Anti-vascular endothelial growth factor drugs combined with laser photocoagulation maintain retinal ganglion cell integrity in patients with diabetic macular edema: study protocol for a prospective, non-randomized, controlled clinical trial

The integrity of retinal ganglion cells is tightly associated with diabetic macular degeneration that leads to damage and death of retinal ganglion cells,affecting vision.The major clinical treatments for diabetic macular edema are anti-vascular endothelial growth factor drugs and laser photocoagulation.However,although the macular thickness can be normalized with each of these two therapies used alone,the vision does not improve in many patients.This might result from the incomplete recovery of retinal ganglion cell injury.Therefore,a prospective,non-randomized,controlled clinical trial was designed to investigate the effect of anti-vascular endothelial growth factor drugs combined with laser photocoagulation on the integrity of retinal ganglion cells in patients with diabetic macular edema and its relationship with vision recovery.In this trial,150 patients with diabetic macular edema will be equally divided into three groups according to therapeutic methods,followed by treatment with anti-vascular endothelial growth factor drugs,laser photocoagulation therapy,and their combination.All patients will be followed up for 12 months.The primary outcome measure is retinal ganglion cell-inner plexiform layer thickness at 12 months after treatment.The secondary outcome measures include retinal ganglion cell-inner plexiform layer thickness before and 1,3,6,and 9 months after treatment,retinal nerve fiber layer thickness,best-corrected visual acuity,macular area thickness,and choroidal thickness before and 1,3,6,9,and 12 months after treatment.Safety measure is the incidence of adverse events at 1,3,6,9,and 12 months after treatment.The study protocol hopes to validate the better efficacy and safety of the combined treatment in patients with diabetic macula compared with the other two monotherapies alone during the 12-month follow-up period.The trial is designed to focus on clarifying the time-effect relationship between imaging measures related to the integrity of retinal ganglion cells and best-corrected visual acuity.The trial protocol was approved by the Medical Ethics Committee of the Affiliated Hospital of Beihua University with approval No.(2023)(26)on April 25,2023,and was registered with the Chinese Clinical Trial Registry(registration number:ChiCTR2300072478,June 14,2023,protocol version:2.0).

Optimal scheduling of a township integrated-energy system using the adjustable heat-electricity ratio model

With the expansion and implementation of rural revitalization strategies,there is a constant need for new energy sources for the construction of new townships.Consequently,integrated energy systems with the interconnection and interaction of multiple energy sources are developing rapidly.Biomass energy,a renewable green energy source with low pollution and wide distribution,has significant application potential in integrated energy systems.Considering the application of biomass energy in townships,this study established an integrated biomass energy system and proposed a model to optimize its operation.Lowest economic cost and highest clean energy utilization rate were considered as the objective functions.In addition,a plan was suggested to adjust the heat-electricity ratio based on the characteristics of the combined heat and power of the biomass.Finally,a simulation analysis conducted for a town in China was discussed,demonstrating that the construction of a township integrated-energy system and the use of biomass can significantly reduce operating costs and improve the energy utilization rate.Moreover,by adjusting the heat-electricity ratio,the economic cost was further reduced by 6.70%,whereas the clean energy utilization rate was increased by 5.14%.

First-line immunotherapy for advanced non-small cell lung cancer:current progress and future prospects

Global Cancer Statistics 2022 reported the prevalence and high mortality rate of lung cancer.Notably,non-small cell lung cancer(NSCLC)accounts for the majority of the histologic types1.Precision therapy for lung cancer has progressed rapidly and immune checkpoint inhibitors(ICIs)have become a leading research topic.Indeed,ICI therapy has been shown to improve the prognosis of lung cancer patients.

Blood gas analysis as a surrogate for microhemodynamic monitoring in sepsis

BACKGROUND:Emergency patients with sepsis or septic shock are at high risk of death.Despite increasing attention to microhemodynamics,the clinical use of advanced microcirculatory assessment is limited due to its shortcomings.Since blood gas analysis is a widely used technique reflecting global oxygen supply and consumption,it may serve as a surrogate for microcirculation monitoring in septic treatment.METHODS:We performed a search using PubMed,Web of Science,and Google scholar.The studies and reviews that were most relevant to septic microcirculatory dysfunctions and blood gas parameters were identified and included.RESULTS:Based on the pathophysiology of oxygen metabolism,the included articles provided a general overview of employing blood gas analysis and its derived set of indicators for microhemodynamic monitoring in septic care.Notwithstanding flaws,several parameters are linked to changes in the microcirculation.A comprehensive interpretation of blood gas parameters can be used in order to achieve hemodynamic optimization in septic patients.CONCLUSION:Blood gas analysis in combination with clinical performance is a reliable alternative for microcirculatory assessments.A deep understanding of oxygen metabolism in septic settings may help emergency physicians to better use blood gas analysis in the evaluation and treatment of sepsis and septic shock.

Inhibition of fibroblast activation protein ameliorates cartilage matrix degradation and osteoarthritis progression

Fibroblast activation protein(Fap)is a serine protease that degrades denatured type I collagen,α2-antiplasmin and FGF21.Fap is highly expressed in bone marrow stromal cells and functions as an osteogenic suppressor and can be inhibited by the bone growth factor Osteolectin(Oln).Fap is also expressed in synovial fibroblasts and positively correlated with the severity of rheumatoid arthritis(RA).However,whether Fap plays a critical role in osteoarthritis(OA)remains poorly understood.Here,we found that Fap is significantly elevated in osteoarthritic synovium,while the genetic deletion or pharmacological inhibition of Fap significantly ameliorated posttraumatic OA in mice.Mechanistically,we found that Fap degrades denatured type II collagen(Col II)and Mmp13-cleaved native Col II.Intra-articular injection of r Fap significantly accelerated Col II degradation and OA progression.In contrast,Oln is expressed in the superficial layer of articular cartilage and is significantly downregulated in OA.Genetic deletion of Oln significantly exacerbated OA progression,which was partially rescued by Fap deletion or inhibition.Intra-articular injection of r Oln significantly ameliorated OA progression.Taken together,these findings identify Fap as a critical pathogenic factor in OA that could be targeted by both synthetic and endogenous inhibitors to ameliorate articular cartilage degradation.

Mo/Fe bimetallic pyrophosphates derived from Prussian blue analogues for rapid electrocatalytic oxygen evolution

Efficient and stable oxygen evolution electrocatalysts are indispensable for industrial applications of water splitting and hydrogen production.Herein,a simple and practical method was applied to fabricate(Mo,Fe)P2O7@NF electrocatalyst by directly growing Mo/Fe bimetallic pyrophosphate derived from Prussian blue analogues on three-dimensional porous current collector.In alkaline media,the developed material possesses good hydrophilic features and exhibits best-in-class oxygen evolution reaction(OER)performances.Surprisingly,the(Mo,Fe)P_(2)O_(7)@NF only requires overpotentials of 250 and 290 mV to deliver 100 and 600 mA cm^(-2)in 1 mol L^(-1)KOH,respectively.Furthermore,the(Mo,Fe)P_(2)O_(7)@NF shows outstanding performances in alkaline salty water and 1 mol L^(-1)high purity KOH.A worthwhile pathway is provided to combine bimetallic pyrophosphate with commercial Ni foam to form robust electrocatalysts for stable electrocatalytic OER,which has a positive impact on both hydrogen energy application and environmental restoration.

Eu(Ⅲ)在蒙脱石上的吸附及碳酸根和磷酸根对其吸附的影响

锕系核素在处置库围岩和缓冲回填材料中的吸附和迁移参数是处置库安全评价的重要数据模块之一,而Eu(Ⅲ)由于其与三价锕系元素An(Ⅲ)相似的离子半径和化学性质常被用于模拟三价锕系元素的化学行为。本文通过批式吸附实验研究了固液比、接触时间、离子强度、p H、碳酸根及磷酸根等对Eu(Ⅲ)在蒙脱石上吸附的影响,重点关注了吸附机理和表面种态。研究结果表明,低p H时Eu(Ⅲ)在蒙脱石上的吸附方式为外层配位吸附,近中性时为内层配位吸附,高p H时则以表面沉淀的方式被吸附。离子强度的增大对Eu(Ⅲ)在低p H时的吸附产生抑制作用。低p H时碳酸根对Eu(Ⅲ)吸附的影响不明显,但在高p H时其会改变Eu(Ⅲ)的表面吸附种态。尽管磷酸根本身的吸附非常弱,但磷酸根会显著增强Eu(Ⅲ)的吸附。X射线光电子能谱结果和磷酸根吸附实验说明Eu(Ⅲ)在蒙脱石表面上形成了Eu PO4沉淀。本工作研究了蒙脱石/Eu(Ⅲ)二元体系和蒙脱石/Eu(Ⅲ)/阴离子三元体系的吸附行为,并用光谱技术探究了其吸附种态,为理解三价锕系核素在蒙脱石上的吸附行为提供了重要参考。

抗血管生成药物联合免疫检查点抑制剂治疗晚期非小细胞肺癌的研究进展

肺癌是中国乃至全世界发病率和死亡率最高的癌种,其中非小细胞肺癌(non-small cell lung cancer,NSCLC)约占85%。肿瘤的生长和转移依赖于肿瘤新生血管的形成,抗血管生成治疗的地位日益显著,但仅接受抗血管生成单药治疗无法使患者预后明显改善。近年来,免疫检查点抑制剂(immune checkpoint inhibitor,ICI)的应用显著地改善了部分肺癌患者的预后,但接受ICI单药治疗人群的缓解率较低,而抗血管生成药物和免疫检查点抑制剂均能调节肿瘤微环境、有潜在协同作用机制,联合应用于抗肿瘤治疗有较好前景。本文将就抗血管生成药物联合免疫检查点抑制剂在晚期NSCLC中的研究及应用进行综述。

Abutment pressure distribution for longwall face mining through abandoned roadways

Abutment pressure distribution is different when a longwall panel is passing through the abandoned gate roads in a damaged coal seam. According to the geological condition of panel E13103 in Cuijiazhai Coal Mine in China, theoretical analysis and finite element numerical simulation were used to determine the front pressure distribution characteristics when the longwall face is 70, 50, 30, 20, 10, and 5 m from the abandoned roadways. The research results show that the influence range of abutment pressure is 40 to 45 m outby the face, and the peak value of front abutment pressure is related to the distance between the face and abandoned roadways. When the distance between the longwall face and abandoned roadways is reduced from 50 to 10 m, the front abutment pressure peak value kept increasing. When the distance is 10 m, it has reached the maximum. The peak value is located in 5 to 6 m outby the faceline. When the distance between the longwall face and abandoned roadways is reduced from 10 to 5 m, the front abutment pressure sharply decreases, the intact coal yields and is even in plastic state. The peak value transfers to the other side of the abandoned roadways. The research results provide a theoretical basis for determining the advance support distance of two roadways in the panel and the reinforcement for face stability when the longwall face is passing through the abandoned roadways.

SVEP1 PKHD1 P53在原发性肝癌组织中的表达及其临床意义

目的:使用免疫组化法检测SVEP1、PKHD1与P53在原发性肝癌组织中的表达,结合临床病理因素分析其预测肝癌患者术后复发情况的临床意义。方法:回顾性分析2013年1月至2014年1月于天津医科大学肿瘤医院行手术切除且随访资料完整的103例原发性肝癌患者的临床资料。以ROC曲线为主要统计方法探究不同指标的免疫组化评分对于患者预后的预测效果。根据其临界值将患者分为高危组和低危组,以无瘤生存期主要研究指标比较两组间的差异。结果:患者中位年龄为55(21～88)岁,中位AFP水平70.6(1.03～718 840.0)μg/L,中位CA19-9水平22.89(0.6～1 000.0)kU/L,中位肿瘤大小4.5(1.0～27.0)cm。通过免疫组化法检测SVEP1、PKHD1、P53在原发性肝癌中的表达情况,表达水平使用免疫组化评分进行量化,三个指标免疫组化评分的ROC曲线中AUC面积分别为0.861、0.829、0.716,临界值分别为4、4、1分(P<0.001)。SVEP1高危组(≤4分)与低危组(>4分)3年无瘤生存率分别为4.1%和51.7%;PKHD1高危组(≤4分)与低危组(>4分)3年无瘤生存率分别为5.3%和51.9%;P53高危组(>1分)与低危组(≤1分)3年无瘤生存率分别为6.3%和27.3%,每个指标两组间差异均有统计学意义(P<0.001,<0.001,0.003)。PKHD1与SVEP1联合应用时,其ROC曲线的AUC面积为0.897(P<0.001),敏感性为76.5%,特异性为94.4%。结论:P53预测原发性肝癌复发的准确性不足,不推荐首选使用。SVEP1、PKHD1预测原发性肝癌复发准确性较高,SVEP1特异性较高,PKHD1敏感性较强,两者联用效果更佳。

Research on power-supply cost of regional power system under carbon-peak target

With the establishment of the carbon-peak target by 2030,the direction of carbon emission reduction in China’s energy system has been further clarified.As the industry with the largest proportion of carbon emissions in China,the lowcarbon transformation of the electric power industry is critical to realize the carbon-peak target.Current research mostly focuses on technical analysis or system cost accounting of the carbon-peak realization path at the national level.There is a lack of targeted research on regional power systems with complex inter-regional power flow exchange and limited energy resource development.Simultaneously,the calculation of the system cost lacks the perspective of the life cycle and ignores the inertia of the stock and change inertia of incremental disturbance.From the perspective of the life cycle,this study proposes a calculation model of power supply cost for regional power systems according to the carbon-peak target,analyzes the realization path of the carbon target from an economic perspective,and provides references for the path selection and policy formulation of system transformation.

Production Capacity Evaluation of Horizontal Shale Gas Wells in Fuling District

One of the important indicators of shale gas reservoir excavation is capacity evaluation,which directly affects whether large-scale shale gas reservoirs can be excavated.Capacity evaluation is the basis of system analysis and dynamic prediction.Therefore,it is particularly important to conduct capacity evaluation studies on shale gas horizontal wells.In order to accurately evaluate the horizontal well productivity of shale gas staged fracturing,this paper uses a new method to evaluate the productivity of Fuling shale gas.The new method is aimed at the dynamic difference of horizontal wells and effectively analyzes the massive data,which are factors affecting the productivity of shale gas horizontal wells.According to the pressure system,production dynamic characteristics,well trajectory position,fracturing transformation mode and penetration depth,32 wells were divided into four types.Then,based on the classification,the principal component analysis methods can be used to evaluate the horizontal well productivity of shale gas.The new method of capacity evaluation has improved the accuracy by 10.25%compared with the traditional method,which provides a theoretical basis for guiding the efficient development of the horizontal wells of Fuling shale gas.

A survey on deploying mobile deep learning applications:A systemic and technical perspective

With the rapid development of mobile devices and deep learning,mobile smart applications using deep learning technology have sprung up.It satisfies multiple needs of users,network operators and service providers,and rapidly becomes a main research focus.In recent years,deep learning has achieved tremendous success in image processing,natural language processing,language analysis and other research fields.Despite the task performance has been greatly improved,the resources required to run these models have increased significantly.This poses a major challenge for deploying such applications on resource-restricted mobile devices.Mobile intelligence needs faster mobile processors,more storage space,smaller but more accurate models,and even the assistance of other network nodes.To help the readers establish a global concept of the entire research direction concisely,we classify the latest works in this field into two categories,which are local optimization on mobile devices and distributed optimization based on the computational position of machine learning tasks.We also list a few typical scenarios to make readers realize the importance and indispensability of mobile deep learning applications.Finally,we conjecture what the future may hold for deploying deep learning applications on mobile devices research,which may help to stimulate new ideas.

内复制及其在肿瘤发生发展中的作用

大多数的二倍体细胞通常通过G1期(DNA合成前期)、S期(DNA合成期)、G2期(DNA合成后期)和M期(分裂期)经典细胞周期完成细胞增殖。然而,在动、植物中也广泛存在着一种与有丝分裂不同的细胞周期过程,即内复制。在内复制过程中,G期和S期交替出现,细胞并不发生分裂,导致产生多倍体细胞。内复制在人体的正常发育、器官形成、创伤愈合过程中必不可少。近年来,越来越多的研究关注内复制与肿瘤发生、演进的关系。本文就内复制的生理作用做一概述,并讨论内复制在肿瘤发生、发展中的可能作用及相关分子机制。

A Study on the Strength Surplus Coefficient of Cement

This study considers P.O42.5 cement from different sources and evaluates the related surplus coefficient(defined as the proportionality factor linking the measured compressive strength value of the cement after 28 days to the“standard”value of cement strength).The needed tests have been conducted using a mixer,a pressure testing machine,a flexural testing machine,a vibrating table a ramming rod,a feeder and a metal ruler.The average value of the measured cement strength surplus coefficient of cement produced by five distinct cement manufacturers has been found to be 1.16.These results can be used as the basis to reduce the production cost and improve the performance of commercial concrete.

How psychiatrists coordinate treatment for COVID-19: a retrospective study and experience from China

Background Patients with C0VID-19 are at high risk of developing mental health problems;however,the prevalence and management of mental disorders and how psychiatrists coordinate the treatment are unclear.Aims We aimed to investigate the mental health problems of patients infected with C0VID-19 and to identify the role of psychiatrists in the clinical treatment team during the pandemic.We also share the experience of psychiatric consultations of patients with COVID-19 in Shanghai,China.Methods We analysed data from the psychiatric medical records of 329 patients with COVID-19 in the Shanghai Public Health Clinical Center from 20 January to 8 March 2020.We collected information including sociodemographic characteristics,whether patients received psychiatric consultation,mental health symptoms,psychiatric diagnoses,psychiatric treatments and severity level of COVID-19.Results Psychiatric consultations were received by 84(25.5%)patients with COVID-19.The most common symptoms of mental health problems were sleep disorders(75%),anxiety(58.3%)and depressive symptoms(11.9%).The psychiatric consultation rate was highest in critically ill patients(69.2%),with affective symptoms or disturbed behaviour as their main mental health problems.Psychiatric diagnoses for patients who received consultation included acute stress reaction(39.3%),sleep disorders(33.3%),anxiety(15.5%),depression(7.1%)and delirium(4.8%).In terms of psychiatric treatments,86.9%of patients who received psychiatric consultation were treated with psychotropic medications,including non-benzodiazepine sedative-hypnotic agents(54.8%),antidepressants(26.2%),benzodiazepines(22.6%)and antipsychotics(10.7%).Among the 76 patients who were discharged from the hospital,79%had recovered from mental health problems and were not prescribed any psychotropic medications.The symptoms of the remaining 21%of patients had improved and they were prescribed medications to continue the treatment.Conclusions This is the first study to report psychiatric consultations for patients with COVID-19.Our study indicated that a considerable proportion of patients with COVID-19,especially critically ill cases,experienced mental health problems.Given the remarkable effect of psychiatric treatments,we recommend that psychiatrists be timely and actively involved in the treatment of COVID-19.

Magmatic and hydrothermal zircon growth during multiple orogenic cycles in an evolving mantle wedge

The Hongseong area of the Hongseong-Imjingang Belt in the central-western Korean Peninsula forms part of a subduction-collision system that is correlated with the Qinling-Dabie-Sulu Belt in China. Several serpentinized ultramafic bodies carrying blocks of metamorphosed mafic rocks occur in this area. Here we investigate zircon grains in serpentinites from Bibong(BB) and Wonnojeon(WNJ), and high-pressure(HP) mafic granulite from Baekdong(BD) localities based on U-Pb, REE and Lu-Hf analyses. The zircons from BD HP mafic granulite show distinct age peaks at 838 Ma, 617 Ma and 410 Ma, with minor peaks at1867 Ma, 1326 Ma and 167 Ma. The Neoproterozoic age peaks in these rocks as well as in the serpentinites suggest subduction-related melt-fluid interaction in the mantle wedge at this time. The older zircon grains ranging in age from the Early to Middle Paleoproterozoic might represent detrital grains from the basement rocks transferred to the wedge mantle through sediment subduction. The BD HP mafic granulite shows a Middle Paleozoic age peak(Devonian; 410 Ma). The 242-245 Ma age peaks in the compiled age data of zircon grains serpentinites from BB and WNJ correspond to a major Triassic event that further added melts and fluids into the ancient mantle wedge to crystallize new zircons. In the chondrite normalized rare earth element diagram, the magmatic zircon grains from the studied rocks show LREE depletion and HREE enrichment with sharply negative Eu and Pr anomalies and positive Ce and Sm anomalies. The REE patterns of hydrothermal zircons show LREE enrichment, and relatively flat patterns with negative Eu anomaly. Zircon Hf signature from the WNJ serpentinite show negative εHf(t)(-18.5 and-23.5) values indicating an enriched mantle source with TDM in the range of 1614 Ma and1862 Ma. Zircons from the BD HP mafic granulite also show slightly negative εHf(t)(average-4.3) and TDM in the range of 1365-1935 Ma. Our study provides evidence for multiple zircon growth in an evolving mantle wedge that witnessed melt and fluid interaction during different orogenic cycles.

Research Progress of the Maternal-Fetal Interface Immune Microenvironment Regulated by Traditional Chinese Medicine in the Treatment of Recurrent Spontaneous Abortion

This article is a summary of the research progress of the maternal-fetal interface immune microenvironment regulated by traditional Chinese medicine in the treatment of recurrent spontaneous abortion.The imbalance of the immune microenvironment at the maternal-fetal interface is closely related to the occurrence of recurrent spontaneous abortion.Traditional Chinese medicine can maintain the homeostasis of the immune microenvironment at the maternal-fetal interface by regulating the function of immune cells and the expression of related cytokines.

IMAGE IMPROVEMENT IN THE WAVELET DOMAIN FOR OPTICAL COHERENCE TOMOGRAMS

In this paper,an image processing method for improving the quality of optical coherence tomography(OCT)images is proposed.Wavelet denoising based on context modeling and contrast enhancement by means of the contrast measure in the wavelet domain is carried out on the OCT images in succession.Three parameters are selected to assess the effectiveness of the method.It is shown from the results that the proposed method can not only enhance the contrast of images,but also improve signal-to-noise ratio.Compared with two other typical algorithms,it has the best visual effect.

Banana somatic embryogenesis and biotechnological application

As one of the most important economic crops for both staple food and fruit widely cultivated in the tropics and subtropics,banana(Musa spp.)is susceptible to a plethora of abiotic and biotic stresses.Breeding cultivars resistant to abiotic and biotic stressors without adverse effects on yield and fruit quality are the objectives of banana improvement programs.However,conventional breeding approaches are time-consuming and severely hampered by inherent banana problems(polyploidy and sterility).Therefore,genetic transformation is becoming increasingly popular and can provide rapid solutions.Numerous efforts have been made to develop superior banana cultivars with better resistance to abiotic and biotic stresses and optimum yields using genetic modification strategies.Somatic embryogenesis(SE)through embryogenic cell suspension(ECS)cultures is an ideal recipient system for genetic transformation in banana.The purpose of this paper is to review the current status of banana somatic embryo research,clarify the process of banana somatic embryo induction and culture,and summarize the main influencing factors in the process of somatic embryogenesis.At the same time,their applications in breeding technologies such as cryopreservation,protoplast culture,genetic transformation and gene editing were also summarized,in order to provide reference for the research and practical application of banana somatic embryogenesis in the future.