiting in China

Background： Few studies have attempted to evaluate the use of antiemetic therapy for chemotherapyinduced nausea and vomiting （CINV） at a national level in China or to assess how treatment regimens adhere to current guidelines. Methods： We searched the China Health Insurance Research Association （CHIRA） Database to identify patients with cancer who were 〉 18 years old and received either moderately or highly emetogenie chemotherapy （MEC and HEC, respectively） between 2008 and 2012. Patients＇ characteristics as well as usage of specific antiemetic regimens were analyzed using descriptive statistics. Results： Of the 14,548 patients included in the study, 6,477 received HEC while 8,071 were treated with MEC. Approximately 89.9% used antiemetics prophylactically to prevent acute CINV and 71.5% for delayed CINV while 9.0% were prescribed antiemetics as rescue therapy. A significantly lower proportion of patients treated with HEC received prophylactic antiemetic therapy for delayed CINV as compared to those treated with MEC （59.4% vs. 81.3 %; P〈0.001）. The HEC group had a slightly lower proportion of patients using a mixed regimen containing a 5-HT3 antagonist to prevent both acute and delayed CINV than the MEC group （P〈0.012）; however, a higher proportion received a mixed regimen containing eorticosteroids （P≤0.007）. Although more than half of the patients in the HEC group took three antiemeties to prevent acute and delayed CINV, these rates were significantly lower than those of the MEC group （both P〈0.001）. Finally, analysis of the regimens used revealed that there is over-utilization of drugs within the same class of antiemetic. Conclusions： These findings indicate that more attention is needed for treatment of delayed CINV, in terms of both overall use and the components of a typical treatment regimen.

Constraint-induced movement therapy in treatment of acute and sub-acute stroke: a meta-analysis of 16 randomized controlled trials

OBJECTIVE： The aim of this meta-analysis was to evaluate the clinical efficacy of constraint-induced movement therapy in acute and sub-acute stroke. DATA SOURCES： The key words were stroke, cerebrovascular accident, constraint-induced therapy, forced use, and randomized controlled trial. The databases, including China National Knowledge Infrastructure, WanFang, Weipu Information Resources System, Chinese Biomedical Literature Database, PubMed, Med- line, Embase, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews, were searched for studies on randomized controlled trials for treating acute or sub-acute stroke published before March 2016. DATA SELECTION： We retrieved relevant randomized controlled trials that compared constraint-induced movement therapy in treatment of acute or sub-acute stroke with traditional rehabilitation therapy （tradi- tional occupational therapy）. Patients were older than 18 years, had disease courses less than 6 months, and were evaluated with at least one upper extremity function scale. Study quality was evaluated, and data that met the criteria were extracted. Stata 11.0 software was used for the meta-analysis. OUTCOME MEASURES： Fugl-Meyer motor assessment of the arm, the action research-arm test, a motor activity log for amount of use and quality of movement, the Wolf motor function test, and a modified Bar- thel index. RESULTS： A total of 16 prospective randomized controlled trials （379 patients in the constraint-induced movement-therapy group and 359 in the control group） met inclusion criteria. Analysis showed significant mean differences in favor of constraint-induced movement therapy for the Fugl-Meyer motor assessment of the arm （weighted mean difference （WMD） = 10.822; 95% confidence intervals （95% CI）： 7.419-14.226）, the action research-arm test （WMD = 10.718; 95% CI： 5.704-15.733）, the motor activity log for amount of use and quality of movement （WMD = 0.812; 95% CI： 0.331-1.293） and the modified Barthel index （WMD = 10.706; 95% CI： 4.417-16.966）. CONCLUSION： Constraint-induced movement therapy may be more beneficial than traditional rehabili- tation therapy for improving upper limb function after acute or sub-acute stroke.

A Comprehensive Review of Isogeometric Topology Optimization:Methods,Applications and Prospects

Topology Optimization(TO)is a powerful numerical technique to determine the optimal material layout in a design domain,which has accepted considerable developments in recent years.The classic Finite Element Method(FEM)is applied to compute the unknown structural responses in TO.However,several numerical deficiencies of the FEM significantly influence the effectiveness and efficiency of TO.In order to eliminate the negative influence of the FEM on TO,IsoGeometric Analysis(IGA)has become a promising alternative due to its unique feature that the Computer-Aided Design(CAD)model and Computer-Aided Engineering(CAE)model can be unified into a same mathematical model.In the paper,the main intention is to provide a comprehensive overview for the developments of Isogeometric Topology Optimization(ITO)in methods and applications.Finally,some prospects for the developments of ITO in the future are also presented.

Colorectal cancer screening behavior and willingness:An outpatient survey in China

AIM： To identity the factors influencing colorectal cancer （CRC） screening behavior and willingness among Chinese outpatients.METHODS： An outpatient-based face-to-face survey was conducted from August 18 to September 7, 2010 in Changhai Hospital. A total of 1200 consecutive patients aged ≥ 18 years were recruited for interview. The patient＇s knowledge about CRC and screening was pre-measured as a predictor variable, and other pre- dictors included age, gender, educational level, month- ly household income and health insurance status. The relationship between these predictors and screening behavior, screening willingness and screening approach were examined using Pearson＇s 2 test and logistic regression analyses.RESULTS： Of these outpatients, 22.5% had undergone CRC screening prior to this study. Patients who had participated in the screening were more likely to have good knowledge about CRC and screening （OR： 5.299, 95% CI： 3.415-8.223）, have health insurance （OR： 1.996, 95% CI： 1.426-2.794） and older in age. Higher income, however, was found to be a barrier to the screening （OR： 0.633, 95% CI： 0.467-0.858）. An analysis of screening willingness showed that 37.5% of the patients would voluntarily participated in a screen at the recommended age, but 41.3% would do so under doctor＇s advice. Screening willingness was positively correlated with the patient＇s knowledge sta- tus. Patients with higher knowledge levels would like to participate in the screening （OR： 4.352, 95% CI： 3.008-6.298）, and they would select colonoscopy as a screening approach （OR： 3.513, 95% CI： 2.290-5.389）. However, higher income level was, again, a bar- rier to colonoscopic screening （OR： 0.667, 95% CI： 0.505-0.908）. CONCLUSION： Patient＇s level of knowledge and in-ome should be taken into consideration when conducting a feasible CRC screening.

Microencapsulated essential oils combined with organic acids improves immune antioxidant capacity and intestinal barrier function as well as modulates the hindgut microbial community in piglets

Background:The objective of this experiment was to evaluate the effect of a combination of microencapsulated essential oils and organic acids(MOA)on growth performance,immuno-antioxidant status,intestinal barrier function and microbial structure of the hindgut in piglets.A total of 120 piglets(Duroc×[Landrace×Yorkshire];weighted 7.66±1.79 kg,weaned at d 28)were randomly selected and allocated to 3 treatments with 4 replicates per group and 10 piglets per replicate according to the initial body weight and gender.The dietary treatments were as follows:1)basal diet(Ctrl);2)Ctrl+chlortetracycline(75 mg/kg)(AGP);3)Ctrl+MOA(1500 mg/kg).The experiment period was lasted for 21 d.Results:Compared to the Ctrl group,dietary supplemented MOA alleviated(P<0.05)the diarrhea rate from d 12 to 21,enhanced(P<0.05)the concentration of serum interlukin-10 and glutathione peroxidase in piglets on d 11 after weaning and serum superoxide dismutase in 21-day piglets.The MOA group also improved(P<0.05)the apparent digestibility of dry matter(DM),organic matter(OM)and gross energy(GE),up-regulated(P<0.05)the mRNA expression level of occludin,claudin-1 and mucin-2 in ileum and increased(P<0.05)the contents of propionic and butyric acids in the cecum of piglets.The MOA group modulated the cecal and colonic microbial community structure and increased(P<0.05)the abundance of Faecalibacterium and Muribaculaceae in cecum and Streptococcus and Weissella in colon.Additionally,AGP group decreased(P<0.05)apparent digestibility of DM,OM and GE as well as down-regulated(P<0.05)relative gene expression level of claudin-1 in duodenum and jejunum,ZO-1 and mucin-1 in jejunum of piglets.Conclusion:In summary,dietary supplemented MOA alleviated diarrhea and improved nutrient apparent digestibility in piglets via enhancing immuno-antioxidant properties,increasing digestive enzyme activity,upregulating the expression of intestinal barrier-related genes,and modifying the microbial community structure of the cecum and colon.Therefore,dietary supplementation with MOA as an alternative to antibiotics was feasible to improve intestinal health of piglets in practical production.

Selenium(Ⅵ) removal from caustic solution by synthetic Ca-Al-Cl layered double hydroxides

To extract selenium(Ⅵ)from the highly caustic leachate of copper anode slime,the Ca-Al-Cl layered double hydroxides(Ca-Al-Cl-LDHs)with a formula of Ca2 Al(OH)6 Cl·2 H2 O by three co-precipitation methods were synthesized.A plate-like morphology and hexagonal crystal structure with typical mineral phases and functional groups were identified by the FESEM,XRD,FTIR,BET and XPS analysis.The forward feeding sample exhibits the best adsorption capacity of Se(Ⅵ).The factor experiments then reveal a favorable adsorption process with low temperature,low NaOH concentration and high adsorbent dosage.Furthermore,the adsorption kinetics and isotherm parameters can be well described by the Langmuir isotherm and the pseudo-second-order models,respectively.Accordingly,the maximum adsorption amount of Se(Ⅵ)onto Ca-Al-Cl-LDHs reaches188.6 mg/g at 50 ℃.

Clinical practice guidelines on liver transplantation for hepatocellular carcinoma in China(2018 edition)

Introduction Over 300000 people in China die each year of hepatocellular carcinoma(HCC),which accounts for approximately half of HCCrelated deaths worldwide.Liver transplantation(LT)is generally recognized as one of the most effective therapeutic approaches for end-stage liver diseases.Since the beginning of the second LT boom in the 1990s,LT in China has been developed rapidly with professional and large-scale trends,and it is approaching or has reached the level of developed countries in terms of quantity and quality.According to the China Liver Transplant Registry,the number of transplants for HCC accounted for 36.8%of the total number of LT cases during the past 5 years in the mainland of China.In order to develop an effective,safe and standardized protocol to guide the national LT practice,the clinical guidelines of LT for HCC was launched in 2014 by multidisciplinary experts from Chinese Society of Organ Transplantation,Chinese Medical Association and Chinese Association of Organ Transplantation,Chinese Medical Doctor Association.Recently,there have been new clinical and scientific advances in the field of LT and to keep abreast of these achievements,the original clinical practice guidelines need to be updated.

Establishment and validation of a computer-assisted colonic polyp localization system based on deep learning

BACKGROUND Artificial intelligence in colonoscopy is an emerging field,and its application may help colonoscopists improve inspection quality and reduce the rate of missed polyps and adenomas.Several deep learning-based computer-assisted detection(CADe)techniques were established from small single-center datasets,and unrepresentative learning materials might confine their application and generalization in wide practice.Although CADes have been reported to identify polyps in colonoscopic images and videos in real time,their diagnostic performance deserves to be further validated in clinical practice.AIM To train and test a CADe based on multicenter high-quality images of polyps and preliminarily validate it in clinical colonoscopies.METHODS With high-quality screening and labeling from 55 qualified colonoscopists,a dataset consisting of over 71000 images from 20 centers was used to train and test a deep learning-based CADe.In addition,the real-time diagnostic performance of CADe was tested frame by frame in 47 unaltered full-ranged videos that contained 86 histologically confirmed polyps.Finally,we conducted a selfcontrolled observational study to validate the diagnostic performance of CADe in real-world colonoscopy with the main outcome measure of polyps per colonoscopy in Changhai Hospital.RESULTS The CADe was able to identify polyps in the test dataset with 95.0%sensitivity and 99.1%specificity.For colonoscopy videos,all 86 polyps were detected with 92.2%sensitivity and 93.6%specificity in frame-by-frame analysis.In the prospective validation,the sensitivity of CAD in identifying polyps was 98.4%(185/188).Folds,reflections of light and fecal fluid were the main causes of false positives in both the test dataset and clinical colonoscopies.Colonoscopists can detect more polyps(0.90 vs 0.82,P<0.001)and adenomas(0.32 vs 0.30,P=0.045)with the aid of CADe,particularly polyps<5 mm and flat polyps(0.65 vs 0.57,P<0.001;0.74 vs 0.67,P=0.001,respectively).However,high efficacy is not realized in colonoscopies with inadequate bowel preparation and withdrawal time(P=0.32;P=0.16,respectively).CONCLUSION CADe is feasible in the clinical setting and might help endoscopists detect more polyps and adenomas,and further confirmation is warranted.

Graphene-immobilized flower-like Ni3S2 nanoflakes as a stable binder-free anode material for sodium-ion batteries

A binder-free Ni3S2 electrode was prepared directly on a graphene-coated Ni foam （G/Ni） substrate through surface sulfiding of substrate using thiourea as the sulfur source in this work. The Ni3S2 showed a flower-like morphology and was uniformly distributed on the G/Ni surface. The flower-like Ni3S2 was composed of cross-arrayed nanoflakes with a diameter and a thickness of 1-2 μm and -50 nm, re- spectively. The free space in the flowers and the thin feature of Ni3S2 buffered the volume changes and relieved mechanical strain during re- peated cycling. The intimate contact with the Ni substrate and the fixing effect of graphene maintained the structural stability of the Ni3S2 electrode during cycling. The G/Ni-supported Ni3S2 maintained a reversible capacity of 250 mAh·g^-1 after 100 cycles at 50 mA·g^-1, demon- strating the good cycling stability as a result of the unique microstructure of this electrode material.