Background:Septic shock is a common systemic inflammatory response syndrome for critical patients in the intensive care unit.Ulinastatin is currently used for the treatment of septic shock.Our study sought to evaluate...Background:Septic shock is a common systemic inflammatory response syndrome for critical patients in the intensive care unit.Ulinastatin is currently used for the treatment of septic shock.Our study sought to evaluate the efficacy and safety of ulinastatin in the treatment of septic shock patients.Methods:Three English databases(Embase,Medline,and Cochrane Library)and four Chinese databases(China National Knowledge Infrastructure,Wanfang data,SinoMed,and VIP)were searched for published randomized controlled trials.Stata 16.0 software was used to conduct the meta-analysis.Results:A total of 48 articles were included(Chinese article 47,1 in English).The results show that the treatment of ulinastatin could reduce mortality(risk ratio=0.63,95%confidence interval(CI)(0.55,0.72)),multiple organ dysfunction syndrome(risk ratio=0.6,95%CI(0.53,0.68)),length of intensive care unit stay(mean difference(MD)=-3.92,95%CI(-4.65,-3.18)),length of hospital stay(MD=-4.39,95%CI(-6.63,-2.15))and decrease Acute Physiology and Chronic Health Evaluation II score(MD=-4.55,95%CI(-5.63,-3.47))and Sequential Organ Failure Assessment score(MD=-2.02,95%CI(-2.59,-1.44))with P<0.001.Moreover,it lowers TNF-α(standardized mean difference(SMD)=-1.78,95%CI(-2.24,-1.32)),Interleukin-6(SMD=-1.17,95%CI(-1.55,-0.8)),C reactive protein(SMD=-1.49,95%CI(-1.99,-0.99)),hypersensitive C-reactive protein(SMD=-1.9,95%CI(-2.87,-0.94))and procalcitonin(SMD=-0.89,95%CI(-1.12,-0.67))levels in the body.Conclusions:Available evidence shows that ulinastatin reduces case mortality rate,multiple organ dysfunction syndrome,length of intensive care unit stay,and length of hospital stay and decreases Acute Physiology and Chronic Health Evaluation II score and Sequential Organ Failure Assessment score.Moreover,it also lowers TNF-α,Interleukin-6,C reactive protein,hypersensitive C-reactive protein,and procalcitonin levels in the body.展开更多
Background:Patients with type 2 diabetes are at high risk for developing multiple chronic complications.However,there is a lack of studies of the cumulative number of diabetic complications in China.Methods:A retrospe...Background:Patients with type 2 diabetes are at high risk for developing multiple chronic complications.However,there is a lack of studies of the cumulative number of diabetic complications in China.Methods:A retrospective cohort study was performed from 2009 to 2021.Type 2 diabetes patients who were first diagnosed after the age of 35 years between January 1,2009,and December 31,2017,were included.Five states were defined according to the number of chronic complications:no(S0),one(S1),two(S2),three(S3),and four or more complications(S4).A multi-state Markov model was constructed to estimate transition probability,transition intensity,mean sojourn time,and the possible factors for each state.Results:The study included 32653 type 2 diabetes patients(mean age,59.59 years;15929(48.8%)male),and mean follow-up time of 7.75 years.In all,4375 transitions were observed.The 12-year transition probability of from state S0 to S1 was the lowest at 16.4%,while that from S2 to S3 was the highest,at 45.6%.Higher fasting blood glucose,lower high-density lipoprotein cholesterol,higher total cholesterol,and an unhealthy diet were associated with higher risk of progression from S0 to S1.Being female,less than 60 years old,weekly physical activity,and vegetarian diet decreased this risk.Being female and less than 60 years old reduced the likelihood of transition from S1 to S2,whereas lower high-density lipoprotein cholesterol increased this likelihood.Conclusions:Following the occurrence of two complications in type 2 diabetes patients,the risk for accumulating a third complication within a short time is significantly increased.It is important to take advantage of the stable window period when patients have fewer than two complications,strengthen the monitoring of blood glucose and blood lipids,and encourage patients to maintain good living habits to prevent further deterioration.展开更多
Continuous renal replacement therapy(CRRT)is widely used for treating critically-ill patients in the emergency department in China.Anticoagulant therapy is needed to prevent clotting in the extracorporeal circulation ...Continuous renal replacement therapy(CRRT)is widely used for treating critically-ill patients in the emergency department in China.Anticoagulant therapy is needed to prevent clotting in the extracorporeal circulation during CRRT.Regional citrate anticoagulation(RCA)has been shown to potentially be safer and more effective,and is now recommended as the preferred anticoagulant method for CRRT.However,there is still a lack of unified standards for RCA management in the world,and there are many problems in using this method in clinical practice.The Emergency Medical Doctor Branch of the Chinese Medical Doctor Association(CMDA)organized a panel of domestic emergency medicine experts and international experts of CRRT to discuss RCA-related issues,including the advantages and disadvantages of RCA in CRRT anticoagulation,the principle of RCA,parameter settings for RCA,monitoring of RCA(mainly metabolic acid-base disorders),and special issues during RCA.Based on the latest available research evidence as well as the paneled experts'clinical experience,considering the generalizability,suitability,and potential resource utilization,while also balancing clinical advantages and disadvantages,a total of 16 guideline recommendations were formed from the experts'consensus.展开更多
Grape berry shape is an important agricultural trait.Clarifying its genetic basis is significant for cultivating grape varieties that meet market demands.However,the current study by forward genetics has not achieved ...Grape berry shape is an important agricultural trait.Clarifying its genetic basis is significant for cultivating grape varieties that meet market demands.However,the current study by forward genetics has not achieved in-depth results.Here,a high-density map was constructed to identify quantitative trait loci(QTLs)for berry shape.A total of 358709 polymorphic SNPs were obtained using whole-genome resequencing(WGS)based on 208 F2 individuals derived from round grape‘E42-6’and oblong grape‘Rizamat’.The 1635.65 cM high-density map was divided into 19 linkage groups with an average distance of 0.37 cM.Using this map,three significant QTLs for fruit shape index(ShI:ratio of berry length to berry width)identified over three years were mapped onto LG4 and LG5,including one stable QTL on Chr5 with the genomic region of 0.47–1.94 Mb.Combining with gene annotation and expression patterns based on RNA-seq data from two contrasting F2 individuals with round and oblong berry(their average ShI was 1.89 and 1.10,respectively)at four developmental stages,four candidate genes were selected from the above QTLs.They were mainly involved in DNA replication,cell wall modification,and phytohormone biosynthesis.Further analysis of RNA-seq data revealed that several important phytohormone synthesis and metabolic pathways were enriched based on differentially expressed genes(DEGs),which was consistent with the results of QTL mapping for genes related to plant hormone biosynthesis in the F2 population.Furthermore,a comparison of plant hormone content showed that there were significant differences in IAA and tZ content between the two contrasting F2 individuals at different developmental stages.Our findings provide molecular insights into the genetic variation in grape berry shape.Stable QTLs and their tightly linked markers offer the possibility of marker-assisted selection to accelerate berry shape breeding.展开更多
Geochemical behaviors of heavy metals are closely related to their chemical state that can be divided by sequential extraction into exchangeable(F1),bound to carbonates(F2),bound to Fe-Mn oxides(F3),bound to organic m...Geochemical behaviors of heavy metals are closely related to their chemical state that can be divided by sequential extraction into exchangeable(F1),bound to carbonates(F2),bound to Fe-Mn oxides(F3),bound to organic matter or sulfide(F4),and residual(F5).Uranium in sediment of the Huanghe(Yellow)River,China,in different chemical states was extracted using the five-step procedure of Tessier and the source and sink were analyzed.Results show that more than 70%of the total uranium was immobile residual F5 in abundance,followed in order of F4>F3>F2>F1,indicating that the main source of uranium in the sediments was from weathered rock in the drainage basin.In addition,the uranium in the sediments presents potential exogenous input in the Lanzhou,Baotou,and Tongguan reach.Fe-Mn oxides are main carriers of unstable uranium,especially those of F1 and F3.Calcite and illite are secondary adsorption minerals of unstable uranium in sediments under natural conditions.Human activities can also produce an obvious impact on uranium speciation.This study provides a reference for the application of sequential extraction in analyzing the source and sink of uranium in river sediments.展开更多
Artificial intelligent aided design and manufacturing have been recognized as one kind of robust data-driven and data-intensive technologies in the integrated computational material engi-neering(ICME)era.Motivated by ...Artificial intelligent aided design and manufacturing have been recognized as one kind of robust data-driven and data-intensive technologies in the integrated computational material engi-neering(ICME)era.Motivated by the dramatical developments of the services of China Railway High-speed series for more than a decade,it is essential to reveal the foundations of lifecycle man-agement of those trains under environmental conditions.Here,the smart design and manufacturing of welded Q350 steel frames of CR200J series are introduced,presenting the capability and opportu-nity of ICME in weight reduction and lifecycle management at a cost-effective approach.In order to address the required fatigue life time enduring more than 9×10^(6)km,the response of optimized frames to the static and the dynamic loads are comprehensively investigated.It is highlighted that the maximum residual stress of the optimized welded frame is reduced to 69 MPa from 477 MPa of previous existing one.Based on the measured stress and acceleration from the railways,the fatigue life of modified frame under various loading modes could fulfil the requirements of the lifecycle man-agement.Moreover,our recent developed intelligent quality control strategy of welding process mediated by machine learning is also introduced,envisioning its application in the intelligent weld-ing.展开更多
BACKGROUND This study investigate the anti-tumor effect of curcumin and whether its mediated by hsa_circ_0136666 through miR-1301-3p/CXCL1 in colorectal carcinoma(CRC).Through multiple experiments,we have drawn the co...BACKGROUND This study investigate the anti-tumor effect of curcumin and whether its mediated by hsa_circ_0136666 through miR-1301-3p/CXCL1 in colorectal carcinoma(CRC).Through multiple experiments,we have drawn the conclusion that curcumin inhibited CRC development through the hsa_circ_0136666/miR-1301-3p/CXCL1 axis,hinting at a novel treatment option for curcumin to prevent CRC development.AIM To determine whether hsa_circ_0136666 involvement in curcumin-triggered CRC progression was mediated by sponging miR-1301-3p.METHODS Cell counting kit-8,colony-forming cell,5-ethynyl-2’-deoxyuridine,and flow cytometry assays were carried out to determine cell proliferation,apoptosis,and cell cycle progression.Real-time quantitative polymerase chain reaction quantified hsa_circ_0136666,miR-1301-3p,and chemokine(C-X-C motif)ligand 1(CXCL1),and western blot analysis determined CXCL1,B-cell lymphoma-2(Bcl-2),and Bcl-2 related X protein(Bax)protein levels.CircBank or starbase software was first used for the prediction of miR-1301-3p binding with hsa_circ_0136666 and CXCL1,followed by RNA pull-down,RNA immunoprecipitation,and dualluciferase reporter assay validation.In vivo experiments were implemented in a murine xenograft model.RESULTS Curcumin blocked CRC cell proliferation but boosted apoptosis.Moreover,elevated hsa_circ_0136666 Levels were observed in CRC cells,which were reduced by curcumin.In vitro,hsa_circ_0136666 overexpression abolished the antitumor activity of CRC cells.Mechanical analysis revealed the ability of hsa_circ_0136666 to sponge miR-1301-3p to modulate CXCL1 levels.CONCLUSION Curcumin inhibited CRC development through the hsa_circ_0136666/miR-1301-3p/CXCL1 axis,hinting at a novel treatment option for curcumin to prevent CRC development.展开更多
Background:Coronavirus disease 2019(COVID-19)has now spread to most countries and regions of the world.Risk factors associated with multi-drug resistant organism(MDRO)infections in patients with COVID-19 have not been...Background:Coronavirus disease 2019(COVID-19)has now spread to most countries and regions of the world.Risk factors associated with multi-drug resistant organism(MDRO)infections in patients with COVID-19 have not been well studied yet.In the present study,we aimed to identify the risk factors associated with the MDRO infections and their impact on in-hospital mortality of COVID-19 patients.Methods:This retrospective cohort study was conducted between December 2019 and April 2020 at two tertiary hospitals in Wuhan,China.Data of cases were collected through electronic medical records system.This study was focused on cases with bacterial culture records.Risk factors and outcomes associated with MDRO infections were analyzed using logistic regression model.Results:Of the 2891 patients,370 patients have bacterial culture results,and MDROs were isolated in 38 patients.Respiratory tract infections(67.3%)were the most common hospital acquired infections.Variables independently associated with MDRO infections were dyspnea at admission(odds ratio(OR)4.74;95%confidence interval(CI)2.06-10.88;P<0.001),intensive care unit(ICU)admission(OR 5.02;95%CI 1.99-12.63;P<0.01),and invasive mechanical ventilation(OR 5.13;95%CI 2.15-12.27;P<0.001),adjusted for age and gender.MDROs infection was also a significant risk factor of death for the patients,adjusted for age,gender,severity of illness,ICU admission and mechanical ventilation(OR 1.12,95%CI:0.43-2.96,P=0.817).Conclusion:In our study,dyspnea at admission,ICU admission and invasive mechanical ventilation were associated with the presence of MDRO infections,and clinicians should be alert in MDRO infections in COVID-19 hospitalized patients.展开更多
Objective:The COVID-19 pandemic poses a significant threat to global health.Given the lack of studies on risk factors for COVID-19 progression at present,this study aimed to build a predictive model to predict the pro...Objective:The COVID-19 pandemic poses a significant threat to global health.Given the lack of studies on risk factors for COVID-19 progression at present,this study aimed to build a predictive model to predict the progression risk among hospitalized COVID-19 patients.Methods:We extracted data from 1074 mild and moderate COVID-19 patients from Electronic Health Records(EHRs)in a designated Wuhan hospital including demographic characteristics and clinical and laboratory information.Disease progression was defined as progressing to severe critical illness after admission.The LASSO regression was used to select the predicted variables and a logistic regression model was applied to build the predictive model.Nomogram was used to show the results.Results:Seven variables were included in the predictive model:age per 10 years(OR,1.15;95%CI,1.03-1.29),lactate dehydrogenase(OR,1.73;95%CI,1.14-2.62),neutrophil-to-lymphocyte ratio(OR,2.07;95%CI,1.42-3.02),eosinophil count(OR,2.10;95%CI,1.20-3.69),albumin(OR,2.37;95%CI,1.65-3.45),hemoglobin(OR,1.50;95%CI,1.10-2.05),D-dimer(OR,1.63;95%CI,1.19-2.23).The mean area under the receiver operating characteristic curve of the predictive model was 0.72(95%CI,0.69-0.76).Conclusions:This study built a predictive model that could effectively predict the progression risk among hospitalized COVID-19 patients.展开更多
AIM To find an accurate and simple predictor for postoperative short-term complications after gastrectomy. METHODS Two hundred and twenty-three patients undergoing gastric cancer resection between October 1,2015 and S...AIM To find an accurate and simple predictor for postoperative short-term complications after gastrectomy. METHODS Two hundred and twenty-three patients undergoing gastric cancer resection between October 1,2015 and September 30,2016 were enrolled in this study. Univariate and multivariate analyses were used toidentify risk factors for complications after gastrectomy. The cutoff values and diagnostic accuracy were examined by receiver operating characteristic curves.RESULTS Sixty-two(27.8%) patients had short-term complications after gastric cancer resection. The postoperative decrease in serum albumin(?ALB) was an independent risk factor for complications(OR = 17.957,95%CI: 6.073-53.095,P < 0.001). The cutoff value was 14.0% and the area under the curve was higher than that of C-reactive protein on postoperative day 3(area under the curve: 0.806 vs 0.709). Patients with ?ALB ≥ 14.0% were more likely to have short-term complications after gastrectomy(46.7% vs 5.0%,P < 0.001),prolonged hospital stay(17.2 ± 10.8 d vs 14.1 ± 4.2 d,P = 0.007) and higher comprehensive complication index(P < 0.001) than those with ?ALB < 14.0%.CONCLUSION Postoperative ?ALB with a cutoff of 14.0% can be used to recognize patients who have high risk of short-term complications following gastric cancer resection.展开更多
Many studies have demonstrated that leukoaraiosis is associated with impaired cerebrovascular reserve function. However, the definitive hemodynamic changes that occur in leukoaraiosis are not clear, and there are many...Many studies have demonstrated that leukoaraiosis is associated with impaired cerebrovascular reserve function. However, the definitive hemodynamic changes that occur in leukoaraiosis are not clear, and there are many controversies. This study aimed to investigate hemodynamic changes in symptomatic leukoaraiosis using transcranial Doppler ultrasonography and the breath-holding test in a Chinese Han population, from northern China. A total of 203 patients who were diagnosed with ischemic stroke or clinical chronic progressive ischemic symptoms were enrolled in this study, including 97 males and 106 females, with an age range of 43-93 years. The severity of leukoaraiosis was evaluated according to the Fazekas grading scale, and patients were divided into four groups accordingly. Grade 0 was no leukoaraiosis, and grades I, II, and III were mild, moderate, and severe leukoaraiosis, respectively, with 44, 79, 44, and 36 cases in each group. Transcranial Doppler ultrasonography and the breath-holding test were performed. The mean blood flow velocity of the bilateral middle cerebral artery was measured and the breath-holding index was calculated. The breath holding index was correlated with leukoaraiosis severity and cognitive impairment. Patients with a low breath holding index presented poor performance in the Montreal Cognitive Assessment (MoCA) and executive function tests. That is, the lower the breath holding index, the lower the scores for the MoCA and the higher for the trail-making test Parts A and B. These results indicate that the breath-holding index is a useful parameter for the evaluation of cerebrovascular reserve impairment in patients with leukoaraiosis. In addition, the breath-holding index can reflect cognitive dysfunction, providing a new insight into the pathophysiology of leukoaraiosis. This study was approved by the Ethics Committee of the Fifth Peoples Hospital of Shenyang, China (approval No. 20160301) and registered in the Chinese Clinical Trial Registry (registration number: ChiCTR1800014421).展开更多
Nanoimprint lithography(NIL) is an emerging micro/nano-patterning technique,which is a high-resolution,high-throughput and yet simple fabrication process.According to International Technology Roadmap for Semiconductor...Nanoimprint lithography(NIL) is an emerging micro/nano-patterning technique,which is a high-resolution,high-throughput and yet simple fabrication process.According to International Technology Roadmap for Semiconductor(ITRS),NIL has emerged as the next generation lithography candidate for the22 nm and 16 nm technological nodes.In this paper,we present an overview of nanoimprint lithography.The classfication,research focus,critical issues,and the future of nanoimprint lithography are intensively elaborated.A pattern as small as 2.4 nm has been demonstrated.Full-wafer nanoimprint lithography has been completed on a 12-inch wafer.Recently,12.5 nm pattern resolution through soft molecular scale nanoimprint lithography has been achieved by EV Group,a leading nanoimprint lithography technology supplier.展开更多
Objective Asymptomatic carotid stenosis(ACS)is closely associated to the incidence of severe cerebrovascular diseases.Early identifying the individuals with ACS and its associated risk factors could be beneficial for ...Objective Asymptomatic carotid stenosis(ACS)is closely associated to the incidence of severe cerebrovascular diseases.Early identifying the individuals with ACS and its associated risk factors could be beneficial for primary prevention of stroke.This study aimed to investigate a machine-learning algorithm for the detection of ACS among high-risk population of stroke based on the associated risk factors.Methods A novel model of machine learning was utilized to screen the associated predictors of ACS based on 30 potential risk factors.The algorithm of this model adopted a random forest pattern based on the training data and then was verified using the testing data.All of the original data were retrieved from the China National Stroke Screening and Prevention Project(CNSSPP),including demographic,clinical and laboratory characteristics.The individuals with high risk of stroke were enrolled and randomly divided into a training group and a testing group at a ratio of 4:1.The identification of carotid stenosis by carotid artery duplex scans was set as the golden standard.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)was used to evaluate the efficacy of the model in detecting ACS.Results Of 2841 high risk individual of stroke enrolled,326(11.6%)were diagnosed as ACS by ultrasonography.The top five risk fectors contributing to ACS in this model were identified as family history of dyslipidemia,high level of lowdensity lipoprotein cholesterol(LDL-c),low level of high-density lipoprotein cholesterol(HDL-c),aging,and low body.展开更多
Strapdown inertial navigation system(SINS) requires an initialization process that establishes the relationship between the body frame and the local geographic reference.This process,called alignment,is generally us...Strapdown inertial navigation system(SINS) requires an initialization process that establishes the relationship between the body frame and the local geographic reference.This process,called alignment,is generally used to estimate the initial attitude angles.This is possible because an accurate determination of the inertial measurement unit(IMU) motion is available based on the measurement obtained from global position system(GPS).But the update frequency of GPS is much lower than SINS.Due to the non-synchronous data streams from GPS and SINS,the initial attitude angles may not be computed accurately enough.In addition,the estimated initial attitude angles may have relatively large uncertainties that can affect the accuracy of other navigation parameters.This paper presents an effective approach of matching the velocities which are provided by GPS and SINS.In this approach,a digital high-pass filter,which implements a pre-filtering scheme of the measured signal,is used to filter the Schuler cycle of discrete velocity difference between the SINS and GPS.Simulation results show that this approach improves the accuracy greatly and makes the convergence time satisfy the required accuracy.展开更多
One of the reasons behind failed engineering surfaces and mechanical components is particle erosion wear;thus,to mitigate its happening,biomimetic engineering is the current state-of-the-art being applied.Hence,this p...One of the reasons behind failed engineering surfaces and mechanical components is particle erosion wear;thus,to mitigate its happening,biomimetic engineering is the current state-of-the-art being applied.Hence,this paper reviews the literature and the development trends on erosive wear resistance that employ biomimetic methods as well as analyze the bio-inspired surface,the bio-inspired structure,the bio-based materials,the associated challenges,and the future trends.Furthermore,the feasibility of the multi-biological and perspective on the coupling biomimetic method for anti-erosion wear are studied.It is concluded that the design of anti-erosion materials or structures by the bio-inspired methods is of great significance in the development of engineering applications.展开更多
The microstructural formation of the semi-solid AlSi7Mg alloy stirred by electromagnetic field is investigated together withthe tempeatre field of the stirred melt at continuously cooling. A impoat kinetic factor for ...The microstructural formation of the semi-solid AlSi7Mg alloy stirred by electromagnetic field is investigated together withthe tempeatre field of the stirred melt at continuously cooling. A impoat kinetic factor for primny a-Al nucleation is proposed. It isfound that a low temperatUre gradient exists in the electromagnetic stirred melt. This is why the first dendritic arms and secondary de-ndritic arms are refmed. Experimefltal results also show that the root remelting of secontw dendritic arms is an twortat mechanismfor the primary α-Al refmement. Strong electromagnetic stirring greatly reduces the composition supercooling in the melt and eliminatesprefedrig growth of the first dendritic arms. Therefore, many rosettes or spherical Primary α-Al phase particles form finally.展开更多
基金funded Secondary Classroom Project fund of Capital Medical University (Project Number:D2KT 2021092).
文摘Background:Septic shock is a common systemic inflammatory response syndrome for critical patients in the intensive care unit.Ulinastatin is currently used for the treatment of septic shock.Our study sought to evaluate the efficacy and safety of ulinastatin in the treatment of septic shock patients.Methods:Three English databases(Embase,Medline,and Cochrane Library)and four Chinese databases(China National Knowledge Infrastructure,Wanfang data,SinoMed,and VIP)were searched for published randomized controlled trials.Stata 16.0 software was used to conduct the meta-analysis.Results:A total of 48 articles were included(Chinese article 47,1 in English).The results show that the treatment of ulinastatin could reduce mortality(risk ratio=0.63,95%confidence interval(CI)(0.55,0.72)),multiple organ dysfunction syndrome(risk ratio=0.6,95%CI(0.53,0.68)),length of intensive care unit stay(mean difference(MD)=-3.92,95%CI(-4.65,-3.18)),length of hospital stay(MD=-4.39,95%CI(-6.63,-2.15))and decrease Acute Physiology and Chronic Health Evaluation II score(MD=-4.55,95%CI(-5.63,-3.47))and Sequential Organ Failure Assessment score(MD=-2.02,95%CI(-2.59,-1.44))with P<0.001.Moreover,it lowers TNF-α(standardized mean difference(SMD)=-1.78,95%CI(-2.24,-1.32)),Interleukin-6(SMD=-1.17,95%CI(-1.55,-0.8)),C reactive protein(SMD=-1.49,95%CI(-1.99,-0.99)),hypersensitive C-reactive protein(SMD=-1.9,95%CI(-2.87,-0.94))and procalcitonin(SMD=-0.89,95%CI(-1.12,-0.67))levels in the body.Conclusions:Available evidence shows that ulinastatin reduces case mortality rate,multiple organ dysfunction syndrome,length of intensive care unit stay,and length of hospital stay and decreases Acute Physiology and Chronic Health Evaluation II score and Sequential Organ Failure Assessment score.Moreover,it also lowers TNF-α,Interleukin-6,C reactive protein,hypersensitive C-reactive protein,and procalcitonin levels in the body.
基金supported by the National Natural Science Foundation of China(grant No.72074011)the Real World Study Project of Hainan Boao Lecheng Pilot Zone(Real World Study Base of NMPA)(HNLC2022RWS012)+1 种基金the fundamental research funds for central public welfare research institutes(2023CZ-11)National Natural Science Foundation of China(No.82003536).
文摘Background:Patients with type 2 diabetes are at high risk for developing multiple chronic complications.However,there is a lack of studies of the cumulative number of diabetic complications in China.Methods:A retrospective cohort study was performed from 2009 to 2021.Type 2 diabetes patients who were first diagnosed after the age of 35 years between January 1,2009,and December 31,2017,were included.Five states were defined according to the number of chronic complications:no(S0),one(S1),two(S2),three(S3),and four or more complications(S4).A multi-state Markov model was constructed to estimate transition probability,transition intensity,mean sojourn time,and the possible factors for each state.Results:The study included 32653 type 2 diabetes patients(mean age,59.59 years;15929(48.8%)male),and mean follow-up time of 7.75 years.In all,4375 transitions were observed.The 12-year transition probability of from state S0 to S1 was the lowest at 16.4%,while that from S2 to S3 was the highest,at 45.6%.Higher fasting blood glucose,lower high-density lipoprotein cholesterol,higher total cholesterol,and an unhealthy diet were associated with higher risk of progression from S0 to S1.Being female,less than 60 years old,weekly physical activity,and vegetarian diet decreased this risk.Being female and less than 60 years old reduced the likelihood of transition from S1 to S2,whereas lower high-density lipoprotein cholesterol increased this likelihood.Conclusions:Following the occurrence of two complications in type 2 diabetes patients,the risk for accumulating a third complication within a short time is significantly increased.It is important to take advantage of the stable window period when patients have fewer than two complications,strengthen the monitoring of blood glucose and blood lipids,and encourage patients to maintain good living habits to prevent further deterioration.
文摘Continuous renal replacement therapy(CRRT)is widely used for treating critically-ill patients in the emergency department in China.Anticoagulant therapy is needed to prevent clotting in the extracorporeal circulation during CRRT.Regional citrate anticoagulation(RCA)has been shown to potentially be safer and more effective,and is now recommended as the preferred anticoagulant method for CRRT.However,there is still a lack of unified standards for RCA management in the world,and there are many problems in using this method in clinical practice.The Emergency Medical Doctor Branch of the Chinese Medical Doctor Association(CMDA)organized a panel of domestic emergency medicine experts and international experts of CRRT to discuss RCA-related issues,including the advantages and disadvantages of RCA in CRRT anticoagulation,the principle of RCA,parameter settings for RCA,monitoring of RCA(mainly metabolic acid-base disorders),and special issues during RCA.Based on the latest available research evidence as well as the paneled experts'clinical experience,considering the generalizability,suitability,and potential resource utilization,while also balancing clinical advantages and disadvantages,a total of 16 guideline recommendations were formed from the experts'consensus.
基金financially supported by National Key R&D Program of China(Grant No.2019YFD1001401)Project of Construction of Grape Germplasm Resources Sharing Platform(Grant No.PT2029)+2 种基金Zhengzhou Major Scientific and Technological Innovation Projects(Grant No.2020CXZX0082)National Modern Agricultural Industry Technology System Construction Special Project(Grant No.CARS-29-yc-1)Special Project of Science,Technology Innovation Project of Chinese Academy of Agricultural Sciences(Grant No.CAAS-ASTIP-2019-ZFRI).
文摘Grape berry shape is an important agricultural trait.Clarifying its genetic basis is significant for cultivating grape varieties that meet market demands.However,the current study by forward genetics has not achieved in-depth results.Here,a high-density map was constructed to identify quantitative trait loci(QTLs)for berry shape.A total of 358709 polymorphic SNPs were obtained using whole-genome resequencing(WGS)based on 208 F2 individuals derived from round grape‘E42-6’and oblong grape‘Rizamat’.The 1635.65 cM high-density map was divided into 19 linkage groups with an average distance of 0.37 cM.Using this map,three significant QTLs for fruit shape index(ShI:ratio of berry length to berry width)identified over three years were mapped onto LG4 and LG5,including one stable QTL on Chr5 with the genomic region of 0.47–1.94 Mb.Combining with gene annotation and expression patterns based on RNA-seq data from two contrasting F2 individuals with round and oblong berry(their average ShI was 1.89 and 1.10,respectively)at four developmental stages,four candidate genes were selected from the above QTLs.They were mainly involved in DNA replication,cell wall modification,and phytohormone biosynthesis.Further analysis of RNA-seq data revealed that several important phytohormone synthesis and metabolic pathways were enriched based on differentially expressed genes(DEGs),which was consistent with the results of QTL mapping for genes related to plant hormone biosynthesis in the F2 population.Furthermore,a comparison of plant hormone content showed that there were significant differences in IAA and tZ content between the two contrasting F2 individuals at different developmental stages.Our findings provide molecular insights into the genetic variation in grape berry shape.Stable QTLs and their tightly linked markers offer the possibility of marker-assisted selection to accelerate berry shape breeding.
基金Supported by the National Natural Science Foundation of China(Nos.41876077,41376085)。
文摘Geochemical behaviors of heavy metals are closely related to their chemical state that can be divided by sequential extraction into exchangeable(F1),bound to carbonates(F2),bound to Fe-Mn oxides(F3),bound to organic matter or sulfide(F4),and residual(F5).Uranium in sediment of the Huanghe(Yellow)River,China,in different chemical states was extracted using the five-step procedure of Tessier and the source and sink were analyzed.Results show that more than 70%of the total uranium was immobile residual F5 in abundance,followed in order of F4>F3>F2>F1,indicating that the main source of uranium in the sediments was from weathered rock in the drainage basin.In addition,the uranium in the sediments presents potential exogenous input in the Lanzhou,Baotou,and Tongguan reach.Fe-Mn oxides are main carriers of unstable uranium,especially those of F1 and F3.Calcite and illite are secondary adsorption minerals of unstable uranium in sediments under natural conditions.Human activities can also produce an obvious impact on uranium speciation.This study provides a reference for the application of sequential extraction in analyzing the source and sink of uranium in river sediments.
基金supported by the National Basic Scientific Research Project of China (No.JCKY2020607B003)CRRC (No.202CDA001)
文摘Artificial intelligent aided design and manufacturing have been recognized as one kind of robust data-driven and data-intensive technologies in the integrated computational material engi-neering(ICME)era.Motivated by the dramatical developments of the services of China Railway High-speed series for more than a decade,it is essential to reveal the foundations of lifecycle man-agement of those trains under environmental conditions.Here,the smart design and manufacturing of welded Q350 steel frames of CR200J series are introduced,presenting the capability and opportu-nity of ICME in weight reduction and lifecycle management at a cost-effective approach.In order to address the required fatigue life time enduring more than 9×10^(6)km,the response of optimized frames to the static and the dynamic loads are comprehensively investigated.It is highlighted that the maximum residual stress of the optimized welded frame is reduced to 69 MPa from 477 MPa of previous existing one.Based on the measured stress and acceleration from the railways,the fatigue life of modified frame under various loading modes could fulfil the requirements of the lifecycle man-agement.Moreover,our recent developed intelligent quality control strategy of welding process mediated by machine learning is also introduced,envisioning its application in the intelligent weld-ing.
基金Supported by National Natural Science Foundation of China,No.81960508Yunnan Province Wang Bin Expert Workstation,No.202205AF150011.
文摘BACKGROUND This study investigate the anti-tumor effect of curcumin and whether its mediated by hsa_circ_0136666 through miR-1301-3p/CXCL1 in colorectal carcinoma(CRC).Through multiple experiments,we have drawn the conclusion that curcumin inhibited CRC development through the hsa_circ_0136666/miR-1301-3p/CXCL1 axis,hinting at a novel treatment option for curcumin to prevent CRC development.AIM To determine whether hsa_circ_0136666 involvement in curcumin-triggered CRC progression was mediated by sponging miR-1301-3p.METHODS Cell counting kit-8,colony-forming cell,5-ethynyl-2’-deoxyuridine,and flow cytometry assays were carried out to determine cell proliferation,apoptosis,and cell cycle progression.Real-time quantitative polymerase chain reaction quantified hsa_circ_0136666,miR-1301-3p,and chemokine(C-X-C motif)ligand 1(CXCL1),and western blot analysis determined CXCL1,B-cell lymphoma-2(Bcl-2),and Bcl-2 related X protein(Bax)protein levels.CircBank or starbase software was first used for the prediction of miR-1301-3p binding with hsa_circ_0136666 and CXCL1,followed by RNA pull-down,RNA immunoprecipitation,and dualluciferase reporter assay validation.In vivo experiments were implemented in a murine xenograft model.RESULTS Curcumin blocked CRC cell proliferation but boosted apoptosis.Moreover,elevated hsa_circ_0136666 Levels were observed in CRC cells,which were reduced by curcumin.In vitro,hsa_circ_0136666 overexpression abolished the antitumor activity of CRC cells.Mechanical analysis revealed the ability of hsa_circ_0136666 to sponge miR-1301-3p to modulate CXCL1 levels.CONCLUSION Curcumin inhibited CRC development through the hsa_circ_0136666/miR-1301-3p/CXCL1 axis,hinting at a novel treatment option for curcumin to prevent CRC development.
基金supported by Clinical Toxicology Grants from Chinese Society of Toxicology(No.CST2020CT604).
文摘Background:Coronavirus disease 2019(COVID-19)has now spread to most countries and regions of the world.Risk factors associated with multi-drug resistant organism(MDRO)infections in patients with COVID-19 have not been well studied yet.In the present study,we aimed to identify the risk factors associated with the MDRO infections and their impact on in-hospital mortality of COVID-19 patients.Methods:This retrospective cohort study was conducted between December 2019 and April 2020 at two tertiary hospitals in Wuhan,China.Data of cases were collected through electronic medical records system.This study was focused on cases with bacterial culture records.Risk factors and outcomes associated with MDRO infections were analyzed using logistic regression model.Results:Of the 2891 patients,370 patients have bacterial culture results,and MDROs were isolated in 38 patients.Respiratory tract infections(67.3%)were the most common hospital acquired infections.Variables independently associated with MDRO infections were dyspnea at admission(odds ratio(OR)4.74;95%confidence interval(CI)2.06-10.88;P<0.001),intensive care unit(ICU)admission(OR 5.02;95%CI 1.99-12.63;P<0.01),and invasive mechanical ventilation(OR 5.13;95%CI 2.15-12.27;P<0.001),adjusted for age and gender.MDROs infection was also a significant risk factor of death for the patients,adjusted for age,gender,severity of illness,ICU admission and mechanical ventilation(OR 1.12,95%CI:0.43-2.96,P=0.817).Conclusion:In our study,dyspnea at admission,ICU admission and invasive mechanical ventilation were associated with the presence of MDRO infections,and clinicians should be alert in MDRO infections in COVID-19 hospitalized patients.
基金supported by the National Key Technology R&D Program of China(No.2020YFC0840800).
文摘Objective:The COVID-19 pandemic poses a significant threat to global health.Given the lack of studies on risk factors for COVID-19 progression at present,this study aimed to build a predictive model to predict the progression risk among hospitalized COVID-19 patients.Methods:We extracted data from 1074 mild and moderate COVID-19 patients from Electronic Health Records(EHRs)in a designated Wuhan hospital including demographic characteristics and clinical and laboratory information.Disease progression was defined as progressing to severe critical illness after admission.The LASSO regression was used to select the predicted variables and a logistic regression model was applied to build the predictive model.Nomogram was used to show the results.Results:Seven variables were included in the predictive model:age per 10 years(OR,1.15;95%CI,1.03-1.29),lactate dehydrogenase(OR,1.73;95%CI,1.14-2.62),neutrophil-to-lymphocyte ratio(OR,2.07;95%CI,1.42-3.02),eosinophil count(OR,2.10;95%CI,1.20-3.69),albumin(OR,2.37;95%CI,1.65-3.45),hemoglobin(OR,1.50;95%CI,1.10-2.05),D-dimer(OR,1.63;95%CI,1.19-2.23).The mean area under the receiver operating characteristic curve of the predictive model was 0.72(95%CI,0.69-0.76).Conclusions:This study built a predictive model that could effectively predict the progression risk among hospitalized COVID-19 patients.
基金Supported by the National Natural Science Foundation of China,No.81372364the State Key Program of Nanjing of China,No.ZKX14022
文摘AIM To find an accurate and simple predictor for postoperative short-term complications after gastrectomy. METHODS Two hundred and twenty-three patients undergoing gastric cancer resection between October 1,2015 and September 30,2016 were enrolled in this study. Univariate and multivariate analyses were used toidentify risk factors for complications after gastrectomy. The cutoff values and diagnostic accuracy were examined by receiver operating characteristic curves.RESULTS Sixty-two(27.8%) patients had short-term complications after gastric cancer resection. The postoperative decrease in serum albumin(?ALB) was an independent risk factor for complications(OR = 17.957,95%CI: 6.073-53.095,P < 0.001). The cutoff value was 14.0% and the area under the curve was higher than that of C-reactive protein on postoperative day 3(area under the curve: 0.806 vs 0.709). Patients with ?ALB ≥ 14.0% were more likely to have short-term complications after gastrectomy(46.7% vs 5.0%,P < 0.001),prolonged hospital stay(17.2 ± 10.8 d vs 14.1 ± 4.2 d,P = 0.007) and higher comprehensive complication index(P < 0.001) than those with ?ALB < 14.0%.CONCLUSION Postoperative ?ALB with a cutoff of 14.0% can be used to recognize patients who have high risk of short-term complications following gastric cancer resection.
文摘Many studies have demonstrated that leukoaraiosis is associated with impaired cerebrovascular reserve function. However, the definitive hemodynamic changes that occur in leukoaraiosis are not clear, and there are many controversies. This study aimed to investigate hemodynamic changes in symptomatic leukoaraiosis using transcranial Doppler ultrasonography and the breath-holding test in a Chinese Han population, from northern China. A total of 203 patients who were diagnosed with ischemic stroke or clinical chronic progressive ischemic symptoms were enrolled in this study, including 97 males and 106 females, with an age range of 43-93 years. The severity of leukoaraiosis was evaluated according to the Fazekas grading scale, and patients were divided into four groups accordingly. Grade 0 was no leukoaraiosis, and grades I, II, and III were mild, moderate, and severe leukoaraiosis, respectively, with 44, 79, 44, and 36 cases in each group. Transcranial Doppler ultrasonography and the breath-holding test were performed. The mean blood flow velocity of the bilateral middle cerebral artery was measured and the breath-holding index was calculated. The breath holding index was correlated with leukoaraiosis severity and cognitive impairment. Patients with a low breath holding index presented poor performance in the Montreal Cognitive Assessment (MoCA) and executive function tests. That is, the lower the breath holding index, the lower the scores for the MoCA and the higher for the trail-making test Parts A and B. These results indicate that the breath-holding index is a useful parameter for the evaluation of cerebrovascular reserve impairment in patients with leukoaraiosis. In addition, the breath-holding index can reflect cognitive dysfunction, providing a new insight into the pathophysiology of leukoaraiosis. This study was approved by the Ethics Committee of the Fifth Peoples Hospital of Shenyang, China (approval No. 20160301) and registered in the Chinese Clinical Trial Registry (registration number: ChiCTR1800014421).
基金supported by Natural Science Foundation of Shanghai(No.11ZR1432100)Shanghai Postdoctoral Science Foundation(11R21420900)
文摘Nanoimprint lithography(NIL) is an emerging micro/nano-patterning technique,which is a high-resolution,high-throughput and yet simple fabrication process.According to International Technology Roadmap for Semiconductor(ITRS),NIL has emerged as the next generation lithography candidate for the22 nm and 16 nm technological nodes.In this paper,we present an overview of nanoimprint lithography.The classfication,research focus,critical issues,and the future of nanoimprint lithography are intensively elaborated.A pattern as small as 2.4 nm has been demonstrated.Full-wafer nanoimprint lithography has been completed on a 12-inch wafer.Recently,12.5 nm pattern resolution through soft molecular scale nanoimprint lithography has been achieved by EV Group,a leading nanoimprint lithography technology supplier.
基金Fund supported by the Medical Science and Tech no logy Development Foundatio n(YKK18114)the Gen era I Social Development Medical and Health Project of Nanjing Science and Technology Commission(201803029).
文摘Objective Asymptomatic carotid stenosis(ACS)is closely associated to the incidence of severe cerebrovascular diseases.Early identifying the individuals with ACS and its associated risk factors could be beneficial for primary prevention of stroke.This study aimed to investigate a machine-learning algorithm for the detection of ACS among high-risk population of stroke based on the associated risk factors.Methods A novel model of machine learning was utilized to screen the associated predictors of ACS based on 30 potential risk factors.The algorithm of this model adopted a random forest pattern based on the training data and then was verified using the testing data.All of the original data were retrieved from the China National Stroke Screening and Prevention Project(CNSSPP),including demographic,clinical and laboratory characteristics.The individuals with high risk of stroke were enrolled and randomly divided into a training group and a testing group at a ratio of 4:1.The identification of carotid stenosis by carotid artery duplex scans was set as the golden standard.The receiver operating characteristic(ROC)curve and the area under the curve(AUC)was used to evaluate the efficacy of the model in detecting ACS.Results Of 2841 high risk individual of stroke enrolled,326(11.6%)were diagnosed as ACS by ultrasonography.The top five risk fectors contributing to ACS in this model were identified as family history of dyslipidemia,high level of lowdensity lipoprotein cholesterol(LDL-c),low level of high-density lipoprotein cholesterol(HDL-c),aging,and low body.
基金supported by the National Natural Science Foundation of China (6083400560775001)
文摘Strapdown inertial navigation system(SINS) requires an initialization process that establishes the relationship between the body frame and the local geographic reference.This process,called alignment,is generally used to estimate the initial attitude angles.This is possible because an accurate determination of the inertial measurement unit(IMU) motion is available based on the measurement obtained from global position system(GPS).But the update frequency of GPS is much lower than SINS.Due to the non-synchronous data streams from GPS and SINS,the initial attitude angles may not be computed accurately enough.In addition,the estimated initial attitude angles may have relatively large uncertainties that can affect the accuracy of other navigation parameters.This paper presents an effective approach of matching the velocities which are provided by GPS and SINS.In this approach,a digital high-pass filter,which implements a pre-filtering scheme of the measured signal,is used to filter the Schuler cycle of discrete velocity difference between the SINS and GPS.Simulation results show that this approach improves the accuracy greatly and makes the convergence time satisfy the required accuracy.
基金This work was supported by the Natural Science Foundation of China under Grant 51875113Natural Science Foundation of the Heilongjiang Province of China under Grant F2016003Natural Science Joint Guidance Foundation of the Heilongjiang Province of China under Grant LH2019E027.Also,we are grateful to Mr.Vishwanath Pooneeth for excellent language polishing.
文摘One of the reasons behind failed engineering surfaces and mechanical components is particle erosion wear;thus,to mitigate its happening,biomimetic engineering is the current state-of-the-art being applied.Hence,this paper reviews the literature and the development trends on erosive wear resistance that employ biomimetic methods as well as analyze the bio-inspired surface,the bio-inspired structure,the bio-based materials,the associated challenges,and the future trends.Furthermore,the feasibility of the multi-biological and perspective on the coupling biomimetic method for anti-erosion wear are studied.It is concluded that the design of anti-erosion materials or structures by the bio-inspired methods is of great significance in the development of engineering applications.
文摘The microstructural formation of the semi-solid AlSi7Mg alloy stirred by electromagnetic field is investigated together withthe tempeatre field of the stirred melt at continuously cooling. A impoat kinetic factor for primny a-Al nucleation is proposed. It isfound that a low temperatUre gradient exists in the electromagnetic stirred melt. This is why the first dendritic arms and secondary de-ndritic arms are refmed. Experimefltal results also show that the root remelting of secontw dendritic arms is an twortat mechanismfor the primary α-Al refmement. Strong electromagnetic stirring greatly reduces the composition supercooling in the melt and eliminatesprefedrig growth of the first dendritic arms. Therefore, many rosettes or spherical Primary α-Al phase particles form finally.