目的探讨应用磁共振质子密度脂肪分数(MRI-PDFF)诊断超重和肥胖儿童非酒精性脂肪性肝炎(NASH)的效能。方法2022年12月~2023年12月江油市903医院诊治的超重/肥胖的非酒精性脂肪性肝病(NAFLD)儿童102例,其中超重儿童74例和肥胖儿童28例,使...目的探讨应用磁共振质子密度脂肪分数(MRI-PDFF)诊断超重和肥胖儿童非酒精性脂肪性肝炎(NASH)的效能。方法2022年12月~2023年12月江油市903医院诊治的超重/肥胖的非酒精性脂肪性肝病(NAFLD)儿童102例,其中超重儿童74例和肥胖儿童28例,使用3.0 T MRI扫描仪行肝脏检查,获取MRI-PDFF,使用FibroScan诊断仪检查获得肝脏硬度检测(LSM)和受控衰减参数(CAP),行肝穿刺诊断NASH,绘制受试者工作特征曲线(ROC),计算曲线下面积(AUC),评估诊断效能。结果在102例超重/肥胖的NAFLD儿童中,经组织学检查诊断单纯性非酒精性脂肪肝(SNFL)75例和NASH 27例;NASH组BMI、血清ALT、AST、TG、MRI-PDFF、LSM和CAP分别为(32.2±3.4)kg/m^(2)、(92.7±31.3)U/L、(96.8±34.1)U/L、(3.1±1.2)mmol/L、(12.5±4.7)%、(11.7±1.4)kPa和(370.4±146.9)dB/m,与SNFL组【分别为(26.7±2.2)kg/m^(2)、(38.2±4.4)U/L、(33.0±3.4)U/L、(2.3±0.7)mmol/L、(7.7±2.0)%、(6.2±1.0)kPa和(262.3±61.2)dB/m】比,差异具有统计学意义(P<0.05),NASH组超重和肥胖占比分别37.0%和63.0%,与SNFL组的85.3%和14.7%比,差异具有统计学意义(P<0.05);经ROC曲线分析显示,以MRI-PDFF为11.9%为截断点,其诊断NASH的AUC为0.87(95%CI为0.80~0.93),敏感性为81.5%,特异性为85.3%,而分别以LSM为10.8 kPa和CAP为310.5dB/m为截断点,其诊断的AUC为0.81(95%CI为0.78~0.89),敏感性为85.2%,特异性为58.7%,后者的特异性较差。结论应用MRI-PDFF诊断儿童NASH的效能较优,但考虑到临床的便捷性,使用弹性成像检测诊断也可获得初步结果,以便必要时进一步检查。展开更多
The accumulation of excessive nitrate in the atmosphere not only jeopardizes human health but also disrupts the balance of the nitrogen cycle in the ecosystem.Among various nitrate removal technologies,electrocatalyti...The accumulation of excessive nitrate in the atmosphere not only jeopardizes human health but also disrupts the balance of the nitrogen cycle in the ecosystem.Among various nitrate removal technologies,electrocatalytic nitrate reduction reaction(eNO_(3)RR)has been widely studied for its advantages of being eco-friendly,easy to operate,and controllable under environmental conditions with renewable energy as the driving force.Transition metal-based catalysts(TMCs)have been widely used in electrocatalysis due to their abundant reserves,low costs,easy-to-regulate electronic structure and considerable electrochemical activity.In addition,TMCs have been extensively studied in terms of the kinetics of the nitrate reduction reaction,the moderate adsorption energy of nitrogen-containing species and the active hydrogen supply capacity.Based on this,this review firstly discusses the mechanism as well as analyzes the two main reduction products(N_(2)and NH_(3))of eNO_(3)RR,and reveals the basic guidelines for the design of efficient nitrate catalysts from the perspective of the reaction mechanism.Secondly,this review mainly focuses on the recent advances in the direction of eNO_(3RR)with four types of TMCs,Fe,Co,Ni and Cu,and unveils the interfacial modulation strategies of Fe,Co,Ni and Cu catalysts for the activity,reaction pathway and stability.Finally,reasonable suggestions and opportunities are proposed for the challenges and future development of eNO_(3)RR.This review provides far-reaching implications for exploring cost-effective TMCs to replace high-cost noble metal catalysts(NMCs)for eNO_(3)RR.展开更多
文摘目的探讨应用磁共振质子密度脂肪分数(MRI-PDFF)诊断超重和肥胖儿童非酒精性脂肪性肝炎(NASH)的效能。方法2022年12月~2023年12月江油市903医院诊治的超重/肥胖的非酒精性脂肪性肝病(NAFLD)儿童102例,其中超重儿童74例和肥胖儿童28例,使用3.0 T MRI扫描仪行肝脏检查,获取MRI-PDFF,使用FibroScan诊断仪检查获得肝脏硬度检测(LSM)和受控衰减参数(CAP),行肝穿刺诊断NASH,绘制受试者工作特征曲线(ROC),计算曲线下面积(AUC),评估诊断效能。结果在102例超重/肥胖的NAFLD儿童中,经组织学检查诊断单纯性非酒精性脂肪肝(SNFL)75例和NASH 27例;NASH组BMI、血清ALT、AST、TG、MRI-PDFF、LSM和CAP分别为(32.2±3.4)kg/m^(2)、(92.7±31.3)U/L、(96.8±34.1)U/L、(3.1±1.2)mmol/L、(12.5±4.7)%、(11.7±1.4)kPa和(370.4±146.9)dB/m,与SNFL组【分别为(26.7±2.2)kg/m^(2)、(38.2±4.4)U/L、(33.0±3.4)U/L、(2.3±0.7)mmol/L、(7.7±2.0)%、(6.2±1.0)kPa和(262.3±61.2)dB/m】比,差异具有统计学意义(P<0.05),NASH组超重和肥胖占比分别37.0%和63.0%,与SNFL组的85.3%和14.7%比,差异具有统计学意义(P<0.05);经ROC曲线分析显示,以MRI-PDFF为11.9%为截断点,其诊断NASH的AUC为0.87(95%CI为0.80~0.93),敏感性为81.5%,特异性为85.3%,而分别以LSM为10.8 kPa和CAP为310.5dB/m为截断点,其诊断的AUC为0.81(95%CI为0.78~0.89),敏感性为85.2%,特异性为58.7%,后者的特异性较差。结论应用MRI-PDFF诊断儿童NASH的效能较优,但考虑到临床的便捷性,使用弹性成像检测诊断也可获得初步结果,以便必要时进一步检查。
基金National Natural Science Foundation of China(Nos.52172291 and 52122312)“Dawn”Program of Shanghai Education Commission,China(No.22SG31)。
文摘The accumulation of excessive nitrate in the atmosphere not only jeopardizes human health but also disrupts the balance of the nitrogen cycle in the ecosystem.Among various nitrate removal technologies,electrocatalytic nitrate reduction reaction(eNO_(3)RR)has been widely studied for its advantages of being eco-friendly,easy to operate,and controllable under environmental conditions with renewable energy as the driving force.Transition metal-based catalysts(TMCs)have been widely used in electrocatalysis due to their abundant reserves,low costs,easy-to-regulate electronic structure and considerable electrochemical activity.In addition,TMCs have been extensively studied in terms of the kinetics of the nitrate reduction reaction,the moderate adsorption energy of nitrogen-containing species and the active hydrogen supply capacity.Based on this,this review firstly discusses the mechanism as well as analyzes the two main reduction products(N_(2)and NH_(3))of eNO_(3)RR,and reveals the basic guidelines for the design of efficient nitrate catalysts from the perspective of the reaction mechanism.Secondly,this review mainly focuses on the recent advances in the direction of eNO_(3RR)with four types of TMCs,Fe,Co,Ni and Cu,and unveils the interfacial modulation strategies of Fe,Co,Ni and Cu catalysts for the activity,reaction pathway and stability.Finally,reasonable suggestions and opportunities are proposed for the challenges and future development of eNO_(3)RR.This review provides far-reaching implications for exploring cost-effective TMCs to replace high-cost noble metal catalysts(NMCs)for eNO_(3)RR.
