Objectives Renal replacement therapy(RRT)is increasingly adopted for critically ill patients diagnosed with acute kidney injury,but the optimal time for initiation remains unclear and prognosis is uncertain,leading to...Objectives Renal replacement therapy(RRT)is increasingly adopted for critically ill patients diagnosed with acute kidney injury,but the optimal time for initiation remains unclear and prognosis is uncertain,leading to medical complexity,ethical conflicts,and decision dilemmas in intensive care unit(ICU)settings.This study aimed to develop a decision aid(DA)for the family surrogate of critically ill patients to support their engagement in shared decision-making process with clinicians.Methods Development of DA employed a systematic process with user-centered design(UCD)principle,which included:(i)competitive analysis:searched,screened,and assessed the existing DAs to gather insights for design strategies,developmental techniques,and functionalities;(ii)user needs assessment:interviewed family surrogates in our hospital to explore target user group's decision-making experience and identify their unmet needs;(iii)evidence syntheses:integrate latest clinical evidence and pertinent information to inform the content development of DA.Results The competitive analysis included 16 relevant DAs,from which we derived valuable insights using existing resources.User decision needs were explored among a cohort of 15 family surrogates,revealing four thematic issues in decision-making,including stuck into dilemmas,sense of uncertainty,limited capacity,and delayed decision confirmation.A total of 27 articles were included for evidence syntheses.Relevant decision making knowledge on disease and treatment,as delineated in the literature sourced from decision support system or clinical guidelines,were formatted as the foundational knowledge base.Twenty-one items of evidence were extracted and integrated into the content panels of benefits and risks of RRT,possible outcomes,and reasons to choose.The DA was drafted into a web-based phototype using the elements of UCD.This platform could guide users in their preparation of decision-making through a sequential four-step process:identifying treatment options,weighing the benefits and risks,clarifying personal preferences and values,and formulating a schedule for formal shared decision-making with clinicians.Conclusions We developed a rapid prototype of DA tailored for family surrogate decision makers of critically ill patients in need of RRT in ICU setting.Future studies are needed to evaluate its usability,feasibility,and clinical effects of this intervention.展开更多
BACKGROUND Skeletal muscle abnormalities,such as muscle mass depletion(sarcopenia)and fatty infiltration of the muscle(myosteatosis),are frequent complications in cirrhotic patients scheduled for transjugular intrahep...BACKGROUND Skeletal muscle abnormalities,such as muscle mass depletion(sarcopenia)and fatty infiltration of the muscle(myosteatosis),are frequent complications in cirrhotic patients scheduled for transjugular intrahepatic portosystemic shunt(TIPS).AIM To investigate the association and predictive value of sarcopenia and myosteatosis for overt hepatic encephalopathy(HE)and mortality after TIPS.METHODS The records of cirrhotic patients who underwent the TIPS procedure at our hospital between January 2020 and June 2021 were retrospectively retrieved.The transversal psoas muscle thickness(TPMT)and psoas muscle attenuation(PMA)measured from the unenhanced abdominal computed tomography(CT)at the level of the third lumbar vertebrae were used to analyze the sarcopenia and myosteatosis,respectively.The area under curve(AUC)was used to evaluate the discriminative power of TPMT,PMA,and relevant clinical parameters.Furthermore,log-rank test was performed to compare the incidence of overt HE and survival between the different groups,and the association of risk factors with overt HE and mortality was analyzed using Cox proportional hazards regression models.RESULTS A total of 108 patients were collected.Among these patients,45.4%of patients developed overt HE after TIPS treatment.Furthermore,32.4%and 28.7%of these patients were identified to have myosteatosis and sarcopenia,respectively.Myosteatosis(51.0%vs 16.9%,P<0.001)and sarcopenia(40.8 vs 18.6%,P=0.011)were found to be more frequent in patients with overt HE,when compared to patients without overt HE.The receiver operating characteristics analysis indicated that the predictive power of TPMT and PMA in overt HE(AUC=0.713 and 0.778,respectively)was higher when compared to the neutrophil lymphocyte ratio(AUC=0.636).The cumulative incidence of overt HE was the highest in patients with concomitant sarcopenia and myosteatosis,followed by patients with myosteatosis or sarcopenia,while this was the lowest in patients without sarcopenia and myosteatosis.In addition,sarcopenia and myosteatosis were independently associated with overt HE and mortality after adjusting for confounding factors in post-TIPS patients.CONCLUSION CT-based estimations for sarcopenia and myosteatosis can be used as reliable predictors for the risk of developing overt HE and mortality in cirrhotic patients after TIPS.展开更多
Background:There have been few reports on long-term survival of gastric cancer patients.This study analyzed the survival data of gastric cancer patients obtained from the population-based Qidong Cancer Registry betwee...Background:There have been few reports on long-term survival of gastric cancer patients.This study analyzed the survival data of gastric cancer patients obtained from the population-based Qidong Cancer Registry between 1972 and 2011,providing a basis for evaluation of gastric cancer treatment and prognosis.Methods:The cumulative observed survival rate and relative survival rate of gastric cancer patients were calculated using Hakulinen's method via the SURV3.01 software,which was developed by the Finnish Cancer Registry.The date of the last follow-up for the survival status of the 15,401 registered cases was April 30,2012.Results:The 1-,5-,10-,20-,and 30-year observed survival rates were 33.82%,14.18%,10.35%,6.63%,and 4.19%,respectively,and the 1-,5-,10-,20-,and 30-year relative survival rates were 35.43%,18.13%,17.50%,21.96%,and32.84%,respectively.For males,the corresponding observed survival rates were 34.50%,14.40%,10.42%,6.46%,and4.05%,and the corresponding relative survival rates were 36.23%,18.67%,18.28%,23.73%,and 38.61%.For females,the corresponding observed survival rates were 32.62%,13.80%,10.22%,6.95%,and 4.46%,and the corresponding relative survival rates were 34.03%,17.21%,16.28%,19.70%,and 26.78%.Significant differences in relative survival rates were observed between sexes(P=0.003).For the 15-34,35-44,45-54,55-64,65-74,and 75+ age groups,the 5-year relative survival rates were 16.13%,21.77%,18.63%,12.61%,7.99%,and 2.94%,respectively,and the 10-year relative survival rates were 16.49%,22.83%,20.50%,15.97%,15.88%,and 15.73%,respectively.Remarkable improvement could be observed for the 5-,10-,and 15-year relative survival rates in Qidong beginning in the 1980 s.Conclusion:The survival outcome of registered gastric cancer cases in Qidong showed gradual progress over the past two decades.展开更多
In the present work, we explore the solar-blind ultraviolet(UV) photodetectors(PDs) with enhanced photoresponse,fabricated on Ga/Ga2O3 nanocomposite films. Through pre-burying metal Ga layers and thermally post-an...In the present work, we explore the solar-blind ultraviolet(UV) photodetectors(PDs) with enhanced photoresponse,fabricated on Ga/Ga2O3 nanocomposite films. Through pre-burying metal Ga layers and thermally post-annealing the laminated Ga2 O3/Ga/Ga2O3 structures, Ga/Ga2O3 nanocomposite films incorporated with Ga nanospheres are obtained. For the prototype PD, it is found that the photocurrent and photoresponsivity will first increase and then decrease monotonically with the thickness of the pre-buried Ga layer increasing. Each of all PDs shows a spectrum response peak at 260 nm, demonstrating the ability to detect solar-blind UV light. Adjustable photoresponse enhancement factors are achieved by means of the surface plasmon in the nanocomposite films. The PD with a 20 nm thick Ga interlayer exhibits the best solar-blind UV photoresponse characteristics with an extremely low dark current of 8.52 p A at 10-V bias, a very high light-to-dark ratio of ~ 8 × 10~5, a large photoresponsivity of 2.85 A/W at 15-V bias, and a maximum enhancement factor of ~ 220. Our research provides a simple and practical route to high performance solar-blind UV PDs and potential applications in the field of optoelectronics.展开更多
MetarhizosidesA-G(1-7),seven new polysubstituted phenyl glucosides,were isolated from the extracts of solid rice medium of a marine-derived fungus Metarrhizium anisopliae.Compounds 1-7 all contain a polysubstituted ph...MetarhizosidesA-G(1-7),seven new polysubstituted phenyl glucosides,were isolated from the extracts of solid rice medium of a marine-derived fungus Metarrhizium anisopliae.Compounds 1-7 all contain a polysubstituted phenyl group and the sugar unit is identified as 4'-O-methyl-β-D-glucopyranose.Their structures were elucidated by NMR spectroscopy and chemical method.These compounds were evaluated for anti-inflammatory activity by using LPS-stimulated murine macrophage RAW 264.7 cells and the cytotoxicities against four human cancer cell lines.展开更多
Highly charged nickel ions have been suggested as candidates for the ultra-precise optical clock, meanwhile the relevant experiment has been carried out. In the framework of the multiconfiguration Dirac–Hartree–Fock...Highly charged nickel ions have been suggested as candidates for the ultra-precise optical clock, meanwhile the relevant experiment has been carried out. In the framework of the multiconfiguration Dirac–Hartree–Fock(MCDHF)method, we calculated the hyperfine interaction constants, the Landég-factors, and the electric quadrupole moments for the low-lying states in the 61Ni11+,61Ni12+,61Ni14+, and61Ni15+ ions. These states are clock states of the selected clock transitions in highly charged nickel ions(see Fig. 1). Based on discussing the effects of the electron correlations, the Breit interaction, and quantum electrodynamics(QED) effect on these physical quantities, reasonable uncertainties were obtained for our calculated results. In addition, the electric quadrupole frequency shifts and the Zeeman frequency shifts of the clock transitions concerned were analyzed.展开更多
Direct ZnO x-ray detectors with tunable sensitivity are realized by delicately controlling the oxygen flux during the sputtering deposition process. The photocurrents induced by x-rays from a 40 kV x-ray tube with a C...Direct ZnO x-ray detectors with tunable sensitivity are realized by delicately controlling the oxygen flux during the sputtering deposition process. The photocurrents induced by x-rays from a 40 kV x-ray tube with a Cu anode increase apparently as the oxygen flux decreases, which is attributed to the introduction of Vo detects.By introducing Vo defects, the annihilation rate of the photo-generated electron-hole pairs will be greatly slowed down, leading to a remarkable photoconductive gain. This finding informs a novel way to design the x-ray detectors based on abundant oxide materials.展开更多
Spinel lithium titanate(Li_(4)Ti_(5)O_(12),LTO),with the merits of safety operation voltage,stable crystal structure,and minor lattice volume changes,becomes an optimal anode material for high-power Li-ion batteries.H...Spinel lithium titanate(Li_(4)Ti_(5)O_(12),LTO),with the merits of safety operation voltage,stable crystal structure,and minor lattice volume changes,becomes an optimal anode material for high-power Li-ion batteries.However,the inherent wide bandgap and low lithiation reactivity of Li_(4)Ti_(5)O_(12)bring about poor conductivity and lithiation dynamics,limiting its further applications.Herein,we design and prepare unique Li_(4)Ti_(5)O_(12)anode materials with extremely low dopant content of Na^(+)utilizing the amorphous precursors.The resultant Li_(4)Na_(0.008-)Ti_(5)O_(12.004)sample(denoted as NLTO-0.008)presents superior rate performances and cycle ability,with a reversible capacity of 149.4 mAh·g^(-1)at the current rate of10.0C.NLTO-0.008 retains the charge capacity of151.3 mAh·g^(-1)with a capacity loss of 0.5%after 1000cycles at the current rate of 1.0C(charge)/10.0C(discharge).The kinetic studies furtherly demonstrate that the lithiation reaction energy and diffusion energy barrier decrease by 28.8%and 30%,respectively.Crystal structure analysis indicates that Na^(+)occupies the 16d Li site and forms distorted LiO_(4)tetrahedron and TiO_(6)octahedron.This lattice distortion forms open diffusion channels,thus enhancing the Li^(+)diffusion dynamics and decreasing the lithiation reaction energy barrier for Li_(4)Ti_(5)O_(12).Therefore,the pre-sodiation strategy may arouse great interest in understanding and developing intercalation-type transitionmetal-based electrode materials in high-power lithium-ion batteries.展开更多
Background:Dengue cases have been reported each year for the past 25 years in Guangdong Province,China with a recorded historical peak in 2014.This study aims to describe the epidemiological characteristics of this la...Background:Dengue cases have been reported each year for the past 25 years in Guangdong Province,China with a recorded historical peak in 2014.This study aims to describe the epidemiological characteristics of this large outbreak in order to better understand its epidemic factors and to inform control strategies.Methods:Data for clinically diagnosed and laboratory-confirmed dengue fever cases in 2014 were extracted from the China Notifiable Infectious Disease Reporting System.We analyzed the incidence and characteristics of imported and indigenous cases in terms of population,temporal and spatial distributions.Results:A total of 45224 dengue fever cases and 6 deaths were notified in Guangdong Province in 2014,with an incidence of 47.3 per 100000 people.The elderly(65+years)represented 11.7%of total indigenous cases with the highest incidence(72.3 per 100000).Household workers and the unemployed accounted for 23.1%of indigenous cases.The majority of indigenous cases occurred in the 37th to 44th week of 2014(September and October)and almost all(20 of 21)prefecture-level cities in Guangdong were affected.Compared to the non-Pearl River Delta Region,the Pearl River Delta Region accounted for the majority of dengue cases and reported cases earlier in 2014.Dengue virus serotypes 1(DENV-1),2(DENV-2)and 3(DENV-3)were detected and DENV-1 was predominant(88.4%).Conclusions:Dengue fever is a serious public health problem and is emerging as a continuous threat in Guangdong Province.There is an urgent need to enhance dengue surveillance and control,especially for the high-risk populations in high-risk areas.展开更多
Screening for liver cancer(hepatocellular carcinoma)in China started in early 1970s with the application of alpha-fetoprotein(AFP)in high-incidence regions.It has been extended to nationwide areas,emerging from the co...Screening for liver cancer(hepatocellular carcinoma)in China started in early 1970s with the application of alpha-fetoprotein(AFP)in high-incidence regions.It has been extended to nationwide areas,emerging from the concepts of conducting screening in populations at-risk with positive hepatitis B surface antigen to the practice programs in rural and urban areas,and finally to the development of recommendations to guide medical practice for health care providers.The implementation of screening for liver cancer has resulted in earlier detection and hence the early curable treatment for patients who have gained short-or long-term survival,and even reduction in mortality rates,although these outcomes are more anecdotal than rigorously evidence-based.AFP or ultrasound examination has been considered as sensitive and specific methods for early detection but are with limitations.The combined use of these two modalities for screening populations at-risk every six months seems to have been reached consensus.The feasibility of screening for liver cancer is still debated because of differing opinions and even opposition to the choice of targeted sub-populations,the intrinsic necessity,and the contributions of the main risk factors among Western countries and China/Asian areas.Yet,the over 51%of global burden of liver cancer is in China,the solution to the early detection and treatment of liver cancer should fully consider the actual situation in China.The effectiveness of screening for liver cancer is worthy of anticipation.展开更多
Peroxisome proliferator-activated receptor gamma (PPARy) is a member of the PPARs, which are transcription factors of the steroid receptor superfamily. PPARy acts as an important molecule for regulating energy homeo...Peroxisome proliferator-activated receptor gamma (PPARy) is a member of the PPARs, which are transcription factors of the steroid receptor superfamily. PPARy acts as an important molecule for regulating energy homeostasis, modulates the hypothalamic-pituitary-gonadal (HPG) axis, and is reciprocally regulated by HPG. In the human, PPARγprotein is highly expressed in ejaculated spermatozoa, implying a possible role of PPARγ signaling in regulating sperm energy dissipation. PPARγ protein is also expressed in Sertoli cells and germ cells (spermatocytes). Its activation can be induced during capacitation and the acrosome reaction. This mini-review will focus on how PPARy signaling may affect fertility and sperm quality and the potential reversibility of these adverse effects.展开更多
Lens-to-sample distances, delay time, atmospheric condition, laser pulse energy, etc. had obvious effects on the analytical performance of laser-induced breakdown spectroscopy. In this paper, these parameters are inve...Lens-to-sample distances, delay time, atmospheric condition, laser pulse energy, etc. had obvious effects on the analytical performance of laser-induced breakdown spectroscopy. In this paper, these parameters are investigated in greater detail and we will explain how they have influences on the analytical performance. The results show that the focal plane under the sample surface can improve precision and detection limit, and the delay time should be decided according to sensitivity and accuracy. Spectral line intensity is stronger in argon than helium, nitrogen and air gas environment. Pulse energy should exceed energy threshold (about 50 m J) which can generate plasma, and the energy should not exceed about 300 mJ to avoid plasma shielding. Under optimum parameters, concentration relative standard deviation of C, Si, Mn, P, S, Ni, and Cr for low-alloyed steel (sample number 11278) which were measured 11 times is 2.37%, 2.18%, 2.23%, 7.8%, 9.34%, 1.92%, and 2.13%, respectively. And the detection limit of C, Si, Mn, P, S, Ni, and Cr for pure steel is 0.0045%, 0.0072%, 0.0069%, 0.0027%, 0.0024%, 0.0047%, and 0.0024%, respectively.展开更多
Peroxisome proliferator-activated receptorsγ(PPARγ)is a master regulator that controls energy metabolism and cell fate.PPARγ2,a PPARγisoform,is highly expressed in the normal prostate but expressed at lower levels...Peroxisome proliferator-activated receptorsγ(PPARγ)is a master regulator that controls energy metabolism and cell fate.PPARγ2,a PPARγisoform,is highly expressed in the normal prostate but expressed at lower levels in prostate cancer tissues.In the present study,PC3 and LNCaP cells were used to examine the benefits of restoring PPARγ2 activity.PPARγ2 was overexpressed in PC3 and LNCaP cells,and cell proliferation and migration were detected.Hematoxylin and eosin(H&E)staining was used to detect pathological changes.The genes regulated by PPARγ2 overexpression were detected by microarray analysis.The restoration of PPARγ2 in PC3 and LNCaP cells inhibited cell proliferation and migration.PC3-PPARγ2 tissue recombinants showed necrosis in cancerous regions and leukocyte infiltration in the surrounding stroma by H&E staining.We found higher mixed lineage kinase domain-like(MLKL)and lower microtubule-associated protein 1 light chain 3(LC3)expression in cancer tissues compared to controls by immunohistochemistry(IHC)staining.Microarray analysis showed that PPARγ2 gain of function in PC3 cells resulted in the reprogramming of lipid-and energy metabolism-associated signaling pathways.These data indicate that PPARγ2 exerts a crucial tumor-suppressive effect by triggering necrosis and an inflammatory reaction in human prostate cancer.展开更多
Objective To study the chemical constituents of whole plant of Phyllanthus urinaria and their biological activity.Methods The chemical constituents were isolated and purified by repeated column chromatography over sil...Objective To study the chemical constituents of whole plant of Phyllanthus urinaria and their biological activity.Methods The chemical constituents were isolated and purified by repeated column chromatography over silica gel,Rp-C18(reverse phase),MCI,and Sephadex LH-20,as well as semi-preparative HPLC.NMR spectroscopic analyses were used for the structure identification.In this case,the inhibitory rate of NO production of the isolated triterpenoids was evaluated.Results Seven triterpenoids,identified as28-norlup-20(29)-ene-3,17β-diol(1),betulin(2),β-betulinic acid(3),3-oxofriedelan-28-oic acid(4),oleanolic acid(5),3R-E-coumaroyltaraxerol(6),and 3R-Zcoumaroyltaraxerol(7),were isolated and identified from the whole plants of P.urinaria.Compounds 1-5 exerted inhibitory effects against NO production in LPS-induced RAW264.7 mouse macrophages with the inhibitory rate of NO production ranging from 4.0%to 27.8%at the concentration of 25 μmol/L.Conclusion To the best of our knowledge,this is the first report of compounds 1-4,6,and 7 from the family Euphorbiaceae.Compounds 1-5 exhibited inhibitory effects against NO production in LPS-induced RAW264.7 mouse macrophages.展开更多
Twenty-one benzoylated phloroglucinol derivatives bearing homoadamantyl frameworks were isolated from the aerial parts of Hypericum sampsonii,including two new ones named hyperisampsins N and O(1 and 2).The structur...Twenty-one benzoylated phloroglucinol derivatives bearing homoadamantyl frameworks were isolated from the aerial parts of Hypericum sampsonii,including two new ones named hyperisampsins N and O(1 and 2).The structures of 1 and 2 were elucidated by extensive NMR and mass spectrometric analyses.Their absolute configurations were further determined by using TDDFT ECD calculations.Compounds 2,7,and 8 were evaluated for their cytotoxic activities against five human cancer cell lines,of which,2 and 8 exhibited significant cytotoxic activities toward HL-60 cell and moderate activities against others cell lines.展开更多
The knowledge of the hyperpolarizabilities of atoms and ions is helpful for the analysis of the high order effects of the frequency shifts in precision spectroscopy experiments. Liu et al. [Phys. Rev. Lett. 114, 22300...The knowledge of the hyperpolarizabilities of atoms and ions is helpful for the analysis of the high order effects of the frequency shifts in precision spectroscopy experiments. Liu et al. [Phys. Rev. Lett. 114, 223001(2015)] proposed to establish all-optical trapped ion clocks using laser at the magic wavelength for clock transition. To evaluate the high-order frequency shifts in this new scheme of optical clocks, hyperpolarizabilities are needed, but absent. Using the finite field method based on the B-spline basis set and model potentials, we calculated the electric-field-dependent energy shifts of the ground and low-lying excited states in Be+, Mg+, and Ca+ in the field strength range of 0.0-6×10.5 a.u.. The scalar and tensor polarizabilities(α0, α2) and hyperpolarizabilities(γ0, γ2, γ4) were deduced. The results of the hyperpolarizabilities for Be+ showed good agreement with the values in literature, implying that the present method can be applied for the effective estimation of the atomic hyperpolarizabilities,which are rarely reported but needed in experiments. The feasibility of optical trapping of Ca+ is discussed, and the contributions of hyperpolarizabilities to the transition frequency shift for Ca+ in the optical dipole trap are estimated using quasi-electrostatic approximation.展开更多
Cloud computing can provide a great capacity for massive computing, storage as well as processing. The capacity comes from the cloud computing system itself, which can be likened to a virtualized resource pool that su...Cloud computing can provide a great capacity for massive computing, storage as well as processing. The capacity comes from the cloud computing system itself, which can be likened to a virtualized resource pool that supports virtualization applications as well as load migration. Based on the existing technologies, the paper proposes a resource virtualization model (RVM) utilizing a hybrid-graph structure. The hybrid-graph structure can formally represent the critical entities such as private clouds, nodes within the private clouds, and resource including its type and quantity. It also provides a clear description of the logical relationship and the dynamic expansion among them as well. Moreover, based on the RVM, a resource converging algorithm and a maintaining algorithm of the resource pool which can timely reflect the dynamic variation of the private cloud and resource are presented. The algorithms collect resources and put them into the private cloud resource pools and global resource pools, and enable a real-time maintenance for the dynamic variation of resource to ensure the continuity and reliability. Both of the algorithms use a queue structure to accomplish functions of resource converging. Finally, a simulation platform of cloud computing is designed to test the algorithms proposed in the paper. The results show the correctness and the reliability of the algorithms.展开更多
Two pairs of chlorine-containing phenylpropanoid enantiomers(1a/1b and 2a/2b) were isolated from the rhizomes of Acorus tatarinowii. Interestingly, these optical isomers(1a/1b and 2a/2b) were co-existed in the sam...Two pairs of chlorine-containing phenylpropanoid enantiomers(1a/1b and 2a/2b) were isolated from the rhizomes of Acorus tatarinowii. Interestingly, these optical isomers(1a/1b and 2a/2b) were co-existed in the same plant, which were characterized as the first halogen-containing natural products from the genus Acorus. Their structures and absolute configurations were elucidated by a combination of spectroscopic analysis and a single-crystal X-ray diffraction, assisted by a modified Mosher's method. The phenylpropanoid isomers(1a/1b and 2a/2b) were evaluated for their antioxidant activities using DPPH assay and cytotoxic activities against five human cancer cell lines.展开更多
文摘Objectives Renal replacement therapy(RRT)is increasingly adopted for critically ill patients diagnosed with acute kidney injury,but the optimal time for initiation remains unclear and prognosis is uncertain,leading to medical complexity,ethical conflicts,and decision dilemmas in intensive care unit(ICU)settings.This study aimed to develop a decision aid(DA)for the family surrogate of critically ill patients to support their engagement in shared decision-making process with clinicians.Methods Development of DA employed a systematic process with user-centered design(UCD)principle,which included:(i)competitive analysis:searched,screened,and assessed the existing DAs to gather insights for design strategies,developmental techniques,and functionalities;(ii)user needs assessment:interviewed family surrogates in our hospital to explore target user group's decision-making experience and identify their unmet needs;(iii)evidence syntheses:integrate latest clinical evidence and pertinent information to inform the content development of DA.Results The competitive analysis included 16 relevant DAs,from which we derived valuable insights using existing resources.User decision needs were explored among a cohort of 15 family surrogates,revealing four thematic issues in decision-making,including stuck into dilemmas,sense of uncertainty,limited capacity,and delayed decision confirmation.A total of 27 articles were included for evidence syntheses.Relevant decision making knowledge on disease and treatment,as delineated in the literature sourced from decision support system or clinical guidelines,were formatted as the foundational knowledge base.Twenty-one items of evidence were extracted and integrated into the content panels of benefits and risks of RRT,possible outcomes,and reasons to choose.The DA was drafted into a web-based phototype using the elements of UCD.This platform could guide users in their preparation of decision-making through a sequential four-step process:identifying treatment options,weighing the benefits and risks,clarifying personal preferences and values,and formulating a schedule for formal shared decision-making with clinicians.Conclusions We developed a rapid prototype of DA tailored for family surrogate decision makers of critically ill patients in need of RRT in ICU setting.Future studies are needed to evaluate its usability,feasibility,and clinical effects of this intervention.
基金Natural Science Foundation of Anhui Province,No.2108085MH301The Key Project of University Research Found of Anhui Province Education Department,No.2022AH040189.
文摘BACKGROUND Skeletal muscle abnormalities,such as muscle mass depletion(sarcopenia)and fatty infiltration of the muscle(myosteatosis),are frequent complications in cirrhotic patients scheduled for transjugular intrahepatic portosystemic shunt(TIPS).AIM To investigate the association and predictive value of sarcopenia and myosteatosis for overt hepatic encephalopathy(HE)and mortality after TIPS.METHODS The records of cirrhotic patients who underwent the TIPS procedure at our hospital between January 2020 and June 2021 were retrospectively retrieved.The transversal psoas muscle thickness(TPMT)and psoas muscle attenuation(PMA)measured from the unenhanced abdominal computed tomography(CT)at the level of the third lumbar vertebrae were used to analyze the sarcopenia and myosteatosis,respectively.The area under curve(AUC)was used to evaluate the discriminative power of TPMT,PMA,and relevant clinical parameters.Furthermore,log-rank test was performed to compare the incidence of overt HE and survival between the different groups,and the association of risk factors with overt HE and mortality was analyzed using Cox proportional hazards regression models.RESULTS A total of 108 patients were collected.Among these patients,45.4%of patients developed overt HE after TIPS treatment.Furthermore,32.4%and 28.7%of these patients were identified to have myosteatosis and sarcopenia,respectively.Myosteatosis(51.0%vs 16.9%,P<0.001)and sarcopenia(40.8 vs 18.6%,P=0.011)were found to be more frequent in patients with overt HE,when compared to patients without overt HE.The receiver operating characteristics analysis indicated that the predictive power of TPMT and PMA in overt HE(AUC=0.713 and 0.778,respectively)was higher when compared to the neutrophil lymphocyte ratio(AUC=0.636).The cumulative incidence of overt HE was the highest in patients with concomitant sarcopenia and myosteatosis,followed by patients with myosteatosis or sarcopenia,while this was the lowest in patients without sarcopenia and myosteatosis.In addition,sarcopenia and myosteatosis were independently associated with overt HE and mortality after adjusting for confounding factors in post-TIPS patients.CONCLUSION CT-based estimations for sarcopenia and myosteatosis can be used as reliable predictors for the risk of developing overt HE and mortality in cirrhotic patients after TIPS.
基金supported partially by the National Central Cancer Registries of China(the Tumor Follow-up Registration Programs MF2008293,2009-193,and 2010-90)by the National Science and Technology Mega-Projects of China(2012ZX100020009-018 and 2012ZX10002-008)
文摘Background:There have been few reports on long-term survival of gastric cancer patients.This study analyzed the survival data of gastric cancer patients obtained from the population-based Qidong Cancer Registry between 1972 and 2011,providing a basis for evaluation of gastric cancer treatment and prognosis.Methods:The cumulative observed survival rate and relative survival rate of gastric cancer patients were calculated using Hakulinen's method via the SURV3.01 software,which was developed by the Finnish Cancer Registry.The date of the last follow-up for the survival status of the 15,401 registered cases was April 30,2012.Results:The 1-,5-,10-,20-,and 30-year observed survival rates were 33.82%,14.18%,10.35%,6.63%,and 4.19%,respectively,and the 1-,5-,10-,20-,and 30-year relative survival rates were 35.43%,18.13%,17.50%,21.96%,and32.84%,respectively.For males,the corresponding observed survival rates were 34.50%,14.40%,10.42%,6.46%,and4.05%,and the corresponding relative survival rates were 36.23%,18.67%,18.28%,23.73%,and 38.61%.For females,the corresponding observed survival rates were 32.62%,13.80%,10.22%,6.95%,and 4.46%,and the corresponding relative survival rates were 34.03%,17.21%,16.28%,19.70%,and 26.78%.Significant differences in relative survival rates were observed between sexes(P=0.003).For the 15-34,35-44,45-54,55-64,65-74,and 75+ age groups,the 5-year relative survival rates were 16.13%,21.77%,18.63%,12.61%,7.99%,and 2.94%,respectively,and the 10-year relative survival rates were 16.49%,22.83%,20.50%,15.97%,15.88%,and 15.73%,respectively.Remarkable improvement could be observed for the 5-,10-,and 15-year relative survival rates in Qidong beginning in the 1980 s.Conclusion:The survival outcome of registered gastric cancer cases in Qidong showed gradual progress over the past two decades.
基金supported by the National Natural Science Foundation of China(Grant Nos.11674405 and 11675280)the Fund from the Laboratory of Microfabrication in Institute of Physics,Chinese Academy of Sciences
文摘In the present work, we explore the solar-blind ultraviolet(UV) photodetectors(PDs) with enhanced photoresponse,fabricated on Ga/Ga2O3 nanocomposite films. Through pre-burying metal Ga layers and thermally post-annealing the laminated Ga2 O3/Ga/Ga2O3 structures, Ga/Ga2O3 nanocomposite films incorporated with Ga nanospheres are obtained. For the prototype PD, it is found that the photocurrent and photoresponsivity will first increase and then decrease monotonically with the thickness of the pre-buried Ga layer increasing. Each of all PDs shows a spectrum response peak at 260 nm, demonstrating the ability to detect solar-blind UV light. Adjustable photoresponse enhancement factors are achieved by means of the surface plasmon in the nanocomposite films. The PD with a 20 nm thick Ga interlayer exhibits the best solar-blind UV photoresponse characteristics with an extremely low dark current of 8.52 p A at 10-V bias, a very high light-to-dark ratio of ~ 8 × 10~5, a large photoresponsivity of 2.85 A/W at 15-V bias, and a maximum enhancement factor of ~ 220. Our research provides a simple and practical route to high performance solar-blind UV PDs and potential applications in the field of optoelectronics.
基金This work was financially supported by the Program for Changjiang Scholars of Ministry of Education of the People's Republic of China(No.T2016088)the National Natural Science Foundation for Distinguished Young Scholars(No.81725021)+2 种基金the National Natural Science Foundation of China(No.31900288)the Program from the(hina Postdoctoral Science Foundation(No.2019M652660)the Integrated Innovative Team for Major Human Diseases Program of Tongji Medical College(HUST,China).
文摘MetarhizosidesA-G(1-7),seven new polysubstituted phenyl glucosides,were isolated from the extracts of solid rice medium of a marine-derived fungus Metarrhizium anisopliae.Compounds 1-7 all contain a polysubstituted phenyl group and the sugar unit is identified as 4'-O-methyl-β-D-glucopyranose.Their structures were elucidated by NMR spectroscopy and chemical method.These compounds were evaluated for anti-inflammatory activity by using LPS-stimulated murine macrophage RAW 264.7 cells and the cytotoxicities against four human cancer cell lines.
基金Project supported by the National Natural Science Foundation of China(Grant Nos.11704398 and 11934014)the National Key Research and Development Program of China(Grant No.2017YFA0304402)the Strategic Priority Research Program of the Chinese Academy of Sciences(Grant No.XDB21030300)。
文摘Highly charged nickel ions have been suggested as candidates for the ultra-precise optical clock, meanwhile the relevant experiment has been carried out. In the framework of the multiconfiguration Dirac–Hartree–Fock(MCDHF)method, we calculated the hyperfine interaction constants, the Landég-factors, and the electric quadrupole moments for the low-lying states in the 61Ni11+,61Ni12+,61Ni14+, and61Ni15+ ions. These states are clock states of the selected clock transitions in highly charged nickel ions(see Fig. 1). Based on discussing the effects of the electron correlations, the Breit interaction, and quantum electrodynamics(QED) effect on these physical quantities, reasonable uncertainties were obtained for our calculated results. In addition, the electric quadrupole frequency shifts and the Zeeman frequency shifts of the clock transitions concerned were analyzed.
基金Supported by the National Natural Science Foundation of China under Grant Nos 11675280,11674405,61874139 and 11875088
文摘Direct ZnO x-ray detectors with tunable sensitivity are realized by delicately controlling the oxygen flux during the sputtering deposition process. The photocurrents induced by x-rays from a 40 kV x-ray tube with a Cu anode increase apparently as the oxygen flux decreases, which is attributed to the introduction of Vo detects.By introducing Vo defects, the annihilation rate of the photo-generated electron-hole pairs will be greatly slowed down, leading to a remarkable photoconductive gain. This finding informs a novel way to design the x-ray detectors based on abundant oxide materials.
基金financially supported by the National Natural Science Foundation of China(No.52002116)the Key Science and Technology Program of Henan Province(No.192102210004)。
文摘Spinel lithium titanate(Li_(4)Ti_(5)O_(12),LTO),with the merits of safety operation voltage,stable crystal structure,and minor lattice volume changes,becomes an optimal anode material for high-power Li-ion batteries.However,the inherent wide bandgap and low lithiation reactivity of Li_(4)Ti_(5)O_(12)bring about poor conductivity and lithiation dynamics,limiting its further applications.Herein,we design and prepare unique Li_(4)Ti_(5)O_(12)anode materials with extremely low dopant content of Na^(+)utilizing the amorphous precursors.The resultant Li_(4)Na_(0.008-)Ti_(5)O_(12.004)sample(denoted as NLTO-0.008)presents superior rate performances and cycle ability,with a reversible capacity of 149.4 mAh·g^(-1)at the current rate of10.0C.NLTO-0.008 retains the charge capacity of151.3 mAh·g^(-1)with a capacity loss of 0.5%after 1000cycles at the current rate of 1.0C(charge)/10.0C(discharge).The kinetic studies furtherly demonstrate that the lithiation reaction energy and diffusion energy barrier decrease by 28.8%and 30%,respectively.Crystal structure analysis indicates that Na^(+)occupies the 16d Li site and forms distorted LiO_(4)tetrahedron and TiO_(6)octahedron.This lattice distortion forms open diffusion channels,thus enhancing the Li^(+)diffusion dynamics and decreasing the lithiation reaction energy barrier for Li_(4)Ti_(5)O_(12).Therefore,the pre-sodiation strategy may arouse great interest in understanding and developing intercalation-type transitionmetal-based electrode materials in high-power lithium-ion batteries.
基金supported by Guangdong Provincial Science and Technology Project Fundings(NO.2013A020229005,NO.2014A040401041,NO.2015A020213004).
文摘Background:Dengue cases have been reported each year for the past 25 years in Guangdong Province,China with a recorded historical peak in 2014.This study aims to describe the epidemiological characteristics of this large outbreak in order to better understand its epidemic factors and to inform control strategies.Methods:Data for clinically diagnosed and laboratory-confirmed dengue fever cases in 2014 were extracted from the China Notifiable Infectious Disease Reporting System.We analyzed the incidence and characteristics of imported and indigenous cases in terms of population,temporal and spatial distributions.Results:A total of 45224 dengue fever cases and 6 deaths were notified in Guangdong Province in 2014,with an incidence of 47.3 per 100000 people.The elderly(65+years)represented 11.7%of total indigenous cases with the highest incidence(72.3 per 100000).Household workers and the unemployed accounted for 23.1%of indigenous cases.The majority of indigenous cases occurred in the 37th to 44th week of 2014(September and October)and almost all(20 of 21)prefecture-level cities in Guangdong were affected.Compared to the non-Pearl River Delta Region,the Pearl River Delta Region accounted for the majority of dengue cases and reported cases earlier in 2014.Dengue virus serotypes 1(DENV-1),2(DENV-2)and 3(DENV-3)were detected and DENV-1 was predominant(88.4%).Conclusions:Dengue fever is a serious public health problem and is emerging as a continuous threat in Guangdong Province.There is an urgent need to enhance dengue surveillance and control,especially for the high-risk populations in high-risk areas.
基金This work was supported partially by the China Cancer Foundation Programand by Chinese National Key Projects(2012ZX10002009,2018ZX10732202-001).
文摘Screening for liver cancer(hepatocellular carcinoma)in China started in early 1970s with the application of alpha-fetoprotein(AFP)in high-incidence regions.It has been extended to nationwide areas,emerging from the concepts of conducting screening in populations at-risk with positive hepatitis B surface antigen to the practice programs in rural and urban areas,and finally to the development of recommendations to guide medical practice for health care providers.The implementation of screening for liver cancer has resulted in earlier detection and hence the early curable treatment for patients who have gained short-or long-term survival,and even reduction in mortality rates,although these outcomes are more anecdotal than rigorously evidence-based.AFP or ultrasound examination has been considered as sensitive and specific methods for early detection but are with limitations.The combined use of these two modalities for screening populations at-risk every six months seems to have been reached consensus.The feasibility of screening for liver cancer is still debated because of differing opinions and even opposition to the choice of targeted sub-populations,the intrinsic necessity,and the contributions of the main risk factors among Western countries and China/Asian areas.Yet,the over 51%of global burden of liver cancer is in China,the solution to the early detection and treatment of liver cancer should fully consider the actual situation in China.The effectiveness of screening for liver cancer is worthy of anticipation.
文摘Peroxisome proliferator-activated receptor gamma (PPARy) is a member of the PPARs, which are transcription factors of the steroid receptor superfamily. PPARy acts as an important molecule for regulating energy homeostasis, modulates the hypothalamic-pituitary-gonadal (HPG) axis, and is reciprocally regulated by HPG. In the human, PPARγprotein is highly expressed in ejaculated spermatozoa, implying a possible role of PPARγ signaling in regulating sperm energy dissipation. PPARγ protein is also expressed in Sertoli cells and germ cells (spermatocytes). Its activation can be induced during capacitation and the acrosome reaction. This mini-review will focus on how PPARy signaling may affect fertility and sperm quality and the potential reversibility of these adverse effects.
文摘Lens-to-sample distances, delay time, atmospheric condition, laser pulse energy, etc. had obvious effects on the analytical performance of laser-induced breakdown spectroscopy. In this paper, these parameters are investigated in greater detail and we will explain how they have influences on the analytical performance. The results show that the focal plane under the sample surface can improve precision and detection limit, and the delay time should be decided according to sensitivity and accuracy. Spectral line intensity is stronger in argon than helium, nitrogen and air gas environment. Pulse energy should exceed energy threshold (about 50 m J) which can generate plasma, and the energy should not exceed about 300 mJ to avoid plasma shielding. Under optimum parameters, concentration relative standard deviation of C, Si, Mn, P, S, Ni, and Cr for low-alloyed steel (sample number 11278) which were measured 11 times is 2.37%, 2.18%, 2.23%, 7.8%, 9.34%, 1.92%, and 2.13%, respectively. And the detection limit of C, Si, Mn, P, S, Ni, and Cr for pure steel is 0.0045%, 0.0072%, 0.0069%, 0.0027%, 0.0024%, 0.0047%, and 0.0024%, respectively.
基金The work was supported by the National Natural Science Foundation of China(NSFCNo.81874171 and 81703259).
文摘Peroxisome proliferator-activated receptorsγ(PPARγ)is a master regulator that controls energy metabolism and cell fate.PPARγ2,a PPARγisoform,is highly expressed in the normal prostate but expressed at lower levels in prostate cancer tissues.In the present study,PC3 and LNCaP cells were used to examine the benefits of restoring PPARγ2 activity.PPARγ2 was overexpressed in PC3 and LNCaP cells,and cell proliferation and migration were detected.Hematoxylin and eosin(H&E)staining was used to detect pathological changes.The genes regulated by PPARγ2 overexpression were detected by microarray analysis.The restoration of PPARγ2 in PC3 and LNCaP cells inhibited cell proliferation and migration.PC3-PPARγ2 tissue recombinants showed necrosis in cancerous regions and leukocyte infiltration in the surrounding stroma by H&E staining.We found higher mixed lineage kinase domain-like(MLKL)and lower microtubule-associated protein 1 light chain 3(LC3)expression in cancer tissues compared to controls by immunohistochemistry(IHC)staining.Microarray analysis showed that PPARγ2 gain of function in PC3 cells resulted in the reprogramming of lipid-and energy metabolism-associated signaling pathways.These data indicate that PPARγ2 exerts a crucial tumor-suppressive effect by triggering necrosis and an inflammatory reaction in human prostate cancer.
基金New Century Excellent Talents in University,State Education Ministry of China(No.NCET-2008-0224)National Natural Science Foundation of China(No.31200258,81641129)Fundamental Research Funds for Central Universities(No.2012QN012)
文摘Objective To study the chemical constituents of whole plant of Phyllanthus urinaria and their biological activity.Methods The chemical constituents were isolated and purified by repeated column chromatography over silica gel,Rp-C18(reverse phase),MCI,and Sephadex LH-20,as well as semi-preparative HPLC.NMR spectroscopic analyses were used for the structure identification.In this case,the inhibitory rate of NO production of the isolated triterpenoids was evaluated.Results Seven triterpenoids,identified as28-norlup-20(29)-ene-3,17β-diol(1),betulin(2),β-betulinic acid(3),3-oxofriedelan-28-oic acid(4),oleanolic acid(5),3R-E-coumaroyltaraxerol(6),and 3R-Zcoumaroyltaraxerol(7),were isolated and identified from the whole plants of P.urinaria.Compounds 1-5 exerted inhibitory effects against NO production in LPS-induced RAW264.7 mouse macrophages with the inhibitory rate of NO production ranging from 4.0%to 27.8%at the concentration of 25 μmol/L.Conclusion To the best of our knowledge,this is the first report of compounds 1-4,6,and 7 from the family Euphorbiaceae.Compounds 1-5 exhibited inhibitory effects against NO production in LPS-induced RAW264.7 mouse macrophages.
基金financially supported by the Program for New Century Excellent Talents in University,State Education Ministry of China(No.NCET-2008-0224)National Science and Technology Project of China(No.2011ZX09102-004)+2 种基金the National Natural Science Foundation of China(Nos.31370372,81573316,81641129 and 21502057)the Fundamental Research Fund for the Central Universities(No.2016YXMS149)the China Postdoctoral Science Foundation(No.2015M572154)
文摘Twenty-one benzoylated phloroglucinol derivatives bearing homoadamantyl frameworks were isolated from the aerial parts of Hypericum sampsonii,including two new ones named hyperisampsins N and O(1 and 2).The structures of 1 and 2 were elucidated by extensive NMR and mass spectrometric analyses.Their absolute configurations were further determined by using TDDFT ECD calculations.Compounds 2,7,and 8 were evaluated for their cytotoxic activities against five human cancer cell lines,of which,2 and 8 exhibited significant cytotoxic activities toward HL-60 cell and moderate activities against others cell lines.
基金supported by the National Natural Science Foundation of China (Grant No. 91536102)the National Basic Research Program of China (Grant No. 2012CB821305)
文摘The knowledge of the hyperpolarizabilities of atoms and ions is helpful for the analysis of the high order effects of the frequency shifts in precision spectroscopy experiments. Liu et al. [Phys. Rev. Lett. 114, 223001(2015)] proposed to establish all-optical trapped ion clocks using laser at the magic wavelength for clock transition. To evaluate the high-order frequency shifts in this new scheme of optical clocks, hyperpolarizabilities are needed, but absent. Using the finite field method based on the B-spline basis set and model potentials, we calculated the electric-field-dependent energy shifts of the ground and low-lying excited states in Be+, Mg+, and Ca+ in the field strength range of 0.0-6×10.5 a.u.. The scalar and tensor polarizabilities(α0, α2) and hyperpolarizabilities(γ0, γ2, γ4) were deduced. The results of the hyperpolarizabilities for Be+ showed good agreement with the values in literature, implying that the present method can be applied for the effective estimation of the atomic hyperpolarizabilities,which are rarely reported but needed in experiments. The feasibility of optical trapping of Ca+ is discussed, and the contributions of hyperpolarizabilities to the transition frequency shift for Ca+ in the optical dipole trap are estimated using quasi-electrostatic approximation.
基金supported by National Natural Science Foundation of China(No.61101139)Natural Science Foundation of Fujian Province(Nos.2012J01244 and 2012J01243)Hunan Provincial Project of Science and Technology(No.2013FJ3090)
文摘Cloud computing can provide a great capacity for massive computing, storage as well as processing. The capacity comes from the cloud computing system itself, which can be likened to a virtualized resource pool that supports virtualization applications as well as load migration. Based on the existing technologies, the paper proposes a resource virtualization model (RVM) utilizing a hybrid-graph structure. The hybrid-graph structure can formally represent the critical entities such as private clouds, nodes within the private clouds, and resource including its type and quantity. It also provides a clear description of the logical relationship and the dynamic expansion among them as well. Moreover, based on the RVM, a resource converging algorithm and a maintaining algorithm of the resource pool which can timely reflect the dynamic variation of the private cloud and resource are presented. The algorithms collect resources and put them into the private cloud resource pools and global resource pools, and enable a real-time maintenance for the dynamic variation of resource to ensure the continuity and reliability. Both of the algorithms use a queue structure to accomplish functions of resource converging. Finally, a simulation platform of cloud computing is designed to test the algorithms proposed in the paper. The results show the correctness and the reliability of the algorithms.
基金financially supported by the Program for New Century Excellent Talents in University, State Education Ministry of China (No. NCET2008-0224)the National Natural Science Foundation of China (Nos. 31370372, 81573316, 31570361, 31200258)
文摘Two pairs of chlorine-containing phenylpropanoid enantiomers(1a/1b and 2a/2b) were isolated from the rhizomes of Acorus tatarinowii. Interestingly, these optical isomers(1a/1b and 2a/2b) were co-existed in the same plant, which were characterized as the first halogen-containing natural products from the genus Acorus. Their structures and absolute configurations were elucidated by a combination of spectroscopic analysis and a single-crystal X-ray diffraction, assisted by a modified Mosher's method. The phenylpropanoid isomers(1a/1b and 2a/2b) were evaluated for their antioxidant activities using DPPH assay and cytotoxic activities against five human cancer cell lines.