Chinese plum(Prunus salicina Lindl.)originates from China and makes a large contribution to the global production of plums.The P.salicina‘Wushancuili'has a green coloration and high fruit quality and is economica...Chinese plum(Prunus salicina Lindl.)originates from China and makes a large contribution to the global production of plums.The P.salicina‘Wushancuili'has a green coloration and high fruit quality and is economically important in eliminating poverty and protecting ecology in the Yangtze River Three Gorges Reservoir.However,rain-induced cracking(rain-cracking,literally skin cracking caused by rain)is a limitation to‘Wushancuili'fruit production and causes severe losses.This study reported a high-quality‘Wushancuili'genome assembly consisting of a 302.17-Mb sequence with eight pseudo-chromosomes and a contig N50 of 23.59 Mb through the combination of Illumina sequencing,Pacific Biosciences HiFiⅢsequencing,and high-throughput chromosome conformation capture technology.A total of 25109 protein-coding genes are predicted and 54.17%of the genome is composed of repetitive sequences.‘Wushancuili'underwent a remarkable orthoselection during evolution.Gene identification revealed that loss-of-function in four core MYB10 genes results in the anthocyanin deficiency and absence of red color,revealing the green coloration due to the residual high chlorophyll in fruit skin.Besides,the occurrence of cracking is assumed to be closely associated with cell wall modification and frequently rain-induced pathogen enrichment through transcriptomic analysis.The loss of MYB10 genes might render fruit more susceptible to pathogen-mediated cracking by weakening the epidermal strength and reactive oxygen species(ROS)scavenging.Our findings provided fundamental knowledge regarding fruit coloration and rain-cracking and will facilitate genetic improvement and cultivation management in Chinese plums.展开更多
Chronic osteomyelitis is a painful and serious disease caused by infected surgical prostheses or infected fractures.Traditional treatment includes surgical debridement followed by prolonged systemic antibiotics.Howeve...Chronic osteomyelitis is a painful and serious disease caused by infected surgical prostheses or infected fractures.Traditional treatment includes surgical debridement followed by prolonged systemic antibiotics.However,excessive antibiotic use has been inducing rapid emergence of antibiotic-resistant bacteria worldwide.Additionally,it is difficult for antibiotics to penetrate internal sites of infection such as bone,thus limiting their efficacy.New approaches to treat chronic osteomyelitis remain a major challenge for orthopedic surgeons.Luckily,the development of nanotechnology has brought new antimicrobial options with high specificity to infection sites,offering a possible way to address these challenges.Substantial progress has been made in constructing antibacterial nanomaterials for treatment of chronic osteomyelitis.Here,we review some current strategies for treatment of chronic osteomyelitis and their underlying mechanisms.展开更多
BACKGROUND The effectiveness of Platelet-Rich Plasma(PRP)in the treatment of patients with Achilles tendon rupture(ATR)and Achilles tendinopathy(AT)has been controversial.AIM To assess PRP injections’effectiveness in...BACKGROUND The effectiveness of Platelet-Rich Plasma(PRP)in the treatment of patients with Achilles tendon rupture(ATR)and Achilles tendinopathy(AT)has been controversial.AIM To assess PRP injections’effectiveness in treating ATR and AT.METHODS A comprehensive review of relevant literature was conducted utilizing multiple databases such as Cochrane Library,PubMed,Web of Science,Chinese Science and Technology Journal,EMBASE,and China Biomedical CD-ROM.The present investigation integrated randomized controlled trials that assessed the effectiveness of platelet-rich plasma injections in managing individuals with Achilles tendon rupture and tendinopathy.The eligibility criteria for the trials encompassed publications that were published within the timeframe of January 1,1966 to December 2022.The statistical analysis was performed utilizing the Review Manager 5.4.1,the visual analogue scale(VAS),Victorian Institute Ankle Function Scale(VISA-A),and Achilles Tendon Thickness were used to assess outcomes.RESULTS This meta-analysis included 13 randomized controlled trials,8 of which were randomized controlled trials of PRP for AT and 5 of which were randomized controlled trials of PRP for ATR.PRP for AT at 6 wk[weighted mean difference(WMD)=1.92,95%CI:-0.54 to 4.38,I2=34%],at 3 mo[WMD=0.20,95%CI:-2.65 to 3.05,I2=60%],and 6 mo[WMD=2.75,95%CI:-2.76 to 8.26,I2=87%)after which there was no significant difference in VISA-A scores between the PRP and control groups.There was no significant difference in VAS scores between the PRP group and the control group after 6 wk[WMD=6.75,95%CI:-6.12 to 19.62,I2=69%]and 6 mo[WMD=10.46,95%CI:-2.44 to 23.37,I2=69%]of treatment,and at mid-treatment at 3 mo[WMD=11.30,95%CI:7.33 to 15.27,I2=0%]after mid-treatment,the PRP group demonstrated better outcomes than the control group.Post-treatment patient satisfaction[WMD=1.07,95%CI:0.84 to 1.35,I2=0%],Achilles tendon thickness[WMD=0.34,95%CI:-0.04 to 0.71,I2=61%]and return to sport[WMD=1.11,95%CI:0.87 to 1.42,I2=0%]were not significantly different between the PRP and control groups.The study did not find any statistically significant distinction between the groups that received PRP treatment and those that did not,regarding the Victorian Institute of Sport Assessment-Achilles scores at 3 mo[WMD=-1.49,95%CI:-5.24 to 2.25,I2=0%],6 mo[WMD=-0.24,95%CI:-3.80 to 3.32,I2=0%],and 12 mo[WMD=-2.02,95%CI:-5.34 to 1.29,I2=87%]for ATR patients.Additionally,no significant difference was observed between the PRP and the control groups in improving Heel lift height respectively at 6 mo[WMD=-3.96,95%CI:-8.61 to 0.69,I2=0%]and 12 mo[WMD=-1.66,95%CI:-11.15 to 7.83,I2=0%]for ATR patients.There was no significant difference in calf circumference between the PRP group and the control group after 6 mo[WMD=1.01,95%CI:-0.78 to 2.80,I2=54%]and 12 mo[WMD=-0.55,95%CI:-2.2 to 1.09,I2=0%]of treatment.There was no significant difference in ankle mobility between the PRP and control groups at 6 mo of treatment[WMD=-0.38,95%CI:-2.34 to 1.58,I2=82%]and after 12 mo of treatment[WMD=-0.98,95%CI:-1.41 to-0.56,I2=10%]there was a significant improvement in ankle mobility between the PRP and control groups.There was no significant difference in the rate of return to exercise after treatment[WMD=1.20,95%CI:0.77 to 1.87,I2=0%]and the rate of adverse events[WMD=0.85,95%CI:0.50 to 1.45,I2=0%]between the PRP group and the control group.CONCLUSION The use of PRP for AT improved the patient’s immediate VAS scores but not VISA-A scores,changes in Achilles tendon thickness,patient satisfaction,or return to sport.Treatment of ATR with PRP injections alone improved long-term ankle mobility but had no significant effect on VISA-A scores,single heel lift height,calf circumference or return to sport.Additional research employing more extensive sampling sizes,more strict experimental methods,and standard methodologies may be necessary to yield more dependable and precise findings.展开更多
The microwave discharge cusped field thruster is a novel concept of electric micropropulsion device,which operatesμN level thrust in low mass flow rate conditions,making use of a coaxial transmission line resonator.W...The microwave discharge cusped field thruster is a novel concept of electric micropropulsion device,which operatesμN level thrust in low mass flow rate conditions,making use of a coaxial transmission line resonator.With its advantages of low thrust noise and high thrust resolution over a wide range of thrust,the thruster has emerged as a candidate thruster for the space-borne gravitational wave detection mission.The cathode effects commonly exist in many kinds of electric propulsion,and they are typically significant in micropropulsions.In order to find out the cathode position effects on a microwave discharge cusped field thruster,a thermionic cathode is mounted on a cross-slider for coupling.Under different cathode positions,the plume is analyzed by a Faraday probe and a retarding potential analyzer to analyze the performance and discharge characteristics.The results show that the magnetic mirror effect leads to significant degradation of anode current and an increase in low-energy ion ratio as the cathode moves away from the thruster exit.The electron conduction route also significantly impacts anode current efficiency,related to the cathode-exit distance and the thruster magnetic topology.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
Jet precession has previously been proposed to explain the apparently repeating features in the light curves of a few gamma-ray bursts(GRBs).In this paper,we further apply the precession model to a bright GRB 220408B ...Jet precession has previously been proposed to explain the apparently repeating features in the light curves of a few gamma-ray bursts(GRBs).In this paper,we further apply the precession model to a bright GRB 220408B by examining both its temporal and spectral consistency with the predictions of the model.As one of the recently confirmed GRBs observed by our GRID CubeSat mission,GRB 220408B is noteworthy as it exhibits three apparently similar emission episodes.Furthermore,the similarities are reinforced by their strong temporal correlations and similar features in terms of spectral evolution and spectral lags.Our analysis demonstrates that these features can be well explained by the modulated emission of a Fast-Rise-Exponential-Decay(FRED)shape light curve intrinsically produced by a precessing jet with a precession period of 18.4_(-0.2)~(+0.2)s,a nutation period of11.1_(-0.2)~(+0.2)s and viewed off-axis.This study provides a straightforward explanation for the complex yet similar multiepisode GRB light curves.展开更多
BACKGROUND Heterotopic ossification(HO)refers to the formation of new bone in non-skeletal tissues such as muscles,tendons or other soft tissues.Severe muscle and soft tissue injury often lead to the formation of HO.H...BACKGROUND Heterotopic ossification(HO)refers to the formation of new bone in non-skeletal tissues such as muscles,tendons or other soft tissues.Severe muscle and soft tissue injury often lead to the formation of HO.However,anterior HO of the ankle is rarely reported.CASE SUMMARY We report a patient with massive HO in front of the ankle joint for 23 years.In 1998,the patient was injured by a falling object on the right lower extremity,which gradually formed a massive heterotopic bone change in the right calf and dorsum of the foot.The patient did not develop gradual ankle function limitations until nearly 36 mo ago,and underwent resection of HO.Even after 23 years and resection of HO,the ankle joint was still able to move.CONCLUSION It is recommended that the orthopedist should be aware of HO and distinguish it from bone tumor.展开更多
随着电力市场和碳市场的发展,将需求响应和碳交易机制引入综合能源系统运行调度中,有助于引导用户和系统运营商优化用电和调度计划。通过分时电价和需求响应激励补贴等综合型激励措施引导用户参与需求响应,并基于IGDT(information gap d...随着电力市场和碳市场的发展,将需求响应和碳交易机制引入综合能源系统运行调度中,有助于引导用户和系统运营商优化用电和调度计划。通过分时电价和需求响应激励补贴等综合型激励措施引导用户参与需求响应,并基于IGDT(information gap decision theory)理论构建了考虑阶梯式碳交易机制以及需求响应的综合能源系统双层随机优化调度模型,并通过KKT条件和大M法将双层模型转化为单层模型进行求解。结果表明,引入需求响应和阶梯式碳交易机制之后能够实现综合能源系统的低碳环保运行。展开更多
Objective To investigate the indigenous lactobacilli from the vagina of pregnant women and to screen the isolates with antagonistic potential against pathogenic microorganisms. Methods The strains were isolated from p...Objective To investigate the indigenous lactobacilli from the vagina of pregnant women and to screen the isolates with antagonistic potential against pathogenic microorganisms. Methods The strains were isolated from pregnant women's vagina and identified using the API50CH system. The ability of the isolates to produce hydrogen peroxide was analyzed semi-quantitatively using the TMB-HRP-MRS agar. The antagonistic effects of the isolates on pathogenic microorganisms were determined with a double layer agar plate. Results One hundred and three lactobacilli strains were isolated from 60 samples of vaginal secretion from healthy pregnant women. Among them, 78 strains could produce hydrogen peroxide, in which 68%, 80%, 80%, and 88% had antagonistic effects against Candida albicans CMCC98001, Staphylococcus aureus CMCC26003, Escherichia coli CMCC44113, and Pseudomonas aeruginosa CMCC10110, respectively. Conclusion The recovery of hydrogen peroxide-producing lactobacilli decreases with the increasing pregnant age and time. The most commonly isolated species from vagina of Chinese pregnant women are Lactobacillus acidophilus and Lactobacillus crispatus. Most of L. acidophilus and L. crispatus produce a high H2O2 level.展开更多
Intrinsic radiation of materials is one of the major backgrounds for many rare-event search experiments.Thus,the production of pure materials in an underground laboratory is a promising approach for eliminating cosmog...Intrinsic radiation of materials is one of the major backgrounds for many rare-event search experiments.Thus,the production of pure materials in an underground laboratory is a promising approach for eliminating cosmogenic radionuclides.In this paper,we demonstrate a procedure to evaluate the yields of cosmogenic radionuclides in copper and germanium in the second phase of the China Jinping Underground Laboratory.Our results show that for copper and germanium materials,the largest cosmogenic background comes from 3 H and57,58,60Co,and 3 H and 68Ge,respectively,which all have yields on the order of 10-7 kg-1 day-1.The corresponding radioactivities after 90 days pf exposure underground are estimated to be lower than 10-6μBq kg-1.展开更多
Based on the monthly precipitation and air temperature from 1960 to 1989 in the Luanhe River Basin, the standardized precipitation evapotranspiration index (SPEI) and standardized precipitation index (SPI) at thre...Based on the monthly precipitation and air temperature from 1960 to 1989 in the Luanhe River Basin, the standardized precipitation evapotranspiration index (SPEI) and standardized precipitation index (SPI) at three- and six-month time scales and the self-calibrating Palmer drought severity index (sc-PDSI) were calculated to evaluate droughts in the study area. Temporal variations of the drought severity from 1960 to 1989 were analyzed and compared based on the results of different drought indices, and some typical drought events were identified. Spatial distributions of the drought severity according to the indices were also plotted and investigated. The results reveal the following: the performances of different drought indices are closely associated with the drought duration and the dominant factors of droughts; the SPEI is more accurate than the SPI when both evaporation and precipitation play important roles in drought events; the drought severity shown by the sc-PDSI is generally milder than the actual drought severity from 1960 to 1989; and the evolution of the droughts is usually delayed according to the scPDSI. This study provides valuable references for building drought early warning and mitigation systems in the Luanhe River Basin.展开更多
Objective:To evaluate the effects of action observation therapy,which is based on mirror neuron theory,on upper limb function and activities of daily living in patients with stroke.Methods:Sixty-one patients with stro...Objective:To evaluate the effects of action observation therapy,which is based on mirror neuron theory,on upper limb function and activities of daily living in patients with stroke.Methods:Sixty-one patients with stroke were randomly divided into two groups;those in the control group received routine rehabilitation treatment and nursing,whereas those in the experimental group additionally received eight weeks of action observation therapy for 30 min,six times per week.Patients receiving action observation therapy watched videos depicting a model performing specific motor actions typically performed in daily life before enacting the same actions themselves.All patients were assessed using the FugleMeyer assessment,Barthel index and the modified Ashworth scale at baseline and at eight weeks,after treatment.Results:After the eight weeks of treatment,both groups of patients exhibited significant improvement in all the measurements(all p<0.05).Furthermore,the FugleMeyer assessment,Barthel index and modified Ashworth scale scores were significantly higher in the experimental group compared to the control group(all p<0.05).Conclusion:Action observation therapy significantly improves upper extremity motor function and performance of activities of daily living,and alleviates upper limb spasticity in patients with stroke.展开更多
The broad-energy germanium(BEGe)detector,with the ability of background discrimination using pulse shape discrimination,is a competitive candidate for neutrinoless double beta decay(ovββ)experiments.In this paper,we...The broad-energy germanium(BEGe)detector,with the ability of background discrimination using pulse shape discrimination,is a competitive candidate for neutrinoless double beta decay(ovββ)experiments.In this paper,we report our measurements of key parameters for detector modeling in a commercial p-type BEGe detector.Point-like sources are used to investigate energy resolution and linearity of the detector.A cylindrical volume source is used for efficiency calibration.With an assembled device for source positioning and a collimated ^(133)Ba source,the detector is scanned to check its active volume.Using an^(241)Am point-like source,the dead layer thicknesses is measured at about 0.17 mm on the front and 1.18 mm on the side.The detector characterization is of importance for BEGe detectors to be used in the ovββ experiments at China JinPing underground Laboratory(CJPL).展开更多
Gamma-Ray Integrated Detectors(GRID)mis-sion is a student project designed to use multiple gamma-ray detectors carried by nanosatellites(CubeSats),forming a full-time all-sky gamma-ray detection network that monitors ...Gamma-Ray Integrated Detectors(GRID)mis-sion is a student project designed to use multiple gamma-ray detectors carried by nanosatellites(CubeSats),forming a full-time all-sky gamma-ray detection network that monitors the transient gamma-ray sky in the multi-mes-senger astronomy era.A compact CubeSat gamma-ray detector,including its hardware and firmware,was designed and implemented for the mission.The detector employs four Gd 2 Al 2 Ga 3 O 12:Ce(GAGG:Ce)scintillators coupled with four silicon photomultiplier(SiPM)arrays to achieve a high gamma-ray detection efficiency between 10 keV and 2 MeV with low power and small dimensions.The first detector designed by the undergraduate student team onboard a commercial CubeSat was launched into a Sun-synchronous orbit on October 29,2018.The detector was in a normal observation state and accumulated data for approximately one month after on-orbit functional and performance tests,which were conducted in 2019.展开更多
Objective:To investigate the effects of mirror neuron theory-based visual feedback therapy(VFT)on restoration of upper limb function of stroke patients and motor-related cortical function using functional magnetic res...Objective:To investigate the effects of mirror neuron theory-based visual feedback therapy(VFT)on restoration of upper limb function of stroke patients and motor-related cortical function using functional magnetic resonance imaging(fMRI).Methods:Hemiplegic stroke patients were randomly divided into two groups:a VFT group and a control(CTL)group.Sixteen patients in the VFT group received conventional rehabilitation(CR)and VFT for 8 weeks,while 15 patients in the CTL group received only CR.The Barthel Index(BI)was used to assess the activities of daily living at baseline and the 8th week of the recovery training period.The Fugl-Meyer assessment(FMA)scale,somatosensory evoked potential(SEP),and fMRI were used to evaluate the recovery effect of the training therapies.The latencies and amplitudes of N9 and N20 were measured.Before recovery training,fMRI was performed for all patients in the VFT and CTL groups.In addition,17 patients(9 in the VFT group and 8 in the CTL group)underwent fMRI for follow-up 2 months after treatment.Qualitative data were analyzed using the x2 test.The independent sample t-test was used to compare normally distributed data among different groups,the paired sample t-test was used to compare data between groups,and the non-parametric test was used to comparing data without normal distribution among groups.Results:There were no significant differences between the VFT and CTL group in all indexes.However,after 8 weeks of recovery training,these indexes were all significantly improved(P<0.05).As compared with the CTL group,the FMA scores,BI,and N9/N20 latencies and amplitudes of SEP in the VFT group were significantly improved(P<0.05).Two months after recovery training,fMRI showed that the degree of activation of the bilateral central anterior gyrus.parietal lobe,and auxiliary motor areas was significantly higher in the VFT group than the CTL group(P<0.05).Conclusions:VFT based on mirror neuron theory is an effective approach to improve upper extremity motor function and daily activity performance of stroke patients.The therapeutic mechanism promotes motor relearning by activating the mirror neuron system and motor cortex.SEP amplitudes increased only for patients who participated in visual feedback.VFT promotes sensory-motor plasticity and behavioral changes in both the motor and sensory domains.展开更多
In a multi-energy collaboration system, cooling, heating, electricity, and other energy components are coupled to complement each other. Through multi-energy coordination and cooperation, they can significantly improv...In a multi-energy collaboration system, cooling, heating, electricity, and other energy components are coupled to complement each other. Through multi-energy coordination and cooperation, they can significantly improve their individual operating efficiency and overall economic benefits. Demand response, as a multi-energy supply and demand balance method, can further improve system flexibility and economy. Therefore, a multi-energy cooperative system optimization model has been proposed, which is driven by price-based demand response to determine the impact of power-demand response on the optimal operating mode of a multi-energy cooperative system. The main components of the multi-energy collaborative system have been analyzed. The multi-energy coupling characteristics have been identified based on the energy hub model. Using market elasticity as a basis, a price-based demand response model has been built. The model has been optimized to minimize daily operating cost of the multi-energy collaborative system. Using data from an actual situation, the model has been verified, and we have shown that the adoption of price-based demand response measures can significantly improve the economy of multi-energy collaborative systems.展开更多
Last December 2019,a cluster of viral pneumonia cases identified as coronavirus disease 2019(COVID-19)was reported in Wuhan,China.We aimed to explore the frequencies of nasal symptoms in patients with COVID-19,includi...Last December 2019,a cluster of viral pneumonia cases identified as coronavirus disease 2019(COVID-19)was reported in Wuhan,China.We aimed to explore the frequencies of nasal symptoms in patients with COVID-19,including loss of smell and taste,as well as their presentation as the first symptom of the disease and their association with the severity of COVID-19.In this retrospective study,1206 laboratory-confirmed COVID-19 patients were included and followed up by telephone one month after discharged from Tongji Hospital,Wuhan.Demographic data,laboratory values,comorbidities,symptoms,and numerical rating scale scores(0–10)of nasal symptoms were extracted from the hospital medical records,and confirmed or reevaluated by the telephone follow-up.From patients(n=1172)completing follow-up,199(17%)subjects had severe COVID-19 and 342(29.2%)reported nasal symptoms.20.6%COVID-19 patients had loss of taste(median score=6),while 11.4%had loss of smell(median score=5).Loss of taste scores,but not loss of smell scores,were significantly increased in severe vs.nonsevere COVID-19 patients.Interleukin(IL)-6 and lactose dehydrogenase(LDH)serum levels were positively correlated with loss of taste scores.About 80%of COVID-19 patients recovered from smell and taste dysfunction in 2 weeks.In this cohort,only 1 out of 10 hospital admitted patients had loss of smell while 1 out of 5 reported loss of taste which was associated to severity of COVID-19.Most patients recovered smell and taste dysfunctions in 2 weeks.展开更多
AIM:To evaluate impact of radiation therapy dose escalation through intensity modulated radiation therapy with simultaneous integrated boost(IMRT-SIB).METHODS:We retrospectively reviewed the patients who underwent fou...AIM:To evaluate impact of radiation therapy dose escalation through intensity modulated radiation therapy with simultaneous integrated boost(IMRT-SIB).METHODS:We retrospectively reviewed the patients who underwent four-dimensional-based IMRT-SIBbased neoadjuvant chemoradiation protocol.During the concurrent chemoradiation therapy,radiation therapy was through IMRT-SIB delivered in 28 consecutive daily fractions with total radiation doses of 56 Gy to tumor and 5040 Gy dose-painted to clinical tumor volume,with a regimen at the discretion of the treating medical oncologist.This was followed by surgical tumor resection.We analyzed pathological completion response(p CR) rates its relationship with overall survival and event-freesurvival.RESULTS:Seventeen patients underwent dose escalation with the IMRT-SIB protocol between 2007 and 2014 and their records were available for analysis.Among the IMRT-SIB-treated patients,the toxicity appeared mild,the most common side effects were grade 1-3 esophagitis(46%) and pneumonitis(11.7%).There were no cardiac events.The Ro resection rate was 94%(n = 16),the p CR rate was 47%(n = 8),and the postoperative morbidity was zero.There was one mediastinal failure found,one patient had local failure at the anastomosis site,and the majority of failures were distant in the lung or bone.The 3-year diseasefree survival and overall survival rates were 41%(n = 7) and 53%(n = 9),respectively.CONCLUSION:The dose escalation through IMRT-SIB in the chemoradiation regimen seems responsible for down-staging the distal esophageal with well-tolerated complications.展开更多
基金financially supported by the Construction Program for Chongqing's Distinctive“Wushancuili”Industry(Grant No.4322200370)Strategic Cooperation Project of Chongqing Municipality and Chinese Academy of Agricultural Sciences(Grant No.4322300181)Fundamental Research Funds for Central Universities-Talent induction project(Grant Nos.SWU-KR22001,SWU-KQ22070)。
文摘Chinese plum(Prunus salicina Lindl.)originates from China and makes a large contribution to the global production of plums.The P.salicina‘Wushancuili'has a green coloration and high fruit quality and is economically important in eliminating poverty and protecting ecology in the Yangtze River Three Gorges Reservoir.However,rain-induced cracking(rain-cracking,literally skin cracking caused by rain)is a limitation to‘Wushancuili'fruit production and causes severe losses.This study reported a high-quality‘Wushancuili'genome assembly consisting of a 302.17-Mb sequence with eight pseudo-chromosomes and a contig N50 of 23.59 Mb through the combination of Illumina sequencing,Pacific Biosciences HiFiⅢsequencing,and high-throughput chromosome conformation capture technology.A total of 25109 protein-coding genes are predicted and 54.17%of the genome is composed of repetitive sequences.‘Wushancuili'underwent a remarkable orthoselection during evolution.Gene identification revealed that loss-of-function in four core MYB10 genes results in the anthocyanin deficiency and absence of red color,revealing the green coloration due to the residual high chlorophyll in fruit skin.Besides,the occurrence of cracking is assumed to be closely associated with cell wall modification and frequently rain-induced pathogen enrichment through transcriptomic analysis.The loss of MYB10 genes might render fruit more susceptible to pathogen-mediated cracking by weakening the epidermal strength and reactive oxygen species(ROS)scavenging.Our findings provided fundamental knowledge regarding fruit coloration and rain-cracking and will facilitate genetic improvement and cultivation management in Chinese plums.
基金Supported by the Science project of Hunan Provincial Health Commission,No.202204073347.
文摘Chronic osteomyelitis is a painful and serious disease caused by infected surgical prostheses or infected fractures.Traditional treatment includes surgical debridement followed by prolonged systemic antibiotics.However,excessive antibiotic use has been inducing rapid emergence of antibiotic-resistant bacteria worldwide.Additionally,it is difficult for antibiotics to penetrate internal sites of infection such as bone,thus limiting their efficacy.New approaches to treat chronic osteomyelitis remain a major challenge for orthopedic surgeons.Luckily,the development of nanotechnology has brought new antimicrobial options with high specificity to infection sites,offering a possible way to address these challenges.Substantial progress has been made in constructing antibacterial nanomaterials for treatment of chronic osteomyelitis.Here,we review some current strategies for treatment of chronic osteomyelitis and their underlying mechanisms.
基金Supported by Scientific Research Project of Hunan Education Department,No.21B0031 and No.21B0042
文摘BACKGROUND The effectiveness of Platelet-Rich Plasma(PRP)in the treatment of patients with Achilles tendon rupture(ATR)and Achilles tendinopathy(AT)has been controversial.AIM To assess PRP injections’effectiveness in treating ATR and AT.METHODS A comprehensive review of relevant literature was conducted utilizing multiple databases such as Cochrane Library,PubMed,Web of Science,Chinese Science and Technology Journal,EMBASE,and China Biomedical CD-ROM.The present investigation integrated randomized controlled trials that assessed the effectiveness of platelet-rich plasma injections in managing individuals with Achilles tendon rupture and tendinopathy.The eligibility criteria for the trials encompassed publications that were published within the timeframe of January 1,1966 to December 2022.The statistical analysis was performed utilizing the Review Manager 5.4.1,the visual analogue scale(VAS),Victorian Institute Ankle Function Scale(VISA-A),and Achilles Tendon Thickness were used to assess outcomes.RESULTS This meta-analysis included 13 randomized controlled trials,8 of which were randomized controlled trials of PRP for AT and 5 of which were randomized controlled trials of PRP for ATR.PRP for AT at 6 wk[weighted mean difference(WMD)=1.92,95%CI:-0.54 to 4.38,I2=34%],at 3 mo[WMD=0.20,95%CI:-2.65 to 3.05,I2=60%],and 6 mo[WMD=2.75,95%CI:-2.76 to 8.26,I2=87%)after which there was no significant difference in VISA-A scores between the PRP and control groups.There was no significant difference in VAS scores between the PRP group and the control group after 6 wk[WMD=6.75,95%CI:-6.12 to 19.62,I2=69%]and 6 mo[WMD=10.46,95%CI:-2.44 to 23.37,I2=69%]of treatment,and at mid-treatment at 3 mo[WMD=11.30,95%CI:7.33 to 15.27,I2=0%]after mid-treatment,the PRP group demonstrated better outcomes than the control group.Post-treatment patient satisfaction[WMD=1.07,95%CI:0.84 to 1.35,I2=0%],Achilles tendon thickness[WMD=0.34,95%CI:-0.04 to 0.71,I2=61%]and return to sport[WMD=1.11,95%CI:0.87 to 1.42,I2=0%]were not significantly different between the PRP and control groups.The study did not find any statistically significant distinction between the groups that received PRP treatment and those that did not,regarding the Victorian Institute of Sport Assessment-Achilles scores at 3 mo[WMD=-1.49,95%CI:-5.24 to 2.25,I2=0%],6 mo[WMD=-0.24,95%CI:-3.80 to 3.32,I2=0%],and 12 mo[WMD=-2.02,95%CI:-5.34 to 1.29,I2=87%]for ATR patients.Additionally,no significant difference was observed between the PRP and the control groups in improving Heel lift height respectively at 6 mo[WMD=-3.96,95%CI:-8.61 to 0.69,I2=0%]and 12 mo[WMD=-1.66,95%CI:-11.15 to 7.83,I2=0%]for ATR patients.There was no significant difference in calf circumference between the PRP group and the control group after 6 mo[WMD=1.01,95%CI:-0.78 to 2.80,I2=54%]and 12 mo[WMD=-0.55,95%CI:-2.2 to 1.09,I2=0%]of treatment.There was no significant difference in ankle mobility between the PRP and control groups at 6 mo of treatment[WMD=-0.38,95%CI:-2.34 to 1.58,I2=82%]and after 12 mo of treatment[WMD=-0.98,95%CI:-1.41 to-0.56,I2=10%]there was a significant improvement in ankle mobility between the PRP and control groups.There was no significant difference in the rate of return to exercise after treatment[WMD=1.20,95%CI:0.77 to 1.87,I2=0%]and the rate of adverse events[WMD=0.85,95%CI:0.50 to 1.45,I2=0%]between the PRP group and the control group.CONCLUSION The use of PRP for AT improved the patient’s immediate VAS scores but not VISA-A scores,changes in Achilles tendon thickness,patient satisfaction,or return to sport.Treatment of ATR with PRP injections alone improved long-term ankle mobility but had no significant effect on VISA-A scores,single heel lift height,calf circumference or return to sport.Additional research employing more extensive sampling sizes,more strict experimental methods,and standard methodologies may be necessary to yield more dependable and precise findings.
基金supported by the National Key R&D Program of China(No.2020YFC2201000)National Natural Science Foundation of China(No.11927812)。
文摘The microwave discharge cusped field thruster is a novel concept of electric micropropulsion device,which operatesμN level thrust in low mass flow rate conditions,making use of a coaxial transmission line resonator.With its advantages of low thrust noise and high thrust resolution over a wide range of thrust,the thruster has emerged as a candidate thruster for the space-borne gravitational wave detection mission.The cathode effects commonly exist in many kinds of electric propulsion,and they are typically significant in micropropulsions.In order to find out the cathode position effects on a microwave discharge cusped field thruster,a thermionic cathode is mounted on a cross-slider for coupling.Under different cathode positions,the plume is analyzed by a Faraday probe and a retarding potential analyzer to analyze the performance and discharge characteristics.The results show that the magnetic mirror effect leads to significant degradation of anode current and an increase in low-energy ion ratio as the cathode moves away from the thruster exit.The electron conduction route also significantly impacts anode current efficiency,related to the cathode-exit distance and the thruster magnetic topology.
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.
基金support by the National Key Research and Development Programs of China(2022YFF0711404,2022SKA0130102)the National SKA Program of China(2022SKA0130100)+4 种基金the National Natural Science Foundation of China(grant Nos.11833003,U2038105,U1831135,12121003)the science research grants from the China Manned Space Project with NO.CMS-CSST-2021-B11the Fundamental Research Funds for the Central Universitiesthe Program for Innovative Talents and Entrepreneur in Jiangsusupported by the National Postdoctoral Program for Innovative Talents(grant No.BX20200164)。
文摘Jet precession has previously been proposed to explain the apparently repeating features in the light curves of a few gamma-ray bursts(GRBs).In this paper,we further apply the precession model to a bright GRB 220408B by examining both its temporal and spectral consistency with the predictions of the model.As one of the recently confirmed GRBs observed by our GRID CubeSat mission,GRB 220408B is noteworthy as it exhibits three apparently similar emission episodes.Furthermore,the similarities are reinforced by their strong temporal correlations and similar features in terms of spectral evolution and spectral lags.Our analysis demonstrates that these features can be well explained by the modulated emission of a Fast-Rise-Exponential-Decay(FRED)shape light curve intrinsically produced by a precessing jet with a precession period of 18.4_(-0.2)~(+0.2)s,a nutation period of11.1_(-0.2)~(+0.2)s and viewed off-axis.This study provides a straightforward explanation for the complex yet similar multiepisode GRB light curves.
基金Supported by Scientific research project of Hunan Education Department,No.21B0075Science project of Hunan Provincial Health Commission,No.B2015-82。
文摘BACKGROUND Heterotopic ossification(HO)refers to the formation of new bone in non-skeletal tissues such as muscles,tendons or other soft tissues.Severe muscle and soft tissue injury often lead to the formation of HO.However,anterior HO of the ankle is rarely reported.CASE SUMMARY We report a patient with massive HO in front of the ankle joint for 23 years.In 1998,the patient was injured by a falling object on the right lower extremity,which gradually formed a massive heterotopic bone change in the right calf and dorsum of the foot.The patient did not develop gradual ankle function limitations until nearly 36 mo ago,and underwent resection of HO.Even after 23 years and resection of HO,the ankle joint was still able to move.CONCLUSION It is recommended that the orthopedist should be aware of HO and distinguish it from bone tumor.
文摘随着电力市场和碳市场的发展,将需求响应和碳交易机制引入综合能源系统运行调度中,有助于引导用户和系统运营商优化用电和调度计划。通过分时电价和需求响应激励补贴等综合型激励措施引导用户参与需求响应,并基于IGDT(information gap decision theory)理论构建了考虑阶梯式碳交易机制以及需求响应的综合能源系统双层随机优化调度模型,并通过KKT条件和大M法将双层模型转化为单层模型进行求解。结果表明,引入需求响应和阶梯式碳交易机制之后能够实现综合能源系统的低碳环保运行。
基金China Scholarship Council (2003836007)863 Program of China (2008AA10Z337)973 Program of China (2005DKA21202-1)
文摘Objective To investigate the indigenous lactobacilli from the vagina of pregnant women and to screen the isolates with antagonistic potential against pathogenic microorganisms. Methods The strains were isolated from pregnant women's vagina and identified using the API50CH system. The ability of the isolates to produce hydrogen peroxide was analyzed semi-quantitatively using the TMB-HRP-MRS agar. The antagonistic effects of the isolates on pathogenic microorganisms were determined with a double layer agar plate. Results One hundred and three lactobacilli strains were isolated from 60 samples of vaginal secretion from healthy pregnant women. Among them, 78 strains could produce hydrogen peroxide, in which 68%, 80%, 80%, and 88% had antagonistic effects against Candida albicans CMCC98001, Staphylococcus aureus CMCC26003, Escherichia coli CMCC44113, and Pseudomonas aeruginosa CMCC10110, respectively. Conclusion The recovery of hydrogen peroxide-producing lactobacilli decreases with the increasing pregnant age and time. The most commonly isolated species from vagina of Chinese pregnant women are Lactobacillus acidophilus and Lactobacillus crispatus. Most of L. acidophilus and L. crispatus produce a high H2O2 level.
基金supported by the National Natural Science Foundation of China(No.U1865205).
文摘Intrinsic radiation of materials is one of the major backgrounds for many rare-event search experiments.Thus,the production of pure materials in an underground laboratory is a promising approach for eliminating cosmogenic radionuclides.In this paper,we demonstrate a procedure to evaluate the yields of cosmogenic radionuclides in copper and germanium in the second phase of the China Jinping Underground Laboratory.Our results show that for copper and germanium materials,the largest cosmogenic background comes from 3 H and57,58,60Co,and 3 H and 68Ge,respectively,which all have yields on the order of 10-7 kg-1 day-1.The corresponding radioactivities after 90 days pf exposure underground are estimated to be lower than 10-6μBq kg-1.
基金supported by the National Natural Science Foundation of China(Grant No.41171220)the Program for Changjiang Scholars and Innovative Research Team in University of the Ministry of Education of China(Grant No.IRT13062)+2 种基金the Programme of Introducing Talents of Discipline to Universities(the 111 Project,Grant No.B08048)the Jiangsu Provincial Collaborative Innovation Center for World Water Valley and Water Ecological Civilizationthe National Cooperative Innovation Center for Water Safety and Hydro-Science
文摘Based on the monthly precipitation and air temperature from 1960 to 1989 in the Luanhe River Basin, the standardized precipitation evapotranspiration index (SPEI) and standardized precipitation index (SPI) at three- and six-month time scales and the self-calibrating Palmer drought severity index (sc-PDSI) were calculated to evaluate droughts in the study area. Temporal variations of the drought severity from 1960 to 1989 were analyzed and compared based on the results of different drought indices, and some typical drought events were identified. Spatial distributions of the drought severity according to the indices were also plotted and investigated. The results reveal the following: the performances of different drought indices are closely associated with the drought duration and the dominant factors of droughts; the SPEI is more accurate than the SPI when both evaporation and precipitation play important roles in drought events; the drought severity shown by the sc-PDSI is generally milder than the actual drought severity from 1960 to 1989; and the evolution of the droughts is usually delayed according to the scPDSI. This study provides valuable references for building drought early warning and mitigation systems in the Luanhe River Basin.
基金supported by funds from the Jaxing City Science and Technology Plan Project of Zhejiang province(2014AY21031-9)Zhejiang Provincial National Science Foundation of China(LY12H17004)the National Natural Science Foundation of China(81201504).
文摘Objective:To evaluate the effects of action observation therapy,which is based on mirror neuron theory,on upper limb function and activities of daily living in patients with stroke.Methods:Sixty-one patients with stroke were randomly divided into two groups;those in the control group received routine rehabilitation treatment and nursing,whereas those in the experimental group additionally received eight weeks of action observation therapy for 30 min,six times per week.Patients receiving action observation therapy watched videos depicting a model performing specific motor actions typically performed in daily life before enacting the same actions themselves.All patients were assessed using the FugleMeyer assessment,Barthel index and the modified Ashworth scale at baseline and at eight weeks,after treatment.Results:After the eight weeks of treatment,both groups of patients exhibited significant improvement in all the measurements(all p<0.05).Furthermore,the FugleMeyer assessment,Barthel index and modified Ashworth scale scores were significantly higher in the experimental group compared to the control group(all p<0.05).Conclusion:Action observation therapy significantly improves upper extremity motor function and performance of activities of daily living,and alleviates upper limb spasticity in patients with stroke.
基金supported by National Natural Science Foundation of China(Nos.11175099&11355001)Tsinghua University Initiative Scientific Research Program(Nos.20151080354&2014Z21016)
文摘The broad-energy germanium(BEGe)detector,with the ability of background discrimination using pulse shape discrimination,is a competitive candidate for neutrinoless double beta decay(ovββ)experiments.In this paper,we report our measurements of key parameters for detector modeling in a commercial p-type BEGe detector.Point-like sources are used to investigate energy resolution and linearity of the detector.A cylindrical volume source is used for efficiency calibration.With an assembled device for source positioning and a collimated ^(133)Ba source,the detector is scanned to check its active volume.Using an^(241)Am point-like source,the dead layer thicknesses is measured at about 0.17 mm on the front and 1.18 mm on the side.The detector characterization is of importance for BEGe detectors to be used in the ovββ experiments at China JinPing underground Laboratory(CJPL).
基金supported by the Tsinghua University Initiative Scientific Research Program,the National Natural Science Foundation of China(Nos.11633003,12025301,and 11821303)the National Key R&D Program of China(Nos.2018YFA0404502 and 2016YFA040080X).
文摘Gamma-Ray Integrated Detectors(GRID)mis-sion is a student project designed to use multiple gamma-ray detectors carried by nanosatellites(CubeSats),forming a full-time all-sky gamma-ray detection network that monitors the transient gamma-ray sky in the multi-mes-senger astronomy era.A compact CubeSat gamma-ray detector,including its hardware and firmware,was designed and implemented for the mission.The detector employs four Gd 2 Al 2 Ga 3 O 12:Ce(GAGG:Ce)scintillators coupled with four silicon photomultiplier(SiPM)arrays to achieve a high gamma-ray detection efficiency between 10 keV and 2 MeV with low power and small dimensions.The first detector designed by the undergraduate student team onboard a commercial CubeSat was launched into a Sun-synchronous orbit on October 29,2018.The detector was in a normal observation state and accumulated data for approximately one month after on-orbit functional and performance tests,which were conducted in 2019.
基金This study was supported in part by grants from Zhejiang province medical and health technology achievement Funding project(2018ZH044)Zhejiang province medical and health science and technology project.(2020KY317)+1 种基金Zhejiang province natural science foundation(LQ19H170001)2019-2021 period key discipline construction plan funded project of traditional Chinese medicine in Jiaxing city(2019 XK-A07).
文摘Objective:To investigate the effects of mirror neuron theory-based visual feedback therapy(VFT)on restoration of upper limb function of stroke patients and motor-related cortical function using functional magnetic resonance imaging(fMRI).Methods:Hemiplegic stroke patients were randomly divided into two groups:a VFT group and a control(CTL)group.Sixteen patients in the VFT group received conventional rehabilitation(CR)and VFT for 8 weeks,while 15 patients in the CTL group received only CR.The Barthel Index(BI)was used to assess the activities of daily living at baseline and the 8th week of the recovery training period.The Fugl-Meyer assessment(FMA)scale,somatosensory evoked potential(SEP),and fMRI were used to evaluate the recovery effect of the training therapies.The latencies and amplitudes of N9 and N20 were measured.Before recovery training,fMRI was performed for all patients in the VFT and CTL groups.In addition,17 patients(9 in the VFT group and 8 in the CTL group)underwent fMRI for follow-up 2 months after treatment.Qualitative data were analyzed using the x2 test.The independent sample t-test was used to compare normally distributed data among different groups,the paired sample t-test was used to compare data between groups,and the non-parametric test was used to comparing data without normal distribution among groups.Results:There were no significant differences between the VFT and CTL group in all indexes.However,after 8 weeks of recovery training,these indexes were all significantly improved(P<0.05).As compared with the CTL group,the FMA scores,BI,and N9/N20 latencies and amplitudes of SEP in the VFT group were significantly improved(P<0.05).Two months after recovery training,fMRI showed that the degree of activation of the bilateral central anterior gyrus.parietal lobe,and auxiliary motor areas was significantly higher in the VFT group than the CTL group(P<0.05).Conclusions:VFT based on mirror neuron theory is an effective approach to improve upper extremity motor function and daily activity performance of stroke patients.The therapeutic mechanism promotes motor relearning by activating the mirror neuron system and motor cortex.SEP amplitudes increased only for patients who participated in visual feedback.VFT promotes sensory-motor plasticity and behavioral changes in both the motor and sensory domains.
基金supported by State Grid Corporation Technology Project (5400-201956447A-0-0-00)。
文摘In a multi-energy collaboration system, cooling, heating, electricity, and other energy components are coupled to complement each other. Through multi-energy coordination and cooperation, they can significantly improve their individual operating efficiency and overall economic benefits. Demand response, as a multi-energy supply and demand balance method, can further improve system flexibility and economy. Therefore, a multi-energy cooperative system optimization model has been proposed, which is driven by price-based demand response to determine the impact of power-demand response on the optimal operating mode of a multi-energy cooperative system. The main components of the multi-energy collaborative system have been analyzed. The multi-energy coupling characteristics have been identified based on the energy hub model. Using market elasticity as a basis, a price-based demand response model has been built. The model has been optimized to minimize daily operating cost of the multi-energy collaborative system. Using data from an actual situation, the model has been verified, and we have shown that the adoption of price-based demand response measures can significantly improve the economy of multi-energy collaborative systems.
基金the Natural Science Foundation of Hubei Province of China(No.2018CFB602)National Key R&D Program of China(No.2018YFC0116800)National Natural Science Foundation of China(Nos:81630024,81920108011,and 81900925)。
文摘Last December 2019,a cluster of viral pneumonia cases identified as coronavirus disease 2019(COVID-19)was reported in Wuhan,China.We aimed to explore the frequencies of nasal symptoms in patients with COVID-19,including loss of smell and taste,as well as their presentation as the first symptom of the disease and their association with the severity of COVID-19.In this retrospective study,1206 laboratory-confirmed COVID-19 patients were included and followed up by telephone one month after discharged from Tongji Hospital,Wuhan.Demographic data,laboratory values,comorbidities,symptoms,and numerical rating scale scores(0–10)of nasal symptoms were extracted from the hospital medical records,and confirmed or reevaluated by the telephone follow-up.From patients(n=1172)completing follow-up,199(17%)subjects had severe COVID-19 and 342(29.2%)reported nasal symptoms.20.6%COVID-19 patients had loss of taste(median score=6),while 11.4%had loss of smell(median score=5).Loss of taste scores,but not loss of smell scores,were significantly increased in severe vs.nonsevere COVID-19 patients.Interleukin(IL)-6 and lactose dehydrogenase(LDH)serum levels were positively correlated with loss of taste scores.About 80%of COVID-19 patients recovered from smell and taste dysfunction in 2 weeks.In this cohort,only 1 out of 10 hospital admitted patients had loss of smell while 1 out of 5 reported loss of taste which was associated to severity of COVID-19.Most patients recovered smell and taste dysfunctions in 2 weeks.
文摘AIM:To evaluate impact of radiation therapy dose escalation through intensity modulated radiation therapy with simultaneous integrated boost(IMRT-SIB).METHODS:We retrospectively reviewed the patients who underwent four-dimensional-based IMRT-SIBbased neoadjuvant chemoradiation protocol.During the concurrent chemoradiation therapy,radiation therapy was through IMRT-SIB delivered in 28 consecutive daily fractions with total radiation doses of 56 Gy to tumor and 5040 Gy dose-painted to clinical tumor volume,with a regimen at the discretion of the treating medical oncologist.This was followed by surgical tumor resection.We analyzed pathological completion response(p CR) rates its relationship with overall survival and event-freesurvival.RESULTS:Seventeen patients underwent dose escalation with the IMRT-SIB protocol between 2007 and 2014 and their records were available for analysis.Among the IMRT-SIB-treated patients,the toxicity appeared mild,the most common side effects were grade 1-3 esophagitis(46%) and pneumonitis(11.7%).There were no cardiac events.The Ro resection rate was 94%(n = 16),the p CR rate was 47%(n = 8),and the postoperative morbidity was zero.There was one mediastinal failure found,one patient had local failure at the anastomosis site,and the majority of failures were distant in the lung or bone.The 3-year diseasefree survival and overall survival rates were 41%(n = 7) and 53%(n = 9),respectively.CONCLUSION:The dose escalation through IMRT-SIB in the chemoradiation regimen seems responsible for down-staging the distal esophageal with well-tolerated complications.