Background:Nonalcoholic fatty liver disease(NAFLD)is associated with disordered lipid and iron metabolism.Our previous study has substantiated the pivotal role of Caveolin-1(Cav-1)in protecting hepatocytes and mediati...Background:Nonalcoholic fatty liver disease(NAFLD)is associated with disordered lipid and iron metabolism.Our previous study has substantiated the pivotal role of Caveolin-1(Cav-1)in protecting hepatocytes and mediating iron metabolism in the liver.This study aimed to explore the specific mechanisms underlying the regulation of iron metabolism by Cav-1 in NAFLD.Methods:Hepatocyte-specific Cav-1 overexpression mice and knockout mice were used in this study.Cav-1-knockdown of RAW264.7 cells and mouse primary hepatocytes were performed to verify the changes in vitro.Moreover,a high-fat diet and palmitic acid plus oleic acid treatment were utilized to construct a NAFLD model in vivo and in vitro,respectively,while a high-iron diet was used to construct an in vivo iron overload model.Besides,iron concentration,the expression of Cav-1 and iron metabolism-related proteins in liver tissue or serum were detected using iron assay kit,Prussian blue staining,Western blotting,immunofluorescence staining,immunohistochemical staining and ELISA.The related indicators of lipid metabolism and oxidative stress were evaluated by the corresponding reagent kit and staining.Results:Significant disorder of lipid and iron metabolism occurred in NAFLD.The expression of Cav-1 was decreased in NAFLD hepatocytes(P<0.05),accompanied by iron metabolism disorder.Cav-1 enhanced the iron storage capacity of hepatocytes by activating the ferritin light chain/ferritin heavy chain pathway in NAFLD,subsequently alleviating the oxidative stress induced by excess ferrous ions in the liver.Further,CD68^(+) CD163^(+) macrophages expressing Cav-1 were found to accelerate iron accumulation in the liver,which was contrary to the effect of Cav-1 in hepatocytes.Positive correlations were also observed between the serum Cav-1 concentration and the serum iron-related protein levels in NAFLD patients and healthy volunteers(P<0.05).Conclusions:These findings confirm that Cav-1 is an essential target protein that regulates iron and lipid metabolic homeostasis.It is a pivotal molecule for predicting and protecting against the development of NAFLD.展开更多
Coronary artery calcification is common in elderly,diabetic,and dialysis-dependent patients,poses a great challenge to interventional therapy and significantly increases the risk of complications and poor prognosis.[1...Coronary artery calcification is common in elderly,diabetic,and dialysis-dependent patients,poses a great challenge to interventional therapy and significantly increases the risk of complications and poor prognosis.[1]Traditional rotational atherectomy and excimer laser coronary atherectomy are both special treatment techniques for severely calcified lesions,but they are difficult to use in clinical practice due to complicated operations.Intravascular lithotripsy(IVL)is a new way of treating calcified lesion.展开更多
AIM: To compare the influence of different transplant sites in bone marrow mesenchymal stem cell (MSC)-based therapy for liver fibrosis. METHODS: MSCs isolated from Sprague Dawley (SD) rats were induced into hepatocyt...AIM: To compare the influence of different transplant sites in bone marrow mesenchymal stem cell (MSC)-based therapy for liver fibrosis. METHODS: MSCs isolated from Sprague Dawley (SD) rats were induced into hepatocyte-like cells. Liver fibrosis in SD rats was induced with carbon tetrachloride. Following hepatocyte induction in vitro, 4',6-diamidino- 2-phenylindole (DAPI)-labeled MSCs were transplanted by intravenous, intrahepatic, and intraperitoneal injection. Histopathological staining, immunohistochemistry, and biochemical analysis were used to compare the morphological and functional liver regeneration among different MSC injection modalities. The expression differences of interleukins, growth factor, extracellular matrix, matrix metalloproteinases, and tissue inhibitor of metalloproteinase were examined by real-time reverse transcription-polymerase chain reaction (RT-PCR) andenzyme linked immunosorbent assay (ELISA). RESULTS: Four days after exposure to hepatocyte differentiation medium, MSCs that did not express hepatocyte markers could express α-fetoprotein, albumin, and cytokeratin 18. The results of histopathological staining, immunohistochemistry, and biochemical analysis indicated that intravenous injection is more effective at rescuing liver failure than other injection modalities. DAPI-labeled cells were found around liver lobules in all three injection site groups, but the intravenous group had the highest number of cells. PCR and ELISA analysis indicated that interleukin-10 (IL-10) was highest in the intravenous group, whereas il1β, il6, tnfα and tgfβ, which can be regulated by IL10 and are promoters of liver fibrosis, were significantly lower than in the other groups. CONCLUSION: MSC administration is able to protect against liver fibrosis. Intravenous injection is the most favorable treatment modality through promotion of IL10 expression.展开更多
BACKGROUND The most effective treatment for advanced cirrhosis and portal hypertension is liver transplantation(LT).However,splenomegaly and hypersplenism can persist even after LT in patients with massive splenomegal...BACKGROUND The most effective treatment for advanced cirrhosis and portal hypertension is liver transplantation(LT).However,splenomegaly and hypersplenism can persist even after LT in patients with massive splenomegaly.AIM To examine the feasibility of performing partial splenectomy during LT in patients with advanced cirrhosis combined with severe splenomegaly and hypersplenism.METHODS Between October 2015 and February 2019,762 orthotopic LTs were performed for patients with end-stage liver diseases in Tianjin First Center Hospital.Eighty-four cases had advanced cirrhosis combined with severe splenomegaly and hypersplenism.Among these patients,41 received partial splenectomy during LT(PSLT group),and 43 received only LT(LT group).Patient characteristics,intraoperative parameters,and postoperative outcomes were retrospectively analyzed and compared between the two groups.RESULTS The incidence of postoperative hypersplenism(2/41,4.8%)and recurrent ascites(1/41,2.4%)in the PSLT group was significantly lower than that in the LT group(22/43,51.2%;8/43,18.6%,respectively).Seventeen patients(17/43,39.5%)in the LT group required two-stage splenic embolization,and further splenectomy was required in 6 of them.The operation time and intraoperative blood loss in the PSLT group(8.6±1.3 h;640.8±347.3 mL)were relatively increased compared with the LT group(6.8±0.9 h;349.4±116.1 mL).The incidence of postoperative bleeding,pulmonary infection,thrombosis and splenic arterial steal syndrome in the PSLT group was not different to that in the LT group,respectively.CONCLUSION Simultaneous PSLT is an effective treatment and should be performed in patients with advanced cirrhosis combined with severe splenomegaly and hypersplenism to prevent postoperative persistent hypersplenism.展开更多
Mesenchymal hamartomas of the liver(MHLs) in adults are rare and potentially premalignant lesions, which present as solid/cystic neoplasms. We report a rare case of orthotopic liver transplantation in a patient with a...Mesenchymal hamartomas of the liver(MHLs) in adults are rare and potentially premalignant lesions, which present as solid/cystic neoplasms. We report a rare case of orthotopic liver transplantation in a patient with a giant MHL. In 2013, a 34-year-old female sought medical advice after a 2-year history of progressive abdominal distention and respiratory distress. Physical examination revealed an extensive mass in the abdomen. Computed tomography(CT) of her abdomen revealed multiple liver cysts, with the diameter of largest cyst being 16 cm × 14 cm. The liver hilar structures were not clearly displayed. The adjacent organs were compressed and displaced. Initial laboratory tests, including biochemical investigations and coagulation profile, were unremarkable. Tumor markers, including levels of AFP, CEA and CA19-9, were within the normal ranges. The patient underwent orthotopic liver transplantation in November 2013, the liver being procured from a 40-year-old man after cardiac death following traumatic brain injury. Warm ischemic time was 7.5 min and cold ischemic time was 3 h. The recipient underwent classical orthotopic liver transplantation. The recipient operative procedure took 8.5 h, the anhepatic phase lasting for 1 h without the use of venovenous bypass. The immunosuppressive regimen includedintraoperative induction with basiliximab and high-dose methylprednisolone, and postoperative maintenance with tacrolimus, mycophenolate mofetil, and prednisone. The recipient's diseased liver weighed 21 kg(dry weight) and measured 41 cm × 32 cm × 31 cm. Histopathological examination confirmed the diagnosis of an MHL. The patient did not experience any acute rejection episode or other complication. All the laboratory tests returned to normal within one month after surgery. Three months after transplantation, the immunosuppressive therapy was reduced to tacrolimus monotherapy, and the T-tube was removed after cholangiography showed no abnormalities. Twelve months after transplantation, the patient remains well and is fulfilling all normal activities. Adult giant MHL is extremely rare. Symptoms, physical signs, laboratory results, and radiographic imaging are nonspecific and inconclusive. Surgical excision of the lesion is imperative to make a definite diagnosis and as a cure. Liver transplantation should be considered as an option in the treatment of a non-resectable MHL.展开更多
Delirium is a severe acute neuropsychiatric syndrome that commonly occurs in the elderly and is considered an independent risk factor for later dementia.However,given its inherent complexity,few animal models of delir...Delirium is a severe acute neuropsychiatric syndrome that commonly occurs in the elderly and is considered an independent risk factor for later dementia.However,given its inherent complexity,few animal models of delirium have been established and the mechanism underlying the onset of delirium remains elusive.Here,we conducted a comparison of three mouse models of delirium induced by clinically relevant risk factors,including anesthesia with surgery(AS),systemic inflammation,and neurotransmission modulation.We found that both bacterial lipopolysaccharide(LPS)and cholinergic receptor antagonist scopolamine(Scop)induction reduced neuronal activities in the delirium-related brain network,with the latter presenting a similar pattern of reduction as found in delirium patients.Consistently,Scop injection resulted in reversible cognitive impairment with hyperactive behavior.No loss of cholinergic neurons was found with treatment,but hippocampal synaptic functions were affected.These findings provide further clues regarding the mechanism underlying delirium onset and demonstrate the successful application of the Scop injection model in mimicking delirium-like phenotypes in mice.展开更多
Since the research on verification to passive design strategies in sustainable building is at the initial stage,and its test method and verification conclusion are not scientific enough to validate,this paper proposes...Since the research on verification to passive design strategies in sustainable building is at the initial stage,and its test method and verification conclusion are not scientific enough to validate,this paper proposes the necessity of building physical environmental monitoring to quantitative optimization of passive strategies efficiency from the perspective of architecture design and building environment. Adopting comparative research method,this research chooses six types of atrium space in cold climate in China as a prototype,focusing on building physical environmental performance difference in and between atrium and building main space. Spatial parameters of the atrium space will be divided into four factors: spatial geometry,interfacial properties,internal and external related categories. With subdividing these four factors into sub-factors,this paper makes crosscomparison among the sub-factors to clarify passive strategies effectiveness in atrium. Data comparison analysis shows that Winter atrium passive strategy in cold regions from traditional view is not obvious in practical application,and test data need to be stratified refined in atrium design in case of optimizing passive strategy from building prototype perspective.展开更多
Building buffer zone space is not only one of essential approaches for better mental quality of interior building space, but also an important factor that may influence interior thermal comfort and energy consumption....Building buffer zone space is not only one of essential approaches for better mental quality of interior building space, but also an important factor that may influence interior thermal comfort and energy consumption. This study aims to analyze regulative advantages of buffer zone to the surrounding functional spaces. Based on a fieldwork test in a typical office building in cold climate zone in Beijing,China,the monitor data show interior physical performance in the Winter. The research selects two types of different buffer zones in the same building. One is a south-faced greenhouse which has large dimension with plenty of vegetation,and the other is a simple atrium in the middle of five floor building with mount of skylights. The factors and their influence to surrounding functional spaces and the whole building are found out from the comparisons of collected data by floor to floor monitor test on both buffer zones at the same time. The comparisons of two types of buffer zones conclude that the greenhouse is more effective to air quality regulation but not so clearly wellperformed to thermal buffering as expected due to the dominate active central heating in the Winter. This fieldwork test results for building performance can be helpful for both architects and engineers in the early phase of sustainable design.展开更多
Mammalian target of rapamycin(m TOR) inhibitor as an attractive drug target with promising antitumor effects has been widely investigated. High quality clinical trial has been conducted in liver transplant(LT) recipie...Mammalian target of rapamycin(m TOR) inhibitor as an attractive drug target with promising antitumor effects has been widely investigated. High quality clinical trial has been conducted in liver transplant(LT) recipients in Western countries. However, the pertinent studies in Eastern world are paucity. Therefore, we designed a clinical trial to test whether sirolimus can improve recurrence-free survival(RFS) in hepatocellular carcinoma(HCC) patients beyond the Milan criteria after LT. This is an open-labeled, single-arm, prospective, multicenter, and real-world study aiming to evaluate the clinical outcomes of early switch to sirolimus-based regimens in HCC patients after LT. Patients with a histologically proven HCC and beyond the Milan criteria will be enrolled. The initial immunosuppressant regimens are center-specifc for the frst 4-6 weeks. The following regimens integrated sirolimus into the regimens as a combination therapy with reduced calcineurin inhibitors based on the condition of patients and centers. The study is planned for 4 years in total with a 2-year enrollment period and a 2-year follow-up. We predict that sirolimus conversion regimen will provide survival benefts for patients particular in the key indicator RFS as well as better quality of life. If the trial is conducted successfully, we will have a continued monitoring over a longer follow-up time to estimate indicator of overall survival. We hope that the outcome will provide better evidence for clinical decision-making and revising treatment guidelines based on Chinese population data.展开更多
The GECAM series of satellites utilizes LaBr_(3)(Ce),LaBr_(3)(Ce,Sr),and NaI(Tl)crystals as sensitive materials for gamma-ray detectors(GRDs).To investigate the nonlinearity in the detection of low-energy gamma rays a...The GECAM series of satellites utilizes LaBr_(3)(Ce),LaBr_(3)(Ce,Sr),and NaI(Tl)crystals as sensitive materials for gamma-ray detectors(GRDs).To investigate the nonlinearity in the detection of low-energy gamma rays and address the errors in the calibration of the E-C relationship,comprehensive tests and comparative studies of the three aforementioned crystals were conducted using Compton electrons,radioactive sources,and mono-energetic X-rays.The nonlinearity test results of the Compton electrons and X-rays demonstrated substantial differences,with all three crystals presenting a higher nonlinearity for X/-rays than for Compton electrons.Despite the LaBr_(3)(Ce)and LaBr_(3)(Ce,Sr)crystals having higher absolute light yields,they exhibited a noticeable nonlinear decrease in the light yield,especially at energies below 400 keV.The NaI(Tl)crystal demonstrated an"excess"light output in the 6-200 keV range,reaching a maximum"excess"of 9.2%at 30 keV in the X-ray testing and up to 15.5%at 14 keV during Compton electron testing,indicating a significant advantage in the detection of low-energy gamma rays.Furthermore,we explored the underlying causes of the observed nonlinearity in these crystals.This study not only elucidates the detector responses of GECAM,but also initiates a comprehensive investigation of the nonlinearity of domestically produced lanthanum bromide and sodium iodide crystals.展开更多
BACKGROUND This reported procedure combines the orthopedic surgical robot with the unilateral biportal endoscopy-lumbar interbody fusion(UBE-LIF),utilizing the UBE's wide viewing field and operating space to perfo...BACKGROUND This reported procedure combines the orthopedic surgical robot with the unilateral biportal endoscopy-lumbar interbody fusion(UBE-LIF),utilizing the UBE's wide viewing field and operating space to perform minimally invasive decompressive fusion of the lesioned segment,and the orthopedic surgical robot's intelligence and precision to perform percutaneous pedicle screw placement.The advancement of this procedure lies in the superposition of advantages and offsetting disadvantages of the two new technologies,and the maximum effect of treatment is achieved with maximum minimization of invasiveness and precision under the monitoring of imaging instruments to maximize the benefit of patients,and this review reports a case of multiple-segment lumbar decompression and fusion surgery for lumbar disc herniation via robot-assisted UBE for reference.CASE SUMMARY A 44-year-old patient presented to our hospital.Combining various clinical data,we diagnosed the patient with lumbar disc herniation with radiculopathy,lumbar spondylolisthesis,and lumbar spinal stenosis.We developed a surgical plan of"UBE decompression+UBE-LIF+orthopedic surgery robot-assisted percutaneous pedicle screw implantation for internal fixation".The results were satisfactory.CONCLUSION We present an extremely rare case of multiple-segment lumbar decompression and fusion surgery for lumbar disc herniation via robot-assisted UBE and achieved good results.Therefore,the technique is worthy of clinical promotion.展开更多
Structural health monitoring is important to ensuring the health and safety of dams.An inverse analysis method based on a novel hybrid fireworks algorithm (FWA) and the radial basis function (RBF) model is proposed to...Structural health monitoring is important to ensuring the health and safety of dams.An inverse analysis method based on a novel hybrid fireworks algorithm (FWA) and the radial basis function (RBF) model is proposed to diagnose the health condition of concrete dams.The damage of concrete dams is diagnosed by identifying the elastic modulus of materials using the displacement changes at different reservoir water levels.FWA is a global optimization intelligent algorithm.The proposed hybrid algorithm combines the FWA with the pattern search algorithm, which has a high capability for local optimization.Examples of benchmark functions and pseudo-experiment examples of concrete dams illustrate that the hybrid FWA improves the convergence speed and robustness of the original algorithm.To address the time consumption problem, an RBF-based surrogate model was established to replace part of the finite element method in inverse analysis.Numerical examples of concrete dams illustrate that the use of an RBF-based surrogate model significantly reduces the computation time of inverse analysis with little influence on identification accuracy.The presented hybrid FWA combined with the RBF network can quickly and accurately determine the elastic modulus of materials, and then determine the health status of the concrete dam.展开更多
Zr was added to Ti−Nb−Fe alloys to develop low elastic modulus and high strengthβ-Ti alloys for biomedical applications.Ingots of Ti−12Nb−2Fe−(2,4,6,8,10)Zr(at.%)were prepared by arc melting and then subjected to hom...Zr was added to Ti−Nb−Fe alloys to develop low elastic modulus and high strengthβ-Ti alloys for biomedical applications.Ingots of Ti−12Nb−2Fe−(2,4,6,8,10)Zr(at.%)were prepared by arc melting and then subjected to homogenization,cold rolling,and solution treatments.The phases and microstructures of the alloys were analyzed by optical microscopy,X-ray diffraction,and transmission electron microscopy.The mechanical properties were measured by tensile tests.The results indicate that Zr and Fe cause a remarkable solid-solution strengthening effect on the alloys;thus,all the alloys show yield and ultimate tensile strengths higher than 510 MPa and 730 MPa,respectively.Zr plays a weak role in the deformation mechanism.Further,twinning occurs in all the deformed alloys and is beneficial to both strength and plasticity.Ti−12Nb−2Fe−(8,10)Zr alloys with metastableβphases show low elastic modulus,high tensile strength,and good plasticity and are suitable candidate materials for biomedical implants.展开更多
Heterostructures from mechanically-assembled stacks of two-dimensional materials allow for versatile electronic device applications. Here, we demonstrate the intrinsic charge transport behaviors in graphene-black phos...Heterostructures from mechanically-assembled stacks of two-dimensional materials allow for versatile electronic device applications. Here, we demonstrate the intrinsic charge transport behaviors in graphene-black phosphorus heterojunction devices under different charge carrier densities and temperature regimes. At high carder densities or in the ON state, tunneling through the Schottky barrier at the interface between graphene and black phosphorus dominates at low temperatures. With temperature increasing, the Schottky barrier at the interface is vanishing, and the channel current starts to decrease with increasing temperature, behaving like a metal. While at low carder densities or in the OFF state, thermal emission over the Schottky barrier at the interface dominates the carriers transport process. A barrier height of ~ 67.3 meV can be extracted from the thermal emission-diffusion theory.展开更多
AIM: To figure out the contributed factors of the hospitalization expenses of senile cataract patients(HECP) and build up an area-specified senile cataract diagnosis related group(DRG) of Shanghai thereby formula...AIM: To figure out the contributed factors of the hospitalization expenses of senile cataract patients(HECP) and build up an area-specified senile cataract diagnosis related group(DRG) of Shanghai thereby formulating the reference range of HECP and providing scientific basis for the fair use and supervision of the health care insurance fund.METHODS: The data was collected from the first page of the medical records of 22 097 hospitalized patients from tertiary hospitals in Shanghai from 2010 to 2012 whose major diagnosis were senile cataract. Firstly, we analyzed the influence factors of HECP using univariate and multivariate analysis. DRG grouping was conducted according to the exhaustive Chi-squared automatic interaction detector(E-CHAID) model, using HECP as target variable. Finally we evaluated the grouping results using non-parametric test such as Kruskal-Wallis H test, RIV, CV, etc.RESULTS: The 6 DRGs were established as well as criterion of HECP, using age, sex, type of surgery and whether complications/comorbidities occurred as the key variables of classification node of senile cataract cases.CONCLUSION: The grouping of senile cataract cases based on E-CHAID algorithm is reasonable. And the criterion of HECP based on DRG can provide a feasible way of management in the fair use and supervision of medical insurance fund.展开更多
In this work we report that after single-walled carbon nanotubes(SWNTs) are sheared with a pair of titanium scissors,the magnetization becomes larger than that of the corresponding pristine ones. The magnetization inc...In this work we report that after single-walled carbon nanotubes(SWNTs) are sheared with a pair of titanium scissors,the magnetization becomes larger than that of the corresponding pristine ones. The magnetization increases proportionally with the number of SWNTs with sheared ends, suggesting that there exist magnetic moments at the sheared ends of SWNTs.By using the coefficient of this linear relation, the average magnetic moment is estimated to be 41.5 ± 9.8 μB(Bohr magneton) per carbon atom in the edge state at temperature of 300.0 K, suggesting that ultrahigh magnetic fields can be produced. The dangling sigma and pi bonds of the carbon atoms at sheared ends play important roles in determining the unexpectedly high magnetic moments, which may have great potential applications.展开更多
BACKGROUND Post-traumatic cauda equina nerve calcification is extremely rare in clinical practice,and its etiology,pathogenesis,treatment and prognosis are unclear.There are few studies and reports on Post-traumatic c...BACKGROUND Post-traumatic cauda equina nerve calcification is extremely rare in clinical practice,and its etiology,pathogenesis,treatment and prognosis are unclear.There are few studies and reports on Post-traumatic cauda equina nerve calci-fication,and this review reports a case of Post-traumatic cauda equina nerve calcification for reference.CASE SUMMARY A 52-year-old patient presented to our hospital with a history of lumbar spinal stenosis and a lumbar vertebral fracture caused by trauma.The patient's right lower limb had weakness in hip flexion,knee extension and plantarflexion with muscle strength grade 3,right ankle dorsiflexion and thumb dorsiflexion with muscle strength grade 0.The patient's skin sensation below the right knee plane disappeared.The patient's Computed tomography(CT)data showed signs of cauda equina nerve calcification and the terminal filaments in the plane of the third to fifth lumbar vertebrae.After treatment the patient's symptoms were slightly relieved.CONCLUSION We provide an extremely rare case of Post-traumatic cauda equina nerve calcification and offer a conservative treatment plan.However,the etiology,mechanism and treatment of Post-traumatic cauda equina nerve calcification are still unclear.This requires scholars to conduct more research and exploration in this area.展开更多
基金financially supported by the National Natural Science Foundation of China(82074131,81774170,82260926)the Guangdong Basic and Applied Basic Research Foundation(2018B030306012,2022A1515220179,2021A1515011667)+2 种基金the Outstanding Youth Development Scheme project of Southern Medical University(G621299870)the Young Elite Scientists Sponsorship Program by CACM(2021-QNRC2-B28)the China Postdoctoral Science Foundation(2022M721532).
文摘Background:Nonalcoholic fatty liver disease(NAFLD)is associated with disordered lipid and iron metabolism.Our previous study has substantiated the pivotal role of Caveolin-1(Cav-1)in protecting hepatocytes and mediating iron metabolism in the liver.This study aimed to explore the specific mechanisms underlying the regulation of iron metabolism by Cav-1 in NAFLD.Methods:Hepatocyte-specific Cav-1 overexpression mice and knockout mice were used in this study.Cav-1-knockdown of RAW264.7 cells and mouse primary hepatocytes were performed to verify the changes in vitro.Moreover,a high-fat diet and palmitic acid plus oleic acid treatment were utilized to construct a NAFLD model in vivo and in vitro,respectively,while a high-iron diet was used to construct an in vivo iron overload model.Besides,iron concentration,the expression of Cav-1 and iron metabolism-related proteins in liver tissue or serum were detected using iron assay kit,Prussian blue staining,Western blotting,immunofluorescence staining,immunohistochemical staining and ELISA.The related indicators of lipid metabolism and oxidative stress were evaluated by the corresponding reagent kit and staining.Results:Significant disorder of lipid and iron metabolism occurred in NAFLD.The expression of Cav-1 was decreased in NAFLD hepatocytes(P<0.05),accompanied by iron metabolism disorder.Cav-1 enhanced the iron storage capacity of hepatocytes by activating the ferritin light chain/ferritin heavy chain pathway in NAFLD,subsequently alleviating the oxidative stress induced by excess ferrous ions in the liver.Further,CD68^(+) CD163^(+) macrophages expressing Cav-1 were found to accelerate iron accumulation in the liver,which was contrary to the effect of Cav-1 in hepatocytes.Positive correlations were also observed between the serum Cav-1 concentration and the serum iron-related protein levels in NAFLD patients and healthy volunteers(P<0.05).Conclusions:These findings confirm that Cav-1 is an essential target protein that regulates iron and lipid metabolic homeostasis.It is a pivotal molecule for predicting and protecting against the development of NAFLD.
基金Supported by Fengtai District Commission of Health(Fengtai District Health System Science and Research Project NO.2023-81).
文摘Coronary artery calcification is common in elderly,diabetic,and dialysis-dependent patients,poses a great challenge to interventional therapy and significantly increases the risk of complications and poor prognosis.[1]Traditional rotational atherectomy and excimer laser coronary atherectomy are both special treatment techniques for severely calcified lesions,but they are difficult to use in clinical practice due to complicated operations.Intravascular lithotripsy(IVL)is a new way of treating calcified lesion.
基金Supported by Millitary Medicine and Health Foundation of China, No. 08Z030
文摘AIM: To compare the influence of different transplant sites in bone marrow mesenchymal stem cell (MSC)-based therapy for liver fibrosis. METHODS: MSCs isolated from Sprague Dawley (SD) rats were induced into hepatocyte-like cells. Liver fibrosis in SD rats was induced with carbon tetrachloride. Following hepatocyte induction in vitro, 4',6-diamidino- 2-phenylindole (DAPI)-labeled MSCs were transplanted by intravenous, intrahepatic, and intraperitoneal injection. Histopathological staining, immunohistochemistry, and biochemical analysis were used to compare the morphological and functional liver regeneration among different MSC injection modalities. The expression differences of interleukins, growth factor, extracellular matrix, matrix metalloproteinases, and tissue inhibitor of metalloproteinase were examined by real-time reverse transcription-polymerase chain reaction (RT-PCR) andenzyme linked immunosorbent assay (ELISA). RESULTS: Four days after exposure to hepatocyte differentiation medium, MSCs that did not express hepatocyte markers could express α-fetoprotein, albumin, and cytokeratin 18. The results of histopathological staining, immunohistochemistry, and biochemical analysis indicated that intravenous injection is more effective at rescuing liver failure than other injection modalities. DAPI-labeled cells were found around liver lobules in all three injection site groups, but the intravenous group had the highest number of cells. PCR and ELISA analysis indicated that interleukin-10 (IL-10) was highest in the intravenous group, whereas il1β, il6, tnfα and tgfβ, which can be regulated by IL10 and are promoters of liver fibrosis, were significantly lower than in the other groups. CONCLUSION: MSC administration is able to protect against liver fibrosis. Intravenous injection is the most favorable treatment modality through promotion of IL10 expression.
基金National Natural Science Foundation of China,No.81870444Tianjin Natural Science Foundation,No.19JCQNJC10300Spring Bud Plan of Tianjin First Central Hospital,No.TFCHCL201801.
文摘BACKGROUND The most effective treatment for advanced cirrhosis and portal hypertension is liver transplantation(LT).However,splenomegaly and hypersplenism can persist even after LT in patients with massive splenomegaly.AIM To examine the feasibility of performing partial splenectomy during LT in patients with advanced cirrhosis combined with severe splenomegaly and hypersplenism.METHODS Between October 2015 and February 2019,762 orthotopic LTs were performed for patients with end-stage liver diseases in Tianjin First Center Hospital.Eighty-four cases had advanced cirrhosis combined with severe splenomegaly and hypersplenism.Among these patients,41 received partial splenectomy during LT(PSLT group),and 43 received only LT(LT group).Patient characteristics,intraoperative parameters,and postoperative outcomes were retrospectively analyzed and compared between the two groups.RESULTS The incidence of postoperative hypersplenism(2/41,4.8%)and recurrent ascites(1/41,2.4%)in the PSLT group was significantly lower than that in the LT group(22/43,51.2%;8/43,18.6%,respectively).Seventeen patients(17/43,39.5%)in the LT group required two-stage splenic embolization,and further splenectomy was required in 6 of them.The operation time and intraoperative blood loss in the PSLT group(8.6±1.3 h;640.8±347.3 mL)were relatively increased compared with the LT group(6.8±0.9 h;349.4±116.1 mL).The incidence of postoperative bleeding,pulmonary infection,thrombosis and splenic arterial steal syndrome in the PSLT group was not different to that in the LT group,respectively.CONCLUSION Simultaneous PSLT is an effective treatment and should be performed in patients with advanced cirrhosis combined with severe splenomegaly and hypersplenism to prevent postoperative persistent hypersplenism.
基金Supported by National Natural Science Foundation of China,No.81400680the National High Technology Research and Development Program of China,No.2012 AA021001
文摘Mesenchymal hamartomas of the liver(MHLs) in adults are rare and potentially premalignant lesions, which present as solid/cystic neoplasms. We report a rare case of orthotopic liver transplantation in a patient with a giant MHL. In 2013, a 34-year-old female sought medical advice after a 2-year history of progressive abdominal distention and respiratory distress. Physical examination revealed an extensive mass in the abdomen. Computed tomography(CT) of her abdomen revealed multiple liver cysts, with the diameter of largest cyst being 16 cm × 14 cm. The liver hilar structures were not clearly displayed. The adjacent organs were compressed and displaced. Initial laboratory tests, including biochemical investigations and coagulation profile, were unremarkable. Tumor markers, including levels of AFP, CEA and CA19-9, were within the normal ranges. The patient underwent orthotopic liver transplantation in November 2013, the liver being procured from a 40-year-old man after cardiac death following traumatic brain injury. Warm ischemic time was 7.5 min and cold ischemic time was 3 h. The recipient underwent classical orthotopic liver transplantation. The recipient operative procedure took 8.5 h, the anhepatic phase lasting for 1 h without the use of venovenous bypass. The immunosuppressive regimen includedintraoperative induction with basiliximab and high-dose methylprednisolone, and postoperative maintenance with tacrolimus, mycophenolate mofetil, and prednisone. The recipient's diseased liver weighed 21 kg(dry weight) and measured 41 cm × 32 cm × 31 cm. Histopathological examination confirmed the diagnosis of an MHL. The patient did not experience any acute rejection episode or other complication. All the laboratory tests returned to normal within one month after surgery. Three months after transplantation, the immunosuppressive therapy was reduced to tacrolimus monotherapy, and the T-tube was removed after cholangiography showed no abnormalities. Twelve months after transplantation, the patient remains well and is fulfilling all normal activities. Adult giant MHL is extremely rare. Symptoms, physical signs, laboratory results, and radiographic imaging are nonspecific and inconclusive. Surgical excision of the lesion is imperative to make a definite diagnosis and as a cure. Liver transplantation should be considered as an option in the treatment of a non-resectable MHL.
基金supported by the National Natural Science Foundation of China(82071191,82001129)Natural Science Foundation of Sichuan Province(2022NSFSC1509)+1 种基金National Clinical Research Center for Geriatrics of West China Hospital(Z2021LC001)West China Hospital 1.3.5 Project for Disciplines of Excellence(ZYYC20009)。
文摘Delirium is a severe acute neuropsychiatric syndrome that commonly occurs in the elderly and is considered an independent risk factor for later dementia.However,given its inherent complexity,few animal models of delirium have been established and the mechanism underlying the onset of delirium remains elusive.Here,we conducted a comparison of three mouse models of delirium induced by clinically relevant risk factors,including anesthesia with surgery(AS),systemic inflammation,and neurotransmission modulation.We found that both bacterial lipopolysaccharide(LPS)and cholinergic receptor antagonist scopolamine(Scop)induction reduced neuronal activities in the delirium-related brain network,with the latter presenting a similar pattern of reduction as found in delirium patients.Consistently,Scop injection resulted in reversible cognitive impairment with hyperactive behavior.No loss of cholinergic neurons was found with treatment,but hippocampal synaptic functions were affected.These findings provide further clues regarding the mechanism underlying delirium onset and demonstrate the successful application of the Scop injection model in mimicking delirium-like phenotypes in mice.
基金Sponsored by the Key Project of National Natural Science Foundation of China (Grant No.51138004)the National Science and Technology Support Program (Grant No.2012BAJ10B02)
文摘Since the research on verification to passive design strategies in sustainable building is at the initial stage,and its test method and verification conclusion are not scientific enough to validate,this paper proposes the necessity of building physical environmental monitoring to quantitative optimization of passive strategies efficiency from the perspective of architecture design and building environment. Adopting comparative research method,this research chooses six types of atrium space in cold climate in China as a prototype,focusing on building physical environmental performance difference in and between atrium and building main space. Spatial parameters of the atrium space will be divided into four factors: spatial geometry,interfacial properties,internal and external related categories. With subdividing these four factors into sub-factors,this paper makes crosscomparison among the sub-factors to clarify passive strategies effectiveness in atrium. Data comparison analysis shows that Winter atrium passive strategy in cold regions from traditional view is not obvious in practical application,and test data need to be stratified refined in atrium design in case of optimizing passive strategy from building prototype perspective.
基金Sponsored by the Key Project of National Natural Science Foundation of China(Grant No.51138004)the National Science and Technology Support Program(Grant No.2012BAJ10B02)
文摘Building buffer zone space is not only one of essential approaches for better mental quality of interior building space, but also an important factor that may influence interior thermal comfort and energy consumption. This study aims to analyze regulative advantages of buffer zone to the surrounding functional spaces. Based on a fieldwork test in a typical office building in cold climate zone in Beijing,China,the monitor data show interior physical performance in the Winter. The research selects two types of different buffer zones in the same building. One is a south-faced greenhouse which has large dimension with plenty of vegetation,and the other is a simple atrium in the middle of five floor building with mount of skylights. The factors and their influence to surrounding functional spaces and the whole building are found out from the comparisons of collected data by floor to floor monitor test on both buffer zones at the same time. The comparisons of two types of buffer zones conclude that the greenhouse is more effective to air quality regulation but not so clearly wellperformed to thermal buffering as expected due to the dominate active central heating in the Winter. This fieldwork test results for building performance can be helpful for both architects and engineers in the early phase of sustainable design.
基金supported by grants from the National S&T Major Project (2017ZX10203205)Key Program,National Natural Science Foundation of China (81930016)Zhejiang Provincial Natural Science Foundation of China (LY21H160026)。
文摘Mammalian target of rapamycin(m TOR) inhibitor as an attractive drug target with promising antitumor effects has been widely investigated. High quality clinical trial has been conducted in liver transplant(LT) recipients in Western countries. However, the pertinent studies in Eastern world are paucity. Therefore, we designed a clinical trial to test whether sirolimus can improve recurrence-free survival(RFS) in hepatocellular carcinoma(HCC) patients beyond the Milan criteria after LT. This is an open-labeled, single-arm, prospective, multicenter, and real-world study aiming to evaluate the clinical outcomes of early switch to sirolimus-based regimens in HCC patients after LT. Patients with a histologically proven HCC and beyond the Milan criteria will be enrolled. The initial immunosuppressant regimens are center-specifc for the frst 4-6 weeks. The following regimens integrated sirolimus into the regimens as a combination therapy with reduced calcineurin inhibitors based on the condition of patients and centers. The study is planned for 4 years in total with a 2-year enrollment period and a 2-year follow-up. We predict that sirolimus conversion regimen will provide survival benefts for patients particular in the key indicator RFS as well as better quality of life. If the trial is conducted successfully, we will have a continued monitoring over a longer follow-up time to estimate indicator of overall survival. We hope that the outcome will provide better evidence for clinical decision-making and revising treatment guidelines based on Chinese population data.
基金This work was supported by the National Key Research and Development Program(Nos.2022YFB3503600 and 2021YFA0718500)Strategic Priority Research Program of the Chinese Academy of Sciences(Nos.XDA15360102)National Natural Science Foundation of China(Nos.12273042 and 12075258).
文摘The GECAM series of satellites utilizes LaBr_(3)(Ce),LaBr_(3)(Ce,Sr),and NaI(Tl)crystals as sensitive materials for gamma-ray detectors(GRDs).To investigate the nonlinearity in the detection of low-energy gamma rays and address the errors in the calibration of the E-C relationship,comprehensive tests and comparative studies of the three aforementioned crystals were conducted using Compton electrons,radioactive sources,and mono-energetic X-rays.The nonlinearity test results of the Compton electrons and X-rays demonstrated substantial differences,with all three crystals presenting a higher nonlinearity for X/-rays than for Compton electrons.Despite the LaBr_(3)(Ce)and LaBr_(3)(Ce,Sr)crystals having higher absolute light yields,they exhibited a noticeable nonlinear decrease in the light yield,especially at energies below 400 keV.The NaI(Tl)crystal demonstrated an"excess"light output in the 6-200 keV range,reaching a maximum"excess"of 9.2%at 30 keV in the X-ray testing and up to 15.5%at 14 keV during Compton electron testing,indicating a significant advantage in the detection of low-energy gamma rays.Furthermore,we explored the underlying causes of the observed nonlinearity in these crystals.This study not only elucidates the detector responses of GECAM,but also initiates a comprehensive investigation of the nonlinearity of domestically produced lanthanum bromide and sodium iodide crystals.
基金Supported by National Natural Science Foundation of China(Regional Program),No.82060879,No.82360947Gansu Province Key Talent Project,No.2024-4+2 种基金Natural Science Foundation of Gansu Province,No.20JR10RA356Gansu Provincial Joint Research Fund,No.23JRRA1534National Administration of Traditional Chinese Medicine High Level Key Discipline Construction Project of Traditional Chinese Medicine(Traditional Chinese Orthopedics and Traumatology Science),No.203.
文摘BACKGROUND This reported procedure combines the orthopedic surgical robot with the unilateral biportal endoscopy-lumbar interbody fusion(UBE-LIF),utilizing the UBE's wide viewing field and operating space to perform minimally invasive decompressive fusion of the lesioned segment,and the orthopedic surgical robot's intelligence and precision to perform percutaneous pedicle screw placement.The advancement of this procedure lies in the superposition of advantages and offsetting disadvantages of the two new technologies,and the maximum effect of treatment is achieved with maximum minimization of invasiveness and precision under the monitoring of imaging instruments to maximize the benefit of patients,and this review reports a case of multiple-segment lumbar decompression and fusion surgery for lumbar disc herniation via robot-assisted UBE for reference.CASE SUMMARY A 44-year-old patient presented to our hospital.Combining various clinical data,we diagnosed the patient with lumbar disc herniation with radiculopathy,lumbar spondylolisthesis,and lumbar spinal stenosis.We developed a surgical plan of"UBE decompression+UBE-LIF+orthopedic surgery robot-assisted percutaneous pedicle screw implantation for internal fixation".The results were satisfactory.CONCLUSION We present an extremely rare case of multiple-segment lumbar decompression and fusion surgery for lumbar disc herniation via robot-assisted UBE and achieved good results.Therefore,the technique is worthy of clinical promotion.
基金supported by the National Key Research and Development Program of China(Grants No.2016YFC0401600 and 2017YFC0404906)the National Natural Science Foundation of China(Grants No.51769033 and 51779035)the Fundamental Research Funds for the Central Universities(Grants No.DUT17ZD205 and DUT19LK14)
文摘Structural health monitoring is important to ensuring the health and safety of dams.An inverse analysis method based on a novel hybrid fireworks algorithm (FWA) and the radial basis function (RBF) model is proposed to diagnose the health condition of concrete dams.The damage of concrete dams is diagnosed by identifying the elastic modulus of materials using the displacement changes at different reservoir water levels.FWA is a global optimization intelligent algorithm.The proposed hybrid algorithm combines the FWA with the pattern search algorithm, which has a high capability for local optimization.Examples of benchmark functions and pseudo-experiment examples of concrete dams illustrate that the hybrid FWA improves the convergence speed and robustness of the original algorithm.To address the time consumption problem, an RBF-based surrogate model was established to replace part of the finite element method in inverse analysis.Numerical examples of concrete dams illustrate that the use of an RBF-based surrogate model significantly reduces the computation time of inverse analysis with little influence on identification accuracy.The presented hybrid FWA combined with the RBF network can quickly and accurately determine the elastic modulus of materials, and then determine the health status of the concrete dam.
基金the Natural Science Foundation of Shanghai,China(No.15ZR1428400)Shanghai Engineering Research Center of High-Performance Medical Device Materials,China(No.20DZ2255500)the Project of Creation of Life Innovation Materials for Interdisciplinary and International Researcher Development,Tohoku University,sponsored by Ministry,Education,Culture,Sports,Science and Technology,Japan,and the Grant-in Aid for Scientific Research(C)(No.20K05139)from JSPS(Japan Society for the Promotion of Science),Tokyo,Japan.
文摘Zr was added to Ti−Nb−Fe alloys to develop low elastic modulus and high strengthβ-Ti alloys for biomedical applications.Ingots of Ti−12Nb−2Fe−(2,4,6,8,10)Zr(at.%)were prepared by arc melting and then subjected to homogenization,cold rolling,and solution treatments.The phases and microstructures of the alloys were analyzed by optical microscopy,X-ray diffraction,and transmission electron microscopy.The mechanical properties were measured by tensile tests.The results indicate that Zr and Fe cause a remarkable solid-solution strengthening effect on the alloys;thus,all the alloys show yield and ultimate tensile strengths higher than 510 MPa and 730 MPa,respectively.Zr plays a weak role in the deformation mechanism.Further,twinning occurs in all the deformed alloys and is beneficial to both strength and plasticity.Ti−12Nb−2Fe−(8,10)Zr alloys with metastableβphases show low elastic modulus,high tensile strength,and good plasticity and are suitable candidate materials for biomedical implants.
基金Project supported by the National Basic Research Program of China(Grant No.2013CBA01600)the National Key Research&Development Project of China(Grant No.2016YFA0202300)+2 种基金the National Natural Science Foundation of China(Grant Nos.61474141,61674170,61335006,61390501,51325204,and51210003)Youth Innovation Promotion Association of Chinese Academy of Sciences(Grant No.20150005)the China Postdoctoral Science Foundation(Grant No.2017M623146)
文摘Heterostructures from mechanically-assembled stacks of two-dimensional materials allow for versatile electronic device applications. Here, we demonstrate the intrinsic charge transport behaviors in graphene-black phosphorus heterojunction devices under different charge carrier densities and temperature regimes. At high carder densities or in the ON state, tunneling through the Schottky barrier at the interface between graphene and black phosphorus dominates at low temperatures. With temperature increasing, the Schottky barrier at the interface is vanishing, and the channel current starts to decrease with increasing temperature, behaving like a metal. While at low carder densities or in the OFF state, thermal emission over the Schottky barrier at the interface dominates the carriers transport process. A barrier height of ~ 67.3 meV can be extracted from the thermal emission-diffusion theory.
基金Supported by the Key Research and Development Program of Hunan Province(No.2017SK2011)
文摘AIM: To figure out the contributed factors of the hospitalization expenses of senile cataract patients(HECP) and build up an area-specified senile cataract diagnosis related group(DRG) of Shanghai thereby formulating the reference range of HECP and providing scientific basis for the fair use and supervision of the health care insurance fund.METHODS: The data was collected from the first page of the medical records of 22 097 hospitalized patients from tertiary hospitals in Shanghai from 2010 to 2012 whose major diagnosis were senile cataract. Firstly, we analyzed the influence factors of HECP using univariate and multivariate analysis. DRG grouping was conducted according to the exhaustive Chi-squared automatic interaction detector(E-CHAID) model, using HECP as target variable. Finally we evaluated the grouping results using non-parametric test such as Kruskal-Wallis H test, RIV, CV, etc.RESULTS: The 6 DRGs were established as well as criterion of HECP, using age, sex, type of surgery and whether complications/comorbidities occurred as the key variables of classification node of senile cataract cases.CONCLUSION: The grouping of senile cataract cases based on E-CHAID algorithm is reasonable. And the criterion of HECP based on DRG can provide a feasible way of management in the fair use and supervision of medical insurance fund.
基金Project supported by the National Key Research and Development Program of China(Grant Nos.2018YFA0208403 and 2016YFA0200403)the National Natural Science Foundation of China(Grant Nos.51472057,11874129,91323304,and 11674387)+1 种基金the Strategic Priority Research Program of the Chinese Academy of Sciences(Grant No.XDA09040101)the Baotou Rare Earth Research and Development Centre,Chinese Academy of Sciences(Grant No.GZR 2018001)
文摘In this work we report that after single-walled carbon nanotubes(SWNTs) are sheared with a pair of titanium scissors,the magnetization becomes larger than that of the corresponding pristine ones. The magnetization increases proportionally with the number of SWNTs with sheared ends, suggesting that there exist magnetic moments at the sheared ends of SWNTs.By using the coefficient of this linear relation, the average magnetic moment is estimated to be 41.5 ± 9.8 μB(Bohr magneton) per carbon atom in the edge state at temperature of 300.0 K, suggesting that ultrahigh magnetic fields can be produced. The dangling sigma and pi bonds of the carbon atoms at sheared ends play important roles in determining the unexpectedly high magnetic moments, which may have great potential applications.
基金Supported by National Natural Science Foundation of China,No.82060879Natural Science Foundation of Gansu Province,No.20JR10RA356 and No.2022-0405-JCC-1430+2 种基金Lanzhou Science and Technology Plan Project,No.2022-3-30Paikouen-Spine Pathological Fracture Vertebral Body Strengthening Treatment Special Fund Project,No.BKJP2018004Local Projects Transferred by the Central Government in 2021,No.20210200111.
文摘BACKGROUND Post-traumatic cauda equina nerve calcification is extremely rare in clinical practice,and its etiology,pathogenesis,treatment and prognosis are unclear.There are few studies and reports on Post-traumatic cauda equina nerve calci-fication,and this review reports a case of Post-traumatic cauda equina nerve calcification for reference.CASE SUMMARY A 52-year-old patient presented to our hospital with a history of lumbar spinal stenosis and a lumbar vertebral fracture caused by trauma.The patient's right lower limb had weakness in hip flexion,knee extension and plantarflexion with muscle strength grade 3,right ankle dorsiflexion and thumb dorsiflexion with muscle strength grade 0.The patient's skin sensation below the right knee plane disappeared.The patient's Computed tomography(CT)data showed signs of cauda equina nerve calcification and the terminal filaments in the plane of the third to fifth lumbar vertebrae.After treatment the patient's symptoms were slightly relieved.CONCLUSION We provide an extremely rare case of Post-traumatic cauda equina nerve calcification and offer a conservative treatment plan.However,the etiology,mechanism and treatment of Post-traumatic cauda equina nerve calcification are still unclear.This requires scholars to conduct more research and exploration in this area.