Bronchobiliary fistula in a patient with liver cancer

Bronchobiliary fistula(BBF) is a pathologic channel between the biliary tract and bronchial tree. In general, congenital BBF is relatively rare in adult patients. There are a few case reports suggesting that BBF is mainly secondary to hepatobiliary diseases, such as biliary obstruction, tumor, surgery, or liver abscess, and liver tumor is the predominant causative factor [1]. In addition, with the increasing number of liver and biliary surgeries and interventional therapies in recent years, more cases of BBF were reported as a postoperative complication [ 2, 3 ]. In this case, we presented a patient who underwent interventional treatment for liver tumor and was treated for his respiratory symptoms but diagnosed with BBF finally. Here, we summarized the clinical features and main diagnostic procedures of the case, aiming to provide evidence for early identification and diagnosis of BBF.

Future Changes in Extreme High Temperature over China at 1.5℃-5℃ Global Warming Based on CMIP6 Simulations

Extreme high temperature(EHT)events are among the most impact-related consequences related to climate change,especially for China,a nation with a large population that is vulnerable to the climate warming.Based on the latest Coupled Model Intercomparison Project Phase 6(CMIP6),this study assesses future EHT changes across China at five specific global warming thresholds(1.5℃-5℃).The results indicate that global mean temperature will increase by 1.5℃/2℃ before 2030/2050 relative to pre-industrial levels(1861-1900)under three future scenarios(SSP1-2.6,SSP2-4.5,and SSP5-8.5),and warming will occur faster under SSP5-8.5 compared to SSP1-2.6 and SSP2-4.5.Under SSP5-8.5,global warming will eventually exceed 5℃ by 2100,while under SSP1-2.6,it will stabilize around 2℃ after 2050.In China,most of the areas where warming exceeds global average levels will be located in Tibet and northern China(Northwest China,North China and Northeast China),covering 50%-70%of the country.Furthermore,about 0.19-0.44 billion people(accounting for 16%-41%of the national population)will experience warming above the global average.Compared to present-day(1995-2014),the warmest day(TXx)will increase most notably in northern China,while the number of warm days(TX90p)and warm spell duration indicator(WSDI)will increase most profoundly in southern China.For example,relative to the present-day,TXx will increase by 1℃-5℃ in northern China,and TX90p(WSDI)will increase by 25-150(10-80)days in southern China at 1.5℃-5℃ global warming.Compared to 2℃-5℃,limiting global warming to 1.5℃ will help avoid about 36%-87%of the EHT increases in China.

Research on the effects of command-and-control and market-oriented policy tools on China's energy conservation and emissions reduction innovation

The impact of environmental regulation on technology innovation is a hot spot in current research where a large number of empirical studies are based on Porter Hypothesis(PH). However, there are still controversies in academia about the establishment of "weak" and "narrow" versions of PH. Based on the panel data of application for patent of energy conservation and emission reduction(ECER) technology of Chinese city scale during 2008-2014, comprehensive energy price, pollutant emission, etc., mixed regression model and systematic generalized method of moments method were adopted, respectively,to study the impact of market-oriented and command-and-control policy tool on China's ECER technology innovation. The results show that the environmental regulation hindered the technological innovation in the immediate phase; however, it turned out to be positive in the first-lag phase. Hence, the establishment of "weak" PH is time-bounded. The command-and-control policy tool played a more positive role in promoting technological innovation in the first-lag phase than market-oriented policy tool. Therefore, "narrow" PH is not tenable. The reason is that the main participants of China's ECER technology innovation are state-owned companies and public institutions. Regionally speaking, the impact which command-and-control policy tool has on technological innovation at sight was nonsignificant in the eastern, the central, and the western regions of China whilst market-oriented policy tool had a negative effect. And market-oriented policy tool in the central region had strongest negative effect, which would diminish in the eastern region and become weakest in the western region. This was related to regional energy consumption level and the market economic vitality.

Hierarchical Template Matching for Robust Visual Tracking with Severe Occlusions

To tackle the problem of severe occlusions in visual tracking, we propose a hierarchical template-matching method based on a layered appearance model. This model integrates holistic- and part-region matching in order to locate an object in a coarse-to-fine manner. Furthermore, in order to reduce ambiguity in object localization, only the discriminative parts of an object＇ s appearance template are chosen for similarity computing with respect to their cornerness measurements. The similarity between parts is computed in a layer-wise manner, and from this, occlusions can be evaluated. When the object is partly occluded, it can be located accurately by matching candidate regions with the appearance template. When it is completely occluded, its location can be predicted from its historical motion information using a Kalman filter. The proposed tracker is tested on several practical image sequences, and the experimental results show that it can consistently provide accurate object location for stable tracking, even for severe occlusions.

FLUORENE-BASED LIGHT-EMITTING POLYMERS

Several series of fluorene-based light-emitting polymers with the emphasis on achieving efficient and stable bluelight emission are reported. Spiro-functionalization may narrow the emission spectra (with smaller tail at Ionger wavelengths)of fluorene homopolymers to provide purer blue emission. The thermal spectral stability of the polymers could also beimproved because of the elevation of the glass transition temperature caused by the spiro-functionalization. However, theexcimer emission in fluorene homopolymers is not suppressed by the spiro-functionalization. Alternate copolymers of 9,9-dihexylfluorene and substituted phenylenes may emit efficient blue ligh both in solution and in film. The optical propertiesare dependent on the substituion on the phenylene ring. The alkoxy-substituted polymers displayed efficient PL and EL andgood thermal spectral stability. The HOMO and LUMO energy levels of the polymers based on the backbone structure couldbe tuned in a wide range by attaching different functional groups on the phenylene ring. By attaching europium(III) complexat the ends of the side chains in the alternate copolymers, we have demonstrated a new approach to achieving red emissionwith a very narrow spectrum. The copolymers of 9,9-dihexylfluorene and thiophene and bithiophene with differentsubstitutions were also synthesized to study the effect of substitution and regioregularity on the optical and other physicalproperties of the polymers.

Advances in diabetic microvascular complications and related molecular mechanisms

With the change of production and life style, the change of dietary structure and the aggravation of population aging, the incidence and fatality rate of diabetes mellitus have been increasing year by year. The pathogenesis of diabetes varies and is closely related to many factors, such as genetic factors, environmental factors, eating habits and so on. Those that endanger the life quality and survival of diabetic patients are mostly complications, including various macrovascular complications and microvascular complications, such as diabetic cardiomyopathy, diabetic nephropathy, diabetic encephalopathy and diabetic foot. The related molecular mechanisms of the pathogenesis of diabetic nephropathy, diabetic retinopathy and diabetic foot are discussed in this paper to provide reference for new drug research and clinical treatment.

Remnants and fragments of the subducted paleo-Pacific plate:Constraints from geochemistry and geophysics

The subduction and rollback of the paleo-Pacific plate during Mesozoic time was the key engine for the evolution of the continental margin in eastern China. It led to lateral accretion of continental crust in Northeast China, lithospheric destruction beneath the North China Craton, and the generation of huge volumes of felsic magmatic rocks in South China. This had a profound influence on deep material cycles and the evolution of epigenetic environmental systems along the continental margin of East Asia. To fully understand the transformation of the dynamic mechanism during the subduction and rollback of the paleoPacific plate, we have attempted to trace the remnants and fragments of the subducted paleo-Pacific plate at great depths. Such remnants in both temporal and spatial dimensions can be tracked by using geochemical and geophysical approaches. Studies of the trace elements, Mg-Zn isotopes and Os-Nd-Hf-Pb-O isotopes in continental basalts from eastern China reveal a significant number of the remnants of subduction of the paleo-Pacific plate, and the initial subduction can be traced back to the Early Jurassic. Large-scale geophysical imaging unveils a multitude of high-velocity anomalies in the lower mantle of East Asia.Notably, many high-velocity bodies, aptly referred to as “slab graveyards”, are nestled at the base of the lower mantle. Numerous isolated high-velocity anomalies are also present in the upper part of the lower mantle, creating conduits for the descent of the subducted slabs into the lower mantle. However, a resolution of the remnants for the subducted slabs within the lower mantle are quite low. Consequently, their impact on the lower mantle's dynamics is yet to be thoroughly investigated. Finally, the presently observed big mantle wedge(BMW) in East Asia has developed through subduction of the Pacific plate in the Cenozoic.However, following the rollback of the paleo-Pacific plate(began at ~145 Ma), a Cretaceous BMW system would also form above the mantle transition zone in East Asia. There are significant differences in tectonic-magmatic processes and basinforming and hydrocarbon-accumulation processes among different regions along the East Asian continental margin. Such differences may be controlled by variations in the speed and angle of rollback of the paleo-Pacific plate.

Enhanced Grain Refining Effect of Mg–Zr Master Alloy on Magnesium Alloys via a Synergistic Strategy Involving Heterogeneous Nucleation and Solute‑Driven Growth Restriction

Zirconium(Zr)emerges as the most effective grain refiner for magnesium(Mg)alloys incorporating Zr.Typically,Zr is introduced in the form of an Mg–Zr master alloy.However,within Mg–Zr master alloys,Zr predominantly exists in a particle form,which tends to aggregate due to attractive van der Waals forces.The clustered Zr is prone to settling,thereby reducing its refining impact on Mg alloys.In this work,a combined pretreatment process for Mg–Zr master alloys was proposed,encompassing the introduction of a physical field to intervene the agglomeration of particle Zr and the employ of high-temperature dissolution and peritectic reactions to promote the solid solution of Zr.The results demonstrate that the particle Zr within the pretreated Mg–Zr master alloy is effectively dispersed and refined,and greater solute Zr levels can be achieved.The subsequent grain refinement ability was studied on a typical Mg–6Zn–0.6Zr(wt%)alloy.The outcome highlights that an improvement in the grain refinement efficacy(32.4%)of Mg–Zr master alloys was obtained with a holding time of 60 min.The pretreated Mg–Zr master alloy significantly augments the efficiency of grain refinement for Mg alloys through a synergistic strategy involving heterogeneous nucleation and solute-driven growth restriction.The crucial factor in achieving effective grain refinement of Zr in Mg alloys lies in regulating the presence and morphology of Zr in the Mg–Zr master alloy,distinguishing between particle Zr and solute Zr.This study introduces a novel method for developing more efficient Mg–Zr refiners.

National survey of the awareness and implementation status of early pulmonary rehabilitation for patients with critical illness in departments of pulmonary and critical care medicine in 2019

To the Editor:The aim of early pulmonary rehabilitation(PR)in the intensive care unit(ICU)is to reduce the incidence of post-ICU syndrome,increase the number of ventilator-free days,reestablish and improve functional capacity,improve health-related life quality,promote mental health,and enhance participation in everyday life.PR in the ICU is highly effective and plays an important role in recovery of patients with reduced exercise endurance,functional capacity,and health-related life quality.Several surveys outside China have assessed the implementation of early rehabilitation in the ICU,[1]but there are few data from China.This study aimed to investigate the awareness and implementation of early PR in secondary-and tertiary-class hospitals with pulmonary and critical care medicine(PCCM)standardized certification.PCCM staff members were recruited to fill out a selfdesigned questionnaire.We defined early PR as PR within 5 days of ICU admission.

Immunogenicity and Safety of Homologous Booster Doses of CoronaVac COVID-19 Vaccine in Elderly Individuals Aged 60 Years and Older:A Dosing Interval Study—Yunnan Province,China,2021–2022

Summary What is already known about this topic?Neutralization levels induced by inactivated vaccines rapidly wane after primary immunization,and a homologous booster can recall specific immune memory,resulting in a remarkable increase in antibody concentration.The optimal interval between primary and booster doses has yet to be determined.

Safety and Effectiveness of SA58 Nasal Spray Against COVID-19 Infection in Medical Personnel:An Open-Label,Blank-Controlled Study—Hohhot City,Inner Mongolia Autonomous Region,China,2022

Summary What is already known about this topic?The active ingredient of the SA58 Nasal Spray is a broad-spectrum neutralizing antibody with a high neutralizing capacity against different Omicron subvariants in vitro studies.What is added by this report?This study demonstrated the safety and effectiveness of SA58 Nasal Spray against coronavirus disease 2019(COVID-19)infection in medical personnel for the first time.What are the implications for public health practice?This study provides an effective approach for the public to reduce their risk of COVID-19 infection.The findings of this research have the potential to significantly reduce the risk of infection and limit human-to-human transmission in the event of a COVID-19 outbreak.

强流重离子加速器,肩负探索未知世界新使命

重大科技基础设施是为探索未知世界、发现自然规律、实现技术变革提供极限研究手段的大型复杂科学研究系统,是突破科学前沿,解决经济社会发展和国家安全重大科技问题的物质技术基础.《国家重大科技基础设施建设中长期规划(2012-2030年)》明确提出,瞄准科技前沿研究和国家重大战略需求,根据重大科技基础设施发展的国际趋势和国内基础,总体部署16项重大科技基础设施建设项目.强流重离子加速器装置(high intensity heavy-ion accelerator facility,HIAF)作为核物理科学领域的重要部署被列为建设重点项目之一,并于2018年12月底在广东惠州正式启动建设.图1为HIAF装置效果图.

Melt-Lithosphere Interaction Controlled Compositional Variations in Mafic Dikes from Fujian Province,Southeastern China

Late Mesozoic magmatism in southeastern China has been widely considered to be related to the subduction of the Paleo-Pacific Plate.However,it remains controversial whether mafic rocks are derived from the lithosphere or the asthenosphere.Here we present a comprehensive study on mafic dikes from Fujian Province in southeastern China,aiming to understand their source.Two types of mafic rocks have been recognized based on their trace-element features.Type-Ⅰrocks show arc-like trace-elemental characteristics,while type-Ⅱrocks are distinguished by their relatively flat patterns in primitive-mantle-normalized trace-element diagram.Despite such differences between two types of rocks,these mafic dikes show two trends in the plots of^(87)Sr/^(86)Sr(i)versus La/Nb,which can be explained by the influences of crustal contamination and melt-lithospheric mantle interaction,respectively.^(87)Sr/^(86)Sr(i),La/Nb,Sr/Y and Zr/Y ratios of type-I rocks are significantly correlated to the thickness of the underlying lithosphere,and the signals of lithosphere are clearer with increasing lithospheric thickness.This highlights the important influences of melt-lithosphere interaction during their formation.Such observations also indicate that these mafic rocks are more likely to have been originated from the asthenosphere rather than the lithospheric mantle.

Regional Characteristics of Cloud Radiative Effects before and after the South China Sea Summer Monsoon Onset

The South China Sea summer monsoon(SCSSM)onset is characterized by rapid thermodynamical changes in the atmosphere that are critical to regional weather and climate processes.So far,few studies have focused on the changes in the associated cloud and radiative features.This study investigates spatiotemporal characteristics of topof-atmosphere(TOA)cloud radiative effects(CREs)before and after the SCSSM onset over the South China Sea(SCS)and South China(SC),based on the 2001–2016 Clouds and the Earth’s Radiant Energy System(CERES)Energy Balanced and Filled(EBAF)satellite data and ERA-Interim reanalysis data.Before the SCSSM onset,strong net CRE(NCRE)dominated by its cooling shortwave component occurs over SC,while descending motion and weak NCRE prevail over the SCS.In the SCSSM onset pentad,convection,high clouds,and longwave and shortwave CREs(LWCRE and SWCRE)abruptly increase over the southern and central SCS,and their high-value centers subsequently move northeastward and are strongly affected by the western Pacific subtropical high.The strong offset between LWCRE and SWCRE enables the NCRE intensity(TOA radiation budget)to be quite small(large)between the SCS and the western North Pacific after the SCSSM onset.In contrast,low–middle-level clouds and strong cooling SWCRE remain over SC after the SCSSM onset,but the increasing high clouds and LWCRE weaken(intensify)the regional NCRE(TOA radiation budget)intensity.These marked latitudinal differences in CREs between the SCS and SC primarily arise from their respective dominant cloud types and circulation conditions,which manifest the differences between the tropical SCSSM and subtropical East Asian monsoon processes.The results indicate that regional cloud fractions and CREs before and after the SCSSM onset are strongly modulated by quickly changed largescale circulation over the East Asian monsoon regions,and the spatiotemporal variation of CREs is a response to the monsoonal circulation adjustment to a large extent.

Error Inhomogeneity in the Computation of Spherical Mean Displacement

The traditional method for computing the mean displacement in latitude-longitude coordinates is a spherical meridional-zonal resultant displacement method （MRDM）, which regards the displacement as the resultant vector of the meridional and zonal displacement components. However, there are inhomogeneity and singularity in the computation error of the MRDM, especially at high latitudes. Using the NCEP/NCAR long-term monthly mean wind and idealized wind fields, the inhomogeneity in the MRDM was accessed by using a great circle displacement computing method （GCDM） for non-iterative cases. The MRDM and GCDM were also compared for iteration cases by taking the trajectories from a three-time level reference method as the real trajectories. In the horizontal direction, the GCDM assumes that an air particle moves along its locating great circle and that the magnitude of the displacement equals the arc length of the great circle. The inhomogeneity of the MRDM is evaluated in terms of the horizontal dis- tance error from the products of wind speed, lapse time, and angle difference from the GCDM displacement orient. The non-iterative results show that the mean horizontal displacement computed through the MRDM has both compu- tational and analytical errors. The displacement error of the MRDM depends on the wind speed, wind direction, and the departure latitude of the air particle. It increases with the wind speed and the departure latitude. The displacement magnitude error has a four-wave pattern and the displacement direction error has a two-wave feature in the definition range of the wind direction. The iterative result shows that the displacement magnitude error and angle error of the MRDM and GCDM with respect to the reference method increase with the lapse time and have similar distribution patterns. The mean magnitude error and the angle error of the MRDM are nearly twice as large as those of the GCDM.