A bio-inspired strategy has recently been developed for camouflaging nanocarriers with biomembranes,such as natural cell membranes or subcellular structure-derived membranes.This strategy endows cloaked nanomaterials ...A bio-inspired strategy has recently been developed for camouflaging nanocarriers with biomembranes,such as natural cell membranes or subcellular structure-derived membranes.This strategy endows cloaked nanomaterials with improved interfacial properties,superior cell targeting,immune evasion potential,and prolonged duration of systemic circulation.Here,we summarize recent advances in the production and application of exosomal membrane-coated nanomaterials.The structure,properties,and manner in which exosomes communicate with cells are first reviewed.This is followed by a discussion of the types of exosomes and their fabrication methods.We then discuss the applications of biomimetic exosomes and membrane-cloaked nanocarriers in tissue engineering,regenerative medicine,imaging,and the treatment of neurodegenerative diseases.Finally,we appraise the current challenges associated with the clinical translation of biomimetic exosomal membrane-surface-engineered nanovehicles and evaluate the future of this technology.展开更多
Fungi and bacteria afflict humans with innumerous pathogen-related infections and ailments.Most of the commonly employed microbicidal agents target commensal and pathogenic microorganisms without discrimination.To dis...Fungi and bacteria afflict humans with innumerous pathogen-related infections and ailments.Most of the commonly employed microbicidal agents target commensal and pathogenic microorganisms without discrimination.To distinguish and fight the pathogenic species out of the microflora,novel antimicrobials have been developed that selectively target specific bacteria and fungi.The cell wall features and antimicrobial mechanisms that these microorganisms involved in are highlighted in the present review.This is followed by reviewing the design of antimicrobials that selectively combat a specific community of microbes including Gram-positive and Gram-negative bacterial strains as well as fungi.Finally,recent advances in the antimicrobial immunomodulation strategy that enables treating microorganism infections with high specificity are reviewed.These basic tenets will enable the avid reader to design novel approaches and compounds for antibacterial and antifungal applications.展开更多
Radical operation for hilar cholangiocarcinoma(HCCA)is the most effective treatment,but high rates of severe postoperative complication and death remain concerns due to the complexity of biliary and vascular anatomy o...Radical operation for hilar cholangiocarcinoma(HCCA)is the most effective treatment,but high rates of severe postoperative complication and death remain concerns due to the complexity of biliary and vascular anatomy of the hepatobiliary region.De-layed arterial hemorrhage(DAH)occurring>24 h postoperatively usually causes life-threatening bleeding,and relaparotomy for DAH would be difficult and hazardous because of postoperative adhe-sions and critical general condition.As endovascular technique is less invasive and has improved over the recent decades,clini-cians have begun to prefer endovascular treatment(EVT)to surgi-cal treatment of DAH after hepatobiliary pancreatic surgery.How-ever,to our knowledge,a relatively large series of patients dealing with the outcomes of EVT of DAH after surgery for HCCA has not been reported.Herein,we analyzed the technical and clinical out-comes of EVT in 17 patients to evaluate the efficacy and safety of EVT.展开更多
BACKGROUND Marked arterioportal shunt(APS)can be a contraindication for transarterial radioembolization(TARE)because of the risk of radiation-induced liver toxicity or pneumonitis.To date,the best method to close mark...BACKGROUND Marked arterioportal shunt(APS)can be a contraindication for transarterial radioembolization(TARE)because of the risk of radiation-induced liver toxicity or pneumonitis.To date,the best method to close marked APS to reduce intrahepatic shunt(IHS)and hepatopulmonary shunt(HPS)before TARE has not been elucidated.CASE SUMMARY This case report describes a novel strategy of embolization of the portal venous outlet to reduce IHS and HPS caused by marked APS before TARE in a patient with advanced hepatocellular carcinoma(HCC).The patient had a significant intratumoral shunt from the tumor artery to the portal vein and had already been suspected based on pre-interventional magnetic resonance angiography,and digital subtraction angiography(DSA)confirmed the shunt.Selective right portal vein embolization(PVE)was performed to close the APS outlet and DSA confirmed complete closure.Technetium-99m macroaggregated albumin was administered and single photon emission computed tomography revealed a low HPS with 8.4%.Successful TARE was subsequently performed.No major procedurerelated complication occurred.CONCLUSION Closure of APS with PVE during mapping angiography of advanced-stage HCC to enable reduction of HPS and subsequent TARE is feasible.展开更多
AIM: To evaluate the change in spectrum of gastric polyps in the Chinese population in the past ten years.METHODS: A total of 157902 consecutive patients undergoing esophagogastroduodenoscopy(EGD) from 2004 to 2013 in...AIM: To evaluate the change in spectrum of gastric polyps in the Chinese population in the past ten years.METHODS: A total of 157902 consecutive patients undergoing esophagogastroduodenoscopy(EGD) from 2004 to 2013 in a tertiary hospital were retrospectively reviewed using an EGD database.Endoscopic records of 4043 patients diagnosed with gastric polyps were recalled for analysis.Data including demographics,information on polyps such as location,pathological diagnosis,reflux esophagitis and Helicobacter pylori infection were obtained.We focused on epithelial polyps,especially hyperplastic polyps,fundic gland polyps and adenomas,and histological classification of specimens from biopsy and endoscopic polypectomy was performed by professional pathologists,based on the updated guidelines.To explore the age distribution of gastric polyps over time,we divided patients with polyps into four groups: A(aged < 30 years),B(aged 30-44 years),C(aged 45-59 years) and D(aged > 60 years).Differences in localization,age,and sex distribution of gastric polyps were analyzed by statistical software.RESULTS: A total of 157902 EGD procedures were performed in ten years at our digestive endoscopy center,of which 4043 cases were diagnosed with gastric polyps confirmed by pathology.There were 2574(63%) female and 1469(37%) male patients with an average age of 54.7 years.The overall prevalence of gastric polyps was 2.6%(4043/157902).Our database demonstrated a rising prevalence of gastric polyps over the decade,increasing from 1.0%(80/8025) to 4.70%(828/17787) between 2004 and 2013.There has been a change in the spectrum of gastric polyps with the frequencies of FGPs increasing from 19%(15/80) to 77%(638/828) and hyperplastic polyps decreasing from 65%(52/80) to 15%(123/828).Moreover,data on 1921 polyps in 828 patients diagnosed with gastric polyps in 2013 showed that FGP was the most common type in the current polyp spectrum,making up 81.3%(1562/1921).Location and age distribution of gastric polyps have also altered.The prevalence of polyps located in the antrum decreased from 37.5%(30/80) to 9.30%(77/828),with an increasing prevalence of polyps in the corpus,from 45%(36/80) to 64.25%(532/828).The constituent ratio of older patients(aged > 60 years) in the polyp population decreased from 62.5%(50/80) to 32.13%(266/828),while that of patients aged 45-60 years showed an increased trend.CONCLUSION: There was a shift change in the spectrum of gastric polyps in the Chinese population with altered location and age distribution in the past ten years.展开更多
AIM To evaluate the advantages of endoscopic ultrasound(EUS) in the assessment of detailed structures of pancreatic cystic neoplasms(PCNs) compared to computed tomography(CT) and magnetic resonance imaging(MRI).METHOD...AIM To evaluate the advantages of endoscopic ultrasound(EUS) in the assessment of detailed structures of pancreatic cystic neoplasms(PCNs) compared to computed tomography(CT) and magnetic resonance imaging(MRI).METHODS All patients with indeterminate PCNs underwent CT, MRI, and EUS. The detailed information, including size, number, the presence of a papilla/nodule, the presence of a septum, and the morphology of the pancreatic duct of PCNs were compared among the three imaging modalities. The size of each PCN was determined using the largest diameter measured. A cyst consisting of several small cysts was referred to as a motherdaughter cyst. Disagreement among the three imaging modalities regarding the total number of mother cysts resulted in the assumption that the correct number was the one in which the majority of imaging modalities indicated.RESULTS A total of 52 females and 16 males were evaluated. The median size of the cysts was 42.5 mm by EUS, 42.0 mm by CT and 38.0 mm by MRI; there was no significant difference in size as assessed among the three imaging techniques. The diagnostic sensitivity and ability of EUS to classify PCNs were 98.5%(67/68) and 92.6%(63/68), respectively. These percentages were higher than those of CT(73.1%, P < 0.001; 17.1%, P < 0.001) and MRI(81.3%, P = 0.001; 20.3%, P < 0.001). EUS was also able to better assess the number of daughter cysts in mother cysts than CT(P = 0.003); however, there was no significant difference between EUS and MRI in assessing mother-daughter cysts(P = 0.254). The papilla/nodule detection rate by EUS was 35.3%(24/68), much higher than those by CT(5.8%, 3/52) and MRI(6.3%, 4/64). The detection rate of the septum by EUS was 60.3%(41/68), which was higher than those by CT(34.6%, 18/52) and by MRI(46.9%, 30/64); the difference between EUS and CT was significant(P = 0.02). The rate of visualizing the pancreatic duct using EUS was 100%, whereas using CT and MRI it was less than 10%.CONCLUSION EUS helps visualize the detailed structures of PCNs and has many advantages over CT and MRI. EUS is valuable in the diagnosis and assessment of PCNs.展开更多
Hot compression tests in the temperature range of 340-450 ℃ and strain rate range of 0.001-1 s^-1 of spray-formed 7055 aluminum alloy were carried out to study its hot deformation behavior. Three phenomenological mod...Hot compression tests in the temperature range of 340-450 ℃ and strain rate range of 0.001-1 s^-1 of spray-formed 7055 aluminum alloy were carried out to study its hot deformation behavior. Three phenomenological models including Johnson-Cook, modified Fields-Backofen and Arrhenius-type were introduced to predict the flow stresses during the compression process. And then, a comparative predictability of the phenomenological models was estimated in terms of the relative errors, correlation coefficient(R), and average absolute relative error(AARE). The results indicate that Johnson-Cook model and modified Fields-Backofen model cannot well predict the hot deformation behavior due to the large deviation in the process of line regression fitting. Arrhenius-type model obtains the best fit through combining the effect of strain rate and temperature.展开更多
AIM:To identify the determinants of endoscopic submucosal dissection(ESD) operation time.METHODS:This investigation was conducted as a single-center,prospective study in which ESD was performed by the same endoscopist...AIM:To identify the determinants of endoscopic submucosal dissection(ESD) operation time.METHODS:This investigation was conducted as a single-center,prospective study in which ESD was performed by the same endoscopist at the Chinese PLA General Hospital.A total of 173 patients underwent ESD operations performed by Dr.Lu from July 2007 to December 2011,and 183 lesions were enrolled.Patient gender,age,tumor location,gross type,tumor size,pathological type and adhesions were recorded prospectively.The order of treatment represented the experience of the operator.Univariate analysis and multivariate analysis were performed to evaluate the relationships between these factors and ESD procedure time.RESULTS:Univariate analysis showed the ESD time was closely related to the gender(P = 0.0210),tumor size(P < 0.0001),location(P < 0.0001),gross type(P < 0.0001) and adhesion(P = 0.0010).The surgical proficiency level was associated with ESD time in unit area(P < 0.0001).Multivariate analysis revealed that the ESD time was positively correlated with tumor size(P < 0.0001),adhesion(P < 0.0001) and location(P < 0.0001),but negatively correlated with surgical proficiency level(P = 0.0046).CONCLUSION:Large tumor size,adjacency to the cardia,and adhesion are predictors of a long ESD time,whereas high surgical proficiency level predicts a short ESD time.展开更多
AIM:To measure in vitro diameter of imitational varices using a self-made endoscopic scale and confirm its accuracy and clinical feasibility.METHODS:A catheter was introduced into the endoscopeaccessory channel and at...AIM:To measure in vitro diameter of imitational varices using a self-made endoscopic scale and confirm its accuracy and clinical feasibility.METHODS:A catheter was introduced into the endoscopeaccessory channel and attached to a zebra wire guide that was used as a stylet.The wire guide was fixed onto the tip of the catheter by a soft and thin string.By gently advancing the stylet into the catheter,the width of the opening loop at the tip of the endoscope approximated the diameter of the imitational varices.Measurements performed in vitro using this self-made endoscopic ruler were compared to measurements of simulative varices.RESULTS:At the handle,the sleeve moving distance ranged from 5 to 14 mm.There was no obvious proportional relationship between the sleeve movement distance and endoscopic measurement ruler.The results indicated that the gap between the endoscopic measurement and actual measurement of the object size tended to close.The in vitro measurement of the diameter of the simulative varices showed that the two kinds of measuring methods were not significantly different with respect to their accuracy(P=0.8499).CONCLUSION:In vitro experiments confirmed that using a self-designed endoscopic ruler to measure the diameter of simulative varices was objective,accurate and feasible.展开更多
To get a full understanding of hot extrusion,solid solution treatment and aging process on the Al−0.56Mg−0.63Si alloy,the microstructure and mechanical properties of a U-shaped profile were studied through optical mic...To get a full understanding of hot extrusion,solid solution treatment and aging process on the Al−0.56Mg−0.63Si alloy,the microstructure and mechanical properties of a U-shaped profile were studied through optical microscopy,scanning electrical microscopy,transmission electrical microscopy,hardness,and tensile tests.The coarse equiaxed grains existed near the profile edge as a result of the dynamic recrystallization nucleation and exceeding growth during hot extrusion.The fibrous deformed and sub-structured grains located between the two coarse grain layers,due to the occurrence of work-hardening and dynamic recovery.Perpendicular needle β′′precipitates were distributed inside the grain,and obvious precipitates-free zone appeared after aging treatment.The tensile strength,yield strength and elongation of the aged Al−Mg−Si alloy U-shaped profile were no less than 279.4 MPa,258.6 MPa,and 21.6%,respectively.The fracture morphology showed dimple rupture characteristics.The precipitates and grain boundaries played key role in the strengthening contribution.展开更多
BACKGROUND Pancreatic adenoma can potentially transform into adenocarcinoma, so it is recommended to be resected surgically or endoscopically. Endoscopic papillectomy is one of the main treatments for papillary adenom...BACKGROUND Pancreatic adenoma can potentially transform into adenocarcinoma, so it is recommended to be resected surgically or endoscopically. Endoscopic papillectomy is one of the main treatments for papillary adenoma, and bleeding, perforation, and pancreatitis are the most frequent and critical adverse events that restrict its wider use. There is no standard procedure for endoscopic papillectomy yet. The procedure is relevant to postoperative adverse events.AIM To reduce the postoperative adverse event rates and improve patients' postoperative condition, we developed a standard novel procedure for endoscopic papillectomy.METHODS The novel endoscopic papillectomy had two main modifications based on the conventional method: The isolation of bile from pancreatic juice with a bile duct stent and wound surface protection with metal clips and fibrin glue. We performed a single-center retrospective comparison study on the novel and conventional methods to examine the feasibility of the novel method for reducing postoperative adverse events.RESULTS A total of 76 patients, of whom 23 underwent the novel procedure and 53 underwent the conventional procedure, were retrospectively evaluated in this study. The postoperative bleeding and pancreatitis rates of the novel method were significantly lower than those of the conventional method(0 vs 20.75%, P = 0.028, and 17.4% vs 41.5%, P = 0.042, respectively). After applying the novel method, the most critical adverse event, perforation, was entirely prevented, compared to a prevalence of 5.66% with the conventional method. Several postoperative symptoms, including fever, rapid pulse, and decrease in hemoglobin level, were significantly less frequent in the novel group(P = 0.042, 0.049, and 0.014, respectively). Overall, the total adverse event rate of the novel method was lower(0 vs 24.5%, P = 0.007) than that of the conventional method.CONCLUSION Patients who underwent the novel procedure had lower postoperative adverse event rates. This study demonstrates the potential efficacy and safety of the novel endoscopic papillectomy in reducing postoperative adverse events.展开更多
AIM To evaluate the diagnostic value and safety mainly regarding incidents of endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA) for pancreatic cystic lesions(PCLs).METHODS A total of 150 consecutive patient...AIM To evaluate the diagnostic value and safety mainly regarding incidents of endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA) for pancreatic cystic lesions(PCLs).METHODS A total of 150 consecutive patients with suspected PCLs were prospectively enrolled from April 2015 to November 2016. We finally enrolled 140 patients undergoing EUS-FNA. We compared the diagnostic accuracy of EUS-FNA and pathological diagnosis, which is regarded as the gold standard, for PCLs. Patients undergoing EUS-FNA at least 1 wk preoperatively were monitored for incidents and adverse events to evaluate its safety.RESULTS There were 88(62.9%) women and 52(37.1%) men among 140 patients, with a mean age of 50.1(± 15.4) years. There were 67 cysts located in the head/uncinate of the pancreas and 67 in the body/tail, and 6 patients had at least 1 cyst in the pancreas. There were 75 patients undergoing surgery and 55 undergoing EUS-FNA with interval at least 1 wk before other operations, with 3 patients undergoing the procedure twice. The accuracy of EUS-FNA in differentiating benign and malignant lesions was 97.3%(73/75), while the accuracy of characterizing PCL subtype was 84.0%(63/75). The incident rate was 37.9%(22/58), whereas only 1 AE was observed in 58 cases.CONCLUSION EUS-FNA is effective and safe for diagnosis of PCLs, however procedure-related incidents are common. Caution should be taken in patients undergoing EUSFNA.展开更多
BACKGROUND The management strategies for recurrent ampullary adenoma after endoscopic papillectomy are still controversial.Patients with the recurrent papillary lesions need to receive repetitive endoscopic interventi...BACKGROUND The management strategies for recurrent ampullary adenoma after endoscopic papillectomy are still controversial.Patients with the recurrent papillary lesions need to receive repetitive endoscopic interventions due to the limitations of conventional endoscopic techniques.AIM To assess the feasibility,efficacy,and safety of hybrid endoscopic submucosal dissection(ESD)by duodenoscope for recurrent,laterally spreading papillary lesions.METHODS We enrolled two patients with recurrent,laterally spreading,duodenal papillary adenomas with no intraductal extension confirmed by follow-up between March 2017 and September 2018.After marking the resection borders of the lesion using a dual knife,a submucosal cushion was created by injecting a mixture of saline solution,methylene blue,and adrenaline.A total circumferential incision and submucosal excision was performed by dual knife combined with insulated-tip diathermic knife,and then the lesion was ligated and resected using an electric snare.Endoscopic hemostasis was applied during the endoscopic procedures.Moreover,the endoscopic retrograde cholangiopancreatography(ERCP)procedures,including selective cannulation and stent implantation of biliary and pancreatic ducts,were performed.Additionally,we performed endoclip closure for mucosal defect after ESD.RESULTS Hybrid ESD using a duodenoscope and biliary and pancreatic stent placement were performed successfully in two patients.The endoscopic size of recurrent papillary lesions was no more than 2 cm.Generally,the average total procedure time was 95.5 min,and the procedure time of ESD and ERCP was 38.5 min and 15.5 min,respectively.No serious complications occurred during the intraoperative and postoperative periods.The histopathological examination revealed tubulovillous adenoma negative for neoplastic extension at the cut margin in both patients.The duodenoscopic follow-up and histopathology of biopsy specimens at 3 mo after ESD showed no residual or recurrent lesions in ampullary areas in both cases.Both cases have been followed up with no recurrence to June 2020.CONCLUSION Hybrid ESD by duodenoscope is technically challenging,and may be curative for recurrent,laterally spreading papillary adenomas<2 cm.It should be performed cautiously in selected patients by experienced endoscopists.展开更多
BACKGROUND Endoscopic drainage of walled-off necrosis(WON) is still a challenge due to stentassociated problems. We explored endoscopic gastric fenestration(EGF) as an innovative alternative intervention.AIM To assess...BACKGROUND Endoscopic drainage of walled-off necrosis(WON) is still a challenge due to stentassociated problems. We explored endoscopic gastric fenestration(EGF) as an innovative alternative intervention.AIM To assess the feasibility, efficacy and safety of EGF for WON.METHODS Between March 2019 and March 2020, five patients with symptomatic WON in close contact with the stomach wall were treated by EGF. Endoscopic ultrasound(EUS) was used to select appropriate sites for gastric fenestration, which then proceeded layer by layer as in endoscopic submucosal dissection. Both the stomach muscularis propria and pseudocyst capsule were penetrated. Fenestrations were expanded up to 1.5-3 cm for drainage or subsequent necrosectomy.RESULTS EGF failed in Case 1 due to nonadherence of WON to the gastric wall. EGF was successfully implemented in the other four cases by further refinement of fenestration site selection according to computed tomography, endoscopy and EUS features. The average procedure time for EGF was 124 min(EUS assessment, 32.3 min;initial fenestration, 28.8 min;expanded fenestration, 33 min), and tended to decrease as experience gradually increased. The diameter of the fenestration site was 1.5-3 cm, beyond the caliber of a lumen-apposing metal stent(LAMS), to ensure effective drainage or subsequent necrosectomy. Fenestration sites showed surprising capacity for postoperative self-healing within 1-3 wk. No EGF-related complications were seen. WON disappeared within 3 wk after EGF. In Case 3, another separate WON, treated by endoscopic LAMS drainage, recurred within 4 d after LAMS removal due to stent-related hemorrhage, and resolved slowly over almost 3 mo. No recurrences were observed in the five patients.CONCLUSION EGF is an innovative and promising alternative intervention for WON adherent to the gastric wall. The challenge resides in the gauging of actual adherence and in selecting appropriate fenestration sites.展开更多
Due to the worldwide epidemic of allergic disease and a cure nowhere in sight,there is a crucial need to explore its pathophysiological mechanisms.As allergic disease has been associated with gut dysbiosis,we searched...Due to the worldwide epidemic of allergic disease and a cure nowhere in sight,there is a crucial need to explore its pathophysiological mechanisms.As allergic disease has been associated with gut dysbiosis,we searched for a possible mechanism from the perspective of the molecular interface between host and microbiota with concurrent metabolomics and microbiome composition analysis.Sprague-Dawley rats were injected with Artemisia pollen extract to stimulate a hyper reaction to pollen.This hyper reaction decreased the circulation of valine,isoleucine,aspartate,glutamate,glutamine,indole-propionate(IPA),and myo-inositol,and reduced short-chain fatty acids(SCFAs)in feces.Several beneficial genera belonging to Ruminococcaceae,Lachnospiraceae,and Clostridiales declined in the model group,whereas Helicobacter and Akkermansia were only expressed in the model group.Furthermore,the expression of intestinal claudin-3 and liver fatty acid binding protein was downregulated in the model group and associated with metabolic changes and bacteria.Our results suggest that alterations in amino acids as well as their derivatives(especially valine,and IPA which is the reductive product of tryptophan),SCFAs,and the gut microbiome(specifically Akkermansia and Helicobacter)may disrupt the intestinal barrier function by inhibiting the expression of claudin proteins and affecting the mucus layer,which further results in hay fever.展开更多
BACKGROUND: The lack of widely-accepted guidelines for acute cholangitis largely lags behind the progress in medical and surgical technology and science for the management of acute cholangitis. This study aimed to ver...BACKGROUND: The lack of widely-accepted guidelines for acute cholangitis largely lags behind the progress in medical and surgical technology and science for the management of acute cholangitis. This study aimed to verify the Tokyo guidelines for the management of acute cholangitis and cholecystitis of 2007 edition (TG07) in patients with obstructive cholangitis due to benign and malignant diseases. METHODS: The patients were retrieved from our existing ERCP database. Final diagnosis of acute cholangitis was made by detecting purulent bile during biliary drainage. We examined and compared the guidelines concerning benign and malignant obstruction. RESULTS: In 120 patients in our study, 82 and 38 had benign and malignant biliary obstruction, respectively. Guidelines based diagnosis was made in 68 (82.9%), 36 (94.7%), and 104 (86.7%) patients with benign, malignant, and overall biliary obstruction, respectively, which were significantly higher than 44 (53.7%), 17 (44.7%), and 61 (50.8%) diagnosed by Charcot’s triad (P【0.001). Treatment consistent with the guidelines was offered to 58 (70.7%) patients with benign obstruction and15 (39.5%) patients with malignant obstruction (P=0.001). No significant association was observed between clinical compliance, guidelines-based severity grades and clinical outcomes. In the multivariate model, intrahepatic obstruction (OR=11.2, 95% CI: 1.55-226.9) and hypoalbuminemia (≤25.0 g/L; OR=17.3, 95% CI: 3.5-313.6) were independent risk factors for a 30-day mortality. CONCLUSIONS: The TG07 are more reliable than Charcot’s triad for the diagnosis of acute cholangitis albeit with limited prognostic values. Intrahepatic obstruction and hypoalbuminemia are new predictors of poor prognosis and need further assessment.展开更多
Solanum lyratum is one of the temperate plants,broadly distributed in Korea,China,Japan,India,and South-East Asia and well-documented in those oriental ethnic medicine systems for curing cancers,jaundice,edema,gonorrh...Solanum lyratum is one of the temperate plants,broadly distributed in Korea,China,Japan,India,and South-East Asia and well-documented in those oriental ethnic medicine systems for curing cancers,jaundice,edema,gonorrhea,cholecystitis,phlogosis,rheumatoid arthritis,etc.This review systematically summarized the research progress on S.lyratum respecting the botany,traditional uses,phytochemistry,pharmacology,and toxicology to increase people’s in-depth understanding of this plant,by data retrieval in a series of online or off-line electronic databases as far as we can reach.Steroidal saponins and alkaloids,terpenoids,nitrogenous compounds,and flavonoid compounds are the main chemical constituents in S.lyratum.Among them,steroidal alkaloids and saponins are the major active ingredi-ents ever found in S.lyratum,exerting activities of anti-cancer,anti-inflammation,anti-microbial,anti-allergy,and anti-oxidation in vivo or in vitro.As a result,S.lyratum has been frequently prescribed for the abovementioned therapeutic purposes,and there are substantial traditional and modern shreds of evidence of its use.展开更多
For the source limitations and vulnerabilities of the sensor nodes of Wireless Sensor Networks, we propose the new kind of dynamic key protocol for wireless sensor network, using the unidirection of hash function and ...For the source limitations and vulnerabilities of the sensor nodes of Wireless Sensor Networks, we propose the new kind of dynamic key protocol for wireless sensor network, using the unidirection of hash function and the thinking of Hill to study the dynamic key matrix. Through theoretical analysis of some aspects, our method can promote security, connectivity expansibility;the results show that this protocol reduces storage space and communication energy consumption also.展开更多
Vortex beams have attracted great attention due to their promising applications in the fields of high-capacity optical communication,optical micromanipulation,and quantum information processing.Here,we demonstrate vor...Vortex beams have attracted great attention due to their promising applications in the fields of high-capacity optical communication,optical micromanipulation,and quantum information processing.Here,we demonstrate vortex beams with flexible control of the topological charge and modes in a carbon dots random laser for the first time.Vortex beams with different types,including the Laguerre-Gaussian(LG),Bessel-Gaussian(BG),LG-superposition,and polarized vortex beams with topological charges up to 50,have been successfully achieved.Moreover,vortex beams can be well realized in carbon dots random lasers with different emission wavelengths covering from 465 to 612 nm.This work would not only enrich the types of vortex laser,especially for solution-processable lasers,but also provide a new route to realizing multicolor and wavelength-tunable vortex lasers.展开更多
基金supported by the Fundacao para a Ciência e Tecnologia (FCT) (SFRH/BD/148771/2019,2021.05914.BD, PTDC/BTM-MAT/4738/2020)the European Research CouncilDERC Starting Grant (848325).
文摘A bio-inspired strategy has recently been developed for camouflaging nanocarriers with biomembranes,such as natural cell membranes or subcellular structure-derived membranes.This strategy endows cloaked nanomaterials with improved interfacial properties,superior cell targeting,immune evasion potential,and prolonged duration of systemic circulation.Here,we summarize recent advances in the production and application of exosomal membrane-coated nanomaterials.The structure,properties,and manner in which exosomes communicate with cells are first reviewed.This is followed by a discussion of the types of exosomes and their fabrication methods.We then discuss the applications of biomimetic exosomes and membrane-cloaked nanocarriers in tissue engineering,regenerative medicine,imaging,and the treatment of neurodegenerative diseases.Finally,we appraise the current challenges associated with the clinical translation of biomimetic exosomal membrane-surface-engineered nanovehicles and evaluate the future of this technology.
文摘Fungi and bacteria afflict humans with innumerous pathogen-related infections and ailments.Most of the commonly employed microbicidal agents target commensal and pathogenic microorganisms without discrimination.To distinguish and fight the pathogenic species out of the microflora,novel antimicrobials have been developed that selectively target specific bacteria and fungi.The cell wall features and antimicrobial mechanisms that these microorganisms involved in are highlighted in the present review.This is followed by reviewing the design of antimicrobials that selectively combat a specific community of microbes including Gram-positive and Gram-negative bacterial strains as well as fungi.Finally,recent advances in the antimicrobial immunomodulation strategy that enables treating microorganism infections with high specificity are reviewed.These basic tenets will enable the avid reader to design novel approaches and compounds for antibacterial and antifungal applications.
基金supported by a grant from the National Natural Science Foundation of China(31971249).
文摘Radical operation for hilar cholangiocarcinoma(HCCA)is the most effective treatment,but high rates of severe postoperative complication and death remain concerns due to the complexity of biliary and vascular anatomy of the hepatobiliary region.De-layed arterial hemorrhage(DAH)occurring>24 h postoperatively usually causes life-threatening bleeding,and relaparotomy for DAH would be difficult and hazardous because of postoperative adhe-sions and critical general condition.As endovascular technique is less invasive and has improved over the recent decades,clini-cians have begun to prefer endovascular treatment(EVT)to surgi-cal treatment of DAH after hepatobiliary pancreatic surgery.How-ever,to our knowledge,a relatively large series of patients dealing with the outcomes of EVT of DAH after surgery for HCCA has not been reported.Herein,we analyzed the technical and clinical out-comes of EVT in 17 patients to evaluate the efficacy and safety of EVT.
文摘BACKGROUND Marked arterioportal shunt(APS)can be a contraindication for transarterial radioembolization(TARE)because of the risk of radiation-induced liver toxicity or pneumonitis.To date,the best method to close marked APS to reduce intrahepatic shunt(IHS)and hepatopulmonary shunt(HPS)before TARE has not been elucidated.CASE SUMMARY This case report describes a novel strategy of embolization of the portal venous outlet to reduce IHS and HPS caused by marked APS before TARE in a patient with advanced hepatocellular carcinoma(HCC).The patient had a significant intratumoral shunt from the tumor artery to the portal vein and had already been suspected based on pre-interventional magnetic resonance angiography,and digital subtraction angiography(DSA)confirmed the shunt.Selective right portal vein embolization(PVE)was performed to close the APS outlet and DSA confirmed complete closure.Technetium-99m macroaggregated albumin was administered and single photon emission computed tomography revealed a low HPS with 8.4%.Successful TARE was subsequently performed.No major procedurerelated complication occurred.CONCLUSION Closure of APS with PVE during mapping angiography of advanced-stage HCC to enable reduction of HPS and subsequent TARE is feasible.
文摘AIM: To evaluate the change in spectrum of gastric polyps in the Chinese population in the past ten years.METHODS: A total of 157902 consecutive patients undergoing esophagogastroduodenoscopy(EGD) from 2004 to 2013 in a tertiary hospital were retrospectively reviewed using an EGD database.Endoscopic records of 4043 patients diagnosed with gastric polyps were recalled for analysis.Data including demographics,information on polyps such as location,pathological diagnosis,reflux esophagitis and Helicobacter pylori infection were obtained.We focused on epithelial polyps,especially hyperplastic polyps,fundic gland polyps and adenomas,and histological classification of specimens from biopsy and endoscopic polypectomy was performed by professional pathologists,based on the updated guidelines.To explore the age distribution of gastric polyps over time,we divided patients with polyps into four groups: A(aged < 30 years),B(aged 30-44 years),C(aged 45-59 years) and D(aged > 60 years).Differences in localization,age,and sex distribution of gastric polyps were analyzed by statistical software.RESULTS: A total of 157902 EGD procedures were performed in ten years at our digestive endoscopy center,of which 4043 cases were diagnosed with gastric polyps confirmed by pathology.There were 2574(63%) female and 1469(37%) male patients with an average age of 54.7 years.The overall prevalence of gastric polyps was 2.6%(4043/157902).Our database demonstrated a rising prevalence of gastric polyps over the decade,increasing from 1.0%(80/8025) to 4.70%(828/17787) between 2004 and 2013.There has been a change in the spectrum of gastric polyps with the frequencies of FGPs increasing from 19%(15/80) to 77%(638/828) and hyperplastic polyps decreasing from 65%(52/80) to 15%(123/828).Moreover,data on 1921 polyps in 828 patients diagnosed with gastric polyps in 2013 showed that FGP was the most common type in the current polyp spectrum,making up 81.3%(1562/1921).Location and age distribution of gastric polyps have also altered.The prevalence of polyps located in the antrum decreased from 37.5%(30/80) to 9.30%(77/828),with an increasing prevalence of polyps in the corpus,from 45%(36/80) to 64.25%(532/828).The constituent ratio of older patients(aged > 60 years) in the polyp population decreased from 62.5%(50/80) to 32.13%(266/828),while that of patients aged 45-60 years showed an increased trend.CONCLUSION: There was a shift change in the spectrum of gastric polyps in the Chinese population with altered location and age distribution in the past ten years.
基金Supported by Scientific Research Fund of Army of China,No.14BJZ01
文摘AIM To evaluate the advantages of endoscopic ultrasound(EUS) in the assessment of detailed structures of pancreatic cystic neoplasms(PCNs) compared to computed tomography(CT) and magnetic resonance imaging(MRI).METHODS All patients with indeterminate PCNs underwent CT, MRI, and EUS. The detailed information, including size, number, the presence of a papilla/nodule, the presence of a septum, and the morphology of the pancreatic duct of PCNs were compared among the three imaging modalities. The size of each PCN was determined using the largest diameter measured. A cyst consisting of several small cysts was referred to as a motherdaughter cyst. Disagreement among the three imaging modalities regarding the total number of mother cysts resulted in the assumption that the correct number was the one in which the majority of imaging modalities indicated.RESULTS A total of 52 females and 16 males were evaluated. The median size of the cysts was 42.5 mm by EUS, 42.0 mm by CT and 38.0 mm by MRI; there was no significant difference in size as assessed among the three imaging techniques. The diagnostic sensitivity and ability of EUS to classify PCNs were 98.5%(67/68) and 92.6%(63/68), respectively. These percentages were higher than those of CT(73.1%, P < 0.001; 17.1%, P < 0.001) and MRI(81.3%, P = 0.001; 20.3%, P < 0.001). EUS was also able to better assess the number of daughter cysts in mother cysts than CT(P = 0.003); however, there was no significant difference between EUS and MRI in assessing mother-daughter cysts(P = 0.254). The papilla/nodule detection rate by EUS was 35.3%(24/68), much higher than those by CT(5.8%, 3/52) and MRI(6.3%, 4/64). The detection rate of the septum by EUS was 60.3%(41/68), which was higher than those by CT(34.6%, 18/52) and by MRI(46.9%, 30/64); the difference between EUS and CT was significant(P = 0.02). The rate of visualizing the pancreatic duct using EUS was 100%, whereas using CT and MRI it was less than 10%.CONCLUSION EUS helps visualize the detailed structures of PCNs and has many advantages over CT and MRI. EUS is valuable in the diagnosis and assessment of PCNs.
基金Project(2013HH100055) supported by the Basic Research and Science and Technology Innovation Fund of Foshan City,China
文摘Hot compression tests in the temperature range of 340-450 ℃ and strain rate range of 0.001-1 s^-1 of spray-formed 7055 aluminum alloy were carried out to study its hot deformation behavior. Three phenomenological models including Johnson-Cook, modified Fields-Backofen and Arrhenius-type were introduced to predict the flow stresses during the compression process. And then, a comparative predictability of the phenomenological models was estimated in terms of the relative errors, correlation coefficient(R), and average absolute relative error(AARE). The results indicate that Johnson-Cook model and modified Fields-Backofen model cannot well predict the hot deformation behavior due to the large deviation in the process of line regression fitting. Arrhenius-type model obtains the best fit through combining the effect of strain rate and temperature.
文摘AIM:To identify the determinants of endoscopic submucosal dissection(ESD) operation time.METHODS:This investigation was conducted as a single-center,prospective study in which ESD was performed by the same endoscopist at the Chinese PLA General Hospital.A total of 173 patients underwent ESD operations performed by Dr.Lu from July 2007 to December 2011,and 183 lesions were enrolled.Patient gender,age,tumor location,gross type,tumor size,pathological type and adhesions were recorded prospectively.The order of treatment represented the experience of the operator.Univariate analysis and multivariate analysis were performed to evaluate the relationships between these factors and ESD procedure time.RESULTS:Univariate analysis showed the ESD time was closely related to the gender(P = 0.0210),tumor size(P < 0.0001),location(P < 0.0001),gross type(P < 0.0001) and adhesion(P = 0.0010).The surgical proficiency level was associated with ESD time in unit area(P < 0.0001).Multivariate analysis revealed that the ESD time was positively correlated with tumor size(P < 0.0001),adhesion(P < 0.0001) and location(P < 0.0001),but negatively correlated with surgical proficiency level(P = 0.0046).CONCLUSION:Large tumor size,adjacency to the cardia,and adhesion are predictors of a long ESD time,whereas high surgical proficiency level predicts a short ESD time.
基金Supported by Chinese Postdoctoral Science Foundation,Grant 2012T50868
文摘AIM:To measure in vitro diameter of imitational varices using a self-made endoscopic scale and confirm its accuracy and clinical feasibility.METHODS:A catheter was introduced into the endoscopeaccessory channel and attached to a zebra wire guide that was used as a stylet.The wire guide was fixed onto the tip of the catheter by a soft and thin string.By gently advancing the stylet into the catheter,the width of the opening loop at the tip of the endoscope approximated the diameter of the imitational varices.Measurements performed in vitro using this self-made endoscopic ruler were compared to measurements of simulative varices.RESULTS:At the handle,the sleeve moving distance ranged from 5 to 14 mm.There was no obvious proportional relationship between the sleeve movement distance and endoscopic measurement ruler.The results indicated that the gap between the endoscopic measurement and actual measurement of the object size tended to close.The in vitro measurement of the diameter of the simulative varices showed that the two kinds of measuring methods were not significantly different with respect to their accuracy(P=0.8499).CONCLUSION:In vitro experiments confirmed that using a self-designed endoscopic ruler to measure the diameter of simulative varices was objective,accurate and feasible.
基金financial support of project on reliability and life research of typical components in rail trains (K10TZ20P0500) of CRRC Zhuzhou Electric Locomotive Research Institute.
文摘To get a full understanding of hot extrusion,solid solution treatment and aging process on the Al−0.56Mg−0.63Si alloy,the microstructure and mechanical properties of a U-shaped profile were studied through optical microscopy,scanning electrical microscopy,transmission electrical microscopy,hardness,and tensile tests.The coarse equiaxed grains existed near the profile edge as a result of the dynamic recrystallization nucleation and exceeding growth during hot extrusion.The fibrous deformed and sub-structured grains located between the two coarse grain layers,due to the occurrence of work-hardening and dynamic recovery.Perpendicular needle β′′precipitates were distributed inside the grain,and obvious precipitates-free zone appeared after aging treatment.The tensile strength,yield strength and elongation of the aged Al−Mg−Si alloy U-shaped profile were no less than 279.4 MPa,258.6 MPa,and 21.6%,respectively.The fracture morphology showed dimple rupture characteristics.The precipitates and grain boundaries played key role in the strengthening contribution.
基金Supported by National Key R and D Program of China,No. 2016YFC1303601。
文摘BACKGROUND Pancreatic adenoma can potentially transform into adenocarcinoma, so it is recommended to be resected surgically or endoscopically. Endoscopic papillectomy is one of the main treatments for papillary adenoma, and bleeding, perforation, and pancreatitis are the most frequent and critical adverse events that restrict its wider use. There is no standard procedure for endoscopic papillectomy yet. The procedure is relevant to postoperative adverse events.AIM To reduce the postoperative adverse event rates and improve patients' postoperative condition, we developed a standard novel procedure for endoscopic papillectomy.METHODS The novel endoscopic papillectomy had two main modifications based on the conventional method: The isolation of bile from pancreatic juice with a bile duct stent and wound surface protection with metal clips and fibrin glue. We performed a single-center retrospective comparison study on the novel and conventional methods to examine the feasibility of the novel method for reducing postoperative adverse events.RESULTS A total of 76 patients, of whom 23 underwent the novel procedure and 53 underwent the conventional procedure, were retrospectively evaluated in this study. The postoperative bleeding and pancreatitis rates of the novel method were significantly lower than those of the conventional method(0 vs 20.75%, P = 0.028, and 17.4% vs 41.5%, P = 0.042, respectively). After applying the novel method, the most critical adverse event, perforation, was entirely prevented, compared to a prevalence of 5.66% with the conventional method. Several postoperative symptoms, including fever, rapid pulse, and decrease in hemoglobin level, were significantly less frequent in the novel group(P = 0.042, 0.049, and 0.014, respectively). Overall, the total adverse event rate of the novel method was lower(0 vs 24.5%, P = 0.007) than that of the conventional method.CONCLUSION Patients who underwent the novel procedure had lower postoperative adverse event rates. This study demonstrates the potential efficacy and safety of the novel endoscopic papillectomy in reducing postoperative adverse events.
文摘AIM To evaluate the diagnostic value and safety mainly regarding incidents of endoscopic ultrasound-guided fine-needle aspiration(EUS-FNA) for pancreatic cystic lesions(PCLs).METHODS A total of 150 consecutive patients with suspected PCLs were prospectively enrolled from April 2015 to November 2016. We finally enrolled 140 patients undergoing EUS-FNA. We compared the diagnostic accuracy of EUS-FNA and pathological diagnosis, which is regarded as the gold standard, for PCLs. Patients undergoing EUS-FNA at least 1 wk preoperatively were monitored for incidents and adverse events to evaluate its safety.RESULTS There were 88(62.9%) women and 52(37.1%) men among 140 patients, with a mean age of 50.1(± 15.4) years. There were 67 cysts located in the head/uncinate of the pancreas and 67 in the body/tail, and 6 patients had at least 1 cyst in the pancreas. There were 75 patients undergoing surgery and 55 undergoing EUS-FNA with interval at least 1 wk before other operations, with 3 patients undergoing the procedure twice. The accuracy of EUS-FNA in differentiating benign and malignant lesions was 97.3%(73/75), while the accuracy of characterizing PCL subtype was 84.0%(63/75). The incident rate was 37.9%(22/58), whereas only 1 AE was observed in 58 cases.CONCLUSION EUS-FNA is effective and safe for diagnosis of PCLs, however procedure-related incidents are common. Caution should be taken in patients undergoing EUSFNA.
文摘BACKGROUND The management strategies for recurrent ampullary adenoma after endoscopic papillectomy are still controversial.Patients with the recurrent papillary lesions need to receive repetitive endoscopic interventions due to the limitations of conventional endoscopic techniques.AIM To assess the feasibility,efficacy,and safety of hybrid endoscopic submucosal dissection(ESD)by duodenoscope for recurrent,laterally spreading papillary lesions.METHODS We enrolled two patients with recurrent,laterally spreading,duodenal papillary adenomas with no intraductal extension confirmed by follow-up between March 2017 and September 2018.After marking the resection borders of the lesion using a dual knife,a submucosal cushion was created by injecting a mixture of saline solution,methylene blue,and adrenaline.A total circumferential incision and submucosal excision was performed by dual knife combined with insulated-tip diathermic knife,and then the lesion was ligated and resected using an electric snare.Endoscopic hemostasis was applied during the endoscopic procedures.Moreover,the endoscopic retrograde cholangiopancreatography(ERCP)procedures,including selective cannulation and stent implantation of biliary and pancreatic ducts,were performed.Additionally,we performed endoclip closure for mucosal defect after ESD.RESULTS Hybrid ESD using a duodenoscope and biliary and pancreatic stent placement were performed successfully in two patients.The endoscopic size of recurrent papillary lesions was no more than 2 cm.Generally,the average total procedure time was 95.5 min,and the procedure time of ESD and ERCP was 38.5 min and 15.5 min,respectively.No serious complications occurred during the intraoperative and postoperative periods.The histopathological examination revealed tubulovillous adenoma negative for neoplastic extension at the cut margin in both patients.The duodenoscopic follow-up and histopathology of biopsy specimens at 3 mo after ESD showed no residual or recurrent lesions in ampullary areas in both cases.Both cases have been followed up with no recurrence to June 2020.CONCLUSION Hybrid ESD by duodenoscope is technically challenging,and may be curative for recurrent,laterally spreading papillary adenomas<2 cm.It should be performed cautiously in selected patients by experienced endoscopists.
文摘BACKGROUND Endoscopic drainage of walled-off necrosis(WON) is still a challenge due to stentassociated problems. We explored endoscopic gastric fenestration(EGF) as an innovative alternative intervention.AIM To assess the feasibility, efficacy and safety of EGF for WON.METHODS Between March 2019 and March 2020, five patients with symptomatic WON in close contact with the stomach wall were treated by EGF. Endoscopic ultrasound(EUS) was used to select appropriate sites for gastric fenestration, which then proceeded layer by layer as in endoscopic submucosal dissection. Both the stomach muscularis propria and pseudocyst capsule were penetrated. Fenestrations were expanded up to 1.5-3 cm for drainage or subsequent necrosectomy.RESULTS EGF failed in Case 1 due to nonadherence of WON to the gastric wall. EGF was successfully implemented in the other four cases by further refinement of fenestration site selection according to computed tomography, endoscopy and EUS features. The average procedure time for EGF was 124 min(EUS assessment, 32.3 min;initial fenestration, 28.8 min;expanded fenestration, 33 min), and tended to decrease as experience gradually increased. The diameter of the fenestration site was 1.5-3 cm, beyond the caliber of a lumen-apposing metal stent(LAMS), to ensure effective drainage or subsequent necrosectomy. Fenestration sites showed surprising capacity for postoperative self-healing within 1-3 wk. No EGF-related complications were seen. WON disappeared within 3 wk after EGF. In Case 3, another separate WON, treated by endoscopic LAMS drainage, recurred within 4 d after LAMS removal due to stent-related hemorrhage, and resolved slowly over almost 3 mo. No recurrences were observed in the five patients.CONCLUSION EGF is an innovative and promising alternative intervention for WON adherent to the gastric wall. The challenge resides in the gauging of actual adherence and in selecting appropriate fenestration sites.
基金supported by the National Natural Science Foundation of China(81971515 and 81973290)CAMS Innovation Fund for Medical Sciences(2016-I2M-3-011 and 2016-I2M-1-003)+4 种基金the Beijing Key Laboratory of Non-Clinical Drug Metabolism and PK/PD study(Z141102004414062)the National Megaproject for Innovative Drugs(2018ZX09711001-002-002)Beijing Natural Sciences Fund Key Projects(7181007)the Fundamental Research Fund for Central Universities of Peking Union Medical College(3332020037)Beijing Municipal Administration of Hospitals Clinical Medicine Development of Special Funding Support(ZYLX201826)。
文摘Due to the worldwide epidemic of allergic disease and a cure nowhere in sight,there is a crucial need to explore its pathophysiological mechanisms.As allergic disease has been associated with gut dysbiosis,we searched for a possible mechanism from the perspective of the molecular interface between host and microbiota with concurrent metabolomics and microbiome composition analysis.Sprague-Dawley rats were injected with Artemisia pollen extract to stimulate a hyper reaction to pollen.This hyper reaction decreased the circulation of valine,isoleucine,aspartate,glutamate,glutamine,indole-propionate(IPA),and myo-inositol,and reduced short-chain fatty acids(SCFAs)in feces.Several beneficial genera belonging to Ruminococcaceae,Lachnospiraceae,and Clostridiales declined in the model group,whereas Helicobacter and Akkermansia were only expressed in the model group.Furthermore,the expression of intestinal claudin-3 and liver fatty acid binding protein was downregulated in the model group and associated with metabolic changes and bacteria.Our results suggest that alterations in amino acids as well as their derivatives(especially valine,and IPA which is the reductive product of tryptophan),SCFAs,and the gut microbiome(specifically Akkermansia and Helicobacter)may disrupt the intestinal barrier function by inhibiting the expression of claudin proteins and affecting the mucus layer,which further results in hay fever.
文摘BACKGROUND: The lack of widely-accepted guidelines for acute cholangitis largely lags behind the progress in medical and surgical technology and science for the management of acute cholangitis. This study aimed to verify the Tokyo guidelines for the management of acute cholangitis and cholecystitis of 2007 edition (TG07) in patients with obstructive cholangitis due to benign and malignant diseases. METHODS: The patients were retrieved from our existing ERCP database. Final diagnosis of acute cholangitis was made by detecting purulent bile during biliary drainage. We examined and compared the guidelines concerning benign and malignant obstruction. RESULTS: In 120 patients in our study, 82 and 38 had benign and malignant biliary obstruction, respectively. Guidelines based diagnosis was made in 68 (82.9%), 36 (94.7%), and 104 (86.7%) patients with benign, malignant, and overall biliary obstruction, respectively, which were significantly higher than 44 (53.7%), 17 (44.7%), and 61 (50.8%) diagnosed by Charcot’s triad (P【0.001). Treatment consistent with the guidelines was offered to 58 (70.7%) patients with benign obstruction and15 (39.5%) patients with malignant obstruction (P=0.001). No significant association was observed between clinical compliance, guidelines-based severity grades and clinical outcomes. In the multivariate model, intrahepatic obstruction (OR=11.2, 95% CI: 1.55-226.9) and hypoalbuminemia (≤25.0 g/L; OR=17.3, 95% CI: 3.5-313.6) were independent risk factors for a 30-day mortality. CONCLUSIONS: The TG07 are more reliable than Charcot’s triad for the diagnosis of acute cholangitis albeit with limited prognostic values. Intrahepatic obstruction and hypoalbuminemia are new predictors of poor prognosis and need further assessment.
基金funded by a grant (No.21ZYJDJC00080) from the Tianjin Committee of Science and Technology of Chinathe National Key Research and Development Project of China (No.2018YFC1707904,2018YFC1707905,and 2018YFC1707403)the Important Drug Development Fund,Ministry of Science and Technology of China (No.2018ZX09735-002).
文摘Solanum lyratum is one of the temperate plants,broadly distributed in Korea,China,Japan,India,and South-East Asia and well-documented in those oriental ethnic medicine systems for curing cancers,jaundice,edema,gonorrhea,cholecystitis,phlogosis,rheumatoid arthritis,etc.This review systematically summarized the research progress on S.lyratum respecting the botany,traditional uses,phytochemistry,pharmacology,and toxicology to increase people’s in-depth understanding of this plant,by data retrieval in a series of online or off-line electronic databases as far as we can reach.Steroidal saponins and alkaloids,terpenoids,nitrogenous compounds,and flavonoid compounds are the main chemical constituents in S.lyratum.Among them,steroidal alkaloids and saponins are the major active ingredi-ents ever found in S.lyratum,exerting activities of anti-cancer,anti-inflammation,anti-microbial,anti-allergy,and anti-oxidation in vivo or in vitro.As a result,S.lyratum has been frequently prescribed for the abovementioned therapeutic purposes,and there are substantial traditional and modern shreds of evidence of its use.
文摘For the source limitations and vulnerabilities of the sensor nodes of Wireless Sensor Networks, we propose the new kind of dynamic key protocol for wireless sensor network, using the unidirection of hash function and the thinking of Hill to study the dynamic key matrix. Through theoretical analysis of some aspects, our method can promote security, connectivity expansibility;the results show that this protocol reduces storage space and communication energy consumption also.
基金financially supported by the Science and Technology Major Project of Henan Province (No.221100230300)。
文摘Vortex beams have attracted great attention due to their promising applications in the fields of high-capacity optical communication,optical micromanipulation,and quantum information processing.Here,we demonstrate vortex beams with flexible control of the topological charge and modes in a carbon dots random laser for the first time.Vortex beams with different types,including the Laguerre-Gaussian(LG),Bessel-Gaussian(BG),LG-superposition,and polarized vortex beams with topological charges up to 50,have been successfully achieved.Moreover,vortex beams can be well realized in carbon dots random lasers with different emission wavelengths covering from 465 to 612 nm.This work would not only enrich the types of vortex laser,especially for solution-processable lasers,but also provide a new route to realizing multicolor and wavelength-tunable vortex lasers.