The burden of upper motor neuron involvement is correlated with the bilateral limb involvement interval in patients with amyotrophic lateral sclerosis:a retrospective observational study

Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives and may lead them to be confined to bed.However,the effect of upper and lower motor neuron impairment and other risk factors on bilateral limb involvement is unclear.To address this issue,we retrospectively collected data from 586 amyotrophic lateral sclerosis patients with limb onset diagnosed at Peking University Third Hospital between January 2020 and May 2022.A univariate analysis revealed no significant differences in the time intervals of spread in different directions between individuals with upper motor neuron-dominant amyotrophic lateral sclerosis and those with classic amyotrophic lateral sclerosis.We used causal directed acyclic graphs for risk factor determination and Cox proportional hazards models to investigate the association between the duration of bilateral limb involvement and clinical baseline characteristics in amyotrophic lateral sclerosis patients.Multiple factor analyses revealed that higher upper motor neuron scores(hazard ratio[HR]=1.05,95%confidence interval[CI]=1.01–1.09,P=0.018),onset in the left limb(HR=0.72,95%CI=0.58–0.89,P=0.002),and a horizontal pattern of progression(HR=0.46,95%CI=0.37–0.58,P<0.001)were risk factors for a shorter interval until bilateral limb involvement.The results demonstrated that a greater degree of upper motor neuron involvement might cause contralateral limb involvement to progress more quickly in limb-onset amyotrophic lateral sclerosis patients.These findings may improve the management of amyotrophic lateral sclerosis patients with limb onset and the prediction of patient prognosis.

Revitalizing upper blepharoplasty:Preserving volume

Blepharoplasty is a frequently performed aesthetic surgery today aimed at enhancing eyelid appearance and correcting age-related changes.The traditional method of subtraction blepharoplasty,which involved removing fat and excess skin,is now considered outdated.This letter explores Gorgy et al's commentary on Miotti et al's study,highlighting a shift in upper eyelid blepharoplasty towards a more conservative,volume-preserving approach.The study systematically reviewed 10 publications,including three retrospective studies,five comparative studies,and two clinical trials.It emphasizes the trend towards preserving the patient's natural anatomy and focusing on enhancement rather than alteration.However,the study's limitations,such as the lack of long-term comparative re-search,a relatively small sample size,and a single-center design,indicate that further research with extended follow-up is necessary to validate the safety and effectiveness of these techniques.The focus is increasingly on preserving and augmenting volume in upper blepharoplasty rather than removing tissue.

Diagnostic value of upper gastrointestinal imaging for duodenal webbing in adults:A case report

BACKGROUND Duodenal web is a rare congenital malformation,exceedingly uncommon in adults,and often misdiagnosed due to the subtle imaging features.CASE SUMMARY By analyzing the clinical diagnosis process and various imaging findings of a patient from our institution,this case report emphasizes the necessity of upper gastrointestinal series in diagnosing duodenal webs,outlines its typical radiographic features,and provides a literature review on the etiology,clinical presentation,and management of this condition.CONCLUSION This case report emphasizes the necessity of upper gastrointestinal series in diagnosing duodenal webs.

Metastatic lymph node distribution and pathology correlations in upper and lower gastric cancer patients:A multicenter retrospective study

BACKGROUND Gastric cancer(GC)poses a significant threat to public health.However,the clinicopathological features and tumor biological behaviors vary among the GC patients,leading to individual variations in lymph node metastasis.Consequently,the stratification of lymph node dissection according to the specific type,particularly upper GC,has emerged as a prominent area of research.AIM To investigate the distribution of metastatic lymph nodes in patients with upper and lower GC and to analyze the differences in related pathological elements and prognosis.METHODS Differential analysis between upper and lower GC patients with various clinicopathological factors was performed using the chi-square test and rank-sum regression models were used to analyze risk factors affecting patient prognosis.The Kaplan-Meier method was used to construct survival curves associated with prognostic risk factors for GC.RESULTS Significant differences were observed between the two GC populations regarding tumor diameter,histological grade,pT stage,pN stage,tumor-node-metastasis(pTNM)stage,vascular invasion,and adjuvant chemotherapy usage(all P<0.05).Lymph node metastasis rates were highest for Siewert type II patients in groups Nos.1,3,2 and 7;for Siewert type III patients in groups Nos.3,1,2 and 7;and for other/unclassified patients in groups Nos.1,3,7,2.In the lower GC samples,the sequences were Nos.3,6,7,4.Pathological type,pT stage,pTNM stage,and positive vascular invasion were independent risk factors for development of lymph node metastasis.Age,pathological type,pT stage,pN stage,pTNM stage,vascular invasion,and absence of adjuvant chemotherapy were identified as independent prognostic factors.CONCLUSION Upper GC showed a significantly higher malignancy grade and different lymph node metastasis pattern than lower GC.

Vestrogothia spinata(Phosphatocopina,Crustacea),Fossils of Orsten-type Preservation from the Upper Cambrian of Western Hunan,South China

Fossils of Orsten-type preservation represented by the crustacean Skaracarida and Phosphatocopida were found in western Hunan, South China in 2005, including the important phosphatocopid species Vestrogothia spinata based on exquisitely preserved soft-bodied specimens that allow the first growth stage to be reestablished. The taxonomy of Vestrogothia spinata is revised employing the character of a two-divided limb stem of the mandible. A new foundation for the phylogeny of the Phosphatocopina using mandible characters related to crustacean appendages is postulated. Vestrogothia spinata has only previously been found from Sweden.

From Basin Black Shales to Platform Carbonate Rocks:A Study on Sequence Stratigraphy for the Lower Cambrian of the Upper-Yangtze Region in South China

In the Upper-Yangtze region, especially in Guizhou Province and its adjacent areas, the Lower Cambrian is well developed and is marked by a succession from black shales of the basin facies to carbonate rocks of the platform facies. The drowning event of the platform occurring at the turn from Sinian to Cambrian resulted in a set of black shales, i.e. the Niutitang Formation, which makes up the bottom part of the Lower Cambrian. With the shoaling of the sedimentary environment, a set of carbonate rocks, i.e. the Qingxudong Formation, was formed in the top part of the Lower Cambrian. Thus, the Lower Cambrian in the study area makes up one second-order sequence that can be further subdivided into five third-order sequences, and forms a regularly cyclic succession of transgression-regression. There is a regularly vertical stacking pattern for the third-order sequences in the second-order sequence. From bottom to top, the succession of the ＂CS （condensed section） ＋HST （high-stand system tract）＂ of the third-order sequences is changed into the succession of the ＂TST （transgressive system tract）＋CS＋HST＂. Correspondingly, the drowning-type sequence boundary is changed into the exposure-type one. Therefore, both the second-order and the third-order sequences have similar sedimentary-facies architectures. A concomitant with these temporal changes, the Lower Cambrian with a thickness of 1000 m that contains five third-order sequences is changed into a condensed succession that cannot identify third-order sequences toward the southeast with the deepening of the sedimentary environment. According to the elementary features of the third-order sequences, i.e. the regularity o sedimentary-facies successions in space and the synchronism of sedimentary-environment changes in time, the detailed division of the third-order sequences at main logged sections in different paleogeographical background becomes the basis to establish the sequence-stratigraphic framework that can demonstrate two types of facies-changing surface and two types of diachronism in the stratigraphic records. This sequence-stratigraphic framework shows a growing process of the carbonate platform from the base of the condensed succession formed by black shales of basin facies. Resulting from the rapid transgression at the turn from Sinian to Cambrian the ecological space became open, which formed the antecedent condition of paleogeographical setting for ＂the Cambrian Biological Explosion＂. Ultimately, the genetic relationship between the depositional events and the biological-diversity events is very complex and there remain lots of problems that need further research in the future.

Characteristics and Dolomitization of Upper Cambrian to Lower Ordovician Dolomite from Outcrop in Keping Uplift, Western Tarim Basin, Northwest China

Late Cambrian to Early Ordovician sedimentary rocks in the western Tarim Basin, Northwest China, are composed of shallow-marine platform carbonates. The Keping Uplift is located in the northwest region of this basin. On the basis of petrographic and geochemical features, four matrix replacement dolomites and one type of cement dolomite are identified. Matrix replacement dolomites include （1） micritic dolomites （MD1）; （2） fine-coarse euhedral floating dolomites （MD2）; （3） fine-coarse euhedral dolomites （MD3）; and （4） medium-very coarse anhedral mosaic dolomites （MD4）. Dolomite cement occurs in minor amounts as coarse saddle dolomite cement （CD1） that mostly fills vugs and fractures in the matrix dolomites. These matrix dolomites have δ18O values of ？9.7‰ to ？3.0‰ VPDB （Vienna Pee Dee Belemnite）; δ13C values of ？0.8‰ to 3.5‰ VPDB; 87Sr/86Sr ratios of 0.708516 to 0.709643; Sr concentrations of 50 to 257 ppm; Fe contents of 425 to 16878 ppm; and Mn contents of 28 to 144 ppm. Petrographic and geochemical data suggest that the matrix replacement dolomites were likely formed by normal and evaporative seawater in early stages prior to chemical compaction at shallow burial depths. Compared with matrix dolomites, dolomite cement yields lower δ18O values （？12.9‰ to ？9.1‰ VPDB）; slightly lower δ13C values （？1.6‰-0.6‰ VPDB）; higher 87Sr/86Sr ratios （0.709165-0.709764）; and high homogenization temperature （Th） values （98°C-225°C） and salinities （6 wt%-24 wt% NaCl equivalent）. Limited data from dolomite cement shows a low Sr concentration （58.6 ppm） and high Fe and Mn contents （1233 and 1250 ppm, respectively）. These data imply that the dolomite cement precipitated from higher temperature hydrothermal salinity fluids. These fluids could be related to widespread igneous activities in the Tarim Basin occurring during Permian time when the host dolostones were deeply buried. Faults likely acted as important conduits that channeled dolomitizing fluids from the underlying strata into the basal carbonates, leading to intense dolomitization. Therefore, dolomitization, in the Keping Uplift area is likely related to evaporated seawater via seepage reflux in addition to burial processes and hydrothermal fluids.

Controls on the organic carbon content of the lower Cambrian black shale in the southeastern margin of Upper Yangtze

Control of various factors, including mineral components, primary productivity and redox level, on the total organic carbon(TOC) in the lower Cambrian black shale from southeastern margin of Upper Yangtze(Taozichong, Longbizui and Yanbei areas) is discussed in detail in this article. Mineral components in the study strata are dominated by quartz and clay minerals. Quartz in the Niutitang Formation is mainly of biogenic origin, and the content is in positive correlation with TOC, while the content of clay minerals is negatively correlated with TOC. Primary productivity, represented by the content of Mobio(biogenic molybdenum), Babio(biogenic barium) and phosphorus, is positively correlated with TOC. The main alkanes in studied samples are nCC, and odd–even priority values are closed to 1(0.73–1.13), which suggest the organic matter source was marine plankton. Element content ratios of U/Th and Ni/Co and compound ratio Pr/Ph indicate dysoxic–anoxic bottom water, with weak positive relative with TOC. In total, three main points can be drawn to explain the relationship between data and the factors affecting organic accumulation:(1) quartz-rich and clay-mineral-poor deep shelf–slope–basin environment was favorable for living organisms;(2) high productivity provided the material foundation for organic generation;(3) the redox conditions impact slightly on the content of organic matter under high productivity and dysoxic–anoxic condition.

Biological and Molecular Geochemical Evidence for Dinoflagellate Ancestors in the Upper Sinian-Cambrian

Dinoflagellates are single celled organisms that reflect the ecological conditions in modern oceans and lakes. Their earliest undisputed fossil record suggests that dinoflagellates originated from the Middle Triassic (c. 240 Ma ago). However, the presence of molecular biomarkers (dinosterane, 4α-methyl-24-ethylcholestane and tria-romatic dinosteroids) in rock extracts and coccoid dinoflagellate fossils from the upper Sinian to Cambrian of the Tarim basin confirms the hypothesis that dinoflagellates have an ancient origin, and predate the oldest undisputed dinoflagellate fossils at least by 300 Ma, as early as the late Sinian-Cambrian.

Furongian(upper Cambrian) Guole Konservat-Lagersttte from South China

The Guole biota contains common shelly fossils and some exceptionally well-preserved softbodied fossils. Stratigraphically, it is located in the mudstones and siltstones of the Sandu Formation near Guole Town, Jingxi County, Guangxi, South China. It is the first Furongian （late Cambrian） Burgess Shale-type biota found in the world, thereby filling the gap between middle Cambrian and Lower Ordovician Burgess Shale-type Lagerstaitten. Preliminary studies suggest that the Guole biota includes approximately seven metazoan groups as well as algae. These will provide important new evolutionary and ecological information.

Porosity distribution in cyclic dolomites of the Lower Qiulitag Group(Upper Cambrian)in northwestern Tarim Basin,China

Increasing interests in hydrocarbon resources at depths have drawn greater attentions to the deeply-buried carbonate reservoirs in the Tarim Basin in China.In this study,the cyclic dolomite rocks of Upper Cambrian Lower Qiulitag Group from four outcrop sections in northwestern Tarim Basin were selected to investigate and evaluate the petrophysical properties in relation to depositional facies and cyclicity.The Lower Qiulitag Group includes ten lithofacies,which were deposited in intermediate to shallow subtidal,restricted shallow subtidal,intertidal,and supratidal environments on a carbonate ramp system.These lithofacies are vertically stacked into repeated shallowing-upward,meter-scale cycles which are further grouped into six third-order depositional sequences(Sq1 to Sq6).There are variable types of pore spaces in the Lower Qiulitag Group dolomite rocks,including interparticle,intraparticle,and fenestral pores of primary origin,inter crystal,and vuggy pores of late diagenetic modification.The porosity in the dolomites is generally facies-selective as that the microbially-originated thrombolites and stromatolites generally yield a relatively high porosity.In contrast,the high-energy ooidal grainstones generally have very low porosity.In this case,the microbialite-based peritidal cycles and peritidal cycle-dominated highstand(or regressive)successions have relatively high volumes of pore spaces,although highly fluctuating(or vertical inhomogeneous).Accordingly,the grainstone-based subtidal cycles and subtidal cycle-dominated transgressive successions generally yield extremely low porosity.This scenario indicates that porosity development and preservation in the thick dolomite successions are primarily controlled by depositional facies which were influenced by sea-level fluctuations of different orders and later diagenetic overprinting.

A Potential Candidate For the Middle-Upper Cambrian Boundary Stratotype——An Introduction to the Paibi Section in Huayuan,Hunan

The Middle-Upper Cambrian boundary is one of the current stratigraphical problems which remain openin the geological world, since there have been no universally acknowledged delimiting standard and stratotype.Acting on the instruction of Profs. Lu Yanhao and An Taixiang the author studied in details the Paibi Section,which is well exposed as a continuous sequence at an easily accessible locality. The Middle-Upper Cambrianboundary strata are composed of biocalcimicrosparite, indicating the sedimentary environment of anunderwater upheaval on the gentle slope along the frontal margin of the Yangtze carbonate platform. For the upper Middle and lower Upper Cambrian agnostid trilobite zones and conodont zones are erected,and a more accurate correlation between the trilobite and conodont sequences is established. Based on these,the Middle-Upper Cambrian boundary is drawn more reasonably and precisely than what was done before. Inshort, the section studied is superior to other known sections of Middle-Upper Cambrian. and it will probablybe an ideal candidate for the Middle-Upper Cambrian boundary stratotype.

Conodonts from the Upper Cambrian Sesong and Hwajeol Formations in the Sabuk Area, South Korea

This paper presents a conodont biostratigraphic study on the Upper CambrianSesong and Hwajeol Formations in the Sabuk area, Korea. Two samples near the base of the SesongSlate at the Pukil section contain lower Upper Cambrian conodonts, comprising Furnishina furnishi,F. kranzae, F. pernica?, F. triangulata, Hertzina elongata, Laiwugnathus doidyxus?, Phakeloduselongatus, Muellerodus? obliquus, Westergaardodina matsushitai and W. moessebergensis. This is thefirst conodont record of the Upper Cambrian formations recovered yet in the northern limb of thePaekunsan syncline. The faunal assemblage is correlatable with the lower Upper Cambrian W.matsushitai Zone of North China. Four local biozones are recognized in the Hwajeol Formation, i.e.the Proconodontus, Eoconodontus notchpeakensis, cambrooistodus minutus and Cordylodus proavus Zonesin ascending order. This zonal scheme is essentially equivalent to that of the southern limb of thePaekunsan syncline and they are correlatable with zones in other parts of the world, including NorthAmerica, Australia, Iran and China.

Sequence stratigraphy and lithofacies paleogeography of the Middle–Upper Cambrian Xixiangchi Group in the Sichuan Basin and its adjacent area, SW China

Based on isotopic, lithologic and electrical data and logging cycle analysis technique, stratigraphic sequences in the Middle-Upper Cambrian Xixiangchi Group in the Sichuan Basin and its adjacent area are divided, and its sedimentary characteristics and evolution are analyzed. The Xixiangchi Group can be divided into 5 third-order sequences(Sql-Sq5), of which sequences Ⅰ to Ⅲ(Sql-Sq3) are relatively complete, sequences Ⅳ and Ⅴ are denuded in the Late Cambrian because of the Dian-Chuan paleo-uplifts.Third-order sequences of the Xixiangchi Group in this area have the characteristics of thin in the west and thick in the east, showing that the Caledonian paleo-uplift is a synsedimentary paleo-uplift and the paleogeomorphology in the platform is a gentle slope. Sequence Ⅰdevelops high stand systems tract and transgressive systems tract. The other third-order sequences are dominated by highstand systems tracts, and the transgressive systems tracts last shortly in time and are limited in area. The basic features of evaporative-restricted platform of gentle slope type developed continuously in the sedimentary period of the Xixiangchi Group, its sedimentary environment of "high in west and low in east" and the change of micro paleogeomorphology in the platform control the continuous development of sedimentary facies. Open platform is developed only in sequence Ⅰ and sequence Ⅱ, and the inner beach of the platform and the edge beach of the platform are mostly developed in sequence Ⅱ and sequence Ⅲ. It indicates that there are two platform margin zones in the study area,a relatively stable, large-scale platform marginal zone in NE Guizhou-Western Hunan and Hubei, and a moving and small-scale platform marginal zone in North Chongqing-Western Hubei.

Importance of risk assessment,endoscopic hemostasis,and recent advancements in the management of acute non-variceal upper gastrointestinal bleeding

Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)is a common medical emergency in clinical practice.While the incidence has significantly reduced,the mortality rates have not undergone a similar reduction in the last few decades,thus presenting a significant challenge.This editorial outlines the key causes and risk factors of ANVUGIB and explores the current standards and recent updates in risk assessment scoring systems for predicting mortality and endoscopic treatments for achieving hemostasis.Since ANUVGIB predominantly affects the elderly population,the impact of comorbidities may be responsible for the poor outcomes.A thorough drug history is important due to the increasing use of antiplatelet agents and anticoagulants in the elderly.Early risk stratification plays a crucial role in deciding the line of management and predicting mortality.Emerging scoring systems such as the ABC(age,blood tests,co-morbidities)score show promise in predicting mortality and guiding clinical decisions.While conventional endoscopic therapies remain cornerstone approaches,novel techniques like hemostatic powders and over-the-scope clips offer promising alternatives,particularly in cases refractory to traditional modalities.By integrating validated scoring systems and leveraging novel therapeutic modalities,clinicians can enhance patient care and mitigate the substantial morbidity and mortality associated with ANVUGIB.

Clinical characteristics of acute non-varicose upper gastrointestinal bleeding and the effect of endoscopic hemostasis

BACKGROUND Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)constitutes a prevalent emergency within Gastroenterology,encompassing 80%-90%of all gastrointestinal hemorrhage incidents.This condition is distinguished by its abrupt onset,swift progression,and notably elevated mortality rate.AIM To gather clinical data from patients with ANVUGIB at our hospital in order to elucidate the clinical characteristics specific to our institution and analyze the therapeutic effectiveness of endoscopic hemostasis.METHODS We retrospectively retrieved the records of 532 patients diagnosed with ANVUGIB by endoscopy at our hospital between March 2021 and March 2023,utilizing our medical record system.Data pertaining to general patient information,etiological factors,disease outcomes,and other relevant variables were meticulously collected and analyzed.RESULTS Among the 532 patients diagnosed with ANVUGIB,the male-to-female ratio was 2.91:1,with a higher prevalence among males.Notably,43.6%of patients presented with black stool as their primary complaint,while 27.4%had hematemesis as their initial symptom.Upon admission,17%of patients exhibited both hematemesis and black stool,while most ANVUGIB patients primarily complained of overt gastrointestinal bleeding.Urgent routine blood examinations at admission revealed that 75.8%of patients had anemia,with 63.4%experiencing moderate to severe anemia,and 1.5%having extremely severe anemia(hemoglobin<30 g/L).With regard to etiology,53.2%of patients experienced bleeding without a definitive trigger,24.2%had a history of using gastric mucosa-irritating medications,24.2%developed bleeding after alcohol consumption,2.8%attributed it to improper diet,1.7%to emotional excitement,and 2.3%to fatigue preceding the bleeding episode.Drug-induced ANVUGIB was more prevalent in the elderly than middle-aged and young individuals,while bleeding due to alcohol consumption showed the opposite trend.Additionally,diet-related bleeding was more common among the young age group compared to the middle-aged group.Gastrointestinal endoscopy identified peptic ulcers as the most frequent cause of ANVUGIB(73.3%),followed by gastrointestinal malignancies(10.9%),acute gastric mucous lesions(9.8%),and androgenic upper gastrointestinal bleeding(1.5%)among inpatients with ANVUGIB.Of the 532 patients with gastrointestinal bleeding,68 underwent endoscopic hemostasis,resulting in an endoscopic treatment rate of 12.8%,with a high immediate hemostasis success rate of 94.1%.

Advancements in hemostatic strategies for managing upper gastrointestinal bleeding: A comprehensive review

Upper gastrointestinal(GI)hemorrhage presents a substantial clinical challenge.Initial management typically involves resuscitation and endoscopy within 24 h,although the benefit of very early endoscopy(<12 h)for high-risk patients is debated.Treatment goals include stopping acute bleeding,preventing rebleeding,and using a multimodal approach encompassing endoscopic,pharmacological,angiographic,and surgical methods.Pharmacological agents such as vasopressin,prostaglandins,and proton pump inhibitors are effective,but the increase in antithrombotic use has increased GI bleeding morbidity.Endoscopic hemostasis,particularly for nonvariceal bleeding,employs techniques such as electrocoagu-lation and heater probes,with concerns over tissue injury from monopolar electrocoagulation.Novel methods such as Hemospray and Endoclot show promise in creating mechanical tamponades but have limitations.Currently,the first-line therapy includes thermal probes and hemoclips,with over-the-scope clips emerging for larger ulcer bleeding.The gold probe,combining bipolar electrocoagulation and injection,offers targeted coagulation but has faced device-related issues.Future advancements involve combining techniques and improving endoscopic imaging,with studies exploring combined approaches showing promise.Ongoing research is crucial for developing standardized and effective hemorrhage management strategies.

Efficacy and safety of over-the-scope-clips in the therapy of acute nonvariceal upper gastrointestinal bleeding:Meta-analysis

BACKGROUND Acute nonvariceal upper gastrointestinal bleeding(ANVUGIB)is a frequent lifethreatening acute condition in gastroenterology associated with high morbidity and mortality.Over-the-scope-clip(OTSC)is a new endoscopic hemostasis technique,which is being used in ANVUGIB and is more effective.AIM To summarize and analyze the effects of the OTSC in prevention of recurrent bleeding,clinical success rate,procedure time,hospital stay,and adverse events in the treatment of ANVUGIB,to evaluate whether OTSC can replace standard endoscopic therapy as a new generation of treatment for ANVUGIB.METHODS The literature related to OTSC and standard therapy for ANVUGIB published before January 2023 was searched in PubMed,Web of Science,EMBASE,Cochrane,Google,and CNKI databases.Changes in recurrent bleeding(7 or 30 days),clinical results(clinical success rate,conversion rate to surgery,mortality),therapy time(procedure time,hospital stay),and adverse events in the OTSC intervention group were summarized and analyzed,and the MD or OR of 95%CI is calculated by Review Manager 5.3.RESULTS This meta-analysis involved 11 studies with 1266 patients.Total risk of bias was moderate-to-high.For patients in the OTSC group,7-and 30-days recurrent bleeding rates,as well as procedure time,hospital stay,and intensive care unit stay,were greatly inhibited.OTSC could significantly improve the clinical success rate of ANVUGIB.OTSC therapy did not cause serious adverse and was effective in reducing patient mortality.CONCLUSION OTSC may provide more rapid and sustained hemostasis,and thus,promote recovery and reduce mortality in patients with ANVUGIB.In addition,the safety of OTSC is assured.

Reservoir characteristics and formation model of Upper Carboniferous bauxite series in eastern Ordos Basin,NW China

Through core observation,thin section identification,X-ray diffraction analysis,scanning electron microscopy,and low-temperature nitrogen adsorption and isothermal adsorption experiments,the lithology and pore characteristics of the Upper Carboniferous bauxite series in eastern Ordos Basin were analyzed to reveal the formation and evolution process of the bauxite reservoirs.A petrological nomenclature and classification scheme for bauxitic rocks based on three units(aluminum hydroxides,iron minerals and clay minerals)is proposed.It is found that bauxitic mudstone is in the form of dense massive and clastic structures,while the(clayey)bauxite is of dense massive,pisolite,oolite,porous soil and clastic structures.Both bauxitic mudstone and bauxite reservoirs develop dissolution pores,intercrystalline pores,and microfractures as the dominant gas storage space,with the porosity less than 10% and mesopores in dominance.The bauxite series in the North China Craton can be divided into five sections,i.e.,ferrilite(Shanxi-style iron ore,section A),bauxitic mudstone(section B),bauxite(section C),bauxite mudstone(debris-containing,section D)and dark mudstone-coal section(section E).The burrow/funnel filling,lenticular,layered/massive bauxite deposits occur separately in the karst platforms,gentle slopes and low-lying areas.The karst platforms and gentle slopes are conducive to surface water leaching,with strong karstification,well-developed pores,large reservoir thickness and good physical properties,but poor strata continuity.The low-lying areas have poor physical properties but relatively continuous and stable reservoirs.The gas enrichment in bauxites is jointly controlled by source rock,reservoir rock and fractures.This recognition provides geological basis for the exploration and development of natural gas in the Upper Carboniferous in the study area and similar bauxite systems.

Predictive utility of the Rockall scoring system in patients suffering from acute nonvariceal upper gastrointestinal hemorrhage

BACKGROUND Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)represents a sig-nificant clinical challenge due to its unpredictability and potentially severe out-comes.The Rockall risk score has emerged as a critical tool for prognostic asse-ssment in patients with ANVUGIB,aiding in the prediction of rebleeding and mo-rtality.However,its applicability and accuracy in the Chinese population remain understudied.AIM To assess the prognostic value of the Rockall risk score in a Chinese cohort of patients with ANVUGIB.METHODS A retrospective analysis of 168 ANVUGIB patients’medical records was condu-cted.The study employed statistical tests,including the t-test,χ^(2) test,spearman correlation,and receiver operating characteristic(ROC)analysis,to assess the re-lationship between the Rockall score and clinical outcomes,specifically focusing on rebleeding events within 3 months post-assessment.RESULTS Significant associations were found between the Rockall score and various clinical outcomes.High Rockall scores were significantly associated with rebleeding events(r=0.735,R2=0.541,P<0.001)and strongly positively correlated with adverse outcomes.Low hemoglobin levels(t=2.843,P=0.005),high international normalized ratio(t=3.710,P<0.001),active bleeding during endoscopy(χ^(2)=7.950,P=0.005),large ulcer size(t=6.348,P<0.001),and requiring blood transfusion(χ^(2)=6.381,P=0.012)were all significantly associated with rebleeding events.Furthermore,differences in treatment and management strategies were identified between patients with and without rebleeding events.ROC analysis indicated the excellent discriminative power(sensitivity:0.914;specificity:0.816;area under the curve:0.933;Youden index:0.730)of the Rockall score in predicting rebleeding events within 3 months.CONCLUSION This study provides valuable insights into the prognostic value of the Rockall risk score for ANVUGIB in the Chinese population.The results underscore the potential of the Rockall score as an effective tool for risk strati-fication and prognostication,with implications for guiding risk-appropriate management strategies and optimizing care for patients with ANVUGIB.