Stem cells have been confirmed to be involved in the occurrence and development of diabetic retinopathy;however,the underlying mechanisms remain unclear.In this study,we used Citespace software to visually analyze 552...Stem cells have been confirmed to be involved in the occurrence and development of diabetic retinopathy;however,the underlying mechanisms remain unclear.In this study,we used Citespace software to visually analyze 552 articles exploring the stem cell-based treatment of diabetic retinopathy over the past 20 years,which were included in the Web of Science Core Collection.We found the following:(1)a co-citation analysis of the references cited by all 552 articles indicated 15 clusters.In cluster#0,representing the stem cell field,some highly cited landmark studies emerged between 2009–2013.For example,endothelial progenitor cells and diabetic retinopathy gradually received the full attention of scholars,in terms of their relationship and therapeutic prospects.Some researchers also verified the potential of adipose-derived stem cells to differentiate into stable retinal perivascular cells,using a variety of animal models of retinal vascular disease.All of these achievements provided references for the subsequent stem cell research.(2)An analysis of popular keywords among the 552 articles revealed that,during the past 20 years,a relative increase in basic research articles examining stem cells and endothelial progenitor cells for the treatment of diabetic retinopathy was observed.The contents of these articles primarily involved the expression of vascular endothelial growth factor,vascular regeneration,oxidative stress,and inflammatory response.(3)A burst analysis of keywords used in the 552 articles indicated that genetic and cytological research regarding the promotion of angiogenesis was an issue of concern from 2001 to 2012,including several studies addressing the expression of various growth factor genes;from 2014 to 2020,mouse models of diabetic retinopathy were recognized as mature animal models,and the most recent research has focused on macular degeneration,macular edema,neurodegeneration,and inflammatory changes in diabetic animal models.(4)Globally,the current authoritative studies have focused on basic research towards the stem cell treatment of diabetic retinopathy.Existing clinical studies are of low quality and have insufficient evidence levels,and their findings have not yet been widely accepted in clinical practice.Major challenges during stem cell transplantation remain,including stem cell heterogeneity,cell delivery,and the effective homing of stem cells to damaged tissue.However,clinical trials examining potential stem cell-based treatments of diabetic retinopathy,including the use of pluripotent stem cells,retinal pigment epithelial cells,bone marrow mesenchymal stem cells,and endothelial progenitor cells,are currently ongoing,and high-quality clinical evidence is likely to appear in the future,to promote clinical transformation.展开更多
In this work,a series of specimens was prepared by the casting method.Sharp cube-textured substrates were processed by heavy cold rolling and recrystallization annealing(i.e.,the rolling-assisted biaxially textured su...In this work,a series of specimens was prepared by the casting method.Sharp cube-textured substrates were processed by heavy cold rolling and recrystallization annealing(i.e.,the rolling-assisted biaxially textured substrates(RABi TS) method).Both the rolling and the recrystallization texture in the alloy tapes were investigated by X-ray diffraction and electron back-scatter diffraction,respectively.The results showed that a strong copper-type deformation texture was obtained in the heavy cold-rolled substrate.In addition,the recrystallization annealing process was found to be very important for the texture transition in the Cu–Ni alloy substrates.The cube texture content in the Cu60 Ni40 alloy substrates reached 99.7%(≤10°) after optimization of the cold-rolling procedure and the recrystallizing heat-treatment process,whereas the content of low-angle grain boundaries(from 2° to 10° misorientation) in the substrate reached 95.1%.展开更多
Minimally invasive surgery is a kind of surgical operation,which is performed by using professional surgical instruments and equipment to inactivate,resect,repair or reconstruct the pathological changes,deformities an...Minimally invasive surgery is a kind of surgical operation,which is performed by using professional surgical instruments and equipment to inactivate,resect,repair or reconstruct the pathological changes,deformities and wounds in human body through micro-trauma or micro-approach,in order to achieve the goal of treatment,its surgical effect is equivalent to the traditional open surgery,while avoiding the morbidity of conventional surgical wounds.In addition,it also has the advantages of less trauma,less blood loss during operation,less psychological burden and quick recovery on patients,and these minimally invasive techniques provide unique value for the examination and treatment of gastric cancer patients.Surgical minimally invasive surgical techniques have developed rapidly and offer numerous options for the treatment of early gastric cancer(EGC):endoscopic mucosal resection(EMR),underwater EMR(UEMR),endoscopic submucosal dissection(ESD),endoscopic full-thickness resection(EFTR),endoscopic submu-cosal excavation(ESE),submucosal tunnel endoscopic resection,laparoscopic and endoscopic cooperative surgery(LECS);Among them,EMR,EFTR and LECS technologies have a wide range of applications and different modific-ations have been derived from their respective surgical operations,such as band-assisted EMR(BA-EMR),conven-tional EMR(CEMR),over-the-scope clip-assisted EFTR,no-touch EFTR,the inverted LECS,closed LECS,and so on.These new and improved minimally invasive surgeries are more precise,specific and effective in treating different types of EGC.展开更多
BACKGROUND Psychological factors such as anxiety and depression will not only aggravate the symptoms of chronic obstructive pulmonary disease(COPD)patients and reduce the quality of life of patients,but also affect th...BACKGROUND Psychological factors such as anxiety and depression will not only aggravate the symptoms of chronic obstructive pulmonary disease(COPD)patients and reduce the quality of life of patients,but also affect the treatment effect and long-term prognosis.Therefore,it is of great significance to explore the clinical application of senile comprehensive assessment in the treatment of COPD and its influence on psychological factors such as anxiety and depression.AIM To explore the clinical application of comprehensive geriatric assessment in COPD care and its impact on anxiety and depression in elderly patents.METHODS In this retrospective study,60 patients with COPD who were hospitalized in our hospital from 2019 to 2020 were randomly divided into two groups with 30 patients in each group.The control group was given routine nursing,and the observation group was given comprehensive assessment.Clinical symptoms,quality of life[COPD assessment test(CAT)score],anxiety and depression Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)were compared between the two groups.RESULTS CAT scores in the observation group decreased from an average of 24.5 points at admission to an average of 18.3 points at discharge,and in the control group from an average of 24.7 points at admission to an average of 18.3 points at discharge.The average score was 22.1(P<0.05).In the observation group,HAMA scores decreased from 14.2 points at admission to 8.6 points at discharge,and HAMD scores decreased from 13.8 points at admission to 7.4 points at discharge.The mean HAMD scores in the control group decreased from an average of 14.5 at admission to an average of 12.3 at discharge,and from an average of 14.1 at admission to an average of 11.8 at discharge.CONCLUSION The application of comprehensive geriatric assessment in COPD care has a significant effect on improving patients'clinical symptoms and quality of life,and can effectively reduce patients'anxiety and depression.展开更多
AIM To estimate annual direct and indirect costs for patients diagnosed with irritable bowel syndrome(IBS) and subtypes.METHODS Patients completed a standardized questionnaire concerning usage of healthcare resources,...AIM To estimate annual direct and indirect costs for patients diagnosed with irritable bowel syndrome(IBS) and subtypes.METHODS Patients completed a standardized questionnaire concerning usage of healthcare resources, travel costs, meals, and productivity loss of patients when seeking treatment for IBS. Total annual costs per patient were calculated as the sum of direct(including medical and nonmedical) and indirect costs. Total annual costs per patient among various IBS subtypes were compared. Analysis of variance and bootstrapped independent sample t-tests were performed to determine differences between groups after controlling for IBS subtypes.RESULTS A total of 105 IBS patients(64.80% female), mean age of 57.12 years ± 10.31 years), mean disease duration of 4.31 years ± 5.40 years, were included. Total annual costs per patient were estimated as CNy18262.84(USD2933.08). Inpatient and outpatient healthcare use were major cost drivers, accounting for 46.41%and 23.36% of total annual costs, respectively. Productivity loss accounted for 25.32% of total annual costs. The proportions of direct and indirect costs were similarto published studies in other countries. Nationally, the total costs of managing IBS would amount to CNy123.83 billion(USD1.99 billion). Among the IBS subtypes, total annual costs per patient of IBS-M was highest at CNy18891.18(USD3034). Furthermore, there was significant difference in productivity loss among IBS subtypes(P = 0.031).CONCLUSION IBS imposes a huge economic burden on patients and healthcare systems, which could account for 3.3% of the total healthcare budget for the entire Chinese nation. More than two-thirds of total annual costs of IBS consist of inpatient and outpatient healthcare use. Among the subtypes, IBS-M patients appear to have the greatest economic burden but require further confirmation.展开更多
AIM: To evaluate the efficacy and safety of endoscopic papillary large diameter balloon dilation (EPLBD) following limited endoscopic sphincterotomy (EST) and EST alone for removal of large common bile duct (CBD) stones.
Irritable bowel syndrome(IBS)is a common,chronic,functional gastrointestinal disorder with a high incidence rate in the general population,and it is common among the Chinese population.The pathophysiology,etiology and...Irritable bowel syndrome(IBS)is a common,chronic,functional gastrointestinal disorder with a high incidence rate in the general population,and it is common among the Chinese population.The pathophysiology,etiology and pathogenesis of IBS are poorly understood,with no evidence of inflammatory,anatomic,metabolic,or neoplastic factors to explain the symptoms.Treatment approaches are mainly focused on symptommanagement to maintain everyday functioning and to improve quality of life for patients with IBS.However,prescribed medications often result in significant side effects,and many IBS sufferers(particularly Chinese)do not improve.Instead of taking a variety of conventional medications,many have turned to taking traditional Chinese medicine or integrated Chinese and Western medicine for remedy.A number of clinical trials have shown that Chinese herbal,acupuncture or integrative therapies presented improved treatment outcomes and reduced side effects in IBS patients.The purpose of this review article is to examine the treatment approaches of IBS that have been published in recent years,especially in China,to assess the possible differences in treating IBS between China and other countries.This would provide some useful information of unique treatment approach in clinical practice for physicians in the management of IBS in China,thus offering more treatment options for IBS patients with potentially better treatment outcomes while reducing the medical cost burden.展开更多
The booming development of DIW technology present an unprecedented prospect in energetic materials field and has attracted great interest due to its relative simplicity and high flexibility of manufacturing.Herein,a n...The booming development of DIW technology present an unprecedented prospect in energetic materials field and has attracted great interest due to its relative simplicity and high flexibility of manufacturing.Herein,a novel CL-20 based explosive ink formulation have been developed successfully for MEMS initiation systems via DIW technology.We designed PVA/GAP into an oil-in-water(O/W)emulsion,in the way that the aqueous solution of PVA as water phase,the ethyl acetate solution of GAP as oil phase,the combination of Tween 80 and SDS as emulsifier,BPS as a curing agent of GAP.The ideal formulation with good shear-thinning rheology properties and clear gel point was prepared using only 10 wt%emulsion.The dual-cured network formed during the curing process made the printed sample have good mechanical properties.The printed samples had satisfactory molding effect without cracks or fractures,the crystal form of CL-20 not changed and the thermal stability have improved.Deposition of explosive inks via DIW in micro-scale grooves had excellent detonation performances,which critical detonation size was 1×0.045 mm,detonation velocity was 7129 m/s and when the corner reaching 150°can still detonated stably.This study may open new avenues for developing binder systems in explosive ink formulations.展开更多
A new type of explosive ink formulation that can be quickly cured was prepared with unsaturated polyester as binder,styrene as active monomer,2,4,6-trimethylbenzoyl-diphenylphosphine oxide as photoinitiator,and hexani...A new type of explosive ink formulation that can be quickly cured was prepared with unsaturated polyester as binder,styrene as active monomer,2,4,6-trimethylbenzoyl-diphenylphosphine oxide as photoinitiator,and hexanitrohexaazaisowurtzitane(CL-20)as the main explosive.Then the explosive inkdirect writing technology was used to charge the micro-sized energetic devices,the curing mechanism of the explosive ink was discussed,and the microstructure,safety performance and explosive transfer performance of the explosive ink molded samples were tested and analyzed.Results indicate that the composite material has a fast curing molding speed,its hardness can reach 2H within 8 min.The crystal form of CL-20 in the molded sample is still type.The CL-20 based UV-curing explosive ink formulation has good compatibility,its apparent activation energy is increased by about 3.5 kj/mol.The composite presents a significant reduction in impact sensitivity and its characteristic drop height can reach 39.8 cm,whichis about 3 times higher than the raw material.When the line width of charge is 1.0 mm,the critical thickness of the explosion can reach 0.015 mm,and the explosion velocity is 7129 m/s when the charge density is 1.612 g/cm^(3).展开更多
During acute reperfusion,the expression profiles of long noncoding RNAs in adult rats with focal cerebral ischemia undergo broad changes.However,whether long noncoding RNAs are involved in neuroprotective effects foll...During acute reperfusion,the expression profiles of long noncoding RNAs in adult rats with focal cerebral ischemia undergo broad changes.However,whether long noncoding RNAs are involved in neuroprotective effects following focal ischemic stroke in rats remains unclear.In this study,RNA isolation and library preparation was performed for long noncoding RNA sequencing,followed by determining the coding potential of identified long noncoding RNAs and target gene prediction.Differential expression analysis,long noncoding RNA functional enrichment analysis,and co-expression network analysis were performed comparing ischemic rats with and without ischemic postconditioning rats.Rats were subjected to ischemic postconditioning via the brief and repeated occlusion of the middle cerebral artery or femoral artery.Quantitative real-time reverse transcription-polymerase chain reaction was used to detect the expression levels of differentially expressed long noncoding RNAs after ischemic postconditioning in a rat model of ischemic stroke.The results showed that ischemic postconditioning greatly affected the expression profile of long noncoding RNAs and mRNAs in the brains of rats that underwent ischemic stroke.The predicted target genes of some of the identified long noncoding RNAs(cis targets)were related to the cellular response to ischemia and stress,cytokine signal transduction,inflammation,and apoptosis signal transduction pathways.In addition,15 significantly differentially expressed long noncoding RNAs were identified in the brains of rats subjected to ischemic postconditioning.Nine candidate long noncoding RNAs that may be related to ischemic postconditioning were identified by a long noncoding RNA expression profile and long noncoding RNA-mRNA co-expression network analysis.Expression levels were verified by quantitative real-time reverse transcription-polymerase chain reaction.These results suggested that the identified long noncoding RNAs may be involved in the neuroprotective effects associated with ischemic postconditioning following ischemic stroke.The experimental animal procedures were approved by the Animal Experiment Ethics Committee of Kunming Medical University(approval No.KMMU2018018)in January 2018.展开更多
The Cu-Ti-Si alloys containing in-situ formed Ti5Si3 are prepared. In order to clarify the Ti5Si3 formation processes and its microstructure characteristics, the as-cast and deeply etched Cu-Ti-Si alloys with differen...The Cu-Ti-Si alloys containing in-situ formed Ti5Si3 are prepared. In order to clarify the Ti5Si3 formation processes and its microstructure characteristics, the as-cast and deeply etched Cu-Ti-Si alloys with different compositions and cooling rates were investigated using scanning electron microscopy (SEM), transmission electron microscopy (TEM) and X-ray diffraction (XRD). It is found that the eutectic Ti5Si3 phases in Cu-Ti-Si alloys are rod-like with hexagonal cross section which tend to intertwine with each other to form a firm skeleton like a bird nest structure which can make the alloys keep their original shape even after etching off the Cu matrix. In addition, there is Cu in the center of many Ti5Si3 rods, resulting in a core-shell structure. With the increase of the cooling rate, Ti5Si3 distributes more uniformly, and the diameter of Ti5Si3 significantly decreases, with a minimum size of less than 100 nm, while the aspect ratio of Ti5Si3 increases.展开更多
Measurement-device-independent quantum key distribution(MDI-QKD) offers a practical way to realize a startype quantum network. Previous experiments on MDI-QKD networks can only support the point-to-point communication...Measurement-device-independent quantum key distribution(MDI-QKD) offers a practical way to realize a startype quantum network. Previous experiments on MDI-QKD networks can only support the point-to-point communication. We experimentally demonstrate a plug-and-play MDI-QKD network which can support the pointto-multipoint communication among three users. Benefiting from the plug-and-play MDI-QKD architecture,the whole network is automatically stabilized in spectrum, polarization, arrival time, and phase reference. The users only need the encoding devices, which means that the hardware requirements are greatly reduced. Our experiment shows that it is feasible to establish a point-to-multipoint MDI-QKD network.展开更多
Three-dimensional(3D)micro-jet printing is a droplet deposition technique based on liquid-phase materials.To improve the deposition density and performance of energetic films with micro/nanoscale on an energetic chip,...Three-dimensional(3D)micro-jet printing is a droplet deposition technique based on liquid-phase materials.To improve the deposition density and performance of energetic films with micro/nanoscale on an energetic chip,polydopamine(PDA)was utilized as a linker bridge to induce the in-situ self-assembly of CL-20-based energetic film via 3D micro-jet printing.The self-assembly was extensively characterized by confocal laser scanning microscopy(CLSM),SEM,power-XRD,XPS,and DSC.The performance of the self-assembled film was verified by the mechanical properties and detonation properties,and a possible self-assembly mechanism in the layer-by-layer micro-jet printing process was proposed.The results indicated PDA-induced self-assembly enhanced the physical entanglement between the binders and energetic crystal,reduced the porosity from 15.87%to 11.28%,and improved the elastic modulus and the detonation performance of the CL-20-based energetic film.This work proposes a novel and promising energetic film design and fabrication strategy to enhance the interaction between the energetic composite layers in the micro-jet printing process.展开更多
The Monte Carlo(MC)simulation is regarded as the gold standard for dose calculation in brachytherapy,but it consumes a large amount of computing resources.The development of heterogeneous computing makes it possible t...The Monte Carlo(MC)simulation is regarded as the gold standard for dose calculation in brachytherapy,but it consumes a large amount of computing resources.The development of heterogeneous computing makes it possible to substantially accelerate calculations with hardware accelerators.Accordingly,this study develops a fast MC tool,called THUBrachy,which can be accelerated by several types of hardware accelerators.THUBrachy can simulate photons with energy less than 3 MeV and considers all photon interactions in the energy range.It was benchmarked against the American Association of Physicists in Medicine Task Group No.43 Report using a water phantom and validated with Geant4 using a clinical case.A performance test was conducted using the clinical case,showing that a multicore central processing unit,Intel Xeon Phi,and graphics processing unit(GPU)can efficiently accelerate the simulation.GPU-accelerated THUBrachy is the fastest version,which is 200 times faster than the serial version and approximately 500 times faster than Geant4.The proposed tool shows great potential for fast and accurate dose calculations in clinical applications.展开更多
Objective To investigate the clinical features and management of ureteral endometriosis. Methods Patients surgically and histologically diagnosed as ureteral endometriosis from January 2001 to January 2007 in Peking U...Objective To investigate the clinical features and management of ureteral endometriosis. Methods Patients surgically and histologically diagnosed as ureteral endometriosis from January 2001 to January 2007 in Peking Union Medical College Hospital were retrospectively reviewed. Results Ten patients were diagnosed as ureteral endometriosis among 7 561 cases with surgically and histologically proved diagnosis of endometriosis, with an incidence of 0.132%. Nine out of 10 patients were extrinsic ureteral endometriosis and concomitant with severe pelvic endometriosis, and the other was intrinsic ureteral endometriosis. Hormone therapy failed in 2 patients with urinary tract obstruction. Ureterolysis was performed in 6 patients and ureterectomy was performed in 4 patients. One case of ureteral recurrence was observed in a postmenopausal woman without hormonal replacement therapy who received laparoscopic ureterolysis and hysterectomy with bilateral adnexectomy. No relapse was observed in the other 9 patients. Conclusions Ureteral endometriosis is a rare entity. The upper urinary tract should be evaluated in patients with severe endometriosis, even in postmenopausal women. The treatment of ureteral endometriosis usually requires surgery, while ureterolysis should not be performed in patients with extensive disease. As a form of adjuvant therapy of surgery, hormonal therapy is an appropriate option.展开更多
Xenon atoms were produced in their metastable states 5p^56s[3/2]2 and 5p^56s'[1/2]0 in a pulsed DC discharge in a beam, and subsequently excited to the even-parity autoionizing Rydberg states 5p^5np' [3/2] 1,[1/2] 1...Xenon atoms were produced in their metastable states 5p^56s[3/2]2 and 5p^56s'[1/2]0 in a pulsed DC discharge in a beam, and subsequently excited to the even-parity autoionizing Rydberg states 5p^5np' [3/2] 1,[1/2] 1, and 5p^5nf' [5/2] 3 using single photon excitation. The excitation spectra of the even-parity autoionizing resonance series from the metastable 129Xe were obtained by recording the autoionized Xe+ with time-of-flight ion detection in the photon energy range of 28000-42000 cm-1. A wealth of autoionizing resonances were newly observed, from which more precise and systematic spectroscopic data of the level energies and quantum defects were derived.展开更多
基金This study was supported by the Natural Science Foundation of Jilin Province of China,No.20200201495JCJilin Province Health Technology Innovation Project,No.2017J089。
文摘Stem cells have been confirmed to be involved in the occurrence and development of diabetic retinopathy;however,the underlying mechanisms remain unclear.In this study,we used Citespace software to visually analyze 552 articles exploring the stem cell-based treatment of diabetic retinopathy over the past 20 years,which were included in the Web of Science Core Collection.We found the following:(1)a co-citation analysis of the references cited by all 552 articles indicated 15 clusters.In cluster#0,representing the stem cell field,some highly cited landmark studies emerged between 2009–2013.For example,endothelial progenitor cells and diabetic retinopathy gradually received the full attention of scholars,in terms of their relationship and therapeutic prospects.Some researchers also verified the potential of adipose-derived stem cells to differentiate into stable retinal perivascular cells,using a variety of animal models of retinal vascular disease.All of these achievements provided references for the subsequent stem cell research.(2)An analysis of popular keywords among the 552 articles revealed that,during the past 20 years,a relative increase in basic research articles examining stem cells and endothelial progenitor cells for the treatment of diabetic retinopathy was observed.The contents of these articles primarily involved the expression of vascular endothelial growth factor,vascular regeneration,oxidative stress,and inflammatory response.(3)A burst analysis of keywords used in the 552 articles indicated that genetic and cytological research regarding the promotion of angiogenesis was an issue of concern from 2001 to 2012,including several studies addressing the expression of various growth factor genes;from 2014 to 2020,mouse models of diabetic retinopathy were recognized as mature animal models,and the most recent research has focused on macular degeneration,macular edema,neurodegeneration,and inflammatory changes in diabetic animal models.(4)Globally,the current authoritative studies have focused on basic research towards the stem cell treatment of diabetic retinopathy.Existing clinical studies are of low quality and have insufficient evidence levels,and their findings have not yet been widely accepted in clinical practice.Major challenges during stem cell transplantation remain,including stem cell heterogeneity,cell delivery,and the effective homing of stem cells to damaged tissue.However,clinical trials examining potential stem cell-based treatments of diabetic retinopathy,including the use of pluripotent stem cells,retinal pigment epithelial cells,bone marrow mesenchymal stem cells,and endothelial progenitor cells,are currently ongoing,and high-quality clinical evidence is likely to appear in the future,to promote clinical transformation.
基金financially supported by the National Natural Science Foundation of China (No.51571002)the Beijing Natural Science Foundation (No.2172008)+4 种基金the Doctoral Program of Higher Education of Special Research Fund of China (No.20121103110012)the Beijing Municipal Natural Science Foundation B Type (No.KZ201310005003)the China Scholarship Councilthe Technology Program of Beijing CityBeijing University of Technology
文摘In this work,a series of specimens was prepared by the casting method.Sharp cube-textured substrates were processed by heavy cold rolling and recrystallization annealing(i.e.,the rolling-assisted biaxially textured substrates(RABi TS) method).Both the rolling and the recrystallization texture in the alloy tapes were investigated by X-ray diffraction and electron back-scatter diffraction,respectively.The results showed that a strong copper-type deformation texture was obtained in the heavy cold-rolled substrate.In addition,the recrystallization annealing process was found to be very important for the texture transition in the Cu–Ni alloy substrates.The cube texture content in the Cu60 Ni40 alloy substrates reached 99.7%(≤10°) after optimization of the cold-rolling procedure and the recrystallizing heat-treatment process,whereas the content of low-angle grain boundaries(from 2° to 10° misorientation) in the substrate reached 95.1%.
基金Supported by Key R&D projects of provincial science and technology plans of Gansu Province,No.21YF5WA027Scientific Research Program of Health Industry of Gansu Province,No.GSWSKY2020-45+2 种基金Gansu Provincial People's Hospital Intramural Research Fund Program,No.22GSSYD-61Grants from Innovation Base and Talent Project of Gansu Province,No.20JR10RA433The 2021 Central-Guided Local Science and Technology Development Fund,No.ZYYDDFFZZJ-1.
文摘Minimally invasive surgery is a kind of surgical operation,which is performed by using professional surgical instruments and equipment to inactivate,resect,repair or reconstruct the pathological changes,deformities and wounds in human body through micro-trauma or micro-approach,in order to achieve the goal of treatment,its surgical effect is equivalent to the traditional open surgery,while avoiding the morbidity of conventional surgical wounds.In addition,it also has the advantages of less trauma,less blood loss during operation,less psychological burden and quick recovery on patients,and these minimally invasive techniques provide unique value for the examination and treatment of gastric cancer patients.Surgical minimally invasive surgical techniques have developed rapidly and offer numerous options for the treatment of early gastric cancer(EGC):endoscopic mucosal resection(EMR),underwater EMR(UEMR),endoscopic submucosal dissection(ESD),endoscopic full-thickness resection(EFTR),endoscopic submu-cosal excavation(ESE),submucosal tunnel endoscopic resection,laparoscopic and endoscopic cooperative surgery(LECS);Among them,EMR,EFTR and LECS technologies have a wide range of applications and different modific-ations have been derived from their respective surgical operations,such as band-assisted EMR(BA-EMR),conven-tional EMR(CEMR),over-the-scope clip-assisted EFTR,no-touch EFTR,the inverted LECS,closed LECS,and so on.These new and improved minimally invasive surgeries are more precise,specific and effective in treating different types of EGC.
文摘BACKGROUND Psychological factors such as anxiety and depression will not only aggravate the symptoms of chronic obstructive pulmonary disease(COPD)patients and reduce the quality of life of patients,but also affect the treatment effect and long-term prognosis.Therefore,it is of great significance to explore the clinical application of senile comprehensive assessment in the treatment of COPD and its influence on psychological factors such as anxiety and depression.AIM To explore the clinical application of comprehensive geriatric assessment in COPD care and its impact on anxiety and depression in elderly patents.METHODS In this retrospective study,60 patients with COPD who were hospitalized in our hospital from 2019 to 2020 were randomly divided into two groups with 30 patients in each group.The control group was given routine nursing,and the observation group was given comprehensive assessment.Clinical symptoms,quality of life[COPD assessment test(CAT)score],anxiety and depression Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)were compared between the two groups.RESULTS CAT scores in the observation group decreased from an average of 24.5 points at admission to an average of 18.3 points at discharge,and in the control group from an average of 24.7 points at admission to an average of 18.3 points at discharge.The average score was 22.1(P<0.05).In the observation group,HAMA scores decreased from 14.2 points at admission to 8.6 points at discharge,and HAMD scores decreased from 13.8 points at admission to 7.4 points at discharge.The mean HAMD scores in the control group decreased from an average of 14.5 at admission to an average of 12.3 at discharge,and from an average of 14.1 at admission to an average of 11.8 at discharge.CONCLUSION The application of comprehensive geriatric assessment in COPD care has a significant effect on improving patients'clinical symptoms and quality of life,and can effectively reduce patients'anxiety and depression.
文摘AIM To estimate annual direct and indirect costs for patients diagnosed with irritable bowel syndrome(IBS) and subtypes.METHODS Patients completed a standardized questionnaire concerning usage of healthcare resources, travel costs, meals, and productivity loss of patients when seeking treatment for IBS. Total annual costs per patient were calculated as the sum of direct(including medical and nonmedical) and indirect costs. Total annual costs per patient among various IBS subtypes were compared. Analysis of variance and bootstrapped independent sample t-tests were performed to determine differences between groups after controlling for IBS subtypes.RESULTS A total of 105 IBS patients(64.80% female), mean age of 57.12 years ± 10.31 years), mean disease duration of 4.31 years ± 5.40 years, were included. Total annual costs per patient were estimated as CNy18262.84(USD2933.08). Inpatient and outpatient healthcare use were major cost drivers, accounting for 46.41%and 23.36% of total annual costs, respectively. Productivity loss accounted for 25.32% of total annual costs. The proportions of direct and indirect costs were similarto published studies in other countries. Nationally, the total costs of managing IBS would amount to CNy123.83 billion(USD1.99 billion). Among the IBS subtypes, total annual costs per patient of IBS-M was highest at CNy18891.18(USD3034). Furthermore, there was significant difference in productivity loss among IBS subtypes(P = 0.031).CONCLUSION IBS imposes a huge economic burden on patients and healthcare systems, which could account for 3.3% of the total healthcare budget for the entire Chinese nation. More than two-thirds of total annual costs of IBS consist of inpatient and outpatient healthcare use. Among the subtypes, IBS-M patients appear to have the greatest economic burden but require further confirmation.
文摘AIM: To evaluate the efficacy and safety of endoscopic papillary large diameter balloon dilation (EPLBD) following limited endoscopic sphincterotomy (EST) and EST alone for removal of large common bile duct (CBD) stones.
文摘Irritable bowel syndrome(IBS)is a common,chronic,functional gastrointestinal disorder with a high incidence rate in the general population,and it is common among the Chinese population.The pathophysiology,etiology and pathogenesis of IBS are poorly understood,with no evidence of inflammatory,anatomic,metabolic,or neoplastic factors to explain the symptoms.Treatment approaches are mainly focused on symptommanagement to maintain everyday functioning and to improve quality of life for patients with IBS.However,prescribed medications often result in significant side effects,and many IBS sufferers(particularly Chinese)do not improve.Instead of taking a variety of conventional medications,many have turned to taking traditional Chinese medicine or integrated Chinese and Western medicine for remedy.A number of clinical trials have shown that Chinese herbal,acupuncture or integrative therapies presented improved treatment outcomes and reduced side effects in IBS patients.The purpose of this review article is to examine the treatment approaches of IBS that have been published in recent years,especially in China,to assess the possible differences in treating IBS between China and other countries.This would provide some useful information of unique treatment approach in clinical practice for physicians in the management of IBS in China,thus offering more treatment options for IBS patients with potentially better treatment outcomes while reducing the medical cost burden.
基金This work was supported by the Graduate Education Innovation Project of Shanxi Province(2020SY401)No.55 Research Institute of China North Industries Group Corporation Open Innovation Fund(WDZC2020JJ017).
文摘The booming development of DIW technology present an unprecedented prospect in energetic materials field and has attracted great interest due to its relative simplicity and high flexibility of manufacturing.Herein,a novel CL-20 based explosive ink formulation have been developed successfully for MEMS initiation systems via DIW technology.We designed PVA/GAP into an oil-in-water(O/W)emulsion,in the way that the aqueous solution of PVA as water phase,the ethyl acetate solution of GAP as oil phase,the combination of Tween 80 and SDS as emulsifier,BPS as a curing agent of GAP.The ideal formulation with good shear-thinning rheology properties and clear gel point was prepared using only 10 wt%emulsion.The dual-cured network formed during the curing process made the printed sample have good mechanical properties.The printed samples had satisfactory molding effect without cracks or fractures,the crystal form of CL-20 not changed and the thermal stability have improved.Deposition of explosive inks via DIW in micro-scale grooves had excellent detonation performances,which critical detonation size was 1×0.045 mm,detonation velocity was 7129 m/s and when the corner reaching 150°can still detonated stably.This study may open new avenues for developing binder systems in explosive ink formulations.
基金Equipment Development Department of China(61406190401).
文摘A new type of explosive ink formulation that can be quickly cured was prepared with unsaturated polyester as binder,styrene as active monomer,2,4,6-trimethylbenzoyl-diphenylphosphine oxide as photoinitiator,and hexanitrohexaazaisowurtzitane(CL-20)as the main explosive.Then the explosive inkdirect writing technology was used to charge the micro-sized energetic devices,the curing mechanism of the explosive ink was discussed,and the microstructure,safety performance and explosive transfer performance of the explosive ink molded samples were tested and analyzed.Results indicate that the composite material has a fast curing molding speed,its hardness can reach 2H within 8 min.The crystal form of CL-20 in the molded sample is still type.The CL-20 based UV-curing explosive ink formulation has good compatibility,its apparent activation energy is increased by about 3.5 kj/mol.The composite presents a significant reduction in impact sensitivity and its characteristic drop height can reach 39.8 cm,whichis about 3 times higher than the raw material.When the line width of charge is 1.0 mm,the critical thickness of the explosion can reach 0.015 mm,and the explosion velocity is 7129 m/s when the charge density is 1.612 g/cm^(3).
基金the National Natural Science Foundation of China,No.31560295(to LYL)the Yunnan Applied Basic Research Projects of China,Nos.2018FE001(-016)(to WM),2018FE001(-163)(to LYL)the Research Innovation Team of Yunnan Province of China,No.2019HC022(to LYL).
文摘During acute reperfusion,the expression profiles of long noncoding RNAs in adult rats with focal cerebral ischemia undergo broad changes.However,whether long noncoding RNAs are involved in neuroprotective effects following focal ischemic stroke in rats remains unclear.In this study,RNA isolation and library preparation was performed for long noncoding RNA sequencing,followed by determining the coding potential of identified long noncoding RNAs and target gene prediction.Differential expression analysis,long noncoding RNA functional enrichment analysis,and co-expression network analysis were performed comparing ischemic rats with and without ischemic postconditioning rats.Rats were subjected to ischemic postconditioning via the brief and repeated occlusion of the middle cerebral artery or femoral artery.Quantitative real-time reverse transcription-polymerase chain reaction was used to detect the expression levels of differentially expressed long noncoding RNAs after ischemic postconditioning in a rat model of ischemic stroke.The results showed that ischemic postconditioning greatly affected the expression profile of long noncoding RNAs and mRNAs in the brains of rats that underwent ischemic stroke.The predicted target genes of some of the identified long noncoding RNAs(cis targets)were related to the cellular response to ischemia and stress,cytokine signal transduction,inflammation,and apoptosis signal transduction pathways.In addition,15 significantly differentially expressed long noncoding RNAs were identified in the brains of rats subjected to ischemic postconditioning.Nine candidate long noncoding RNAs that may be related to ischemic postconditioning were identified by a long noncoding RNA expression profile and long noncoding RNA-mRNA co-expression network analysis.Expression levels were verified by quantitative real-time reverse transcription-polymerase chain reaction.These results suggested that the identified long noncoding RNAs may be involved in the neuroprotective effects associated with ischemic postconditioning following ischemic stroke.The experimental animal procedures were approved by the Animal Experiment Ethics Committee of Kunming Medical University(approval No.KMMU2018018)in January 2018.
基金This work was financially supported by the Natural Science Foundation of Hebei Province of China(Grant No.E2019502057)the Fundamental Research Funds for the Central Universities,China(Grant No.2018MS120).
文摘The Cu-Ti-Si alloys containing in-situ formed Ti5Si3 are prepared. In order to clarify the Ti5Si3 formation processes and its microstructure characteristics, the as-cast and deeply etched Cu-Ti-Si alloys with different compositions and cooling rates were investigated using scanning electron microscopy (SEM), transmission electron microscopy (TEM) and X-ray diffraction (XRD). It is found that the eutectic Ti5Si3 phases in Cu-Ti-Si alloys are rod-like with hexagonal cross section which tend to intertwine with each other to form a firm skeleton like a bird nest structure which can make the alloys keep their original shape even after etching off the Cu matrix. In addition, there is Cu in the center of many Ti5Si3 rods, resulting in a core-shell structure. With the increase of the cooling rate, Ti5Si3 distributes more uniformly, and the diameter of Ti5Si3 significantly decreases, with a minimum size of less than 100 nm, while the aspect ratio of Ti5Si3 increases.
基金Supported by the National Natural Science Foundation of China under Grant Nos 11674397 and 61671455
文摘Measurement-device-independent quantum key distribution(MDI-QKD) offers a practical way to realize a startype quantum network. Previous experiments on MDI-QKD networks can only support the point-to-point communication. We experimentally demonstrate a plug-and-play MDI-QKD network which can support the pointto-multipoint communication among three users. Benefiting from the plug-and-play MDI-QKD architecture,the whole network is automatically stabilized in spectrum, polarization, arrival time, and phase reference. The users only need the encoding devices, which means that the hardware requirements are greatly reduced. Our experiment shows that it is feasible to establish a point-to-multipoint MDI-QKD network.
文摘Three-dimensional(3D)micro-jet printing is a droplet deposition technique based on liquid-phase materials.To improve the deposition density and performance of energetic films with micro/nanoscale on an energetic chip,polydopamine(PDA)was utilized as a linker bridge to induce the in-situ self-assembly of CL-20-based energetic film via 3D micro-jet printing.The self-assembly was extensively characterized by confocal laser scanning microscopy(CLSM),SEM,power-XRD,XPS,and DSC.The performance of the self-assembled film was verified by the mechanical properties and detonation properties,and a possible self-assembly mechanism in the layer-by-layer micro-jet printing process was proposed.The results indicated PDA-induced self-assembly enhanced the physical entanglement between the binders and energetic crystal,reduced the porosity from 15.87%to 11.28%,and improved the elastic modulus and the detonation performance of the CL-20-based energetic film.This work proposes a novel and promising energetic film design and fabrication strategy to enhance the interaction between the energetic composite layers in the micro-jet printing process.
基金supported by the National Natural Science Foundation of China(No.11875036)。
文摘The Monte Carlo(MC)simulation is regarded as the gold standard for dose calculation in brachytherapy,but it consumes a large amount of computing resources.The development of heterogeneous computing makes it possible to substantially accelerate calculations with hardware accelerators.Accordingly,this study develops a fast MC tool,called THUBrachy,which can be accelerated by several types of hardware accelerators.THUBrachy can simulate photons with energy less than 3 MeV and considers all photon interactions in the energy range.It was benchmarked against the American Association of Physicists in Medicine Task Group No.43 Report using a water phantom and validated with Geant4 using a clinical case.A performance test was conducted using the clinical case,showing that a multicore central processing unit,Intel Xeon Phi,and graphics processing unit(GPU)can efficiently accelerate the simulation.GPU-accelerated THUBrachy is the fastest version,which is 200 times faster than the serial version and approximately 500 times faster than Geant4.The proposed tool shows great potential for fast and accurate dose calculations in clinical applications.
文摘Objective To investigate the clinical features and management of ureteral endometriosis. Methods Patients surgically and histologically diagnosed as ureteral endometriosis from January 2001 to January 2007 in Peking Union Medical College Hospital were retrospectively reviewed. Results Ten patients were diagnosed as ureteral endometriosis among 7 561 cases with surgically and histologically proved diagnosis of endometriosis, with an incidence of 0.132%. Nine out of 10 patients were extrinsic ureteral endometriosis and concomitant with severe pelvic endometriosis, and the other was intrinsic ureteral endometriosis. Hormone therapy failed in 2 patients with urinary tract obstruction. Ureterolysis was performed in 6 patients and ureterectomy was performed in 4 patients. One case of ureteral recurrence was observed in a postmenopausal woman without hormonal replacement therapy who received laparoscopic ureterolysis and hysterectomy with bilateral adnexectomy. No relapse was observed in the other 9 patients. Conclusions Ureteral endometriosis is a rare entity. The upper urinary tract should be evaluated in patients with severe endometriosis, even in postmenopausal women. The treatment of ureteral endometriosis usually requires surgery, while ureterolysis should not be performed in patients with extensive disease. As a form of adjuvant therapy of surgery, hormonal therapy is an appropriate option.
基金supported by the National Natural Science Foundation of China(Grants 22002121,22172121)the National Undergraduate Training Program for Innovation and Entrepreneurship(Grant S202210656087).
基金This work was supported by the National Natural Science Foundation of China (No.20673107), the Chinese National Key Basic Research Special Foundation (No.2007CB815203), and the Chinese Academy of Science (No.KJCX2-SW-H08).
文摘Xenon atoms were produced in their metastable states 5p^56s[3/2]2 and 5p^56s'[1/2]0 in a pulsed DC discharge in a beam, and subsequently excited to the even-parity autoionizing Rydberg states 5p^5np' [3/2] 1,[1/2] 1, and 5p^5nf' [5/2] 3 using single photon excitation. The excitation spectra of the even-parity autoionizing resonance series from the metastable 129Xe were obtained by recording the autoionized Xe+ with time-of-flight ion detection in the photon energy range of 28000-42000 cm-1. A wealth of autoionizing resonances were newly observed, from which more precise and systematic spectroscopic data of the level energies and quantum defects were derived.