一次性医用塑胶制品废弃物闭环式管理体系创新与处置技术

一次性医用塑胶制品废弃物流失、扩散时,破坏生态环境与人体健康。针对一次性医用塑胶制品废弃物闭环式管理体系创新及处置技术进行了阐述。医用塑胶制品废弃物具有高危险性、难降解性和处置专业性的特点,医用塑胶制品废弃物管理存在废弃物全过程管理漏洞较多、废弃物处置技术落后的问题。针对以上问题,设计完善废弃物闭环式管理环节。根据4个环节,研究完善废弃物闭环式分类收集技术、废弃物转运环节的信息化管理处置技术、废弃物消毒环节的环保化处置技术、优化废弃物无害化处置技术,以期改善医用废弃物污染情况,提升医疗活动的环保卫生水平。

The Efficacy and Safety of Dinoprostone Vaginal Insert for Labor Induction Following Optimization of Standard Operating Procedure: A Retrospective Study in China

Background:The study aimed to assess the efficacy and safety of dinoprostone vaginal insert in labor induction following optimization of standard operating procedure(SOP)and to discover independent predictors of vaginal delivery.Methods:This study comprised 551 pregnant women who required cervical ripening with dinoprostone before induction of labor.Using univariate and multivariate analyses,independent predictors of vaginal delivery were identified.Results:443 of the 551 women(80.4%)gave birth vaginally.Vaginal delivery was predicted by maternal age(24-30 vs.<24,P<0.001;30-35 vs.<24,P=0.03),gestational age(P=0.005),birth weight(P<0.001),parity(P=0.001),pre-pregnancy BMI(P<0.001),premature rupture of membranes(P=0.001),meconium-stained amniotic fluid(P<0.001),fundal height(P<0.001)and the Bishop score(P<0.001).None of the women exhibited severe postpartum hemorrhage.Conclusions:The maternal age,gestational age,birth weight,parity,body mass index,premature membrane rupture,amniotic fluid contamination,fundal height,and the Bishop score were independent predictors of vaginal delivery.These may guide the clinical use of dinoprostone for induction of labor.

Three-dimensional printing for heart diseases: clinical application review

Heart diseases remain the top threat to human health,and the treatment of heart diseases changes with each passing day.Convincing evidence shows that three-dimensional(3D)printing allows for a more precise understanding of the complex anatomy associated with various heart diseases.In addition,3D-printed models of cardiac diseases may serve as effective educational tools and for hands-on simulation of surgical interventions.We introduce examples of the clinical applications of different types of 3D printing based on specific cases and clinical application scenarios of 3D printing in treating heart diseases.We also discuss the limitations and clinically unmet needs of 3D printing in this context.

Unusual early-stage pancreatic sarcomatoid carcinoma

Sarcomatoid carcinoma of the pancreas(SCP)is a very rare pathological type of carcinoma that usually has a poor prognosis.Its pathogenesis has not been elucidated.We herein report a case of an early-stage SCP involving successful treatment and a good prognosis.The patient was a 48-year-old Chinese man with a5-mo history of vague abdominal pain.Ultrasonography revealed a 93 mm×94 mm×75 mm mass of mixed echogenicity in the tail of the pancreas.Laboratory test results were within the normal range,with the exception of an obviously increased pretreatment neuron-specific enolase level.The plasma transforming growth factor(TGF)β1 and interleukin-11 levels were obviously increased according to enzyme-linked immunosorbent assay.Microscopically,the excised tumor tissue comprised cancer cells and mesenchymal cells.Immunohistochemical analysis was positive forα-1-antichymotrypsin,pan-cytokeratin,cytokeratin 19,cytokeratin 8/18,and vimentin and negative for CD68and lysozyme.The pathogenetic mechanism of this case shows that TGFβ1 may regulate the epithelial-tomesenchymal transition in SCP.With early eradication of the tumor and systemic therapy,this patient has been alive for more than 3 years without tumor recurrence or distant metastasis.This case is also the first to show that TGFβ1 may regulate the epithelial-tomesenchymal transition in early-stage SCP.

中医情志护理对消化道恶性肿瘤疼痛的影响

目的:探究中医情志护理对消化道恶性肿瘤患者疼痛的影响。方法:将86例消化道恶性肿瘤患者,依据随机数字表法分为2组各43例,对照组采用常规西医护理,观察组采用常规西医护理联合中医情志护理,对比2组患者护理前后疼痛评分、焦虑评分、抑郁评分和睡眠质量的变化情况。结果:护理干预后,2组疼痛评分均下降,观察组患者的疼痛评分,在护理7 d、14 d及出院时低于对照组患者,差异有统计学意义(P<0.05)。护理干预后,2组不良情绪评分均下降,观察组患者护理7 d、14 d和出院时,焦虑、抑郁评分优于对照组,差异有统计学意义(P<0.05)。经过护理,2组出院时睡眠质量均较护理前改善,观察组患者出院时,睡眠质量、入睡时间及总分优于对照组患者,差异有统计学意义(P<0.05)。结论:中医情志护理可有效改善消化道恶性肿瘤患者焦虑、抑郁等负面情绪,缓解了疼痛感受,提高睡眠质量。

A novel technique for automatic seismic data processing using both integral and local feature of seismograms

A novel technique for automatic seismic data processing using both integral and local feature of seismograms was presented in this paper. Here, the term integral feature of seismograms refers to feature which may depict the shape of the whole seismograms. However, unlike some previous efforts which completely abandon the DIAL approach, i.e., signal detection, phase identifi- cation, association, and event localization, and seek to use envelope cross-correlation to detect seismic events directly, our technique keeps following the DIAL approach, but in addition to detect signals corresponding to individual seismic phases, it also detects continuous wave-trains and explores their feature for phase-type identification and signal association. More concrete ideas about how to define wave-trains and combine them with various detections, as well as how to measure and utilize their feature in the seismic data processing were expatiated in the paper. This approach has been applied to the routine data processing by us for years, and test results for a 16 days＇ period using data from the Xinjiang seismic station network were presented. The automatic processing results have fairly low false and missed event rate simultaneously, showing that the new technique has good application prospects for improvement of the automatic seismic data processing.

日粮纤维在猪日粮中的应用研究进展

日粮纤维,一方面会降低养殖成本及养分利用率和猪只生长性能;另一方面,可以通过肠道微生物发酵与抑制病原菌定植提高猪只肠道健康水平。高日粮纤维猪只日粮的负面影响受纤维来源、类型和添加水平影响,而合理使用日粮纤维能改善仔猪肠道健康并提高母猪繁殖性能;添加纤维降解酶可以缓解日粮纤维的抗营养作用,以保证其对仔猪肠道健康的改善作用。文章就日粮纤维类型、使用方法及对猪只营养、肠道健康的影响进行了综述,以期为日粮纤维的有效利用提高养殖生产效益提供参考和依据。

现场快速评估技术在乳腺癌前哨淋巴活检术中的应用价值研究

目的:探讨现场快速评估(rapid on-site evaluation,ROSE)技术在乳腺癌前哨淋巴结活检术(sentinel lymph node biopsy,SLNB)中的应用准确性及临床价值。方法:纳入2019年12月至2021年12月于云南省肿瘤医院确诊的早期乳腺癌患者375例,分为行SLNB组195例(A组)、新辅助化疗后行SLNB组180例(B组),术中应用ROSE技术联合冰冻对A组444枚和B组479枚的前哨淋巴结进行快速诊断。以术后石蜡病理检查为金标准,同时再行细胞学巴氏染色及H&E染色对诊断结果进行比较,绘制各检测方法受试者工作特征(receiver operating characteristic,ROC)曲线,计算ROC曲线下面积(area under curve,AUC)并行McNemar检验,评估ROSE技术的诊断效率、准确度、敏感度及特异度。结果:ROSE技术平均诊断时间为6.53 min/例。A组和B组的ROSE技术的AUC值分别为0.929和0.961、敏感度分别为82.35%和93.81%、特异度分别为97.56%和98.43%,A、B组与其他常规检测诊断方法比较,差异均无统计学意义(P=0.180、P=1.000)。结论:ROSE技术联合冰冻用于乳腺癌SLNB能有效提高诊断效率,具有良好的临床应用及推广价值。

Microstructured fluorescence in liquid crystals with femtosecond laser excitation

This study investigated direct fluorescence generation from a nematic liquid crystal(NLC)NJU-LDn-4 under femtosecond laser excitation.The absorption,transmittance,excitation,and emission spectra of the NLC were assessed.The relationship between the femtosecond pump power and fluorescence intensity was analyzed,revealing a quadratic increase and indicating that two-photon absorption(2PA)is the primary fluorescence mechanism.The LC microstructure was designed using photoalignment technology,allowing the generated fluorescence to reflect the corresponding structure.This research can establish a foundation for tunable LC microstructured fluorescence,with potential applications in fluorescence microscopy and optoelectronics.

Different dosages of methylprednisolone therapy for acute necrotizing encephalopathy of childhood:a 6-year multicenter retrospective study

To the Editor:Acute necrotizing encephalopathy(ANE)is a rare but often devastating neurologic disorder in children.[1]Hereditary susceptibility and cytokine storm play important roles in ANE pathogenesis,[2,3]but the specific molecular biological mechanism is unclear.

Targeting PSAT1 to mitigate metastasis in tumors with p53-72Pro variant

The single-nucleotide polymorphism(SNP)of p53,in particular the codon 72 variants,has recently been implicated as a critical regulator in tumor progression.However,the underlying mechanism remains elusive.Here we found that cancer cells carrying codon 72-Pro variant of p53 showed impaired metastatic potential upon serine supplementation.Proteome-wide mapping of p53-interacting proteins uncovered a specific interaction of the codon 72 proline variant(but not p5372R)with phosphoserine aminotransferase 1(PSAT1).Interestingly,p53^(72P)-PSAT1 interaction resulted in dissociation of peroxisome proliferator-activated receptor-γcoactivator 1α(PGC-1α)that otherwise bound to p53^(72P),leading to subsequent nuclear translocation of PGC-1αand activation of oxidative phosphorylation(OXPHOS)and tricarboxylic acid(TCA)cycle.Depletion of PSAT1 restored p53^(72P)-PGC-1αinteraction and impeded the OXPHOS and TCA function,resulting in mitochondrial dysfunction and metastasis suppression.Notably,pharmacological targeting the PSAT1-p53^(72P)interaction by aminooxyacetic acid(AOA)crippled the growth of liver cancer cells carrying the p53^(72P)variant in both in vitro and patient-derived xenograft models.Moreover,AOA plus regorafenib,an FDA-proved drug for hepatocellular carcinoma and colorectal cancer,achieved a better anti-tumor effect on tumors carrying the p53^(72P)variant.Therefore,our findings identified a gain of function of the p53^(72P)variant on mitochondrial function and provided a promising precision strategy to treat tumors vulnerable to p53^(72P)-PSAT1 perturbation.

Chinese Trauma Surgeon Association for management guidelines of vacuum sealing drainage application in abdominal surgeries-Update and systematic review

Vacuum sealing drainage (VSD) is frequently used in abdominal surgeries. However, relevant guidelines are rare. Chin ese Trauma Surge on Associati on orga nized a committee composed of 28 experts across China in July 2017, aiming to provide an evidence-based recommendation for the application of VSD in abdominal surgeries.Eleven questions regarding the use of VSD in abdominal surgeries were addressed:(1) which type of materials should be respectively chosen for the intraperitoneal cavity, retroperitoneal cavity and superficial incisions?(2) Can VSD be preventively used for a high-risk abdominal incision w让h primary suture?(3) Can VSD be used in severely contaminated/infected abdominal surgical sites?(4) Can VSD be used for temporary abdominal cavity closure under some special conditions such as severe abdominal trauma, infection, liver transplantation and intra-abdominal volume increment in abdominal compartment syndrome?(5) Can VSD be used in abdominal organ inflammation, injury, or postoperative drainage?(6) Can VSD be used in the treatment of intestinal fistula and pancreatic fistula?(7) Can VSD be used in the treatment of intra-abdominal and extra-peritoneal abscess?(8) Can VSD be used in the treatment of abdominal wall wounds, wound cavity, and defects?(9) Does VSD in crease the risk of bleeding?(10) Does VSD increase the risk of intestinal wail injury?(11) Does VSD increase the risk of peritoneal adhesion? Focusing on these questions, evidence-based recommendations were given accordingly. VSD was strongly recommended regarding the questions 2-4. Weak recommendations were made regarding questions 1 and 5-11. Proper use of VSD in abdominal surgeries can lower the risk of infection in abdominal incisions with primary suture, treat severely contaminated/infected surgical sites and facilitate temporary abdominal cavity closure.

Antibiotic usage in Chinese children: a point prevalence survey

Background Children as a population have high antimicrobial prescribing rates which may lead to high resistance of bacteria according to data from some single-center surveys of antibiotic prescribing rates in China. The acquirement of baseline data of antibiotic prescribing is the basis of developing intervention strategies on inappropriate antimicrobial prescriptions. Few studies show clearly the pattern and detailed information on classes of antibiotics and distribution of indications of antibiotic prescriptions in children in China. This study aims to assess the antibiotic prescribing patterns among children and neonates hospitalized in 18 hospitals in China. Methods A 24-hour point prevalence survey on antimicrobial prescribing was conducted in hospitalized neonates and chil-dren in China from December 1st, 2016 to February 28th, 2017. Information on the antibiotic use of patients under 18 years of age who were administered one or more on-going antibiotics in the selected wards over a 24-hour period was collected. These data were submitted to the GARPEC (Global Antimicrobial Resistance, Prescribing and Efficacy in Children and Neonates) web-based application ( https ://pidrg -datab ase.sgul.ac.uk/redca p/ ). For statistical analysis, Microsoft Excel 2007 and SPSS 22.0 were used. Results The antibiotic data were collected in 35 wards in 18 hospitals from 9 provinces. In total, 67.76% (975/1439) of the patients (n = 1439) were given at least one antibiotic, including 58.1% (173/298) of neonates (n = 298) and 70.3% (802/1141) of children (n = 1141). In neonates, the three most frequently prescribed antibiotics were third-generation cephalosporins (41.7%), penicillins plus enzyme inhibitor (23.8%), and carbapenems (11.2%). In children, the three most frequently pre-scribed antibiotics were third-generation cephalosporins (35.5%), macrolides (23.2%), and penicillins plus enzyme inhibi-tors (15.9%). The most common indication for antibiotics was proven or probable bacterial lower respiratory tract infection (30.9% in neonates and 66.6% in children). Conclusions Antibiotics are commonly prescribed in the Chinese children population. It is likely that the third-generation cephalosporins and macrolides are currently overused in Chinese children. Efforts must be made to ensure safe and appropri-ate antibiotic prescribing to reduce and prevent the future development of antibiotic resistance.

Review on thermochromic vanadium dioxide based smart coatings： from lab to commercial application

With an urgent demand of energy efficientcoatings for building fenestrations, vanadium dioxide（VO2）-based thermochromic smart coatings have beenwidely investigated due to the reversible phase transition ofVO2 at a critical transition temperature of 68 ℃, which isaccompanied by the modulation of solar irradiation, espe-cially in the near-infrared region. As for commercialapplications in our daily life, there are still some obstaclesfor VO2-based smart coatings, such as the high phasetransition temperature, optical properties （luminous trans-mittance and solar modulation ability）, environmental sta-bility in a long-time period, as well as mass production. Inthis review, recent progress of thermochromic smart coat-ings to solve above obstacles has been surveyed. Mean-while, future development trends have also been given topromote the goal of commercial production of VO2 smartcoatings.

Serum semaphorin 4C as a diagnostic biomarker in breast cancer:A multicenter retrospective study

Background:To date,there is no approved blood-based biomarker for breast cancer detection.Herein,we aimed to assess semaphorin 4C(SEMA4C),a pivotal protein involved in breast cancer progression,as a serum diagnostic biomarker.Methods:We included 6,213 consecutive inpatients from Tongji Hospital,Qilu Hospital,and Hubei Cancer Hospital.Training cohort and two validation cohorts were introduced for diagnostic exploration and validation.A pan-cancer cohort was used to independently explore the diagnostic potential of SEMA4C among solid tumors.Breast cancer patients who underwent mass excision prior to modified radical mastectomy were also analyzed.We hypothesized that increased pretreatment serum SEMA4C levels,measured using optimized in-house enzymelinked immunosorbent assay kits,could detect breast cancer.The endpoints were diagnostic performance,including area under the receiver operating characteristic curve(AUC),sensitivity,and specificity.Post-surgery pathological diagnosis was the reference standard and breast cancer staging followed the TNM classification.There was no restriction on disease stage for eligibilities.Results:We included 2667 inpatients with breast lesions,2378 patients with other solid tumors,and 1168 healthy participants.Specifically,118 patients with breast cancer were diagnosed with stage 0(5.71%),620 with stage I(30.00%),966 with stage II(46.73%),217 with stage III(10.50%),and 8 with stage IV(0.39%).Patients with breast cancer had significantly higher serum SEMA4C levels than benign breast tumor patients and normal controls(P<0.001).Elevated serum SEMA4C levels had AUC of 0.920(95%confidence interval[CI]:0.900–0.941)and 0.932(95%CI:0.911–0.953)for breast cancer detection in the two validation cohorts.The AUCs for detecting early-stage breast cancer(n=366)and ductal carcinoma in situ(n=85)were 0.931(95%CI:0.916–0.946)and 0.879(95%CI:0.832–0.925),respectively.Serum SEMA4C levels significantly decreased after surgery,and the reduction was more striking after modified radical mastectomy,compared with mass excision(P<0.001).The positive rate of enhanced serum SEMA4C levels was 84.77%for breast cancer and below 20.75%for the other 14 solid tumors.Conclusions:Serum SEMA4C demonstrated promising potential as a candidate biomarker for breast cancer diagnosis.However,validation in prospective settings and by other study groups is warranted.

Repurposing econazole as a pharmacological autophagy inhibitor to treat pancreatic ductal adenocarcinoma

Pancreatic ductal adenocarcinoma(PDAC)is characterized by the highest mortality among carcinomas.The pathogenesis of PDAC requires elevated autophagy,inhibition of which using hydroxychloroquine has shown promise.However,current realization is impeded by its suboptimal use and unpredictable toxicity.Attempts to identify novel autophagy-modulating agents from already approved drugs offer a rapid and accessible approach.Here,using a patient-derived organoid model,we performed a comparative analysis of therapeutic responses among various antimalarial/fungal/parasitic/viral agents,through which econazole(ECON),an antifungal compound,emerged as the top candidate.Further testing in cell-line and xenograft models of PDAC validated this activity,which occurred as a direct consequence of dysfunctional autophagy.More specifically,ECON boosted autophagy initiation but blocked lysosome biogenesis.RNA sequencing analysis revealed that this autophagic induction was largely attributed to the altered expression of activation transcription factor 3(ATF3).Increased nuclear import of ATF3 and its transcriptional repression of inhibitor of differentiation-1(ID-1)led to inactivation of the AKT/mammalian target of rapamycin(m TOR)pathway,thus giving rise to autophagosome accumulation in PDAC cells.The magnitude of the increase in autophagosomes was sufficient to elicit ER stress-mediated apoptosis.Furthermore,ECON,as an autophagy inhibitor,exhibited synergistic effects with trametinib on PDAC.This study provides direct preclinical and experimental evidence for the therapeutic efficacy of ECON in PDAC treatment and reveals a mechanism whereby ECON inhibits PDAC growth.

Cryptobiosis-inspired assembly of “AND” logic gate platform for potential tumor-specific drug delivery

Developing tumor-specific drug delivery systems with minimized off-target cargo leakage remains an enduring challenge.In this study,inspired from the natural cryptobiosis explored by certain organisms and stimuli-responsive polyphenol-metal coordination chemistry,doxorubicin(DOX)-conjugated gelatin nanoparticles with protective shells formed by complex of tannic acid and FeⅢ(DG@TA-FeⅢNPs)were successfully developed as an"AND"logic gate platform for tumor-targeted DOX delivery.Moreover,benefiting from the well-reported photothermal conversion ability of TA-FeⅢcomplex,a synergistic tumor inhibition effect was confirmed by treating 4 T1 tumor-beaing mice with DG@TA-FeⅢNPs and localized near-infrared(NIR)laser irradiation.As a proof of concept study,this work present a simple strategy for developing"AND"logic gate platforms by coating enzyme-degradable drug conjugates with detachable polyphenol-metal shells.

Ultrafast processes in photochromic material YH_xO_y studied by excited-state density functional theory simulation

Oxygen-containing rare-earth metal hydride YH_xO_y,is a newly found photochromic material showing fast photoresponse.While its preparation method,optical properties and structural features have been studied extensively,the photochromic mechanism in YH_xO_yremains unknown Here,using excited-state molecular dynamics simulation based on the recently developed real-time time-dependent density functional theory(RT-TDDFT)method,we study the photochemical reactions in YH_xO_y.We find that under photoexcitation,dihydrogen defects are formed within 100 fs.The dihydrogen defect behaves as a shallow donor and renders the material strongly n-type doped,which could be responsible for the photochromic effect observed in YH_xO_y.We also find that oxygen concentration affects the metastability of the dihydrogen species,meaning that the energy barrier for the dihydrogen to dissociate is related to the oxygen concentration The highest barrier of 0.28 eV is found in our model with O/Y=1:8.If the oxygen concentration is too low,the dihydrogen will quickly dissociate when the excitation is turned off.If the oxygen concentration is too high,the dihydrogen dissociates even when the excitation is still on.

Optical switching properties of Pd-Ni thin-film top-capped switchable mirrors

Switchable mirrors based on magnesium-nickel alloy thin films capped with catalytic Pd-Ni alloy thin films were prepared by a DC magnetron sputtering method. Their composition, structure and surface morphology were studied by XPS, XRD and AFM. Herein, the optical switching properties and durability of the switchable mirrors were investigated by varying the Ni content in the Pd-Ni alloys. Comparing pure Pd catalyst with Pd-Ni top-capped switchable mirrors, the latter show better hydrogenation and dehydrogenation kinetics, and the speed of hydrogen desorption is obviously improved with increasing Ni content in the Pd-Ni alloy. The Pd-Ni capped switchable mirrors also have better optical switching durability. The catalytic Pd layer with the addition of Ni does not influence the transmittance （hydride state） and reflectance （metallic state） of the switchable mirrors. In addition, replacing Pd with Pd-Ni alloy decreases the cost of the switchable mirrors： employing nickel in the alloy Pd89.2Ni10.8 can save about 11% use of Pd. Therefore, the Pd-Ni alloy can provide a cheaper catalytic thin film, and it is expected to have applications in energy-saving windows, hydrogen sensors and hydrogen storage materials.

High catalytic activity for formaldehyde oxidation of an interconnected network structure composed of δ-MnO_(2) nanosheets and γ-MnOOH nanowires

Among the transition metal oxide catalysts,manganese oxides have great potential for formaldehyde(HCHO)oxidation at ambient temperature because of their high activity,nontoxicity,low cost,and polybasic morphologies.In this work,a MnO_(2)-based catalyst(M-MnO_(2))with an interconnected network structure was successfully synthesized by a one-step hydrothermal method.The M-MnO_(2) catalyst was composed of the main catalytic agent,δ-MnO_(2) nanosheets,dispersed in a nonactive framework material of γ-MnOOH nanowires.The catalytic activity of M-MnO_(2) for HCHO oxidation at room temperature was much higher than that of the pure δ-MnO_(2) nanosheets.This is attributed to the special interconnected network structure.The special interconnected network structure has high dispersion and specific surface area,which can provide more surface active oxygen species and higher surface hydroxyl groups to realize rapid decomposition of HCHO.