Left inferior phrenic arterial malformation mimicking gastric varices: A case report and review of literature

BACKGROUND Gastric submucosal arterial dilation resulting from splenic artery occlusion represents an exceedingly rare etiology of acute upper gastrointestinal bleeding(UGIB).Although endoscopy is a widely utilized diagnostic and therapeutic modality for gastrointestinal bleeding,it has limitations in detecting arterial abnormalities.CASE SUMMARY This report presents a rare case of massive UGIB in a 57-year-old male with a tortuous left inferior phrenic artery accompanied by splenic artery occlusion.“Gastric varices”was identified during the patient's endoscopy one year before hemorrhage.Despite initial hemostasis by endoscopic clipping,the patient experienced massive rebleeding after one month,requiring intervention with transcatheter arterial embolization(TAE)to achieve hemostasis.CONCLUSION This is the first case to report UGIB due to a tortuous left inferior phrenic artery.This case highlights the limitations of endoscopy in identifying arterial abnormalities and emphasizes the potential of TAE as a viable alternative for the management of arterial bleeding in the gastrointestinal tract.

重大决策中专家是中立的吗?——对京津冀协同发展中专家社会稳定风险感知的分析

【问题】在重大决策风险评估中,专家的风险感知对科学决策至关重要。对专家的定义常隐含着中立客观的预设,但现实中专家群体内部也存在不同身份角色,不同群体专家社会稳定风险感知背后的差异性影响因素是什么?【方法】论文对参与京津冀协同发展社会稳定风险评估的专家进行问卷调查,采用目标式抽样获取有效样本207个,使用Bootstrap分组回归分析数据。【发现】作为政策目标群体的学者型专家与作为政策执行者的官员型专家的风险感知在政民互动、专业认知度因素上有显著差异性。官员型专家的社会稳定风险感知主要受现实风险特征因素影响,而学者型专家主要受信息公开及政策进展了解度等社会文化因素影响。【结论】论文打破了对专家的中立预设,并将对风险感知群体差异的研究向前推进。应全面理解专家在重大决策中的角色,建设更加科学有效的专家库。

Astragaloside Ⅳ inhibits pathological functions of gastric cancer-associated fibroblasts

AIM To investigate the inhibitory effect of astragaloside IV on the pathological functions of cancer-associated fibroblasts,and to explore the underlying mechanism.METHODS Paired gastric normal fibroblast(GNF) and gastric cancer-associated fibroblast(GCAF) cultures were established from resected tissues. GCAFs were treated with vehicle control or different concentrations of astragaloside Ⅳ. Conditioned media were prepared from GNFs,GCAFs,control-treated GCAFs,and astragaloside Ⅳ-treated GCAFs,and used to culture BGC-823 human gastric cancer cells. Proliferation,migration and invasion capacities of BGC-823 cells were determined by MTT,wound healing,and Transwell invasion assays,respectively. The action mechanism of astragaloside Ⅳ was investigated by detecting the expression of micro RNAs and the expression and secretion of the oncogenic factor,macrophage colonystimulating factor(M-CSF),and the tumor suppressive factor,tissue inhibitor of metalloproteinase 2(TIMP2),in different groups of GCAFs. The expression of the oncogenic pluripotency factors SOX2 and NANOG in BGC-823 cells cultured with different conditioned media was also examined.RESULTS GCAFs displayed higher capacities to induce BGC-823 cell proliferation,migration,and invasion than GNFs(P < 0.01). Astragaloside Ⅳ treatment strongly inhibited the proliferation-,migration-and invasion-promoting capacities of GCAFs(P < 0.05 for 10 μmol/L,P < 0.01 for 20 μmol/L and 40 μmol/L). Compared with GNFs,GCAFs expressed a lower level of micro RNA-214(P < 0.01) and a higher level of micro RNA-301 a(P < 0.01). Astragaloside Ⅳ treatment significantly upregulated micro RNA-214 expression(P < 0.01) and down-regulated micro RNA-301 a expression(P < 0.01) in GCAFs. Reestablishing the micro RNA expression balance subsequently suppressed M-CSF production(P < 0.01) and secretion(P < 0.05),and elevated TIMP2 production(P < 0.01) and secretion(P < 0.05). Consequently,the ability of GCAFs to increase SOX2 and NANOG expression in BGC-823 cells was abolished by astragaloside Ⅳ.CONCLUSION Astragaloside Ⅳ can inhibit the pathological functions of GCAFs by correcting their dysregulation of micro RNA expression,and it is promisingly a potent therapeutic agent regulating tumor microenvironment.

Interaction between Schwann cells and other cells during repair of peripheral nerve injury

Peripheral nerve injury(PNI)is common and,unlike damage to the central nervous system injured nerves can effectively regenerate depending on the location and severity of injury.Peripheral myelinating glia,Schwann cells(SCs),interact with various cells in and around the injury site and are important for debris elimination,repair,and nerve regeneration.Following PNI,Wallerian degeneration of the distal stump is rapidly initiated by degeneration of damaged axons followed by morphologic changes in SCs and the recruitment of circulating macrophages.Interaction with fibroblasts from the injured nerve microenvironment also plays a role in nerve repair.The replication and migration of injury-induced dedifferentiated SCs are also important in repairing the nerve.In particular,SC migration stimulates axonal regeneration and subsequent myelination of regenerated nerve fibers.This mobility increases SC interactions with other cells in the nerve and the exogenous environment,which influence SC behavior post-injury.Following PNI,SCs directly and indirectly interact with other SCs,fibroblasts,and macrophages.In addition,the inter-and intracellular mechanisms that underlie morphological and functional changes in SCs following PNI still require further research to explain known phenomena and less understood cell-specific roles in the repair of the injured peripheral nerve.This review provides a basic assessment of SC function post-PNI,as well as a more comprehensive evaluation of the literature concerning the SC interactions with macrophages and fibroblasts that can influence SC behavior and,ultimately,repair of the injured nerve.

Effect of lentiviral vector-mediated overexpression of hypoxia-inducible factor 1 alpha delivered by pluronic F-127 hydrogel on brachial plexus avulsion in rats

Brachial plexus avulsion often results in massive motor neuron death and severe functional deficits of target muscles. However, no satisfactory treatment is currently available. Hypoxia-inducible factor 1α is a critical molecule targeting several genes associated with ischemia-hypoxia damage and angiogenesis. In this study, a rat model of brachial plexus avulsion-reimplantation was established, in which C5–7 ventral nerve roots were avulsed and only the C6 root reimplanted. Different implants were immediately injected using a microsyringe into the avulsion-reimplantation site of the C6 root post-brachial plexus avulsion. Rats were randomly divided into five groups: phosphate-buffered saline, negative control of lentivirus, hypoxia-inducible factor 1α(hypoxia-inducible factor 1α overexpression lentivirus), gel(pluronic F-127 hydrogel), and gel + hypoxia-inducible factor 1α(pluronic F-127 hydrogel + hypoxia-inducible factor 1α overexpression lentivirus). The Terzis grooming test was performed to assess recovery of motor function. Scores were higher in the hypoxia-inducible factor 1α and gel +hypoxia-inducible factor 1α groups(in particular the gel + hypoxia-inducible factor 1α group) compared with the phosphate-buffered saline group. Electrophysiology, fluorogold retrograde tracing, and immunofluorescent staining were further performed to investigate neural pathway reconstruction and changes of neurons, motor endplates, and angiogenesis. Compared with the phosphate-buffered saline group, action potential latency of musculocutaneous nerves was markedly shortened in the hypoxia-inducible factor 1α and gel + hypoxia-inducible factor1α groups. Meanwhile, the number of fluorogold-positive cells and ChAT-positive neurons, neovascular area(labeled by CD31 around av ulsed sites in ipsilateral spinal cord segments), and the number of motor endplates in biceps brachii(identified by α-bungarotoxin) were all visibly increased, as well as the morphology of motor endplate in biceps brachil was clear in the hypoxia-inducible factor 1α and gel + hypoxia-inducible factor 1α groups. Taken together, delivery of hypoxia-inducible factor 1α overexpression lentiviral vectors mediated by pluronic F-127 effectively promotes spinal root regeneration and functional recovery post-brachial plexus avulsion. All animal procedures were approved by the Institutional Animal Care and Use Committee of Guangdong Medical University, China.

Predictive factors associated with gefitinib response in patients with advanced non-small-cell lung cancer(NSCLC)

Purpose： A number of different clinical characteristics have been reported to singly correlate with therapeutic activity of epidermal growth factor receptor （EGFR） tyrosine kinase inhibitors （TKIs） in advanced non-small-cell lung cancer （NSCLC）. This study aimed to identify predictive factors associated with prognostic benefits of gefitinib. Patients and methods： EGFR gene typing in 33 advanced NSCLC patients received gefitinib （250 mg/day） were analyzed with mutant-enriched PCR assay. Gefitinib response was evaluated with potential predictive factors retrospectively. Results： The overall objective response rate （ORR） and median progression-flee survival （PFS） in the 33 patients treated by gefitinib were 45.5% and 3.0 （2.0-4.0） months. The ORR and median PFS in EGFR gene mutation patients were significantly higher/longer than those in EGFR gene wild-type patients （P〈0.01）. Similarly, the ORR and median PFS in non-smoker patients were significantly higher/longer than those in smoker patients （P〈0.05, P〈0.01, respectively）. However, no difference for ORR and median PFS occurred between male and female patients. Logistic multivariate analysis showed that only EGFR mutated gene was significantly associated with the ORR （P〈0.01）. Both EGFR mutated gene and non-smoker were the major factors that contributed to PFS （P〈0.05）. Conclusions： EGFR mutated gene and non-smoker status are potential predictors for gefitinib response in NSCLC patients.

Melatonin combined with chondroitin sulfate ABC promotes nerve regeneration after root-avulsion brachial plexus injury

After nerve-root avulsion injury of the brachial plexus, oxidative damage, inflammatory reaction, and glial scar formation can affect nerve regeneration and functional recovery. Melatonin(MT) has been shown to have good anti-inflammatory, antioxidant, and neuroprotective effects. Chondroitin sulfate ABC(ChABC) has been shown to metabolize chondroitin sulfate proteoglycans and can reduce colloidal scar formation. However, the effect of any of these drugs alone in the recovery of nerve function after injury is not completely satisfactory. Therefore, this experiment aimed to explore the effect and mechanism of combined application of melatonin and chondroitin sulfate ABC on nerve regeneration and functional recovery after nerve-root avulsion of the brachial plexus. Fifty-two Sprague-Dawley rats were selected and their C5–7 nerve roots were avulsed. Then, the C6 nerve roots were replanted to construct the brachial plexus nerve-root avulsion model. After successful modeling, the injured rats were randomly divided into four groups. The first group(injury) did not receive any drug treatment, but was treated with a pure gel-sponge carrier nerve-root implantation and an ethanol-saline solution via intraperitoneal(i.p.) injection. The second group(melatonin) was treated with melatonin via i.p. injection. The third group(chondroitin sulfate ABC) was treated with chondroitin sulfate ABC through local administration. The fourth group(melatonin + chondroitin sulfate ABC) was treated with melatonin through i.p. injection and chondroitin sulfate ABC through local administration. The upper limb Terzis grooming test was used 2–6 weeks after injury to evaluate motor function. Inflammation and oxidative damage within 24 hours of injury were evaluated by spectrophotometry. Immunofluorescence and neuroelectrophysiology were used to evaluate glial scar, neuronal protection, and nerve regeneration. The results showed that the Terzis grooming-test scores of the three groups that received treatment were better than those of the injury only group. Additionally, these three groups showed lower levels of C5–7 intramedullary peroxidase and malondialdehyde. Further, glial scar tissue in the C6 spinal segment was smaller and the number of motor neurons was greater. The endplate area of the biceps muscle was larger and the structure was clear. The latency of the compound potential of the myocutaneous nerve-biceps muscle was shorter. All these indexes were even greater in the melatonin + chondroitin sulfate ABC group than in the melatonin only or chondroitin sulfate ABC only groups. Thus, the results showed that melatonin combined with chondroitin sulfate ABC can promote nerve regeneration after nerve-root avulsion injury of the brachial plexus, which may be achieved by reducing oxidative damage and inflammatory reaction in the injury area and inhibiting glial scar formation.

Excellent mechanical properties and resistance to cavitation erosion for an ultra-low carbon Cr Mn N stainless steel through quenching and partitioning treatment

The retained austenite content(RAC),the mechanical properties,and the resistance to cavitation erosion(CE)of the00Cr13Mn8Mo N steel after quenching and partitioning(Q&P)processing were investigated.The results show that the Q&P process affected the RAC,which reached the maximum value after partitioning at 400°C for 10 min.The tensile strength of the steel slightly decreased with increasing partitioning temperature and time.However,the elongation and product of strength and elongation first increased and then decreased.The sample partitioned at 400°C for 10 min exhibited the optimal property:a strength-ductility of 23.8 GPa?%.The resistance to CE for the 00Cr13Mn8Mo N steel treated by the Q&P process was improved due to work hardening,spalling,and cavitation-induced martensitic transformation of the retained austenite.

Evolution of carbides and carbon content in matrix of an ultra-high carbon sintered steel during heat treatment process

DTA, thermal expansion, XRD, and SEM were used to evaluate the effect of quenching temperature on the mechanical properties and microstructure of a novel sintered steel Fe-6Co-1Ni-5Cr-5Mo-1C. Lattice parameters and the mass fraction of carbon dissolved in the matrix of the steel quenched were investigated. It is discovered that the hardness of the steel increases with quenching temperature in the range of 840-900℃ and remains constant in the range of 900 to 1100℃. It decreases rapidly when the temperature is higher than 1100℃. The mass fraction of carbon dissolved in the matrix of the steel quenched at 840℃ is 0.38, but when the quenching temperature is increased to 1150℃, it increases to 0.98. The carbides formed during sintering are still present at grain boundaries and in the matrix of the steel quenched at low quenching temperatures, such as 840℃. When the quenching temperature is increased to 1150℃, most of the carbides at grain boundaries are dissolved with just a small amount of spherical M23C6 existing in the matrix of the quenched steel.

Vasopressin decreases neuronal apoptosis during cardiopulmonary resuscitation

The American Heart Association and the European Resuscitation Council recently recommend- ed that vasopressin can be used for cardiopulmonary resuscitation, instead of epinephrine. However, the guidelines do not discuss the effects of vasopressin during cerebral resuscitation. In this study, we intraperitoneally injected epinephrine and/or vasopressin during cardiopul- monary resuscitation in a rat model of asphyxial cardiac arrest. The results demonstrated that, compared with epinephrine alone, the pathological damage to nerve cells was lessened, and the levels of c-Iun N-terminal kinase and p38 expression were significantly decreased in the hippo- campus after treatment with vasopressin alone or the vasopressin and epinephrine combination. No significant difference in resuscitation effects was detected between vasopressin alone and the vasopressin and epinephrine combination. These results suggest that vasopressin alone or the vasopressin and epinephrine combination suppress the activation of mitogen-activated protein kinase and c-Iun N-terminal kinase signaling pathways and reduce neuronal apoptosis during cardiopulmonary resuscitation.

Grain boundary segregation of minor arsenic and nitrogen at elevated temperatures in a microalloyed steel

Auger electron spectroscopy （AES） was used to investigate the grain boundary segregation of arsenic and nitrogen in a kind of microalloyed steel produced by a compact strip production （CSP） technology at 950 to 1100℃, which are similar to the hot working temperature of the steel on a CSP production line. It was discovered that arsenic segregated on grain boundaries when the steel was annealed at 950℃ for 2 h. When the annealing temperature increased to 1100℃, arsenic was also found to have segregated on grain boundaries in the early annealing stage, for instance, within the first 5 min annealing time. However, if the holding time of the steel at this temperature increased to 2 h, arsenic diffused away from grain boundaries into the matrix again. Nitrogen was not found to have segregated on grain boundaries when the steel was annealed at a relatively low temperature, such as 950℃. But when the annealing temperature increased to 1100℃, nitrogen was detected to have segregated at grain boundaries in the steel.

Salvianolic acid B protects the myelin sheath around injured spinal cord axons

Salvianolic acid B,an active pharmaceutical compound present in Salvia miltiorrhiza,exerts a neuroprotective effect in animal models of brain and spinal cord injury.Salvianolic acid B can promote recovery of neurological function;however,its protective effect on the myelin sheath after spinal cord injury remains poorly understood.Thus,in this study,in vitro tests showed that salvianolic acid B contributed to oligodendrocyte precursor cell differentiation,and the most effective dose was 20 μg/m L.For in vivo investigation,rats with spinal cord injury were intraperitoneally injected with 20 mg/kg salvianolic acid B for 8 weeks.The amount of myelin sheath and the number of regenerating axons increased,neurological function recovered,and caspase-3 expression was decreased in the spinal cord of salvianolic acid B-treated animals compared with untreated control rats.These results indicate that salvianolic acid B can protect axons and the myelin sheath,and can promote the recovery of neurological function.Its mechanism of action is likely to be associated with inhibiting apoptosis and promoting the differentiation and maturation of oligodendrocyte precursor cells.

Trigger finger at the wrist caused by an intramuscular lipoma within the carpal tunnel:A case report

BACKGROUND Trigger finger at the wrist,which occurs with finger movement,is an uncommon presentation.Few reports describing cases of trigger finger at the wrist have been published.Thus,we present a case of an intramuscular lipoma arising from an anomalous flexor digitorum muscle belly in a 48-year-old female patient causing painful finger triggering at the wrist and carpal tunnel syndrome(CTS).CASE SUMMARY A 48-year-old woman with complaints of a catching sensation during wrist motion and a progressive tingling sensation on the palmar aspect of the right hand for approximately 2 years was referred to our hospital.Triggering of the index to middle finger was evident with a palpable and audible clunk over the carpal tunnel during passive motion.Tinel’s sign was positive over the carpal tunnel of the right wrist with a positive Phalen’s test.Nerve conduction studies of the median nerve demonstrated a right CTS.Ultrasound examination revealed a 2.5 cm×2.0 cm subcutaneous hyperechoic mass with no obvious blood flow at the wrist of the right arm.Surgical excision of the tumor and muscle mass led to a resolution of the patient’s symptoms,and any triggering or discomfort disappeared.The patient has had no evidence of recurrence at more than 1 year of follow-up.CONCLUSION Triggering of the fingers at the wrist is rare. It must be noted that there are manypossible causes and types of triggering or clicking around the wrist. Accuratediagnosis is mandatory to avoid inaccurate treatment of patients with triggerwrist. During the diagnosis and treatment of CTS, attention should be paid to thevariation of tendon tissue in the carpal tunnel, to avoid only focusing on therelease of transverse carpal ligament and ignoring the removal of anomalousmuscle belly.

A Broadcast Storm Detection and Treatment Method Based on Situational Awareness

At present,the research of blockchain is very popular,but the practical application of blockchain is very few.The main reason is that the concurrency of blockchain is not enough to support application scenarios.After that,applications such as Intervalue increase the concurrency of blockchain transactions.However,due to the problems of network bandwidth and algorithm performance,there is always a broadcast storm,which affects the normal use of nodes in the whole network.However,the emergence of broadcast storms needs to rely on the node itself,which may be very slow.Even if developers debug the corresponding code,they cannot conduct an effective test in the whole network.Broadcast storm problem mainly occurs in scenarios with large transaction volume,such as the financial industry.Due to its characteristics,the concurrency of transactions in the financial industry will increase at a certain time.If there is no effective algorithm to deal with it,the broadcast storm will be triggered and the whole network will be paralyzed.To solve the problem of the broadcast storm,this paper combines blockchain,peer-to-peer network,artificial intelligence,and other technologies,and proposes a broadcast storm detection and processing method based on situation awareness.The purpose is to cut off the further spread of broadcast storms from the node itself and maintain the normal operation of the whole network nodes.

The Impact of the News Frames on Report of the 2020 Pandemic in China’s National Media

News frames is a general application of the Frame Theory in journalistic practice,and the setting of the Frame Theory in news media,to some extent,may make the news agency have more choices of the topics,more channels of the report,and more impacts on readers and audiences.It is for this reason that news media are very interested in setting up their news frame to guide their reportage.It won’t be surprised that when important affairs took place,the media set a theme for their coverage;while at the same time,audiences recognized that they are allowed to know the facts as well to evaluate the events properly.The coverage of disaster news is one of the concrete examples.However,when reading the reportage framework of the news in China,it can be seen that media would be likely to set similar frames for the focus of the report,and this potentially created complexity and difficulty in analyzing disaster news events in terms of content classification,reporting form,and news-making on effectiveness.The outbreak of the 2020 COVID-19 gathered media to work on a centralized proposal–anti-epidemic,so that textual,audio-visual contents and other forms of reporting show a diversified perspective for disaster news.This reporting form is a new challenge for Chinese news media,reflected in their practice on how Chinese government and people fought against the virus,how Chinese medical community dispatched their team to assist COVID-19 fight,and how Chinese media responded to the vilification of foreign media during that period.This paper takes three established media Hubei Daily,CCTV and China Daily as examples for an in-depth analysis.

Prediction of Amazon’s Stock Price Based on ARIMA, XGBoost, and LSTM Models

Finding the best model to predict the trend of stock prices is an issue that has always garnered attention,and it is also closely related to investors’investment dynamics.Even the commonly used autoregressive integrated moving average(ARIMA),extreme gradient boosting(XGBoost),and long short-term memory(LSTM)have their own advantages and disadvantages.We use mean squared error(MSE)to judge the most suitable model for predicting Amazon’s stock price from many aspects and find that LSTM is the model with the best fitting effect and the closest to the real curve.However,the LSTM model still needs to improve in terms of performance so as to reduce the bias.We anticipate the discovery of more models that are apt for predicting stocks in the future.

Genomic investigation and nationwide tracking of pediatric invasive nontyphoidal Salmonella in China

Impact Statement。Invasive nontyphoidal Salmonella(iNTS)causes significant concern with~15%morbidity,affecting populations mainly in African countries.

Stable ultraviolet ultrafast laser based on all-polarizationmaintaining fiber femtosecond laser

We report a high-stability ultrafast ultraviolet(UV)laser source at 352 nm by exploring an all-fiber,all-polarizationmaintaining(all-PM),Yb-doped femtosecond fiber laser at 1060 nm.The output power,pulse width,and optical spectrum width of the fiber laser are 6 W,244 fs,and 17.5 nm,respectively.The UV ultrashort pulses at a repetition rate of 28.9 MHz are generated by leveraging single-pass second-harmonic generation in a 1.3-mm-long BiB_(3)O_(6)(BIBO)and sum frequency generation in a 5.1-mm-long BIBO.The maximum UV output power is 596 mW.The root mean square error of the output power of UV pulses is 0.54%.This laser,with promising stability,is expected to be a nice source for frontier applications in the UV wavelength window.

模糊政策为何执行失败——基于A市燃气企业安全生产标准化建设政策的个案研究

在风险社会中,理解如何执行模糊政策是提升国家治理绩效的重要议题。现有研究关注一般情况下的模糊政策执行,但对风险治理领域的模糊政策执行的影响机制缺乏关注。论文通过纵向单案例研究方法,对A市城镇燃气企业安全生产标准化政策执行走向失败的过程进行梳理。研究发现,在强问责情境下,模糊政策将影响官员的避责策略,执行者能力和领导注意力起到调节作用,进而影响政策执行绩效。在避责动机驱动下,当监管责任清晰但政策手段不够清晰时,即使领导不关注,有能力的执行部门也会采取选择性执行策略,降低风险;当监管责任和政策手段模糊,且领导的注意力不足时,执行者会采取不为式避责策略,导致风险失控;当领导关注时,监管责任清晰但是政策手段模糊,无能力的执行者会采取“扔出烫手山芋”策略以推诿责任,当责任无可推诿时,则会选择表面执行,导致风险积累。论文构建了一个避责视角下模糊政策执行的理论框架,为风险治理领域中模糊政策执行提供了启示。

HtrA1丝氨酸蛋白酶在息肉状脉络膜血管病变发病机制中作用的研究进展

息肉状脉络膜血管病变(PCV)是一种以视网膜下橙红色结节样病灶、视网膜色素上皮层下出血性或浆液性脱离为特征的脉络膜新生血管性病变,好发于亚洲人群。关于PCV的确切发病机制尚不明确,通过以往的研究发现HtrA1丝氨酸蛋白酶在PCV的发病过程中起到重要作用。对HtrA1在PCV发病过程中所起作用的探索结果,有助于指导相应的临床治疗。现对相关研究进展进行综述。