BACKGROUND The neutrophil-to-lymphocyte ratio(NLR),a composite inflammatory biomarker,is associated with the prognosis in patients with colorectal tumors.However,whether the NLR can be used as a predictor of symptomat...BACKGROUND The neutrophil-to-lymphocyte ratio(NLR),a composite inflammatory biomarker,is associated with the prognosis in patients with colorectal tumors.However,whether the NLR can be used as a predictor of symptomatic postoperative ana-stomotic leakage(AL)in elderly patients with colon cancer is unclear.AIM To assess the role of the NLR in predicting the occurrence of symptomatic AL after surgery in elderly patients with colon cancer.METHODS Data from elderly colon cancer patients who underwent elective radical colectomy with anastomosis at three centers between 2018 and 2022 were retrospectively analyzed.Receiver operating characteristic curve analysis was performed to determine the best predictive cutoff value for the NLR.Twenty-two covariates were matched using a 1:1 propensity score matching method,and univariate and multivariate logistic regression analyses were used to determine risk factors for the development of postoperative AL.RESULTS Of the 577 patients included,36(6.2%)had symptomatic AL.The optimal cutoff value of the NLR for predicting AL was 2.66.After propensity score matching,the incidence of AL was significantly greater in the≥2.66 NLR subgroup than in the<2.66 NLR subgroup(11.5%vs 2.5%;P=0.012).Univariate logistic regression analysis revealed statistically significant correlations between blood transfusion intraoperatively and within 2 d postoper-atively,preoperative albumin concentration,preoperative prognostic nutritional index,and preoperative NLR and AL occurrence(P<0.05);multivariate logistic regression analysis revealed that an NLR≥2.66[odds ratio(OR)=5.51;95%confidence interval(CI):1.50-20.26;P=0.010]and blood transfusion intraoperatively and within 2 d postoperatively(OR=2.52;95%CI:0.88-7.25;P=0.049)were risk factors for the occurrence of symptomatic AL.CONCLUSION A preoperative NLR≥2.66 and blood transfusion intraoperatively and within 2 d postoperatively are associated with a higher incidence of postoperative symptomatic AL in elderly patients with colon cancer.The preoperative NLR has predictive value for postoperative symptomatic AL after elective surgery in elderly patients with colon cancer.展开更多
AIM:To evaluate long-term outcomes of radiofrequency(RF) ablation as first-line therapy for single hepatocellular carcinoma(HCC) ≤ 3 cm and to determine survival and prognostic factors.METHODS:We included all 184 pat...AIM:To evaluate long-term outcomes of radiofrequency(RF) ablation as first-line therapy for single hepatocellular carcinoma(HCC) ≤ 3 cm and to determine survival and prognostic factors.METHODS:We included all 184 patients who underwent RF ablation as a first-line treatment for single HCC ≤ 3 cm between April 2005 and December 2013.According to the criteria of Livraghi,the 184 patients were divided into two groups:those suitable for surgical resection(84 cases) and those unsuitable for surgical resection(100 cases).The primary endpoints were the overall survival(OS) rate and safety;the secondary endpoints were primary technique effectiveness and recurrence rate.RESULTS:There were 19(10.3%) cases of ablation related minor complications.The complete tumor ablation rate after one RF session was 97.8%(180/184).The rate of local tumor progression,extrahepatic metastases and intrahepatic distant recurrence were 4.9%(9/184),9.8%(18/184) and 37.5%(69/184),respectively.In the 184 patients,the 1-,3-,and 5-year OS rates were 99.5%,81.0%,and 62.5%,respectively.The 1-,3-,and 5-year OS rates were 100%,86.9%,and 71.4%,respectively,in those suitable for surgical resection and 99.0%,76.0%,and 55.0%,respectively,in those unsuitable for surgical resection(P = 0.021).On univariate and multivariate analyses,poorer OS was associated with Child-Pugh B class and portal hypertension(P < 0.05).CONCLUSION:RF ablation is a safe and effective treatment for single HCC ≤ 3 cm.The OS rate of patients suitable for surgical resection was similar to those reported in surgical series.展开更多
BACKGROUND The biological characteristics of gastric stromal tumors are complex,and their incidence has increased in recent years.Gastric stromal tumors(GST)have potential malignant tendencies,and the probability of t...BACKGROUND The biological characteristics of gastric stromal tumors are complex,and their incidence has increased in recent years.Gastric stromal tumors(GST)have potential malignant tendencies,and the probability of transformation into malignant tumors is as high as 20%-30%.AIM To investigate the value of multi-slice spiral computed tomography(MSCT)in the differential diagnosis of GST and benign gastric polyps,and GST risk stratification assessment.METHODS We included 64 patients with GST(GST group)and 60 with benign gastric polyps(control group),confirmed by pathological examination after surgery in PLA General Hospital,from January 2016 to June 2021.The differences in the MSCT imaging characteristic parameters and enhanced CT values between the two groups before surgery were compared.According to the National Institutes of Health’s standard,GST is divided into low-and high-risk groups for MSCT imaging characteristic parameters and enhanced CT values.RESULTS The incidences of extraluminal growth,blurred boundaries,and ulceration in the GST group were significantly higher than those in the control group(P<0.05).The CT values and enhanced peak CT values in the arterial phase in the CST group were higher than those in the control group(P<0.05).The MSCT differential diagnosis of GST and gastric polyp sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and areas under the curve(AUCs)were 73.44%,83.33%,26.56%,16.67%,0.784,respectively.The receiver operating characteristic curves were plotted with the arterial CT value and enhanced peak CT value,with a statistical difference.The results showed that the sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and AUC value of arterial CT in the differential diagnosis of GST and gastric polyps were 80.18%,62.20%,19.82%,37.80%,and 0.710,respectively.The sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and AUC value of the enhanced peak CT value in the differential diagnosis of GST and gastric polyps were 67.63%,60.40%,32.37%,39.60%,and 0.710,respectively.The incidence of blurred lesion boundaries and ulceration in the high-risk group was significantly higher than that in the low-risk group(P<0.05).The arterial phase and enhanced peak CT values in the high-risk group were significantly higher than those in the low-risk group(P<0.05).CONCLUSION Presurgical MSCT examination has important value in the differential diagnosis of GST and gastric benign polyps and can effectively evaluate the risk grade of GST patients.展开更多
Background:The incidence of combined hepatocellular carcinoma-intrahepatic cholangiocarcinoma(cHCC-ICC)is relatively low,and the knowledge about the prognosis of cHCC-ICC remains obscure.In the study,we aimed to scree...Background:The incidence of combined hepatocellular carcinoma-intrahepatic cholangiocarcinoma(cHCC-ICC)is relatively low,and the knowledge about the prognosis of cHCC-ICC remains obscure.In the study,we aimed to screen existing primary liver cancer staging systems and shed light on the prognosis and risk factors for cHCC-ICC.Methods:We retrospectively reviewed 206 cHCC-ICC patients who received curative surgical resection from April 1999 to March 2017.The correlation of survival measures with the histological types or with tumor staging systems was determined and predictive values of tumor staging systems with cHCC-ICC prognosis were compared.Results:The histological type was not associated with overall survival(OS)(P=0.338)or disease-free survival(DFS)(P=0.843)of patients after curative surgical resection.BCLC,TNM for HCC,and TNM for ICC stages correlated with both OS and DFS in cHCC-ICC(all P<0.05).The predictive values of TNM for HCC and TNM for ICC stages were similar in terms of predicting postoperative OS(P=0.798)and DFS(P=0.191)in cHCC-ICC.TNM for HCC was superior to BCLC for predicting postoperative OS(P=0.022)in cHCC-ICC.Conclusion:The TNM for HCC staging system should be prioritized for clinical applications in predicting cHCC-ICC prognosis.展开更多
BACKGROUND Hypertension is the most modifiable factor associated with cardiovascular events and complications.The conventional blood pressure(BP) meter method is simple but is limited in terms of real-time monitoring ...BACKGROUND Hypertension is the most modifiable factor associated with cardiovascular events and complications.The conventional blood pressure(BP) meter method is simple but is limited in terms of real-time monitoring abnormal BP.Therefore,the development of a multifunction smartwatch(HUAWEI WATCH D) sphygmomanometer could significantly improve integrated BP monitoring.METHODS We enrolled 361 subjects from Chinese PL A General Hospital,Beijing,China to validate the accuracy of the smartwatch versatile sphygmomanometer using ISO 81060-2:2018.Resting and ambulatory BP accuracy of the smartwatch were compared with gold standard clinical sphygmomanometers using ISO 81060-2:2018 guidelines,the accuracy of 24 h systolic blood pressure(SBP) circadian rhythm monitoring,and diurnal high SBP alert for this smartwatch were assessed using a confusion matrix approach.Additionally,we analyzed online users of different ages for compliance.RESULTS Eighty-five subjects underwent resting BP measurements;the mean resting BP differences between two devices were-0.683±6.203 mmHg(SBP)(P=0.723) and 1.628±5.028 mmHg(diastolic blood pressure,DBP)(P=0.183).In 35 subjects’ ambulatory BP measurements,the mean differences of ambulatory BP were-1.943±5.475 mmHg(SBP)(P=0.923) and 3.195±5.862 mmHg(DBP)(P=0.065).All data complied with ISO 81060-2:2018 guidelines(mean ≤±5 mmHg and standard deviation ≤±8 mmHg) with no significant differences.Positive predictive values(PPV) of resting SBP and DBP were 0.635 and 0.671,respectively.The PPV of ambulatory SBP and DBP were 0.686.Also,24 h SBP circadian rhythm monitoring was performed in 107 subjects:accuracy=0.850,specificity=0.864,precision/PPV=0.833,sensitivity=0.833,and F1-measure(F1)=0.833.The accuracy,specificity,precision,sensitivity,and F1 values in 85 subjects undergoing diurnal high SBP alerting were 0.858,0.876,0.706,0.809,and 0.754,respectively.CONCLUSIONS When compared with the gold standard clinical sphygmomanometer,smartwatch results were consistent and accurate.Online user feedback showed that elderly individuals cared more about BP monitoring accuracy,with better compliance.展开更多
BACKGROUND Liver injury is common and also can be fatal,particularly in severe or critical patients with coronavirus disease 2019(COVID-19).AIM To conduct an in-depth investigation into the risk factors for liver inju...BACKGROUND Liver injury is common and also can be fatal,particularly in severe or critical patients with coronavirus disease 2019(COVID-19).AIM To conduct an in-depth investigation into the risk factors for liver injury and into the effective measures to prevent subsequent mortality risk.METHODS A retrospective cohort study was performed on 440 consecutive patients with relatively severe COVID-19 between January 28 and March 9,2020 at Tongji Hospital,Wuhan,China.Data on clinical features,laboratory parameters,medications,and prognosis were collected.RESULTS COVID-19-associated liver injury more frequently occurred in patients aged≥65 years,female patients,or those with other comorbidities,decreased lymphocyte count,or elevated D-dimer or serum ferritin(P<0.05).The disease severity of COVID-19 was an independent risk factor for liver injury(severe patients:Odds ratio[OR]=2.86,95%confidence interval[CI]:1.78-4.59;critical patients:OR=13.44,95%CI:7.21-25.97).The elevated levels of on-admission aspartate aminotransferase and total bilirubin indicated an increased mortality risk(P<0.001).Using intravenous nutrition or antibiotics increased the risk of COVID-19-associated liver injury.Hepatoprotective drugs tended to be of assistance to treat the liver injury and improve the prognosis of patients with COVID-19-associated liver injury.CONCLUSION More intensive monitoring of aspartate aminotransferase or total bilirubin is recommended for COVID-19 patients,especially patients aged≥65 years,female patients,or those with other comorbidities.Drug hepatotoxicity of antibiotics and intravenous nutrition should be alert for COVID-19 patients.展开更多
We investigate the synergism effect of total ionizing dose(TID)on single-event burnout(SEB)for commercial enhancement-mode AlGaN/GaN high-electron mobility transistors.Our experimental results show that the slight deg...We investigate the synergism effect of total ionizing dose(TID)on single-event burnout(SEB)for commercial enhancement-mode AlGaN/GaN high-electron mobility transistors.Our experimental results show that the slight degradation of devices caused by gamma rays can affect the stability of the devices during the impact of high energy particles.During heavy ion irradiation,the safe working values of drain voltage are significantly reduced for devices which have already been irradiated by 60Co gamma rays before.This could be attributed to more charges trapped caused by 60Co gamma rays,which make GaN devices more vulnerable to SEB.Moreover,the electrical parameters of GaN devices after 60Co gamma and heavy-ion irradiations are presented,such as the output characteristic curve,effective threshold voltages,and leakage current of drain.These results demonstrate that the synergistic effect of TID on SEB for GaN power devices does in fact exist.展开更多
BACKGROUND Minimal-fat angiomyolipoma(mf-AML)is often misdiagnosed as renal cell carcinoma before surgery.AIM To analyze the magnetic resonance imaging(MRI)features of mf-AML and the causes of misdiagnosis by MRI befo...BACKGROUND Minimal-fat angiomyolipoma(mf-AML)is often misdiagnosed as renal cell carcinoma before surgery.AIM To analyze the magnetic resonance imaging(MRI)features of mf-AML and the causes of misdiagnosis by MRI before operation.METHODS A retrospective analysis was performed on ten patients with mf-AML confirmed by surgical pathology,all of whom underwent preoperative MRI examination to analyze the morphological characteristics and MRI signals of the tumor.RESULTS MRI revealed a circular-like mass in 4/10(40%)patients,an oval mass in 6/10 patients(60%),a mass with a capsule in 9/10 patients(90%),and a mass with a lipid component in 7/10 patients(70%).The diameter of the masses in all ten patients was from 11 to 47 mm;the diameter was between 11 mm and 40 mm in 8/10(80%)patients and between 40 mm and 47 mm in 2/10(20%)patients.CONCLUSION An oval morphological characteristic is strong evidence for the diagnosis of mf-AML,while a capsule and lipids are atypical manifestations of mf-AML.展开更多
AIM: To compare safety and therapeutic efficacy of laparoscopic radiofrequency(RF) ablation vs computed tomography(CT)-guided RF ablation for large hepatic hemangiomas abutting the diaphragm.METHODS: We retrospectivel...AIM: To compare safety and therapeutic efficacy of laparoscopic radiofrequency(RF) ablation vs computed tomography(CT)-guided RF ablation for large hepatic hemangiomas abutting the diaphragm.METHODS: We retrospectively reviewed our sequential experience of treating 51 large hepatic hemangiomas abutting the diaphragm in 51 patients by CT-guided or laparoscopic RF ablation due to either the presence of symptoms and/or the enlargement of hemangioma.Altogether, 24 hemangiomas were ablated via a CTguided percutaneous approach(CT-guided ablation group), and 27 hemangiomas were treated via a laparoscopic approach(laparoscopic ablation group).RESULTS: The mean diameter of the 51 hemangiomas was 9.6 ± 1.8 cm(range, 6.0-12.0 cm). There was nodifference in the diameter of hemangiomas between the two groups(P > 0.05). RF ablation was performed successfully in all patients. There was no difference in ablation times between groups(P > 0.05). There were 23 thoracic complications in 17 patients: 15(62.5%, 15/24) in the CT-guided ablation group and2(7.4%, 2/27) in the laparoscopic ablation group(P< 0.05). According to the Dindo-Clavien classification,two complications(pleural effusion and diaphragmatic rupture grade Ⅲ) were major in two patients. All others were minor(grade Ⅰ). Both major complications occurred in the CT-guided ablation group. The minor complications were treated successfully with conservative measures, and the two major complications underwent treatment by chest tube drainage and thoracoscopic surgery, respectively. Complete ablation was achieved in 91.7%(22/24) and 96.3%(26/27) in the CT-guided and the laparoscopic ablation groups,respectively(P > 0.05).CONCLUSION: Laparoscopic RF ablation therapy should be used as the first-line treatment option for large hepatic hemangiomas abutting the diaphragm.It avoids thermal injury to the diaphragm and reduces thoracic complications.展开更多
Recent studies have shown that radiofrequency(RF) ablation therapy is a safe, feasible, and effective procedure for hepatic hemangiomas, even huge hepatic hemangiomas. RF ablation has the following advantages in the t...Recent studies have shown that radiofrequency(RF) ablation therapy is a safe, feasible, and effective procedure for hepatic hemangiomas, even huge hepatic hemangiomas. RF ablation has the following advantages in the treatment of hepatic hemangiomas: minimal invasiveness, definite efficacy, high safety, fast recovery, relatively simple operation, and wide applicability. It is necessary to formulate a widely accepted consensus among the experts in China who have extensive expertise and experience in the treatment of hepatic hemangiomas using RF ablation, which is important to standardize the application of RF ablation for the management of hepatic hemangiomas, regarding the selection of patients with suitable indications to receive RF ablation treatment, the technical details of the techniques, therapeutic effect evaluations, management of complications, etc. A final consensus by a Chinese panel of experts who have the expertise of using RF ablation to treat hepatic hemangiomas was reached by means of literature review, comprehensive discussion, and draft approval.展开更多
The Cr-plated coating inside a gun barrel can effectively improve the barrel’s erosion resistance and thus increase the service life.However,due to the cyclic thermal load caused by high-temperature gunpowder,micro-e...The Cr-plated coating inside a gun barrel can effectively improve the barrel’s erosion resistance and thus increase the service life.However,due to the cyclic thermal load caused by high-temperature gunpowder,micro-element damage tends to occur within the Cr coating/steel substrate interface,leading to a gradual deterioration in macro-mechanical properties for the material in the related region.In order to mimic this cyclic thermal load and,thereby,study the thermal erosion behavior of the Cr coating on the barrel’s inner wall,a laser emitter is utilized in the current study.With the help of in-situ tensile test and finite element simulation results,a shear stress distribution law of the Cr coating/steel substrate and a change law of the interface ultimate shear strength are identified.Studies have shown that the Cr coating/steel substrate interface’s ultimate shear strength has a significant weakening effect due to increasing temperature.In this study,the interfacial ultimate shear strength decreases from 2.57 GPa(no erosion)to 1.02 GPa(laser power is 160 W).The data from this experiment is employed to establish a Cr coating/steel substrate interface shear damage model.And this model is used to predict the flaking process of Cr coating by finite element method.The simulation results show that the increase of coating crack spacing and coating thickness will increase the service life of gun barrel.展开更多
The abundance of domesticated sheep varieties and phenotypes is largely the result of long-term natural and artificial selection. However, there is limited information regarding the genetic mechanisms underlying pheno...The abundance of domesticated sheep varieties and phenotypes is largely the result of long-term natural and artificial selection. However, there is limited information regarding the genetic mechanisms underlying phenotypic variation induced by the domestication and improvement of sheep. In this study, to explore genomic diversity and selective regions at the genome level, we sequenced the genomes of 100 sheep across 10 breeds and combined these results with publicly available genomic data from 225 individuals, including improved breeds, Chinese indigenous breeds,African indigenous breeds, and their Asian mouflon ancestor. Based on population structure, the domesticated sheep formed a monophyletic group,while the Chinese indigenous sheep showed a clear geographical distribution trend. Comparative genomic analysis of domestication identified several selective signatures, including IFI44 and IFI44L genes and PANK2 and RNF24 genes, associated with immune response and visual function.Population genomic analysis of improvement demonstrated that candidate genes of selected regions were mainly associated with pigmentation,energy metabolism, and growth development.Furthermore, the IFI44 and IFI44L genes showed a common selection signature in the genomes of 30domesticated sheep breeds. The IFI44 c. 54413058C>G mutation was selected for genotyping and population genetic validation. Results showed that the IFI44 polymorphism was significantly associated with partial immune traits. Our findings identified the population genetic basis of domesticated sheep at the whole-genome level, providing theoretical insights into the molecular mechanism underlying breed characteristics and phenotypic changes during sheep domestication and improvement.展开更多
BACKGROUND The World Health Organization reported that 28637952 people worldwide had been infected with severe acute respiratory syndrome coronavirus 2,the causative agent of coronavirus disease 2019(COVID-19),by Sept...BACKGROUND The World Health Organization reported that 28637952 people worldwide had been infected with severe acute respiratory syndrome coronavirus 2,the causative agent of coronavirus disease 2019(COVID-19),by September 13.AIM The aim was to investigate whether long-term use of renin-angiotensin-aldosterone system(RAAS)inhibitors for the treatment of hypertension aggravates the performance of COVID-19 patients with hypertension.METHODS This was a retrospective analysis of lung computed tomography(CT)data and laboratory values of COVID-19 patients with hypertension who were admitted to Huoshenshan Hospital,Wuhan,Hubei Province,between February 18 and March 31,2020.Patients were divided into two groups.Group A included 19 people who were long-term users of RAAS inhibitors for hypertension;and group B included 28 people who were randomly selected from the database and matched with group A by age,sex,basic diseases,and long-term use of other antihypertensive drugs.All patients underwent a series of CT and laboratory tests.We compared the most severe CT images of the two groups and the laboratory examination results within 2 d of the corresponding CT images.RESULTS The time until the most severe CT images from the onset of COVID-19 was 30.37±14.25 d group A and 26.50±11.97 d in group B.The difference between the two groups was not significant(t=1.01,P=0.32).There were no significant differences in blood laboratory values,C-reactive protein,markers of cardiac injury,liver function,or kidney function between the two groups.There was no significant difference in the appearance of the CT images between the two groups.The semiquantitative scores of each involved lobe were 11.84±5.88 in group A and 10.36±6.04 group B.The difference was not significantly different(t=0.84,P=0.41).CONCLUSION Chest CT is an important imaging tool to monitor the characteristics of COVID-19 and the degree of lung injury.Chronic use of RAAS inhibitors is not related to the severity of COVID-19,and it does not worsen the clinical process.展开更多
Zirconyl pyrophosphate(ZrP_2O_7) was prepared and Cs adsorption behavior was studied.Results show that the distribution coefficient of Cs adsorption on ZrP_2O_7 was about 2800 mL/g.Ion exchange capacity of ZrP_2O_7 wa...Zirconyl pyrophosphate(ZrP_2O_7) was prepared and Cs adsorption behavior was studied.Results show that the distribution coefficient of Cs adsorption on ZrP_2O_7 was about 2800 mL/g.Ion exchange capacity of ZrP_2O_7 was0.35 mmol/g.In dynamic tests,Cs can be separated from other fission products very well by ZrP_2O_7.The ZrP_2O_7was stable both at high temperatures and in high concentration of nitric acid.The Cs adsorption by ZrP_2O_7 is a monolayer and chemical adsorption.展开更多
Over the last several hundred years,donkeys have adapted to high-altitude conditions on the Tibetan Plateau.Interestingly,the kiang,a closely related equid species,also inhabits this region.Previous reports have demon...Over the last several hundred years,donkeys have adapted to high-altitude conditions on the Tibetan Plateau.Interestingly,the kiang,a closely related equid species,also inhabits this region.Previous reports have demonstrated the importance of specific genes and adaptive introgression in divergent lineages for adaptation to hypoxic conditions on the Tibetan Plateau.Here,we assessed whether donkeys and kiangs adapted to the Tibetan Plateau via the same or different biological pathways and whether adaptive introgression has occurred.We assembled a de novo genome from a kiang individual and analyzed the genomes of five kiangs and 93 donkeys(including 24 from the Tibetan Plateau).Our analyses suggested the existence of a strong hard selective sweep at the EPAS1 locus in kiangs.In Tibetan donkeys,however,another gene,i.e.,EGLN1,was likely involved in their adaptation to high altitude.In addition,admixture analysis found no evidence for interspecific gene flow between kiangs and Tibetan donkeys.Our findings indicate that despite the short evolutionary time scale since the arrival of donkeys on the Tibetan Plateau,as well as the existence of a closely related species already adapted to hypoxia,Tibetan donkeys did not acquire adaptation via admixture but instead evolved adaptations via a different biological pathway.展开更多
The high resolution rotational spectrum of 2-(triuoromethyl)pyridine in 2-20 GHz was recorded and analyzed.Spectroscopic parameters including rotational constants,nuclear quadrupole coupling constants of 14N as well a...The high resolution rotational spectrum of 2-(triuoromethyl)pyridine in 2-20 GHz was recorded and analyzed.Spectroscopic parameters including rotational constants,nuclear quadrupole coupling constants of 14N as well as the centrifugal distortion constants were determined.The rotational spectra of ve mono-substituted 13C and one 15N isotopologues were also measured and assigned in natural abundance.Experimental results complemented by ab initio calculations lead to an accurate determination of the skeleton structure.The values of the planar moment inertia Pcc were determined to be 44.46 uA^2 for all the measured isotopologues,indicating a Cs symmetry of this molecule.The molecular electrostatic surface potential was calculated to illustrate the triuoromethyl substitution e ects on the electron distribution.展开更多
基金Supported by the Natural Science Foundation of Gansu Province,China,No.21JR1RA075 and No.22JR5RA895and Lanzhou Science and Technology Program,China,No.2021-1-109.
文摘BACKGROUND The neutrophil-to-lymphocyte ratio(NLR),a composite inflammatory biomarker,is associated with the prognosis in patients with colorectal tumors.However,whether the NLR can be used as a predictor of symptomatic postoperative ana-stomotic leakage(AL)in elderly patients with colon cancer is unclear.AIM To assess the role of the NLR in predicting the occurrence of symptomatic AL after surgery in elderly patients with colon cancer.METHODS Data from elderly colon cancer patients who underwent elective radical colectomy with anastomosis at three centers between 2018 and 2022 were retrospectively analyzed.Receiver operating characteristic curve analysis was performed to determine the best predictive cutoff value for the NLR.Twenty-two covariates were matched using a 1:1 propensity score matching method,and univariate and multivariate logistic regression analyses were used to determine risk factors for the development of postoperative AL.RESULTS Of the 577 patients included,36(6.2%)had symptomatic AL.The optimal cutoff value of the NLR for predicting AL was 2.66.After propensity score matching,the incidence of AL was significantly greater in the≥2.66 NLR subgroup than in the<2.66 NLR subgroup(11.5%vs 2.5%;P=0.012).Univariate logistic regression analysis revealed statistically significant correlations between blood transfusion intraoperatively and within 2 d postoper-atively,preoperative albumin concentration,preoperative prognostic nutritional index,and preoperative NLR and AL occurrence(P<0.05);multivariate logistic regression analysis revealed that an NLR≥2.66[odds ratio(OR)=5.51;95%confidence interval(CI):1.50-20.26;P=0.010]and blood transfusion intraoperatively and within 2 d postoperatively(OR=2.52;95%CI:0.88-7.25;P=0.049)were risk factors for the occurrence of symptomatic AL.CONCLUSION A preoperative NLR≥2.66 and blood transfusion intraoperatively and within 2 d postoperatively are associated with a higher incidence of postoperative symptomatic AL in elderly patients with colon cancer.The preoperative NLR has predictive value for postoperative symptomatic AL after elective surgery in elderly patients with colon cancer.
基金Dr.Jieping Wu Medical Foundation,Nos.320675007131 and 32067501207Clinical-Basic Medicine Cooperation Fund of Capital Medical University,No.1300171711Program for Medical Key Discipline of Shijingshan District,No.20130001
文摘AIM:To evaluate long-term outcomes of radiofrequency(RF) ablation as first-line therapy for single hepatocellular carcinoma(HCC) ≤ 3 cm and to determine survival and prognostic factors.METHODS:We included all 184 patients who underwent RF ablation as a first-line treatment for single HCC ≤ 3 cm between April 2005 and December 2013.According to the criteria of Livraghi,the 184 patients were divided into two groups:those suitable for surgical resection(84 cases) and those unsuitable for surgical resection(100 cases).The primary endpoints were the overall survival(OS) rate and safety;the secondary endpoints were primary technique effectiveness and recurrence rate.RESULTS:There were 19(10.3%) cases of ablation related minor complications.The complete tumor ablation rate after one RF session was 97.8%(180/184).The rate of local tumor progression,extrahepatic metastases and intrahepatic distant recurrence were 4.9%(9/184),9.8%(18/184) and 37.5%(69/184),respectively.In the 184 patients,the 1-,3-,and 5-year OS rates were 99.5%,81.0%,and 62.5%,respectively.The 1-,3-,and 5-year OS rates were 100%,86.9%,and 71.4%,respectively,in those suitable for surgical resection and 99.0%,76.0%,and 55.0%,respectively,in those unsuitable for surgical resection(P = 0.021).On univariate and multivariate analyses,poorer OS was associated with Child-Pugh B class and portal hypertension(P < 0.05).CONCLUSION:RF ablation is a safe and effective treatment for single HCC ≤ 3 cm.The OS rate of patients suitable for surgical resection was similar to those reported in surgical series.
文摘BACKGROUND The biological characteristics of gastric stromal tumors are complex,and their incidence has increased in recent years.Gastric stromal tumors(GST)have potential malignant tendencies,and the probability of transformation into malignant tumors is as high as 20%-30%.AIM To investigate the value of multi-slice spiral computed tomography(MSCT)in the differential diagnosis of GST and benign gastric polyps,and GST risk stratification assessment.METHODS We included 64 patients with GST(GST group)and 60 with benign gastric polyps(control group),confirmed by pathological examination after surgery in PLA General Hospital,from January 2016 to June 2021.The differences in the MSCT imaging characteristic parameters and enhanced CT values between the two groups before surgery were compared.According to the National Institutes of Health’s standard,GST is divided into low-and high-risk groups for MSCT imaging characteristic parameters and enhanced CT values.RESULTS The incidences of extraluminal growth,blurred boundaries,and ulceration in the GST group were significantly higher than those in the control group(P<0.05).The CT values and enhanced peak CT values in the arterial phase in the CST group were higher than those in the control group(P<0.05).The MSCT differential diagnosis of GST and gastric polyp sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and areas under the curve(AUCs)were 73.44%,83.33%,26.56%,16.67%,0.784,respectively.The receiver operating characteristic curves were plotted with the arterial CT value and enhanced peak CT value,with a statistical difference.The results showed that the sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and AUC value of arterial CT in the differential diagnosis of GST and gastric polyps were 80.18%,62.20%,19.82%,37.80%,and 0.710,respectively.The sensitivity,specificity,misdiagnosis rate,missed diagnosis rate,and AUC value of the enhanced peak CT value in the differential diagnosis of GST and gastric polyps were 67.63%,60.40%,32.37%,39.60%,and 0.710,respectively.The incidence of blurred lesion boundaries and ulceration in the high-risk group was significantly higher than that in the low-risk group(P<0.05).The arterial phase and enhanced peak CT values in the high-risk group were significantly higher than those in the low-risk group(P<0.05).CONCLUSION Presurgical MSCT examination has important value in the differential diagnosis of GST and gastric benign polyps and can effectively evaluate the risk grade of GST patients.
基金the Natural Science Foundation of Shanghai(17ZR1405400).
文摘Background:The incidence of combined hepatocellular carcinoma-intrahepatic cholangiocarcinoma(cHCC-ICC)is relatively low,and the knowledge about the prognosis of cHCC-ICC remains obscure.In the study,we aimed to screen existing primary liver cancer staging systems and shed light on the prognosis and risk factors for cHCC-ICC.Methods:We retrospectively reviewed 206 cHCC-ICC patients who received curative surgical resection from April 1999 to March 2017.The correlation of survival measures with the histological types or with tumor staging systems was determined and predictive values of tumor staging systems with cHCC-ICC prognosis were compared.Results:The histological type was not associated with overall survival(OS)(P=0.338)or disease-free survival(DFS)(P=0.843)of patients after curative surgical resection.BCLC,TNM for HCC,and TNM for ICC stages correlated with both OS and DFS in cHCC-ICC(all P<0.05).The predictive values of TNM for HCC and TNM for ICC stages were similar in terms of predicting postoperative OS(P=0.798)and DFS(P=0.191)in cHCC-ICC.TNM for HCC was superior to BCLC for predicting postoperative OS(P=0.022)in cHCC-ICC.Conclusion:The TNM for HCC staging system should be prioritized for clinical applications in predicting cHCC-ICC prognosis.
基金supported by the National Key Research and Development Program of China (2020 YFC1512305)
文摘BACKGROUND Hypertension is the most modifiable factor associated with cardiovascular events and complications.The conventional blood pressure(BP) meter method is simple but is limited in terms of real-time monitoring abnormal BP.Therefore,the development of a multifunction smartwatch(HUAWEI WATCH D) sphygmomanometer could significantly improve integrated BP monitoring.METHODS We enrolled 361 subjects from Chinese PL A General Hospital,Beijing,China to validate the accuracy of the smartwatch versatile sphygmomanometer using ISO 81060-2:2018.Resting and ambulatory BP accuracy of the smartwatch were compared with gold standard clinical sphygmomanometers using ISO 81060-2:2018 guidelines,the accuracy of 24 h systolic blood pressure(SBP) circadian rhythm monitoring,and diurnal high SBP alert for this smartwatch were assessed using a confusion matrix approach.Additionally,we analyzed online users of different ages for compliance.RESULTS Eighty-five subjects underwent resting BP measurements;the mean resting BP differences between two devices were-0.683±6.203 mmHg(SBP)(P=0.723) and 1.628±5.028 mmHg(diastolic blood pressure,DBP)(P=0.183).In 35 subjects’ ambulatory BP measurements,the mean differences of ambulatory BP were-1.943±5.475 mmHg(SBP)(P=0.923) and 3.195±5.862 mmHg(DBP)(P=0.065).All data complied with ISO 81060-2:2018 guidelines(mean ≤±5 mmHg and standard deviation ≤±8 mmHg) with no significant differences.Positive predictive values(PPV) of resting SBP and DBP were 0.635 and 0.671,respectively.The PPV of ambulatory SBP and DBP were 0.686.Also,24 h SBP circadian rhythm monitoring was performed in 107 subjects:accuracy=0.850,specificity=0.864,precision/PPV=0.833,sensitivity=0.833,and F1-measure(F1)=0.833.The accuracy,specificity,precision,sensitivity,and F1 values in 85 subjects undergoing diurnal high SBP alerting were 0.858,0.876,0.706,0.809,and 0.754,respectively.CONCLUSIONS When compared with the gold standard clinical sphygmomanometer,smartwatch results were consistent and accurate.Online user feedback showed that elderly individuals cared more about BP monitoring accuracy,with better compliance.
文摘BACKGROUND Liver injury is common and also can be fatal,particularly in severe or critical patients with coronavirus disease 2019(COVID-19).AIM To conduct an in-depth investigation into the risk factors for liver injury and into the effective measures to prevent subsequent mortality risk.METHODS A retrospective cohort study was performed on 440 consecutive patients with relatively severe COVID-19 between January 28 and March 9,2020 at Tongji Hospital,Wuhan,China.Data on clinical features,laboratory parameters,medications,and prognosis were collected.RESULTS COVID-19-associated liver injury more frequently occurred in patients aged≥65 years,female patients,or those with other comorbidities,decreased lymphocyte count,or elevated D-dimer or serum ferritin(P<0.05).The disease severity of COVID-19 was an independent risk factor for liver injury(severe patients:Odds ratio[OR]=2.86,95%confidence interval[CI]:1.78-4.59;critical patients:OR=13.44,95%CI:7.21-25.97).The elevated levels of on-admission aspartate aminotransferase and total bilirubin indicated an increased mortality risk(P<0.001).Using intravenous nutrition or antibiotics increased the risk of COVID-19-associated liver injury.Hepatoprotective drugs tended to be of assistance to treat the liver injury and improve the prognosis of patients with COVID-19-associated liver injury.CONCLUSION More intensive monitoring of aspartate aminotransferase or total bilirubin is recommended for COVID-19 patients,especially patients aged≥65 years,female patients,or those with other comorbidities.Drug hepatotoxicity of antibiotics and intravenous nutrition should be alert for COVID-19 patients.
基金Supported by the National Natural Science Foundation of China under Grant Nos. U1532261,U1630141,and 61534008the West Light Foundation of Chinese Academy of Sciences under Grant No. 2018-XBQNXZ-B-003
文摘We investigate the synergism effect of total ionizing dose(TID)on single-event burnout(SEB)for commercial enhancement-mode AlGaN/GaN high-electron mobility transistors.Our experimental results show that the slight degradation of devices caused by gamma rays can affect the stability of the devices during the impact of high energy particles.During heavy ion irradiation,the safe working values of drain voltage are significantly reduced for devices which have already been irradiated by 60Co gamma rays before.This could be attributed to more charges trapped caused by 60Co gamma rays,which make GaN devices more vulnerable to SEB.Moreover,the electrical parameters of GaN devices after 60Co gamma and heavy-ion irradiations are presented,such as the output characteristic curve,effective threshold voltages,and leakage current of drain.These results demonstrate that the synergistic effect of TID on SEB for GaN power devices does in fact exist.
文摘BACKGROUND Minimal-fat angiomyolipoma(mf-AML)is often misdiagnosed as renal cell carcinoma before surgery.AIM To analyze the magnetic resonance imaging(MRI)features of mf-AML and the causes of misdiagnosis by MRI before operation.METHODS A retrospective analysis was performed on ten patients with mf-AML confirmed by surgical pathology,all of whom underwent preoperative MRI examination to analyze the morphological characteristics and MRI signals of the tumor.RESULTS MRI revealed a circular-like mass in 4/10(40%)patients,an oval mass in 6/10 patients(60%),a mass with a capsule in 9/10 patients(90%),and a mass with a lipid component in 7/10 patients(70%).The diameter of the masses in all ten patients was from 11 to 47 mm;the diameter was between 11 mm and 40 mm in 8/10(80%)patients and between 40 mm and 47 mm in 2/10(20%)patients.CONCLUSION An oval morphological characteristic is strong evidence for the diagnosis of mf-AML,while a capsule and lipids are atypical manifestations of mf-AML.
基金Supported by the Dr.Jieping Wu Medical Foundation,No.320675007131 and No.32067501207Clinical-Basic Medicine Cooperation Fund of Capital Medical University,No.1300171711the Program for Medical Key Discipline of Shijingshan District,No.20130001
文摘AIM: To compare safety and therapeutic efficacy of laparoscopic radiofrequency(RF) ablation vs computed tomography(CT)-guided RF ablation for large hepatic hemangiomas abutting the diaphragm.METHODS: We retrospectively reviewed our sequential experience of treating 51 large hepatic hemangiomas abutting the diaphragm in 51 patients by CT-guided or laparoscopic RF ablation due to either the presence of symptoms and/or the enlargement of hemangioma.Altogether, 24 hemangiomas were ablated via a CTguided percutaneous approach(CT-guided ablation group), and 27 hemangiomas were treated via a laparoscopic approach(laparoscopic ablation group).RESULTS: The mean diameter of the 51 hemangiomas was 9.6 ± 1.8 cm(range, 6.0-12.0 cm). There was nodifference in the diameter of hemangiomas between the two groups(P > 0.05). RF ablation was performed successfully in all patients. There was no difference in ablation times between groups(P > 0.05). There were 23 thoracic complications in 17 patients: 15(62.5%, 15/24) in the CT-guided ablation group and2(7.4%, 2/27) in the laparoscopic ablation group(P< 0.05). According to the Dindo-Clavien classification,two complications(pleural effusion and diaphragmatic rupture grade Ⅲ) were major in two patients. All others were minor(grade Ⅰ). Both major complications occurred in the CT-guided ablation group. The minor complications were treated successfully with conservative measures, and the two major complications underwent treatment by chest tube drainage and thoracoscopic surgery, respectively. Complete ablation was achieved in 91.7%(22/24) and 96.3%(26/27) in the CT-guided and the laparoscopic ablation groups,respectively(P > 0.05).CONCLUSION: Laparoscopic RF ablation therapy should be used as the first-line treatment option for large hepatic hemangiomas abutting the diaphragm.It avoids thermal injury to the diaphragm and reduces thoracic complications.
文摘Recent studies have shown that radiofrequency(RF) ablation therapy is a safe, feasible, and effective procedure for hepatic hemangiomas, even huge hepatic hemangiomas. RF ablation has the following advantages in the treatment of hepatic hemangiomas: minimal invasiveness, definite efficacy, high safety, fast recovery, relatively simple operation, and wide applicability. It is necessary to formulate a widely accepted consensus among the experts in China who have extensive expertise and experience in the treatment of hepatic hemangiomas using RF ablation, which is important to standardize the application of RF ablation for the management of hepatic hemangiomas, regarding the selection of patients with suitable indications to receive RF ablation treatment, the technical details of the techniques, therapeutic effect evaluations, management of complications, etc. A final consensus by a Chinese panel of experts who have the expertise of using RF ablation to treat hepatic hemangiomas was reached by means of literature review, comprehensive discussion, and draft approval.
文摘The Cr-plated coating inside a gun barrel can effectively improve the barrel’s erosion resistance and thus increase the service life.However,due to the cyclic thermal load caused by high-temperature gunpowder,micro-element damage tends to occur within the Cr coating/steel substrate interface,leading to a gradual deterioration in macro-mechanical properties for the material in the related region.In order to mimic this cyclic thermal load and,thereby,study the thermal erosion behavior of the Cr coating on the barrel’s inner wall,a laser emitter is utilized in the current study.With the help of in-situ tensile test and finite element simulation results,a shear stress distribution law of the Cr coating/steel substrate and a change law of the interface ultimate shear strength are identified.Studies have shown that the Cr coating/steel substrate interface’s ultimate shear strength has a significant weakening effect due to increasing temperature.In this study,the interfacial ultimate shear strength decreases from 2.57 GPa(no erosion)to 1.02 GPa(laser power is 160 W).The data from this experiment is employed to establish a Cr coating/steel substrate interface shear damage model.And this model is used to predict the flaking process of Cr coating by finite element method.The simulation results show that the increase of coating crack spacing and coating thickness will increase the service life of gun barrel.
基金supported by the National Key R&D Program of China (2021YFD1300901)National Natural Science Foundation of China (31960653)+1 种基金West Light Foundation of the Chinese Academy of SciencesNational Joint Research on Improved Breeds of Livestock and Poultry (19210365)。
文摘The abundance of domesticated sheep varieties and phenotypes is largely the result of long-term natural and artificial selection. However, there is limited information regarding the genetic mechanisms underlying phenotypic variation induced by the domestication and improvement of sheep. In this study, to explore genomic diversity and selective regions at the genome level, we sequenced the genomes of 100 sheep across 10 breeds and combined these results with publicly available genomic data from 225 individuals, including improved breeds, Chinese indigenous breeds,African indigenous breeds, and their Asian mouflon ancestor. Based on population structure, the domesticated sheep formed a monophyletic group,while the Chinese indigenous sheep showed a clear geographical distribution trend. Comparative genomic analysis of domestication identified several selective signatures, including IFI44 and IFI44L genes and PANK2 and RNF24 genes, associated with immune response and visual function.Population genomic analysis of improvement demonstrated that candidate genes of selected regions were mainly associated with pigmentation,energy metabolism, and growth development.Furthermore, the IFI44 and IFI44L genes showed a common selection signature in the genomes of 30domesticated sheep breeds. The IFI44 c. 54413058C>G mutation was selected for genotyping and population genetic validation. Results showed that the IFI44 polymorphism was significantly associated with partial immune traits. Our findings identified the population genetic basis of domesticated sheep at the whole-genome level, providing theoretical insights into the molecular mechanism underlying breed characteristics and phenotypic changes during sheep domestication and improvement.
文摘BACKGROUND The World Health Organization reported that 28637952 people worldwide had been infected with severe acute respiratory syndrome coronavirus 2,the causative agent of coronavirus disease 2019(COVID-19),by September 13.AIM The aim was to investigate whether long-term use of renin-angiotensin-aldosterone system(RAAS)inhibitors for the treatment of hypertension aggravates the performance of COVID-19 patients with hypertension.METHODS This was a retrospective analysis of lung computed tomography(CT)data and laboratory values of COVID-19 patients with hypertension who were admitted to Huoshenshan Hospital,Wuhan,Hubei Province,between February 18 and March 31,2020.Patients were divided into two groups.Group A included 19 people who were long-term users of RAAS inhibitors for hypertension;and group B included 28 people who were randomly selected from the database and matched with group A by age,sex,basic diseases,and long-term use of other antihypertensive drugs.All patients underwent a series of CT and laboratory tests.We compared the most severe CT images of the two groups and the laboratory examination results within 2 d of the corresponding CT images.RESULTS The time until the most severe CT images from the onset of COVID-19 was 30.37±14.25 d group A and 26.50±11.97 d in group B.The difference between the two groups was not significant(t=1.01,P=0.32).There were no significant differences in blood laboratory values,C-reactive protein,markers of cardiac injury,liver function,or kidney function between the two groups.There was no significant difference in the appearance of the CT images between the two groups.The semiquantitative scores of each involved lobe were 11.84±5.88 in group A and 10.36±6.04 group B.The difference was not significantly different(t=0.84,P=0.41).CONCLUSION Chest CT is an important imaging tool to monitor the characteristics of COVID-19 and the degree of lung injury.Chronic use of RAAS inhibitors is not related to the severity of COVID-19,and it does not worsen the clinical process.
基金supported by the Defense Advanced Research Project
文摘Zirconyl pyrophosphate(ZrP_2O_7) was prepared and Cs adsorption behavior was studied.Results show that the distribution coefficient of Cs adsorption on ZrP_2O_7 was about 2800 mL/g.Ion exchange capacity of ZrP_2O_7 was0.35 mmol/g.In dynamic tests,Cs can be separated from other fission products very well by ZrP_2O_7.The ZrP_2O_7was stable both at high temperatures and in high concentration of nitric acid.The Cs adsorption by ZrP_2O_7 is a monolayer and chemical adsorption.
基金supported by the National Natural Science Foundation of China (31621062)Strategic Priority Research Program of the Chinese Academy of Sciences (XDA2004010302)+4 种基金Second Tibetan Plateau Scientific Expedition and Research (STEP)Program (2019QZKK05010703)supported by the National Natural Science Foundation of China (91731304, 31822048)Strategic Priority Research Program of the Chinese Academy of Sciences (XDB13020600)Qinghai Department of Science and Technology Major ProjectState Key Laboratory for Conservation and Utilization of Bio-Resources in Yunnan,Yunnan University(2018KF001)supported by the Animal Branch of the Germplasm Bank of Wild Species,Chinese Academy of Sciences (Large Research Infrastructure Funding)
文摘Over the last several hundred years,donkeys have adapted to high-altitude conditions on the Tibetan Plateau.Interestingly,the kiang,a closely related equid species,also inhabits this region.Previous reports have demonstrated the importance of specific genes and adaptive introgression in divergent lineages for adaptation to hypoxic conditions on the Tibetan Plateau.Here,we assessed whether donkeys and kiangs adapted to the Tibetan Plateau via the same or different biological pathways and whether adaptive introgression has occurred.We assembled a de novo genome from a kiang individual and analyzed the genomes of five kiangs and 93 donkeys(including 24 from the Tibetan Plateau).Our analyses suggested the existence of a strong hard selective sweep at the EPAS1 locus in kiangs.In Tibetan donkeys,however,another gene,i.e.,EGLN1,was likely involved in their adaptation to high altitude.In addition,admixture analysis found no evidence for interspecific gene flow between kiangs and Tibetan donkeys.Our findings indicate that despite the short evolutionary time scale since the arrival of donkeys on the Tibetan Plateau,as well as the existence of a closely related species already adapted to hypoxia,Tibetan donkeys did not acquire adaptation via admixture but instead evolved adaptations via a different biological pathway.
基金the National Natural Science Foundation of China(No.21703021 and No.U1931104)Chongqing University under the program of the Foundation of 100 Young,Fundamental and Frontier Research Fund of Chongqing(No.cstc2017jcyjAX0068 and No.cstc2018jcyjAX0050)Venture&Innovation Support Program for Chongqing Overseas Returns(No.cx2018064).
文摘The high resolution rotational spectrum of 2-(triuoromethyl)pyridine in 2-20 GHz was recorded and analyzed.Spectroscopic parameters including rotational constants,nuclear quadrupole coupling constants of 14N as well as the centrifugal distortion constants were determined.The rotational spectra of ve mono-substituted 13C and one 15N isotopologues were also measured and assigned in natural abundance.Experimental results complemented by ab initio calculations lead to an accurate determination of the skeleton structure.The values of the planar moment inertia Pcc were determined to be 44.46 uA^2 for all the measured isotopologues,indicating a Cs symmetry of this molecule.The molecular electrostatic surface potential was calculated to illustrate the triuoromethyl substitution e ects on the electron distribution.