Plasmonic vortices confining orbital angular momentums to surface have aroused wide research interest in the last decade.Recent advances of near-field microscopes have enabled the study on the spatiotemporal dynamics ...Plasmonic vortices confining orbital angular momentums to surface have aroused wide research interest in the last decade.Recent advances of near-field microscopes have enabled the study on the spatiotemporal dynamics of plasmonic vortices,providing a better understanding of optical orbital angular momentums in the evanescent wave regime.However,these works only focused on the objective characterization of plasmonic vortex and have not achieved subjectively tailoring of its spatiotemporal dynamics for specific applications.Herein,it is demonstrated that the plasmonic vortices with the same topological charge can be endowed with distinct spatiotemporal dynamics by simply changing the coupler design.Based on a near-field scanning terahertz microscopy,the surface plasmon fields are directly obtained with ultrahigh spatiotemporal resolution,experimentally exhibiting the generation and evolution divergences during the whole lifetime of plasmonic vortices.The proposed strategy is straightforward and universal,which can be readily applied into visible or infrared frequencies,facilitating the development of plasmonic vortex related researches and applications.展开更多
Designing single-atom catalysts for oxygen reduction reaction(ORR)are fashionable but challenging to boost the zinc-air battery performance.Significantly enhanced ORR activity by manganese(Mn)singleatom catalysts can ...Designing single-atom catalysts for oxygen reduction reaction(ORR)are fashionable but challenging to boost the zinc-air battery performance.Significantly enhanced ORR activity by manganese(Mn)singleatom catalysts can be achieved by accurately regulating the coordination number of isolated Mn atoms.Theoretical calculations indicate that the single Mn-N5sites possess lower free energy barrier and higher oxygen adsorption performance than single Mn-N4sites to accelerate the ORR kinetics.Target to it,here we synthesize an atomically dispersed Mn-N5catalyst by precisely axial coordination of pyridinic-N doped into two-dimensional(2D)porous nanocarbon sheets(~3.56 nm thickness),which reveals outstanding catalytic activity and ultrahigh stability for the ORR in zinc-air battery owing to the inhomogeneous charge distribution of Mn-N5sites compared to the conventional single-site Mn-N4catalyst and Pt/C.This work gives a new strategy for in situ regulating the electronic structure of metal single-atoms and further promoting the overall ORR performance in energy systems.展开更多
The in situ mining technology is applied to the exploitation of medium-and low-maturity shale oil,which can use heaters to warm up the oil shale formations and pyrolyze the kerogen.Due to the low thermal conductivity ...The in situ mining technology is applied to the exploitation of medium-and low-maturity shale oil,which can use heaters to warm up the oil shale formations and pyrolyze the kerogen.Due to the low thermal conductivity of oil shale,electric heaters need extra equipment to improve heat transfer efficiency.In this study,a thermally conductive proppant is fabricated by coating epoxy-resin and graphite on ceramic proppants for the first time,which could support the fracturing crack and transfer heat.The thermal conduction property of epoxy-resin and graphite coated proppants(EGPs)is 245%higher than that of uncoated proppants,which can transfer more heat to the oil shale formation and accelerate the conversion of kerogen.The adhesive property of EGPs is improved by 47.9%under the load force of 1500 nN,which prolongs the time for the fracture to close.In summary,this novel proppant is expected to assist in-situ mining technology in the production of medium and low-maturity shale oil.展开更多
BACKGROUND Chemotherapy followed by gastrojejunostomy remains the main treatment for unresectable gastric cancer(GC)in the middle-or lower-third regions with gastric outlet obstruction(GOO).Radical surgery is performe...BACKGROUND Chemotherapy followed by gastrojejunostomy remains the main treatment for unresectable gastric cancer(GC)in the middle-or lower-third regions with gastric outlet obstruction(GOO).Radical surgery is performed as part of a multimodal treatment strategy for selected patients who respond well to chemotherapy.This study describes a case of successful radical resection with completely laparoscopic subtotal gastrectomy after a modified stomach-partitioning gastrojejunostomy(SPGJ)for obstruction relief,in a patient with GOO.CASE SUMMARY During the initial esophagogastroduodenoscopy,an advanced growth was detected in the lower part of the stomach,which caused an obstruction in the pyloric ring.Following this,a computed tomography(CT)scan revealed the presence of lymph node metastases and tumor invasion in the duodenum,but no evidence of distant metastasis was found.Consequently,we performed a modified SPGJ,a complete laparoscopic SPGJ combined with No.4sb lymph node dissection,for obstruction relief.Seven courses of adjuvant capecitabine plus oxaliplatin combined with Toripalimab(programmed death ligand-1 inhibitor)were administered thereafter.A preoperative CT showed partial response;therefore,completely laparoscopic radical subtotal gastrectomy with D2 lymphadenectomy was performed after conversion therapy,and pathological complete remission was achieved.CONCLUSION Laparoscopic SPGJ combined with No.4sb lymph node dissection was an effective surgical technique for initially unresectable GC with GOO.展开更多
Liposomes are one of the significant classes of antitumor nanomaterials and the most successful nanomedicine drugs in clinical translation. However, it is difficult to accurately reveal liposome delivery modes and dru...Liposomes are one of the significant classes of antitumor nanomaterials and the most successful nanomedicine drugs in clinical translation. However, it is difficult to accurately reveal liposome delivery modes and drug release rates at different p H values to assess the biodistribution and drug delivery pathways in vivo. Here, we established a strategy to integrate Bi-doped carbon quantum dots(CQDs)with liposomes to produce fluorescence visualization and therapeutic effects, namely lipo/Bi-doped CQDs.Lipo/Bi-doped CQDs show good water solubility and physicochemical properties, which can be used for in vitro labeling of colon cancer(CT26) cells and in vivo imaging localization tracking tumors for monitoring. Simultaneously, thanks to the excellent p H sensitivity and ion doping characteristic of Bi-doped CQDs, lipo/Bi-doped CQDs can be used to reveal the drug release rate of liposomes at different p H values and exhibit potential effects in vivo antitumor therapy.展开更多
BACKGROUND The necessity of additional gastrectomy for early gastric cancer (EGC) patients who do not meet curative criteria after endoscopic submucosal dissection (ESD) is controversial. AIM To examine the clinicopat...BACKGROUND The necessity of additional gastrectomy for early gastric cancer (EGC) patients who do not meet curative criteria after endoscopic submucosal dissection (ESD) is controversial. AIM To examine the clinicopathologic characteristics of patients who underwent additional laparoscopic gastrectomy after ESD and to determine the appropriate strategy for treating those after noncurative ESD. METHODS We retrospectively studied 45 patients with EGC who underwent additional laparoscopic gastrectomy after noncurative ESD from January 2013 to January 2019 at the Cancer Hospital of the Chinese Academy of Medical Sciences. We analyzed the patients’ clinicopathological data and identified the predictors of residual cancer (RC) and lymph node metastasis (LNM). RESULTS Surgical specimens showed RC in ten (22.2%) patients and LNM in five (11.1%).Multivariate analysis revealed that positive horizontal margin [odds ratio (OR)=13.393, 95% confidence interval (CI): 1.435-125, P=0.023] and neural invasion (OR=14.714, 95%CI: 1.087-199, P=0.043) were independent risk factors for RC. Undifferentiated type was an independent risk factor for LNM (OR=12.000, 95%CI: 1.197-120, P=0.035). Tumors in all patients with LNM showed submucosal invasion more than 500 μm. Postoperative complications after additional laparoscopic gastrectomy occurred in five (11.1%) patients, and no deaths occurred among patients with complications. CONCLUSION Gastrectomy is necessary not only for patients who have a positive margin after ESD, but also for cases with neural invasion, undifferentiated type, and submucosal invasion more than 500 μm. Laparoscopic gastrectomy is a safe, minimally invasive, and feasible procedure for additional surgery after noncurative ESD. However, further studies are needed to apply these results to clinical practice.展开更多
Gastrointestinal stromal tumors(GISTs)are mesenchymal tumors that arise from the gastrointestinal tract.In rare cases,these tumors are found in intra-abdominal sites unrelated to the gastrointestinal tract,such as the...Gastrointestinal stromal tumors(GISTs)are mesenchymal tumors that arise from the gastrointestinal tract.In rare cases,these tumors are found in intra-abdominal sites unrelated to the gastrointestinal tract,such as the mesentery,omentum and retroperitoneum.However,pancreatic extra-gastrointestinal stromal tumors are extremely rare,with only 14 previous cases reported.A 61-year-old man with no clinical symptoms had a routine check-up,during which an abdominal mass located in the pancreas tail was detected.Abdominal surgery was performed with resection of the pancreas tail and the spleen,and he was diagnosed with lowrisk GISTs.Another 60-year-old man with no clinical symptoms underwent Computed tomography which revealed a well-demarcated tumor,6 cm in diameter,in the head of the pancreas.He was diagnosed with pancreatic GISTs.Here,we describe two rare cases of pancreatic GISTs and review the cases previously reported in the literature.展开更多
A C–Mn dual-phase steel was soaked at 800°C for 90 s and then either rapidly cooled to 450°C and held for 30 s(process A) or rapidly cooled to 350°C and then reheated to 450°C(process B) to simula...A C–Mn dual-phase steel was soaked at 800°C for 90 s and then either rapidly cooled to 450°C and held for 30 s(process A) or rapidly cooled to 350°C and then reheated to 450°C(process B) to simulate the hot-dip galvanizing process. The influence of the hot-dip galvanizing process on the microstructure and mechanical properties of 600-MPa hot-dip galvanized dual-phase steel(DP600) was investigated using optical microscopy, scanning electron microscopy(SEM), transmission electron microscopy(TEM), and tensile tests. The results showed that, in the case of process A, the microstructure of DP600 was composed of ferrite, martensite, and a small amount of bainite. The granular bainite was formed in the hot-dip galvanizing stage, and martensite islands were formed in the final cooling stage after hot-dip galvanizing. By contrast, in the case of process B, the microstructure of the DP600 was composed of ferrite, martensite, bainite, and cementite. In addition, compared with the yield strength(YS) of the DP600 annealed by process A, that for the DP600 annealed by process B increased by approximately 50 MPa because of the tempering of the martensite formed during rapid cooling. The work-hardening coefficient(n value) of the DP600 steel annealed by process B clearly decreased because the increase of the YS affected the computation result for the n value. However, the ultimate tensile strength(UTS) and elongation(A80) of the DP600 annealed by process B exhibited less variation compared with those of the DP600 annealed by process A. Therefore, DP600 with excellent comprehensive mechanical properties(YS = 362 MPa, UTS = 638 MPa, A_(80) = 24.3%, n = 0.17) was obtained via process A.展开更多
BACKGROUND Proximal gastrectomy(PG) is performed widely as a function-preserving operation for early gastric cancer located in the upper third of the stomach and is an important function-preserving approach for esopha...BACKGROUND Proximal gastrectomy(PG) is performed widely as a function-preserving operation for early gastric cancer located in the upper third of the stomach and is an important function-preserving approach for esophagogastric junction(EGJ)adenocarcinoma. The incidence of gastric stump cancer(GSC) after PG is increasing. However, little is known about the GSC following PG because very few studies have been conducted on the disease.AIM To clarify clinicopathologic features, perioperative complications, and long-term survival rates after the resection of GSC following PG.METHODS Data for patients with GSC following PG for adenocarcinoma of the EGJ diagnosed between January 1998 and December 2016 were retrospectively reviewed. Multivariate analysis was performed to identify factors associated with overall survival(OS). GSC was defined in accordance with the Japanese Gastric Cancer Association.RESULTS A total of 35 patients were identified. The median interval between the initial PGand resection of GSC was 4.9(range 0.7-12) years. In 21 of the 35 patients, the tumor was located in a nonanastomotic site of the gastric stump. Total gastrectomy was performed in 27 patients; the other 8 underwent partial gastrectomy. Postoperative complications occurred in 6 patients(17.1%). The tumor stage according to the depth of tumor invasion was T1 in 6 patients, T2 in3 patients, T3 in 9 patients, and T4 in 17 patients. Lymph node metastasis was observed in 18 patients. Calculated 1-, 3-, and 5-year OS rates were 86.5%, 62.3%,and 54.2%, respectively. Multivariate analysis showed advanced T stage to be associated with OS.CONCLUSION This study reveals the characteristics of GSC following PG for adenocarcinoma of the EGJ and suggests that a surgical approach can lead to a satisfactory outcome.展开更多
Brain plasticity, including anatomical changes and functional reorganization, is the physiological basis of functional recovery after spinal cord injury(SCI). The correlation between brain anatomical changes and fun...Brain plasticity, including anatomical changes and functional reorganization, is the physiological basis of functional recovery after spinal cord injury(SCI). The correlation between brain anatomical changes and functional reorganization after SCI is unclear. This study aimed to explore whether alterations of cortical structure and network function are concomitant in sensorimotor areas after incomplete SCI. Eighteen patients with incomplete SCI(mean age 40.94 ± 14.10 years old; male:female, 7:11) and 18 healthy subjects(37.33 ± 11.79 years old; male:female, 7:11) were studied by resting state functional magnetic resonance imaging. Gray matter volume(GMV) and functional connectivity were used to evaluate cortical structure and network function, respectively. There was no significant alteration of GMV in sensorimotor areas in patients with incomplete SCI compared with healthy subjects. Intra-hemispheric functional connectivity between left primary somatosensory cortex(BA1) and left primary motor cortex(BA4), and left BA1 and left somatosensory association cortex(BA5) was decreased, as well as inter-hemispheric functional connectivity between left BA1 and right BA4, left BA1 and right BA5, and left BA4 and right BA5 in patients with SCI. Functional connectivity between both BA4 areas was also decreased. The decreased functional connectivity between the left BA1 and the right BA4 positively correlated with American Spinal Injury Association sensory score in SCI patients. The results indicate that alterations of cortical anatomical structure and network functional connectivity in sensorimotor areas were non-concomitant in patients with incomplete SCI, indicating the network functional changes in sensorimotor areas may not be dependent on anatomic structure. The strength of functional connectivity within sensorimotor areas could serve as a potential imaging biomarker for assessment and prediction of sensory function in patients with incomplete SCI. This trial was registered with the Chinese Clinical Trial Registry(registration number: Chi CTR-ROC-17013566).展开更多
This paper focuses on synchronization of fractionalorder complex dynamical networks with decentralized adaptive coupling.Based on local information among neighboring nodes,two fractional-order decentralized adaptive s...This paper focuses on synchronization of fractionalorder complex dynamical networks with decentralized adaptive coupling.Based on local information among neighboring nodes,two fractional-order decentralized adaptive strategies are designed to tune all or only a small fraction of the coupling gains respectively.By constructing quadratic Lyapunov functions and utilizing fractional inequality techniques,Mittag-Leffler function,and Laplace transform,two sufficient conditions are derived for reaching network synchronization by using the proposed adaptive laws.Finally,two numerical examples are given to verify the theoretical results.展开更多
Objective: To observe the efficacy and safety of topical imiquimod 5% cream in the treatment of uncomplicated infantile hemangiomas (IHs). Methods: A total of 68 IHs were treated with topical imiquimod 5% cream. A...Objective: To observe the efficacy and safety of topical imiquimod 5% cream in the treatment of uncomplicated infantile hemangiomas (IHs). Methods: A total of 68 IHs were treated with topical imiquimod 5% cream. Among them, 36 were superficial, 22 were mixed, and 10 were deep. The size of IHs ranged from 1.0 cm × 1.5 cm to an area of a whole forearm. All the hemangiomas were in a proliferative stage. Imiquimod was applied 3 times weekly in 44 patients and 5 times weekly in 24 patients for up to 36 weeks. Results: All superficial IHs improved, and 18 achieved complete clinical resolution, 10 had excellent improvement, 5 showed moderate improvements, and 3 patients displayed minimal improvement. Two mixed IHs showed excellent improvement, 3 showed moderate improvement and 5 manifested minimal improvements. The remaining 12 mixed IHs and all deep IHs did not respond to the therapy. The total incidence of local adverse events was 58.82%(40/68), which included erythema or edema, local itching, incrustation or peeling, erosion or ulceration, although most of these were mild to moderate reactions and did not affect the treatment. Scarring occurred in 2 mixed IHs. No systemic side effects developed. Conclusion: Imiquimod 5% cream may be a safe and effective alternative for the treatment of superficial IHs and some mixed IHs in which the superficial component predominates. An appropriate treatment duration for proliferative IHs treated with this therapy may be 24 weeks. Some local adverse events, such as crusting and erosion with possible scarfing potential may occur and should be addressed by prompt, but temporary, discontinuation of the imiquimod. Topical imiquimod 5% cream can be prudently used in the treatment of IHs larger than 5.0 cm × 5.0 cm in newborns and infants less than 6 months of age. To our knowledge, this is the largest IH group treated with imiquimod that has been reported in the literature to date.展开更多
基金supported by the National Natural Science Foundation of China(62005193,62135008,62075158,62025504,61935015)the National Science Foundation(2114103)Guangxi Key Laboratory of Optoelectroric Information Processing(GD20202).
文摘Plasmonic vortices confining orbital angular momentums to surface have aroused wide research interest in the last decade.Recent advances of near-field microscopes have enabled the study on the spatiotemporal dynamics of plasmonic vortices,providing a better understanding of optical orbital angular momentums in the evanescent wave regime.However,these works only focused on the objective characterization of plasmonic vortex and have not achieved subjectively tailoring of its spatiotemporal dynamics for specific applications.Herein,it is demonstrated that the plasmonic vortices with the same topological charge can be endowed with distinct spatiotemporal dynamics by simply changing the coupler design.Based on a near-field scanning terahertz microscopy,the surface plasmon fields are directly obtained with ultrahigh spatiotemporal resolution,experimentally exhibiting the generation and evolution divergences during the whole lifetime of plasmonic vortices.The proposed strategy is straightforward and universal,which can be readily applied into visible or infrared frequencies,facilitating the development of plasmonic vortex related researches and applications.
基金supported by the National Natural Science Foundation of China(22275026 and 21805024)the Natural Science Foundation of Chongqing,China(cstc2021jcyj-msxm X0783,cstc2019jscx-msxm X0393 and cstc2018jcyj AX0461)+1 种基金the Scientific and Technological Research Program of Chongqing Municipal Education Commission(KJZD-K202101303,KJQN201901335 and KJQN202001322)the Scientific Research Program of Chongqing Urban Administration(CGKZ2020-26)。
文摘Designing single-atom catalysts for oxygen reduction reaction(ORR)are fashionable but challenging to boost the zinc-air battery performance.Significantly enhanced ORR activity by manganese(Mn)singleatom catalysts can be achieved by accurately regulating the coordination number of isolated Mn atoms.Theoretical calculations indicate that the single Mn-N5sites possess lower free energy barrier and higher oxygen adsorption performance than single Mn-N4sites to accelerate the ORR kinetics.Target to it,here we synthesize an atomically dispersed Mn-N5catalyst by precisely axial coordination of pyridinic-N doped into two-dimensional(2D)porous nanocarbon sheets(~3.56 nm thickness),which reveals outstanding catalytic activity and ultrahigh stability for the ORR in zinc-air battery owing to the inhomogeneous charge distribution of Mn-N5sites compared to the conventional single-site Mn-N4catalyst and Pt/C.This work gives a new strategy for in situ regulating the electronic structure of metal single-atoms and further promoting the overall ORR performance in energy systems.
基金supported by the National Key Research and Development Plan(No.2020YFC1808102)General project of Beijing Natural Fund(No.3222018)+1 种基金the Basic Research Program on Deep Petroleum Resource Accumulation and Key Engineering Technologies(No.U19B6003)the Science Foundation of China University of Petroleum,Bejing(Nos.2462020YXZz018,2462019BJRC007,2462019BJRC007,2462019QNXZ02).
文摘The in situ mining technology is applied to the exploitation of medium-and low-maturity shale oil,which can use heaters to warm up the oil shale formations and pyrolyze the kerogen.Due to the low thermal conductivity of oil shale,electric heaters need extra equipment to improve heat transfer efficiency.In this study,a thermally conductive proppant is fabricated by coating epoxy-resin and graphite on ceramic proppants for the first time,which could support the fracturing crack and transfer heat.The thermal conduction property of epoxy-resin and graphite coated proppants(EGPs)is 245%higher than that of uncoated proppants,which can transfer more heat to the oil shale formation and accelerate the conversion of kerogen.The adhesive property of EGPs is improved by 47.9%under the load force of 1500 nN,which prolongs the time for the fracture to close.In summary,this novel proppant is expected to assist in-situ mining technology in the production of medium and low-maturity shale oil.
基金Supported by the National Natural Science Foundation of China,No.82072734.
文摘BACKGROUND Chemotherapy followed by gastrojejunostomy remains the main treatment for unresectable gastric cancer(GC)in the middle-or lower-third regions with gastric outlet obstruction(GOO).Radical surgery is performed as part of a multimodal treatment strategy for selected patients who respond well to chemotherapy.This study describes a case of successful radical resection with completely laparoscopic subtotal gastrectomy after a modified stomach-partitioning gastrojejunostomy(SPGJ)for obstruction relief,in a patient with GOO.CASE SUMMARY During the initial esophagogastroduodenoscopy,an advanced growth was detected in the lower part of the stomach,which caused an obstruction in the pyloric ring.Following this,a computed tomography(CT)scan revealed the presence of lymph node metastases and tumor invasion in the duodenum,but no evidence of distant metastasis was found.Consequently,we performed a modified SPGJ,a complete laparoscopic SPGJ combined with No.4sb lymph node dissection,for obstruction relief.Seven courses of adjuvant capecitabine plus oxaliplatin combined with Toripalimab(programmed death ligand-1 inhibitor)were administered thereafter.A preoperative CT showed partial response;therefore,completely laparoscopic radical subtotal gastrectomy with D2 lymphadenectomy was performed after conversion therapy,and pathological complete remission was achieved.CONCLUSION Laparoscopic SPGJ combined with No.4sb lymph node dissection was an effective surgical technique for initially unresectable GC with GOO.
基金funded by Beijing Natural Science Foundation (Nos.L222109, 3222018)Military Health Care Project(No.22BJZ22)+6 种基金Science Foundation of China University of Petroleum (Nos.2462019QNXZ02, 2462019BJRC007)National Natural Science Foundation of China (Nos.52211530034, 82273236)Guangdong Provincial Basic and Applied Basic Research Foundation (Nos.2022A151522004, 2022A1515220042)Science and Technology Innovation Commission of Shenzhen (Nos.JSGG20210802153410031, JCYJ20220530141609021)Science and Technology Plan of Shenzhen Nanshan District (No.NS016)Discipline Leader Foundation of Huazhong University of Science and Technology Union Shenzhen Hospital (No.YN2021002)Crosswise Project of Daan Gene (No.HXKY2022002)。
文摘Liposomes are one of the significant classes of antitumor nanomaterials and the most successful nanomedicine drugs in clinical translation. However, it is difficult to accurately reveal liposome delivery modes and drug release rates at different p H values to assess the biodistribution and drug delivery pathways in vivo. Here, we established a strategy to integrate Bi-doped carbon quantum dots(CQDs)with liposomes to produce fluorescence visualization and therapeutic effects, namely lipo/Bi-doped CQDs.Lipo/Bi-doped CQDs show good water solubility and physicochemical properties, which can be used for in vitro labeling of colon cancer(CT26) cells and in vivo imaging localization tracking tumors for monitoring. Simultaneously, thanks to the excellent p H sensitivity and ion doping characteristic of Bi-doped CQDs, lipo/Bi-doped CQDs can be used to reveal the drug release rate of liposomes at different p H values and exhibit potential effects in vivo antitumor therapy.
基金the National Natural Science Foundation of China,No.81772642Beijing Municipal Science and Technology Commission,No.Z161100000116045Capital’s Funds for Health Improvement and Research,No.CFH 2018-2-4022
文摘BACKGROUND The necessity of additional gastrectomy for early gastric cancer (EGC) patients who do not meet curative criteria after endoscopic submucosal dissection (ESD) is controversial. AIM To examine the clinicopathologic characteristics of patients who underwent additional laparoscopic gastrectomy after ESD and to determine the appropriate strategy for treating those after noncurative ESD. METHODS We retrospectively studied 45 patients with EGC who underwent additional laparoscopic gastrectomy after noncurative ESD from January 2013 to January 2019 at the Cancer Hospital of the Chinese Academy of Medical Sciences. We analyzed the patients’ clinicopathological data and identified the predictors of residual cancer (RC) and lymph node metastasis (LNM). RESULTS Surgical specimens showed RC in ten (22.2%) patients and LNM in five (11.1%).Multivariate analysis revealed that positive horizontal margin [odds ratio (OR)=13.393, 95% confidence interval (CI): 1.435-125, P=0.023] and neural invasion (OR=14.714, 95%CI: 1.087-199, P=0.043) were independent risk factors for RC. Undifferentiated type was an independent risk factor for LNM (OR=12.000, 95%CI: 1.197-120, P=0.035). Tumors in all patients with LNM showed submucosal invasion more than 500 μm. Postoperative complications after additional laparoscopic gastrectomy occurred in five (11.1%) patients, and no deaths occurred among patients with complications. CONCLUSION Gastrectomy is necessary not only for patients who have a positive margin after ESD, but also for cases with neural invasion, undifferentiated type, and submucosal invasion more than 500 μm. Laparoscopic gastrectomy is a safe, minimally invasive, and feasible procedure for additional surgery after noncurative ESD. However, further studies are needed to apply these results to clinical practice.
基金Supported by The Beijing Hope Run Special Fund,LC2012A09Beijing Municipal Science and Technology Commission,Z131107002213164
文摘Gastrointestinal stromal tumors(GISTs)are mesenchymal tumors that arise from the gastrointestinal tract.In rare cases,these tumors are found in intra-abdominal sites unrelated to the gastrointestinal tract,such as the mesentery,omentum and retroperitoneum.However,pancreatic extra-gastrointestinal stromal tumors are extremely rare,with only 14 previous cases reported.A 61-year-old man with no clinical symptoms had a routine check-up,during which an abdominal mass located in the pancreas tail was detected.Abdominal surgery was performed with resection of the pancreas tail and the spleen,and he was diagnosed with lowrisk GISTs.Another 60-year-old man with no clinical symptoms underwent Computed tomography which revealed a well-demarcated tumor,6 cm in diameter,in the head of the pancreas.He was diagnosed with pancreatic GISTs.Here,we describe two rare cases of pancreatic GISTs and review the cases previously reported in the literature.
基金financially supported by the National Natural Science Foundation of China (Nos.U1360202,51472030,and 51502014)
文摘A C–Mn dual-phase steel was soaked at 800°C for 90 s and then either rapidly cooled to 450°C and held for 30 s(process A) or rapidly cooled to 350°C and then reheated to 450°C(process B) to simulate the hot-dip galvanizing process. The influence of the hot-dip galvanizing process on the microstructure and mechanical properties of 600-MPa hot-dip galvanized dual-phase steel(DP600) was investigated using optical microscopy, scanning electron microscopy(SEM), transmission electron microscopy(TEM), and tensile tests. The results showed that, in the case of process A, the microstructure of DP600 was composed of ferrite, martensite, and a small amount of bainite. The granular bainite was formed in the hot-dip galvanizing stage, and martensite islands were formed in the final cooling stage after hot-dip galvanizing. By contrast, in the case of process B, the microstructure of the DP600 was composed of ferrite, martensite, bainite, and cementite. In addition, compared with the yield strength(YS) of the DP600 annealed by process A, that for the DP600 annealed by process B increased by approximately 50 MPa because of the tempering of the martensite formed during rapid cooling. The work-hardening coefficient(n value) of the DP600 steel annealed by process B clearly decreased because the increase of the YS affected the computation result for the n value. However, the ultimate tensile strength(UTS) and elongation(A80) of the DP600 annealed by process B exhibited less variation compared with those of the DP600 annealed by process A. Therefore, DP600 with excellent comprehensive mechanical properties(YS = 362 MPa, UTS = 638 MPa, A_(80) = 24.3%, n = 0.17) was obtained via process A.
基金Supported by National Natural Science Foundation of China,No.81772642Beijing Municipal Science and Technology Commission,No.Z161100000116045Capital’s Funds for Health Improvement and Research,CFH 2018-2-4022
文摘BACKGROUND Proximal gastrectomy(PG) is performed widely as a function-preserving operation for early gastric cancer located in the upper third of the stomach and is an important function-preserving approach for esophagogastric junction(EGJ)adenocarcinoma. The incidence of gastric stump cancer(GSC) after PG is increasing. However, little is known about the GSC following PG because very few studies have been conducted on the disease.AIM To clarify clinicopathologic features, perioperative complications, and long-term survival rates after the resection of GSC following PG.METHODS Data for patients with GSC following PG for adenocarcinoma of the EGJ diagnosed between January 1998 and December 2016 were retrospectively reviewed. Multivariate analysis was performed to identify factors associated with overall survival(OS). GSC was defined in accordance with the Japanese Gastric Cancer Association.RESULTS A total of 35 patients were identified. The median interval between the initial PGand resection of GSC was 4.9(range 0.7-12) years. In 21 of the 35 patients, the tumor was located in a nonanastomotic site of the gastric stump. Total gastrectomy was performed in 27 patients; the other 8 underwent partial gastrectomy. Postoperative complications occurred in 6 patients(17.1%). The tumor stage according to the depth of tumor invasion was T1 in 6 patients, T2 in3 patients, T3 in 9 patients, and T4 in 17 patients. Lymph node metastasis was observed in 18 patients. Calculated 1-, 3-, and 5-year OS rates were 86.5%, 62.3%,and 54.2%, respectively. Multivariate analysis showed advanced T stage to be associated with OS.CONCLUSION This study reveals the characteristics of GSC following PG for adenocarcinoma of the EGJ and suggests that a surgical approach can lead to a satisfactory outcome.
基金supported by a grant from Tsinghua University Initiative Scientific Research Program,No.2014081266,20131089382the National Natural Science Foundation of China,No.61171002,60372023
文摘Brain plasticity, including anatomical changes and functional reorganization, is the physiological basis of functional recovery after spinal cord injury(SCI). The correlation between brain anatomical changes and functional reorganization after SCI is unclear. This study aimed to explore whether alterations of cortical structure and network function are concomitant in sensorimotor areas after incomplete SCI. Eighteen patients with incomplete SCI(mean age 40.94 ± 14.10 years old; male:female, 7:11) and 18 healthy subjects(37.33 ± 11.79 years old; male:female, 7:11) were studied by resting state functional magnetic resonance imaging. Gray matter volume(GMV) and functional connectivity were used to evaluate cortical structure and network function, respectively. There was no significant alteration of GMV in sensorimotor areas in patients with incomplete SCI compared with healthy subjects. Intra-hemispheric functional connectivity between left primary somatosensory cortex(BA1) and left primary motor cortex(BA4), and left BA1 and left somatosensory association cortex(BA5) was decreased, as well as inter-hemispheric functional connectivity between left BA1 and right BA4, left BA1 and right BA5, and left BA4 and right BA5 in patients with SCI. Functional connectivity between both BA4 areas was also decreased. The decreased functional connectivity between the left BA1 and the right BA4 positively correlated with American Spinal Injury Association sensory score in SCI patients. The results indicate that alterations of cortical anatomical structure and network functional connectivity in sensorimotor areas were non-concomitant in patients with incomplete SCI, indicating the network functional changes in sensorimotor areas may not be dependent on anatomic structure. The strength of functional connectivity within sensorimotor areas could serve as a potential imaging biomarker for assessment and prediction of sensory function in patients with incomplete SCI. This trial was registered with the Chinese Clinical Trial Registry(registration number: Chi CTR-ROC-17013566).
基金supported by the"Chunhui Plan"Cooperative Research for Ministry of Education(Z2016133)the Open Research Fund of Key Laboratory of Automobile Engineering(Xihua University)+3 种基金Sichuan Province(szjj2016-017)the National Natural Science Foundation of China(51177137)the Scientific Research Foundation of the Education Department of Sichuan Province(16ZB0163)the China Scholarship Council
文摘This paper focuses on synchronization of fractionalorder complex dynamical networks with decentralized adaptive coupling.Based on local information among neighboring nodes,two fractional-order decentralized adaptive strategies are designed to tune all or only a small fraction of the coupling gains respectively.By constructing quadratic Lyapunov functions and utilizing fractional inequality techniques,Mittag-Leffler function,and Laplace transform,two sufficient conditions are derived for reaching network synchronization by using the proposed adaptive laws.Finally,two numerical examples are given to verify the theoretical results.
基金supported by Science and Technology Foundation of shaanxi Province(2005K13-G6)
文摘Objective: To observe the efficacy and safety of topical imiquimod 5% cream in the treatment of uncomplicated infantile hemangiomas (IHs). Methods: A total of 68 IHs were treated with topical imiquimod 5% cream. Among them, 36 were superficial, 22 were mixed, and 10 were deep. The size of IHs ranged from 1.0 cm × 1.5 cm to an area of a whole forearm. All the hemangiomas were in a proliferative stage. Imiquimod was applied 3 times weekly in 44 patients and 5 times weekly in 24 patients for up to 36 weeks. Results: All superficial IHs improved, and 18 achieved complete clinical resolution, 10 had excellent improvement, 5 showed moderate improvements, and 3 patients displayed minimal improvement. Two mixed IHs showed excellent improvement, 3 showed moderate improvement and 5 manifested minimal improvements. The remaining 12 mixed IHs and all deep IHs did not respond to the therapy. The total incidence of local adverse events was 58.82%(40/68), which included erythema or edema, local itching, incrustation or peeling, erosion or ulceration, although most of these were mild to moderate reactions and did not affect the treatment. Scarring occurred in 2 mixed IHs. No systemic side effects developed. Conclusion: Imiquimod 5% cream may be a safe and effective alternative for the treatment of superficial IHs and some mixed IHs in which the superficial component predominates. An appropriate treatment duration for proliferative IHs treated with this therapy may be 24 weeks. Some local adverse events, such as crusting and erosion with possible scarfing potential may occur and should be addressed by prompt, but temporary, discontinuation of the imiquimod. Topical imiquimod 5% cream can be prudently used in the treatment of IHs larger than 5.0 cm × 5.0 cm in newborns and infants less than 6 months of age. To our knowledge, this is the largest IH group treated with imiquimod that has been reported in the literature to date.