Assessing recent recurrence after hepatectomy for hepatitis Brelated hepatocellular carcinoma by a predictive model based on sarcopenia

BACKGROUND Sarcopenia may be associated with hepatocellular carcinoma(HCC)following hepatectomy.But traditional single clinical variables are still insufficient to predict recurrence.We still lack effective prediction models for recent recurrence(time to recurrence<2 years)after hepatectomy for HCC.AIM To establish an interventable prediction model to estimate recurrence-free survival(RFS)after hepatectomy for HCC based on sarcopenia.METHODS We retrospectively analyzed 283 hepatitis B-related HCC patients who underwent curative hepatectomy for the first time,and the skeletal muscle index at the third lumbar spine was measured by preoperative computed tomography.94 of these patients were enrolled for external validation.Cox multivariate analysis was per-formed to identify the risk factors of postoperative recurrence in training cohort.A nomogram model was developed to predict the RFS of HCC patients,and its predictive performance was validated.The predictive efficacy of this model was evaluated using the receiver operating characteristic curve.RESULTS Multivariate analysis showed that sarcopenia[Hazard ratio(HR)=1.767,95%CI:1.166-2.678,P<0.05],alpha-fetoprotein≥40 ng/mL(HR=1.984,95%CI:1.307-3.011,P<0.05),the maximum diameter of tumor>5 cm(HR=2.222,95%CI:1.285-3.842,P<0.05),and hepatitis B virus DNA level≥2000 IU/mL(HR=2.1,95%CI:1.407-3.135,P<0.05)were independent risk factors associated with postoperative recurrence of HCC.Based on the sarcopenia to assess the RFS model of hepatectomy with hepatitis B-related liver cancer disease(SAMD)was established combined with other the above risk factors.The area under the curve of the SAMD model was 0.782(95%CI:0.705-0.858)in the training cohort(sensitivity 81%,specificity 63%)and 0.773(95%CI:0.707-0.838)in the validation cohort.Besides,a SAMD score≥110 was better to distinguish the high-risk group of postoperative recurrence of HCC.CONCLUSION Sarcopenia is associated with recent recurrence after hepatectomy for hepatitis B-related HCC.A nutritional status-based prediction model is first established for postoperative recurrence of hepatitis B-related HCC,which is superior to other models and contributes to prognosis prediction.

Sedimentary architecture of submarine channel-lobe systems under different seafloor topography:Insights from the Rovuma Basin offshore East Africa

Seafloor topography plays an important role in the evolution of submarine lobes.However,it is still not so clear how the shape of slope affects the three-dimensional(3-D)architecture of submarine lobes.In this study,we analyze the effect of topography factors on different hierarchical lobe architectures that formed during Pliocene to Quaternary in the Rovuma Basin offshore East Africa.We characterize the shape,size and growth pattern of different hierarchical lobe architectures using 3-D seismic data.We find that the relief of the topographic slope determines the location of preferential deposition of lobe complexes and single lobes.When the topography is irregular and presents topographic lows,lobe complexes first infill these depressions.Single lobes are deposited preferentially at positions with higher longitudinal(i.e.across-slope)slope gradients.As the longitudinal slope becomes higher,the aspect ratio of the single lobes increases.Lateral(i.e.along-slope)topography does not seem to have a strong influence on the shape of single lobe,but it seems to affect the overlap of single lobes.When the lateral slope gradient is relatively high,the single lobes tend to have a larger overlap surface.Furthermore,as the average of lateral slope and longitudinal slope gets greater,the width/thickness ratio of the single lobe is smaller,i.e.sediments tend to accumulate vertically.The results demonstrate that the shape of slopes more comprehensively influences the 3-D architecture of lobes in natural deep-sea systems than previously other lobe deposits and analogue experiments,which helps us better understand the development and evolution of the distal parts of turbidite systems.

Comparison of fungal vs bacterial infections in the medical intensive liver unit:Cause or corollary for high mortality?

BACKGROUND Due to development of an immune-dysregulated phenotype,advanced liver disease in all forms predisposes patients to sepsis acquisition,including by opportunistic pathogens such as fungi.Little data exists on fungal infection within a medical intensive liver unit(MILU),particularly in relation to acute on chronic liver failure.AIM To investigate the impact of fungal infections among critically ill patients with advanced liver disease,and compare outcomes to those of patients with bacterial infections.METHODS From our prospective registry of MILU patients from 2018-2022,we included 27 patients with culture-positive fungal infections and 183 with bacterial infections.We compared outcomes between patients admitted to the MILU with fungal infections to bacterial counterparts.Data was extracted through chart review.RESULTS All fungal infections were due to Candida species,and were most frequently blood isolates.Mortality among patients with fungal infections was significantly worse relative to the bacterial cohort(93%vs 52%,P<0.001).The majority of the fungal cohort developed grade 2 or 3 acute on chronic liver failure(ACLF)(90%vs 64%,P=0.02).Patients in the fungal cohort had increased use of vasopressors(96%vs 70%,P=0.04),mechanical ventilation(96%vs 65%,P<0.001),and dialysis due to acute kidney injury(78%vs 52%,P=0.014).On MILU admission,the fungal cohort had significantly higher Acute Physiology and Chronic Health Evaluation(108 vs 91,P=0.003),Acute Physiology Score(86 vs 65,P=0.003),and Model for End-Stage Liver Disease-Sodium scores(86 vs 65,P=0.041).There was no significant difference in the rate of central line use preceding culture(52%vs 40%,P=0.2).Patients with fungal infection had higher rate of transplant hold placement,and lower rates of transplant;however,differences did not achieve statistical significance.CONCLUSION Mortality was worse among patients with fungal infections,likely attributable to severe ACLF development.Prospective studies examining empiric antifungals in severe ACLF and associations between fungal infections and transplant outcomes are critical.

水系锌离子电池MnO_(2)正极的3D打印

为了解决MnO_(2)正极在水系锌离子电池中循环稳定性差及离子运输缓慢等问题,采用直写成型技术制备高精度定制的3D打印MnO_(2)正极。流变测试表明,打印墨水表现出剪切变稀行为,存储模量平台值高达10^(5) Pa。SEM图像显示,100次循环后该定制网-层状结构保持完整。具有良好力学强度的3D结构有利于降低电极内残余应力,同时提供更大的比表面积。所得的3D打印正极在50 m A/g的电流密度下循环110次后,比容量为对照传统2D电极的4倍。采用多种非原位技术系统研究了3D打印电池的可逆Mn^(2+)/Mn^(4+)双氧化还原储能机制。

MXenes for perovskite solar cells:Progress and prospects

Perovskite solar cells(PSCs)have been developed over the past decade as the forefront of the state-of-theart photovoltaic technologies owing to their high efficiency and low cost,where nanostructured functional materials play key roles in performance optimization.As a versatile class of two-dimensional(2D)materials,transition metal carbides/nitrides MXenes have gained enormous attentions in PSCs since 2018 due to their superior properties such as excellent metallic conductivity,abundant surface functional groups,tunable work functions,high optical transparency,and mechanical robustness.The explorations of MXenes are of significance in performance promotion and commercialization expansion of devices.As such,this review focuses on the diversified advantages of MXenes,comprehensively summarizing their applications and developments in PSCs as additives,electron/hole transporting layers,interfacial engineering layers,and electrodes in sequence and explaining the relevant mechanisms behind.Simultaneously,the problems emerged from the related studies are considered and the corresponding suggestions like opening up the type of MXenes usage,taking further insight of the modulation of surface termination groups on Fermi levels,understanding the effect on energy level structures of perovskite or other functional layers,and realizing commercialization,etc.are provided for the future in-depth explorations.This review is intended to provide overall perspective of the current status of MXenes and highlight the direction for the future advancements in MXenes design and processes towards efficient,stable,large-area,and low-cost PSCs.

双壳层Si/TiO_(2)/CFs复合物的制备及其储锂性能（英文）

针对硅基阳极在循环过程中体积变化大、SEI膜不稳定、电子电导率和离子电导率低等固有缺陷,采用简单方法合成双壳层Si/TiO2/CFs复合材料。内部刚性TiO2壳层可缓解锂化脱锂过程中纳米硅的巨大体积膨胀,外部弹性碳纤维壳层的交错多孔结构有利于电子和离子的快速传输。该方法制备的Si/TiO2/CFs复合材料具有优异的可逆比容量(583.4 mA h/g)、高倍率性能和良好的循环性能。这种双壳层包覆方法亦可用于合成在循环过程中具有较大体积变化的其他电极材料。

凝胶注模与真空压力浸渗法近净成形制备Al/SiC_P复合材料

针对Al/SiCP复合材料机加工困难的问题,首先采用凝胶注模法得到具有复杂形状的SiCP预制块,再通过真空压力浸渗近净成形制备具有高SiCP体积分数的Al/SiCP复合材料。复合材料基体采用三种合金,分别为纯Al、Al4Mg和Al4Mg2Si。结果表明:适用于凝胶注模的SiCP浆料最佳参数为pH 10,TMAH含量0.5%(质量分数)和固相体积分数52%。在Al基体中添加Mg能改善基体与SiCP颗粒界面的润湿性,从而提高复合材料的相对密度;在Al基体中添加Si有助于抑制有害界面相Al4C3的生成。制备的Al4Mg2Si/SiCP复合材料具有较高的相对密度(99.2%)、良好的热导率(150 W·m-1·K-1)、较低的线膨胀系数(10.1×10-6 K-1)以及优异的弯曲强度(489 MPa)。

采用基于甲基丙烯酸羟乙酯-叔丁醇的凝胶注模体系制备多孔氧化铝陶瓷（英文）

为了获得高强度的多孔氧化铝陶瓷,研发一种基于甲基丙烯酸羟乙酯-叔丁醇(HEMA-TBA)的新型凝胶注模体系。采用流变仪、TG-DSC、SEM和弯曲强度测试等手段分别研究HEMA-TBA凝胶注模体系的聚合、坯体的热分解行为、烧结体的显微组织和力学性能。结果表明:(1)25℃时,适合该体系聚合的引发剂(过氧苯甲酰)的优化加入量为10 mg/mL;(2)含HEMA-TBA凝胶注模体系的氧化铝悬浮液表现为剪切变稀流变行为,且其黏度足够低至凝胶注模工艺要求;(3)多孔氧化铝试样的孔隙度为42%~56%,其相应的弯曲强度为(8±0.5)^(91±4.5)MPa。

固溶加热速率与Al−Mg−Si−Cu合金力学性能、显微组织及织构的关系

通过拉伸试验、扫描电镜、X射线衍射仪和EBSD技术研究固溶加热速率与Al-Mg-Si-Cu合金力学性能、显微组织及织构的关系。实验结果表明,固溶加热速率与力学性能、显微组织及织构的关系是非单调的。随着加热速率的增加,强度变化取决于拉伸方向;加工硬化指数n先减小,后增加;塑性应变比r值先增加,后减小,最后又增加。加热速率对合金最终显微组织和织构有一定影响。随着加热速率的增加,显微组织由拉长晶粒组织转变为等轴晶粒组织,平均晶粒尺寸呈先减小、然后增加、最后再减小的趋势。随着加热速率的增加,尽管织构组分如CubeND{001}<310>和P{011}<122>基本无变化,但织构密度和体积分数呈现先减小、后增加、最后减小的趋势。加热速率对显微组织和织构演变的影响较小。提高加热速率并不总是有利于形成细小的等轴晶粒组织、弱织构以及较大的平均r值,这些与合金的再结晶行为有关。

高温退火对Cu−0.15Zr合金显微组织和性能的影响

采用快速凝固与热锻相结合的方法,制备组织均匀、晶粒细小的Cu−0.15Zr(质量分数,%)合金,研究高温退火过程中合金显微组织演变、力学性能和电导率。该合金表现出良好的热稳定性,即使在700℃退火2 h后,合金强度仅轻微下降。退火过程中纳米级连续分布的Cu_(5)Zr析出相对位错运动起到钉扎作用,从而使基体强化,同时,尺寸较大的颗粒状Cu_(5)Zr析出相通过钉扎晶界阻碍晶粒长大。在700℃退火2 h后,由于空位、位错、晶界以及基体中溶质Zr原子减少,合金电导率达到峰值88%(IACS)。

拉伸加载下应变速率对Al-Mg-Si-Cu合金力学性能、显微组织及织构的影响

通过拉伸测试、显微组织和织构表征研究应变速率对Al-Mg-Si-Cu合金力学性能、显微组织及织构的影响。结果表明,应变速率对力学性能和显微组织有一定的影响,但对织构几乎无影响。总的来说,随着应变速率的增加,合金的屈服强度、极限抗拉强度及伸长率均呈先增加、然后保持不变、最后增加的趋势。所有合金断口附近区域的显微组织与应变速率无关,均由轻微拉长的晶粒组成,但晶界角度分布存在一定差异;随着应变速率的增加,小角度晶界先增加后减少。应变速率的变化对断口附近区域的织构几乎无影响。

先进锂离子电池用三维纳米花状MoS_(2)/石墨阳极

采用两步水热合成法将垂直的二硫化钼(MoS_(2))纳米片可控地负载于石墨烯表面形成纳米花。二硫化钼纳米片和石墨烯形成紧密结合的垂直交互网络结构,使电极具有高的机械完整性和循环稳定性。所得MoS_(2)/石墨烯纳米花阳极在1000 mA/g电流密度下稳定循环700次后,仍具有901.8 mA·h/g的超高比容量,且从第二次循环开始,相应的容量保持率为98.9%。

消化道异物的内镜取出109例临床总结

背景摄入的消化道异物是临床中常见的急症.消化道异物个体化内镜取出方法报道较少.目的探讨摄入的消化道异物个体化内镜取出方法,以提高异物内镜取出成功率.方法采用回顾性队列研究,分析2014-07/2019-04在解放军总医院第三医学中心(原武警总医院)消化内镜中心的消化道异物的临床资料及相应的内镜取出的过程特征.结果109例患者纳入研究,其中男46例(42.2%),女63例(57.8%).年龄11岁-88岁,平均年龄57.3岁,其中52例(47.7%)为老年人.最常见的异物是枣核53例(48.6%),其次是鱼骨24例(22%)、食团15例(13.8%).消化道异物最常见的位置是食管84例(76.9%),其次是结肠7例(6.4%),吻合口6例(5.5%),胃和十二指肠分别为5例(4.5%)、5例(4.5%),咽部2例(1.8%).根据异物特点及其滞留部位和患者自身条件,选择合适的取出器械,制定个体化内镜取出方法,其中咽部异物用时间最短,平均时间为2.5±0.7 min.食管上、中、下段异物所用平均时间分别为7.0±5.3 min、8.3±6.3 min、3.3±1.2 min.吻合口处异物所用时间6.2±4.1 min.胃内异物和十二指肠异物所用平均时间为8.4±1.7 min和9.2±3.1 min.结肠异物所用时间最长,平均时间为15.6±8.0 min.消化道异物内镜取出成功率为97.2%(106/109).结论根据异物特点及其滞留部位和患者自身条件个体化内镜取出消化道异物是安全、有效的方法.

胆道出血6例临床分析及文献复习

背景胆道出血是上消化道出血的少见病因,胆道出血诊治是困难及具有挑战性的.目的探讨胆道出血的原因及处理方法,提高胆道出血诊治水平.方法分析我院2014-2018年确诊的6例胆道出血患者的临床资料、出血原因及其治疗方法,并进行相关文献复习,总结出胆道出血的诊治流程.结果胆道出血患者6例,男性4例,女2例,26-68岁,平均年龄54.2岁.其中肿瘤病变2例,胆囊结石1例,胆囊假性动脉瘤1例;肝移植术后1例;胆道感染1例.外科手术治疗2例,内镜下治疗1例,血管介入治疗1例;内科保守治疗2例.治愈5例,失血性休克死亡1例.结论胆道出血诊治是困难及具有挑战性,提高对胆道出血的认识,及时细致的检查和合理选择处理方式,是提高胆道出血诊治水平的关键.

The role of the Rho/ROCK signaling pathway in inhibiting axonal regeneration in the central nervous system

The Rho/Rho-associated coiled-coil containing protein kinase（Rho/ROCK） pathway is a major signaling pathway in the central nervous system, transducing inhibitory signals to block regeneration. After central nervous system damage, the main cause of impaired regeneration is the presence of factors that strongly inhibit regeneration in the surrounding microenvironment. These factors signal through the Rho/ROCK signaling pathway to inhibit regeneration. Therefore, a thorough understanding of the Rho/ROCK signaling pathway is crucial for advancing studies on regeneration and repair of the injured central nervous system.

Study on Random Initiation Phenomenon for Sympathetic Detonation of Explosive

It is important to understand the characteristics of explosive sympathetic detonation for explosive safety.Sympathetic reaction test of GHL(RDX/Al/Binder)explosive charges with shell are conducted.A model of the sympathetic reaction test is established.The elements-apart method and nodes random-failure method are used in the model to describe the expansion progress of shell expanding and the randomly forming process of fragments.Random detonation phenomena of acceptor charge are simulated.

Correlation of Epstein-Barr virus and its encoded proteins with Helicobacter pylori and expression of c-met and c-myc in gastric carcinoma

瞄准：为了调查 Epstein-Barr 病毒(EBV ) 和 EBV- 的相互关系，并且在胃的致癌作用探索他们的角色，与 Helicobacter pylori (H pylori ) 编码了蛋白质感染和表示遇见 c 并且在胃的癌的 c-myc oncogene 蛋白质。方法：185 胃的癌纸巾被聚合酶链反应(PCR ) 检测为 EBV 染色体的南部的污点和为编码 EBV 的小 RNA 1 (EBER1 ) 的原位杂交(ISH ) 。有积极 EBER1 信号的胃的癌被证实联系 EBV 的胃的癌(EBVaGC ) 。在 185 胃的癌的 H pylori 感染的地位被快速的 urease 和 PCR 估计。有积极 PCR 和 urease 的样品被定义为 H pylori 感染。表示遇见 c 并且在 EBVaGC 和匹配的 EBV 否定的胃的癌(EBVnGC ) 的纸巾的 c-myc oncogene 蛋白质被免疫组织化学检验。RT-PCR 和南部的杂交被用来检测原子抗原(EBNA ) 的表示 1 和 2，潜伏的膜蛋白质(LMP ) 1，在 EBVaGC 情况中的早基因 BARF1 和 BHRF1。结果：在 185 胃的癌的 H pylori 和 EBV 的积极的率是 59.45%(110/185 ) 并且 7.03%(13/185 ) 分别地。没有差别在在 pylori 积极的 H 和 H 之间的性别，年龄，病理学的区别，临床的阶段和淋巴节点转移被发现 pylori 否定的胃的癌。然而，在窦的 H pylori 感染的积极的率胃的癌比贲门和身体的高胃的癌。在我们的系列，年龄，病理学的区别，临床的阶段，淋巴节点转移和癌症的地点不在 EBVnGC 和 EBVaGC 之间是不同的，当在男病人的 EBV 的积极的率比女病人的显著地高时。在联系 EBV 、 EBV 否定的胃的癌的 H pylori 的确实是 46.15%(6/13 ) 并且 81.40%(104/172 ) 分别地。在 EBV 和 H pylori 感染之间没有重要关联。在表示上遇见 c 比在 EBVnGC 组在 EBVaGC 组是显著地更高的。然而，遇见 c 并且 c-myc 表示没显示出在二个组之间的有效差量。EBNA1 的抄本在所有 13 EBVaGCs 被检测，当 EBNA2 和 LMP1 mRNA 没被检测时。13 个盒子中的六个展出了 BARF1 抄本和 2 个展出 BHRF1 抄本。结论：在 EBVnGCs 的 H pylori 的确实比 EBVaGCs 的高，但是没有重要关联在 EBV 感染和 H pylori 感染之间被发现。H pylori 积极的胃的癌在窦地点是占优势的，当 EBVaGC 在贲门 / 身体地点有优势的一个趋势时。EBV 感染在 EBVaGC 与遇见 c 的反常表示然而并非与 c-myc 蛋白质被联系。在表示上遇见 c 没被 LMP1 导致。BARF1 和 BHRF1 可以通过不同小径在 EBVaGC 的肿瘤发生起重要作用。

Andrology in China： current status and 10 years＇ progress

Andrology has a long history in traditional Chinese medicine. There are records of male sexual health, male sexual dysfunction and male infertility from over thousands of years ago. Modern andrology in China had a late start, with the Chinese Androlo~ Association founded in 1995. Within last decade, andrology in China has grown rapidly. In this review article, we summarized the progress of androlo~ in last 10 years and outlined the current status of Chinese andrology with a special focus on progress in male erectile dysfunction, prostate diseases, male infertility and male hormonal contraception.

An Innovative Methodology of Product Design from Nature

Nature is an information sourcebook of behaviour, function, colour and shape which can inspire visual design and invention. Studying the form and functional characteristics of a natural object can provide inspiration for product design and help to improve the marketability of manufactured products. The inspiration can be triggered either by direct observation or captured by three-dimensional （3D） digitising techniques to obtain superficial information （geometry and colour）. An art designer often creates a concept in the form of a two-dimensional （2D） sketch while engineering methods lead to a point cloud in 3D. Each has its limitations in that the art designer commonly lacks the knowledge to build a final product from a 2D sketch and the engi- neering designer＇s 3D point clouds may not be very beautiful. We propose a method for Product Design from Nature （PDN）, coupling aesthetic intent and geometrical characteristics, exploring the interactions between designers and nature＇s systems in PDN. We believe that this approach would considerably reduce the lead time and cost of product design from nature.

2D MXenes as Co-catalysts in Photocatalysis:Synthetic Methods

Since their seminal discovery in 2011,two-dimensional(2D)transition metal carbides/nitrides known as MXenes,that constitute a large family of 2D materials,have been targeted toward various applications due to their outstanding electronic properties.MXenes functioning as co-catalyst in combination with certain photocatalysts have been applied in photocatalytic systems to enhance photogenerated charge separation,suppress rapid charge recombination,and convert solar energy into chemical energy or use it in the degradation of organic compounds.The photocatalytic performance greatly depends on the composition and morphology of the photocatalyst,which,in turn,are determined by the method of preparation used.Here,we review the four different synthesis methods(mechanical mixing,self-assembly,in situ decoration,and oxidation)reported for MXenes in view of their application as co-catalyst in photocatalysis.In addition,the working mechanism for MXenes application in photocatalysis is discussed and an outlook for future research is also provided.