BACKGROUND This case report presents the rare occurrence of hematochezia due to an internal iliac artery aneurysm leading to an arterioenteric fistula,expanding the differential diagnosis for gastrointestinal bleeding...BACKGROUND This case report presents the rare occurrence of hematochezia due to an internal iliac artery aneurysm leading to an arterioenteric fistula,expanding the differential diagnosis for gastrointestinal bleeding.It emphasizes the importance of considering vascular origins in cases of atypical hematochezia,particularly in the absence of common gastrointestinal causes,and highlights the role of imaging and multidisciplinary management in diagnosing and treating such unusual presentations.CASE SUMMARY A 75-year-old man with a history of hypertension presented with 12 d of hematochezia,experiencing bloody stools 7-8 times per day.Initial computed tomography(CT)scans revealed an aneurysmal rupture near the right internal iliac artery with suspected hematoma development.Hemoglobin levels progressively decreased to 7 g/dL.Emergency arterial angiography and iliac arterycovered stent placement were performed,followed by balloon angioplasty.Despite initial stabilization,minor rectal bleeding and abdominal pain persisted,leading to further diagnostic colonoscopy.This identified a neoplasm and potential perforation at the proximal rectum.An exploratory laparotomy confirmed the presence of a hematoma and an aneurysm invading the rectal wall,necessitating partial rectal resection,intestinal anastomosis,and ileostomy.Postoperative recovery was successful,with no further bleeding incidents and normal follow-up CT and colonoscopy results after six months.CONCLUSION In cases of unusual gastrointestinal bleeding,it is necessary to consider vascular causes for effective diagnosis and intervention.展开更多
In light of the limited efficacy of conventional methods for identifying pavement cracks and the absence of comprehensive depth and location data in two-dimensional photographs,this study presents an intelligent strat...In light of the limited efficacy of conventional methods for identifying pavement cracks and the absence of comprehensive depth and location data in two-dimensional photographs,this study presents an intelligent strategy for extracting road cracks.This methodology involves the integration of laser point cloud data obtained from a vehicle-mounted system and a panoramic sequence of images.The study employs a vehicle-mounted LiDAR measurement system to acquire laser point cloud and panoramic sequence image data simultaneously.A convolutional neural network is utilized to extract cracks from the panoramic sequence image.The extracted sequence image is then aligned with the laser point cloud,enabling the assignment of RGB information to the vehicle-mounted three dimensional(3D)point cloud and location information to the two dimensional(2D)panoramic image.Additionally,a threshold value is set based on the crack elevation change to extract the aligned roadway point cloud.The three-dimensional data pertaining to the cracks can be acquired.The experimental findings demonstrate that the use of convolutional neural networks has yielded noteworthy outcomes in the extraction of road cracks.The utilization of point cloud and image alignment techniques enables the extraction of precise location data pertaining to road cracks.This approach exhibits superior accuracy when compared to conventional methods.Moreover,it facilitates rapid and accurate identification and localization of road cracks,thereby playing a crucial role in ensuring road maintenance and traffic safety.Consequently,this technique finds extensive application in the domains of intelligent transportation and urbanization development.The technology exhibits significant promise for use in the domains of intelligent transportation and city development.展开更多
Research Background: Heart failure is a type of organic heart disease caused by excessive ventricular load, leading to insufficient myocardial contractility and decreased cardiac output in the body. With the progressi...Research Background: Heart failure is a type of organic heart disease caused by excessive ventricular load, leading to insufficient myocardial contractility and decreased cardiac output in the body. With the progression of the patient's condition, gastrointestinal dysfunction is frequently complicated. At the same time, the accumulation of feces in the body (colonic impaction) can also increase the burden on the patient’s heart, triggering or exacerbating the occurrence or progression of heart failure. Purpose: this article focuses on the correlation between colonic impaction and heart failure, using the nursing experience of a case of acute left heart failure complicated by colonic impaction as an example, in order to provide clinical evidence for the care of patients with colonic impaction combined with heart failure in the future. Method: By using innovative thinking, the stomach tube is used to replace the enema tube, which is inserted through the anus to reach the end of the colon. By combining acupressure at points such as Zhongwan, Tianzhu, and Guanyuan, it helps promote the elimination of fecal impaction. Conclusion: This case reflects the innovative thinking and adaptability of nurses, providing a new clinical approach for the aggravation of the condition of long-term heart failure patients due to constipation issues. Further research in clinical practice is warranted.展开更多
Brucellosis,caused by Brucella,is one of the most common zoonosis.However,there is still no vaccine for human use.Although some live attenuated vaccines have been approved for animals,the protection effect is not idea...Brucellosis,caused by Brucella,is one of the most common zoonosis.However,there is still no vaccine for human use.Although some live attenuated vaccines have been approved for animals,the protection effect is not ideal.In this study,we developed a dual-antigen nanoconjugate vaccine containing both polysaccharide and protein antigens against Brucella.First,the antigenic polysaccharide was covalently coupled to the outer membrane protein Omp19 using protein glycan coupling technology,and then it was successfully loaded on a nano-carrier through the SpyTag/SpyCatcher system.After confirming the efficient immune activation and safety performance of the dual-antigen nanoconjugate vaccine,the potent serum antibody response against the two antigens and remarkable protective effect in non-lethal and lethal Brucella infection models were further demonstrated through different routes of administration.These results indicated that the dual-antigen nanoconjugate vaccine enhanced both T helper 1 cell(Th1)and Th2 immune responses and protected mice from Brucella infection.Furthermore,we found that this protective effect was maintained for at least 18 weeks.To our knowledge,this is the first Brucella vaccine bearing diverse antigens,including a protein and polysaccharide,on a single nanoparticle.Thus,we also present an attractive technology for co-delivery of different types of antigens using a strategy applicable to other vaccines against infectious diseases.展开更多
BACKGROUND Synchronous colorectal carcinomas(SCRC)are two or more primary colorectal carcinomas identified simultaneously or within 6 mo of the initial presentation in a single patient.Their incidence is low and the n...BACKGROUND Synchronous colorectal carcinomas(SCRC)are two or more primary colorectal carcinomas identified simultaneously or within 6 mo of the initial presentation in a single patient.Their incidence is low and the number of pathological types of SCRC is usually no more than two.It is very unusual that the pathological findings of a patient with SCRC show more than two different pathological subtypes.Here,we report a rare case of SCRC with three pathological subtypes.CASE SUMMARY A 75-year-old woman who had no previous medical history or family history was admitted to the hospital because of intermittent hematochezia for more than a month.Colonoscopy displayed an irregularly shaped neoplasm of the rectum,a tumor-like lesion causing intestinal stenosis in the descending colon,and a polypoidal neoplasm in the ileocecum.Subsequently,she underwent total colectomy,abdominoperineal resection for rectal cancer,and ileostomy.After operation,the pathological report showed three pathological subtypes including well-differentiated adenocarcinoma of the ascending colon,moderately differen-tiated adenocarcinoma of the descending colon,and mucinous adenocarcinoma of the rectum.She is now recovering well and continues to be closely monitored during follow-up.CONCLUSION Preoperative colonoscopy examination,imaging examination,and extensive intraoperative exploration play important roles in reducing the number of missed lesions.展开更多
Excitons in solid state are bosons generated by electron-hole pairs as the Coulomb screening is sufficiently reduced.The exciton condensation can result in exotic physics such as super-fluidity and insulating state.In...Excitons in solid state are bosons generated by electron-hole pairs as the Coulomb screening is sufficiently reduced.The exciton condensation can result in exotic physics such as super-fluidity and insulating state.In charge density wave(CDW)state,1T-TiSe_(2) is one of the candidates that may host the exciton condensation.However,to envision its excitonic effect is still challenging,particularly at the two-dimensional limit,which is applicable to future devices.Here,we realize the epitaxial 1T-TiSe_(2) bilayer,the two-dimensional limit for its 2×2×2 CDW order,to explore the exciton-associated effect.By means of high-resolution scanning tunneling spectroscopy and quasiparticle interference,we discover an unexpected state residing below the conduction band and right within the CDW gap region.As corroborated by our theoretical analysis,this mysterious phenomenon is in good agreement with the electron-exciton coupling.Our study provides a material platform to explore exciton-based electronics and opto-electronics.展开更多
为准确揭示密云水库流域径流变化的物理成因,基于降水、径流非平稳特征诊断结果,采用SWAT(soil and water assessment tool)水文模型,基于Budyko理论的弹性系数法和水量平衡法揭示该流域径流变化原因;对比验证各模型归因结果差异,进一...为准确揭示密云水库流域径流变化的物理成因,基于降水、径流非平稳特征诊断结果,采用SWAT(soil and water assessment tool)水文模型,基于Budyko理论的弹性系数法和水量平衡法揭示该流域径流变化原因;对比验证各模型归因结果差异,进一步探究归因方法和基准期选择对流域径流变化归因结果的影响。结果表明:基于Budyko理论的水量平衡方法更适用于水利工程众多、跨流域调水活动频繁的密云水库流域径流变化归因计算;利用该方法进行分析,当基准期长度达到16年及以上时,流域径流变化归因分析结果逐渐趋于稳定,而基准期选取过短会高估人类活动对径流的减水效应;此外,基准期选取靠近研究初始时段时,计算得到人类活动的减水效应相对较大。综合考虑上述各因素的影响,认为人类活动是密云水库流域径流变化的主导因素;在变化期Ⅰ,其减水效应在-128.32%~-119.56%波动,在变化期Ⅱ,其对径流的削减作用为-75.58%~-70.70%。研究结果有助于提升对密云水库流域径流复杂演变规律和物理成因的科学认识。展开更多
文摘BACKGROUND This case report presents the rare occurrence of hematochezia due to an internal iliac artery aneurysm leading to an arterioenteric fistula,expanding the differential diagnosis for gastrointestinal bleeding.It emphasizes the importance of considering vascular origins in cases of atypical hematochezia,particularly in the absence of common gastrointestinal causes,and highlights the role of imaging and multidisciplinary management in diagnosing and treating such unusual presentations.CASE SUMMARY A 75-year-old man with a history of hypertension presented with 12 d of hematochezia,experiencing bloody stools 7-8 times per day.Initial computed tomography(CT)scans revealed an aneurysmal rupture near the right internal iliac artery with suspected hematoma development.Hemoglobin levels progressively decreased to 7 g/dL.Emergency arterial angiography and iliac arterycovered stent placement were performed,followed by balloon angioplasty.Despite initial stabilization,minor rectal bleeding and abdominal pain persisted,leading to further diagnostic colonoscopy.This identified a neoplasm and potential perforation at the proximal rectum.An exploratory laparotomy confirmed the presence of a hematoma and an aneurysm invading the rectal wall,necessitating partial rectal resection,intestinal anastomosis,and ileostomy.Postoperative recovery was successful,with no further bleeding incidents and normal follow-up CT and colonoscopy results after six months.CONCLUSION In cases of unusual gastrointestinal bleeding,it is necessary to consider vascular causes for effective diagnosis and intervention.
基金founded by National Key R&D Program of China (No.2021YFB2601200)National Natural Science Foundation of China (No.42171416)Teacher Support Program for Pyramid Talent Training Project of Beijing University of Civil Engineering and Architecture (No.JDJQ20200307).
文摘In light of the limited efficacy of conventional methods for identifying pavement cracks and the absence of comprehensive depth and location data in two-dimensional photographs,this study presents an intelligent strategy for extracting road cracks.This methodology involves the integration of laser point cloud data obtained from a vehicle-mounted system and a panoramic sequence of images.The study employs a vehicle-mounted LiDAR measurement system to acquire laser point cloud and panoramic sequence image data simultaneously.A convolutional neural network is utilized to extract cracks from the panoramic sequence image.The extracted sequence image is then aligned with the laser point cloud,enabling the assignment of RGB information to the vehicle-mounted three dimensional(3D)point cloud and location information to the two dimensional(2D)panoramic image.Additionally,a threshold value is set based on the crack elevation change to extract the aligned roadway point cloud.The three-dimensional data pertaining to the cracks can be acquired.The experimental findings demonstrate that the use of convolutional neural networks has yielded noteworthy outcomes in the extraction of road cracks.The utilization of point cloud and image alignment techniques enables the extraction of precise location data pertaining to road cracks.This approach exhibits superior accuracy when compared to conventional methods.Moreover,it facilitates rapid and accurate identification and localization of road cracks,thereby playing a crucial role in ensuring road maintenance and traffic safety.Consequently,this technique finds extensive application in the domains of intelligent transportation and urbanization development.The technology exhibits significant promise for use in the domains of intelligent transportation and city development.
文摘Research Background: Heart failure is a type of organic heart disease caused by excessive ventricular load, leading to insufficient myocardial contractility and decreased cardiac output in the body. With the progression of the patient's condition, gastrointestinal dysfunction is frequently complicated. At the same time, the accumulation of feces in the body (colonic impaction) can also increase the burden on the patient’s heart, triggering or exacerbating the occurrence or progression of heart failure. Purpose: this article focuses on the correlation between colonic impaction and heart failure, using the nursing experience of a case of acute left heart failure complicated by colonic impaction as an example, in order to provide clinical evidence for the care of patients with colonic impaction combined with heart failure in the future. Method: By using innovative thinking, the stomach tube is used to replace the enema tube, which is inserted through the anus to reach the end of the colon. By combining acupressure at points such as Zhongwan, Tianzhu, and Guanyuan, it helps promote the elimination of fecal impaction. Conclusion: This case reflects the innovative thinking and adaptability of nurses, providing a new clinical approach for the aggravation of the condition of long-term heart failure patients due to constipation issues. Further research in clinical practice is warranted.
基金supported by the National Key Research and Development Program of China(2021YFC2102100)the National Natural Science Foundation of China(U20A20361,32271507,81930122,and 82171819)the Beijing Postdoctoral Research Foundation(2021-ZZ-035)。
文摘Brucellosis,caused by Brucella,is one of the most common zoonosis.However,there is still no vaccine for human use.Although some live attenuated vaccines have been approved for animals,the protection effect is not ideal.In this study,we developed a dual-antigen nanoconjugate vaccine containing both polysaccharide and protein antigens against Brucella.First,the antigenic polysaccharide was covalently coupled to the outer membrane protein Omp19 using protein glycan coupling technology,and then it was successfully loaded on a nano-carrier through the SpyTag/SpyCatcher system.After confirming the efficient immune activation and safety performance of the dual-antigen nanoconjugate vaccine,the potent serum antibody response against the two antigens and remarkable protective effect in non-lethal and lethal Brucella infection models were further demonstrated through different routes of administration.These results indicated that the dual-antigen nanoconjugate vaccine enhanced both T helper 1 cell(Th1)and Th2 immune responses and protected mice from Brucella infection.Furthermore,we found that this protective effect was maintained for at least 18 weeks.To our knowledge,this is the first Brucella vaccine bearing diverse antigens,including a protein and polysaccharide,on a single nanoparticle.Thus,we also present an attractive technology for co-delivery of different types of antigens using a strategy applicable to other vaccines against infectious diseases.
文摘BACKGROUND Synchronous colorectal carcinomas(SCRC)are two or more primary colorectal carcinomas identified simultaneously or within 6 mo of the initial presentation in a single patient.Their incidence is low and the number of pathological types of SCRC is usually no more than two.It is very unusual that the pathological findings of a patient with SCRC show more than two different pathological subtypes.Here,we report a rare case of SCRC with three pathological subtypes.CASE SUMMARY A 75-year-old woman who had no previous medical history or family history was admitted to the hospital because of intermittent hematochezia for more than a month.Colonoscopy displayed an irregularly shaped neoplasm of the rectum,a tumor-like lesion causing intestinal stenosis in the descending colon,and a polypoidal neoplasm in the ileocecum.Subsequently,she underwent total colectomy,abdominoperineal resection for rectal cancer,and ileostomy.After operation,the pathological report showed three pathological subtypes including well-differentiated adenocarcinoma of the ascending colon,moderately differen-tiated adenocarcinoma of the descending colon,and mucinous adenocarcinoma of the rectum.She is now recovering well and continues to be closely monitored during follow-up.CONCLUSION Preoperative colonoscopy examination,imaging examination,and extensive intraoperative exploration play important roles in reducing the number of missed lesions.
基金the National Key Research and Development Program of China(Grant Nos.2021YFA1400403,2018YFA0306800,2019YFA0210004,and 2016YFA0300401)the National Natural Science Foundation of China(Grant Nos.92165205,11774149,11790311,11774154,11674158,and 12074175)Innovation Program for Quantum Science and Technology(Grant No.2021ZD0302800)。
文摘Excitons in solid state are bosons generated by electron-hole pairs as the Coulomb screening is sufficiently reduced.The exciton condensation can result in exotic physics such as super-fluidity and insulating state.In charge density wave(CDW)state,1T-TiSe_(2) is one of the candidates that may host the exciton condensation.However,to envision its excitonic effect is still challenging,particularly at the two-dimensional limit,which is applicable to future devices.Here,we realize the epitaxial 1T-TiSe_(2) bilayer,the two-dimensional limit for its 2×2×2 CDW order,to explore the exciton-associated effect.By means of high-resolution scanning tunneling spectroscopy and quasiparticle interference,we discover an unexpected state residing below the conduction band and right within the CDW gap region.As corroborated by our theoretical analysis,this mysterious phenomenon is in good agreement with the electron-exciton coupling.Our study provides a material platform to explore exciton-based electronics and opto-electronics.
文摘为准确揭示密云水库流域径流变化的物理成因,基于降水、径流非平稳特征诊断结果,采用SWAT(soil and water assessment tool)水文模型,基于Budyko理论的弹性系数法和水量平衡法揭示该流域径流变化原因;对比验证各模型归因结果差异,进一步探究归因方法和基准期选择对流域径流变化归因结果的影响。结果表明:基于Budyko理论的水量平衡方法更适用于水利工程众多、跨流域调水活动频繁的密云水库流域径流变化归因计算;利用该方法进行分析,当基准期长度达到16年及以上时,流域径流变化归因分析结果逐渐趋于稳定,而基准期选取过短会高估人类活动对径流的减水效应;此外,基准期选取靠近研究初始时段时,计算得到人类活动的减水效应相对较大。综合考虑上述各因素的影响,认为人类活动是密云水库流域径流变化的主导因素;在变化期Ⅰ,其减水效应在-128.32%~-119.56%波动,在变化期Ⅱ,其对径流的削减作用为-75.58%~-70.70%。研究结果有助于提升对密云水库流域径流复杂演变规律和物理成因的科学认识。