PRaG 3.0 therapy for human epidermal growth factor receptor 2-positive metastatic pancreatic ductal adenocarcinoma:A case report

BACKGROUND Pancreatic ductal adenocarcinoma(PDAC)is a highly fatal disease with limited effective treatment especially after first-line chemotherapy.The human epidermal growth factor receptor 2(HER-2)immunohistochemistry(IHC)positive is associated with more aggressive clinical behavior and shorter overall survival in PDAC.CASE SUMMARY We present a case of multiple metastatic PDAC with IHC mismatch repair proficient but HER-2 IHC weakly positive at diagnosis that didn’t have tumor regression after first-line nab-paclitaxel plus gemcitabine and PD-1 inhibitor treatment.A novel combination therapy PRaG 3.0 of RC48(HER2-antibody-drug conjugate),radio-therapy,PD-1 inhibitor,granulocyte-macrophage colony-stimulating factor and interleukin-2 was then applied as second-line therapy and the patient had confirmed good partial response with progress-free-survival of 6.5 months and overall survival of 14.2 month.She had not developed any grade 2 or above treatment-related adverse events at any point.Percentage of peripheral CD8^(+) Temra and CD4^(+) Temra were increased during first two activation cycles of PRaG 3.0 treatment containing radiotherapy but deceased to the baseline during the maintenance cycles containing no radiotherapy.CONCLUSION PRaG 3.0 might be a novel strategy for HER2-positive metastatic PDAC patients who failed from previous first-line approach and even PD-1 immunotherapy but needs more data in prospective trials.

Long-Term Extreme Wave Characteristics in the Water Adjacent to China Based on ERA5 Reanalysis Data

Extreme waves have a profound impact on coastal infrastructure;thus,understanding the variation law of risky analysis and disaster prevention in coastal zones is necessary.This paper analyzed the spatiotemporal characteristics of extreme wave heights adjacent to China from 1979 to 2018 based on the ERA5 datasets.Nonstationary extreme value analysis is undertaken in eight repre-sentative points to investigate the trends in the values of 50-and 100-year wave heights.Results show that the mean value of extreme waves is the largest in the eastern part of Taiwan Island and the smallest in the Bohai Sea from 1979 to 2018.Only the extreme wave height in the northeastern part of Taiwan Island shows a significant increase trend in the study area.Nonstationary analysis shows remarkable variations in the values of 50-and 100-year significant wave heights in eight points.Considering the annual mean change,E1,E2,S1,and S2 present an increasing trend,while S3 shows a decreasing trend.Most points for the seasonal mean change demon-strate an increasing trend in spring and winter,while other points show a decreasing trend in summer and autumn.Notably,the E1 point growth rate is large in autumn,which is related to the change in typhoon intensity and the northward movement of the typhoon path.

Comparison of ERA5 turbulent fluxes at the air-sea interface with measurements from a wave-following platform

Turbulent fluxes at the air-sea interface were estimated with data collected in 2011-2020 with a low-profile platform named OCARINA during eight experiments in five regions:2011,2015,and 2016 in the Iroise Sea;2012 in the tropical Atlantic;2014 in the Chilie-Peru upwelling;2017 and 2018 in the Mediterranean Sea,and 2018 and 2020 in Barbados.The observations were carried out with moderate winds(2-10 m s^(-1))and average wave heights of 1.5 m.In this study,the authors used the fluxes calculated by the bulk method using OCARINA-sampled data as the input.These data can validate the fluxes estimated from ERAS reanalysis data.The OCARINA and ERA5 data were taken concomitantly.To do this,the authors established an algorithm to extract the OCARINA data as closely as possible to the reanalysis data in time and position.The measurements of the OCARINA platform can conclude on the relevance of the widely used reanalysis data.

The GNSS PWV retrieval using non-observation meteorological parameters based on ERA5 and its relation with precipitation

The pressure and temperature significantly influence precipitable water vapor(PWV) retrieval. Global Navigation Satellite System(GNSS) PWV retrieval is limited because the GNSS stations lack meteorological sensors. First, this article evaluated the accuracy of pressure and temperature in 68 radiosonde stations in China based on ERA5 Reanalysis data from 2015 to 2019 and compared them with GPT3model. Then, the accuracy of pressure and temperature calculated by ERA5 were estimated in 5 representative IGS stations in China. And the PWV calculated by these meteorological parameters from ERA5(ERA5-PWV) were analyzed. Finally, the relation between ERA5-PWV and precipitation was deeply explored using wavelet coherence analysis in IGS stations. These results indicate that the accuracy of pressure and temperature of ERA5 is better than the GPT3 model. In radiosonde stations, the mean BIAS and MAE of pressure and temperature in ERA5 are-0.41/1.15 hpa and-0.97/2.12 K. And the mean RMSEs are 1.35 hpa and 2.87 K, which improve 74.77% and 40.58% compared with GPT3 model. The errors of pressure and temperature of ERA5 are smaller than the GPT3 model in bjfs, hksl and wuh2, and the accuracy of ERA5-PWV is improved by 18.77% compared with the GPT3 model. In addition, there is a significant positive correlation between ERA5-PWV and precipitation. And precipitation is always associated with the sharp rise of ERA5-PWV, which provides important references for rainfall prediction.

Liver biopsy in the post-hepatitis C virus era in Japan

In Japan,liver biopsies were previously crucial in evaluating the severity of hepatitis caused by the hepatitis C virus(HCV)and diagnosing HCV-related hepatocellular carcinoma(HCC).However,due to the development of effective antiviral treatments and advanced imaging,the necessity for biopsies has significantly decreased.This change has resulted in fewer chances for diagnosing liver disease,causing many general pathologists to feel less confident in making liver biopsy diagnoses.This article provides a comprehensive overview of the challenges and potential solutions related to liver biopsies in Japan.First,it highlights the importance of considering steatotic liver diseases as independent conditions that can coexist with other liver diseases due to their increasing prevalence.Second,it emphasizes the need to avoid hasty assumptions of HCC in nodular lesions,because clinically diagnosable HCCs are not targets for biopsy.Third,the importance of diagnosing hepatic immune-related adverse events caused by immune checkpoint inhibitors is increasing due to the anticipated widespread use of these drugs.In conclusion,pathologists should be attuned to the changing landscape of liver diseases and approach liver biopsies with care and attention to detail.

Design Strategies and Practice Paths for Improving Urban Quality in the Stock Era

In the middle and later stages of urbanization development,the growth of the real estate industry will stagnate,and urban renewal will become the mainstream.With the advancement of urban renewal,there are still problems in improving the quality of cities in the stock era and their design strategies.This paper analyzed the Linping Old City organic renewal project and the Xishui River ecological governance project in the stock era of urban quality improvement by sorting out the current development status,historical background,planning types,and design strategies of quality improvement in the stock era from the perspective of urban renewal,combining with project overview,main problems,design methods,and design content.Urban renewal is the leading direction for promoting urban development and construction on a global scale,and countries formulate different plans and practices based on their local characteristics.Urban renewal strategies should be diversified,and focus on livable environments,urban characteristics,etc.,while considering human factors,green innovation,etc.,in order to achieve smart community management and enhance the economic and social benefits brought by urban attractiveness.For successful cases such as the Linping Old City and Xishui River ecological governance project,corresponding urban quality improvement strategies and implementation plans should be formulated according to local conditions,with emphasis on social participation and people’s livelihood improvement.This study can help urban planning pay more attention to rational utilization and upgrading of existing urban resources,adapt to the current urban development situation,and promote sustainable urban development.

Transitivity Analysis of the Energy in China’s New Era

At present,with the steady development of the global economy,more and more countries begin to pay attention to the impact of ecological environment on economic development and human society,so the ecological environment has become a global issue that cannot be ignored in today’s era.Therefore,from the perspective of the ecological philosophy of Diversity&Harmony as well as Interaction&Co-existence,this paper will conduct ecological discourse analysis on the Energy in China’s New Era based on the transitivity system of systemic-functional grammar,and use the Corpus analysis software UAM Corpus Tool 3.3x to label and make statistics on the transitivity system,aiming to explore the distribution characteristics of the transitivity system in this white paper.Through the transitivity analysis of the white paper,this study helps readers to have a deeper understanding of the positive significance contained in the white paper.To a certain extent,it enables readers at home and abroad to understand China’s stance on energy issues and the positive image of China in energy ecology.It also awaken readers’awareness of environmental protection and acquire good habits of resource conservation to be in harmony between human and nature for sustainable development.

The Historic Achievements of the Communist Party of China in Respecting and Protecting Human Rights in the New Era

In the new era,the Communist Party of China(CPC)has made historic achievements in respecting and protecting human rights.Building upon the principle of the“two integrations”(integrating the basic tenets of Marxism with China’s specific realities and fine traditional culture),it has nurtured new theories on respecting and protecting human rights in the new era,which can address the fundamental questions of whom and what the human rights protection efforts in the new era are for.Guided by the principle of“taking our own path,”it has charted a distinct course for the development of human rights,diverging from the Western approach.The CPC has maintained the unity between Party leadership and the respect for and protection of human rights,promoting progress in human rights through the pursuit of“high-quality development,”and ensuring various fundamental rights of the people through the rule of law.Building upon the past experience,the CPC has established the“source”of the institutional framework for respecting and protecting human rights in the new era,crafted the“body”of this institutional framework,and introduced its practical“application.”In promoting the comprehensive advancement of human rights protection,the CPC has facilitated the connotative development of human rights protection in China,empowering China in international human rights discourse,and contributing Chinese strength and wisdom to global human rights governance.

Challenges and Countermeasures of Youth Moral Education in the Era of Big Data

Youth moral education is an extremely important work,which is related to the inheritance of traditional virtues of the Chinese nation,the fundamental plan of“successor,”and the construction of modern Chinese spiritual civilization.In the era of big data,the moral education of youth is facing new challenges and opportunities.The wide application of big data technology has brought about an information explosion,exposing young people to more diverse and complex social information.It not only brings opportunities for positive moral education but also many challenges.The main problems of youth moral education in the era of big data are neglected youth subjectivity,insufficient youth moral practice,and utilitarian youth value orientation.We should develop personalized moral education programs,strengthen the integration of moral knowledge and action,and pay more attention to moral practice to improve the pertinence and effectiveness of moral education for young people in the era of big data.

Progress in The Application of Nursing Care Based on ERAS Concept after Thoracolumbar Fracture Surgery

Thoracic spine fracture is a common orthopedic injury that is usually caused by external forces acting directly on or transmitted to the thoracic spine through other parts of the spine.Thoracic spine fractures can be divided into two types:stable and unstable.An unstable fracture means that the relationship between the vertebral bodies is no longer stable,which may cause serious consequences such as spinal compression,nerve root compression,or spinal cord injury.Surgical treatment is often needed for patients with unstable fractures,nerve root compression,or spinal cord injury to restore stability and function to the thoracic spine.The probability of complications after thoracolumbar fracture surgery is high,which affects the outcome of surgical treatment.To improve postoperative rehabilitation outcomes,this article analyzed the value of nursing care based on the enhanced recovery after surgery(ERAS)concept for patients undergoing thoracolumbar fracture surgery.

Research on the Education Strategy of College Students’Career Planning in the New Era

Career planning is the key educational content for college students,which is related to students’career choices and future development after graduation.However,there are some common problems related to career planning among college students.At the same time,career planning education itself fails to break through the limitations of traditional education,which,to some extent,hinders the future development planning of college students.Based on this,schools should actively introduce advanced education methods in the new era,combine the characteristics of college students on the basis of summarizing the previous planning experience in education,constantly improve and innovate the content and form of career planning education,promote the improvement of college students’education,and enhance the quality of education.

Innovative Strategies for Financial Investment Management Strategies of Enterprises in the New Era

With the in-depth development of economic globalization and the continuous emergence of new technologies,the importance of enterprise financial investment management strategy is becoming more and more prominent.The traditional financial investment management strategy can no longer meet the needs of enterprises in the new era and needs to be innovated with the times.For enterprises,the effectiveness and scientificity of financial investment management strategy will directly affect the competitiveness and long-term development of enterprises.Therefore,this study chooses the innovation based on the financial investment management strategy of enterprises in the new era as the research theme,aiming at exploring the innovative strategy to adapt to the needs of enterprises in the new era.

Analysis of the Spirit of Struggle in the New Era Based on General Secretary Xi Jinping’s New Year’s Greetings in the Past Decade

In order to realize the national rejuvenation,General Secretary Xi Jinping attaches great importance to the spiritual strength of struggle,and has repeatedly advocated that all people should exalt the spirit of strive on different occasions.According to his New Year’s greetings since 2014,Xi Jinping has illustrated the connotation of the spirit of enterprising,the necessity of carrying forward and the requirements for practicing the spirit of struggle from different perspectives,pointing out that all Chinese must keep in mind both domestic and international situations,strive in unity,work creative and industrious with the enthusiasm of seizing every minute,catch the opportunity and solve the problem,make substantial progress on the new journey to construct China into a great modern socialist country in all respects.

ERAS理念下中医特色护理干预在腰椎间盘突出症术后恐动症患者中的应用

目的:探讨加快康复外科(ERAS)理念下中医特色护理干预在腰椎间盘突出症(LDH)术后恐动症患者中的应用效果。方法:选取2023年6月1日~11月1日收治的108例LDH术后恐动症患者为研究对象,按照随机数字表法分为研究组和对照组各54例,对照组实施术后常规护理,研究组在常规护理基础上实施ERAS理念下中医特色护理干预;比较两组不同时间疼痛状况[采用疼痛数字评分法(NRS)]、恐动症状况(采用恐动症TSK评分量表)、自我效能[采用一般自我效能感量表(GSES)]。结果:研究组术后1周、出院时、术后1个月恐动症TSK、NRS评分均低于对照组(P<0.01),研究组不同时间GSES评分高于对照组(P<0.01)。结论:基于ERAS理念构建的中医特色护理干预方案可降低LDH术后恐动症患者的恐动程度,减轻患者疼痛,有利于其快速康复。

《2021年美国创新与竞争法》(3.0版)遏华条文的霸凌色彩探析

《2021年美国创新与竞争法》(3.0版)在政治、教育、人才、科学技术、贸易、空间与军事技术、专利和知识产权等各个领域专门针对并遏制中国,带有鲜明的霸凌色彩。这部法律对华特指化对象调整明显,相关遏华条文数量大、范围广,程度激烈,明显违背法理;语言充斥歧视、贬低、威胁、打压、编造等色调,违反了法律规范性和公平性原则和美国的宪法;对外贸易联合排挤、封锁中国,违背WTO规则;对华科技封锁,严禁航天航空和5G技术交流和合作,违背联合国宪章人类共同进步原则;对中国政府、执政党和国家领导人以及中国守法企业制裁,违背了国际法的国家赦免原则和尊重主权原则,是典型的长臂管辖。因此全面系统分析这部法律的相关遏华条文及其霸凌色彩,可以为我国政府及时制定反制裁的应对之策提供一定的帮助。

飞利浦Ingenia 3.0 T磁共振成像仪射频系统故障三例

磁共振成像无电离辐射且软组织成像效果较好,已成为常规体检和疾病诊断非常重要的医学影像诊疗技术之一。磁共振设备结构复杂,维修及维护成本较高,长期高负荷的运转会导致磁共振设备故障率增加。本文总结了本院飞利浦Ingenia 3.0 T磁共振设备射频系统故障三例,包括de-tuned印刷电路板故障、射频放大器故障及体线圈故障。文中对三例飞利浦磁共振设备射频系统故障的表现进行了描述,对故障产生的原因进行了分析并介绍了故障排除过程,包括观察外观、提取后台日志参数、测量疑似受损部件指标、更换受损部件以及系统测试。通过深入分析射频系统故障案例,分享维修经验,以期提高设备使用率。

数智驱动框架下的非遗档案资源展播服务研究——以《清明上河图3.0》为例

数智驱动下非遗档案资源的展播服务研究,可为新时代档案资源以及中华优秀传统文化的开发与利用提供新思路。本文通过文献分析法,参考医疗信息服务和图书馆服务领域的数智驱动框架,结合数字展播服务和非遗档案资源的特点,提出包含基础设施、数据资源、技术处理、服务应用四个层次的非遗档案资源展播服务数智驱动框架。结合典型案例《清明上河图3.0》对数智驱动框架中各层次进行分析,提出非遗档案数智展播服务发展路径,包括基础设施平台保障、数据资源协同开发、数字技术集成创新、科技赋能文化服务等。

“互联网+”远程指导康复对肩袖损伤ERAS理念下关节镜手术后患者的康复效果研究

目的探讨基于“互联网+”远程指导康复对肩袖损伤ERAS理念下关节镜手术后患者的康复效果。方法选择2021年1月至2022年6月本院收治的肩袖损伤ERAS理念下关节镜手术后患者227例,数字随机法随机分为对照组109例,观察组118例。对照组采取常规康复和随访,观察组采取基于“互联网+”的远程指导康复,持续3个月。比较两组患者手术前后的肩关节Constant Murley评分及生活质量。结果观察组Constant Murley评分及生活质量均高于对照组,差异均有统计学意义(P<0.05)。结论基于“互联网+”远程指导康复能够提升肩袖损伤ERAS理念下关节镜手术后患者的康复效果。

中国区域ERA5-ZTD/PWV精度评估与台风事件响应研究

再分析数据能够提供多种历史气象数据同化产品,为了评估欧洲中期天气预报中心的最新一代ERA5再分析数据集估计的天顶对流层延迟(Zenith Tropospheric Delay,ZTD)和大气可降水量(Precipitable Water Vapor,PWV)产品在中国区域的精度,利用2017—2019年中国区域内14个全球导航卫星系统地面监测站和89个探空站反演的ZTD和PWV数据分别对ERA5-ZTD和ERA5-PWV精度进行了评估。结果表明,除青藏地区的站点外,ERA5-ZTD的精度分布较为均匀,平均Bias、RMSE和STD分别为-6.3 mm、19.3 mm和17.5 mm;ERA5-PWV的精度分布呈现西部内陆高和东南沿海低的趋势,平均Bias、RMSE和STD分别为0.3 mm,2.9 mm和2.7 mm。此外,在研究2019年“利奇马”台风期间ZTD和PWV的时空分布中,提出了使用水汽到达时间差的方法定量估计台风的水汽移动速度。得到台风期间ZTD和PWV具有相同的空间分布规律,且移动方向与台风的移动路径方向是一致的,估计的水汽平均移动速度为12.4 km/h,与台风的平均移动速度16.1 km/h非常接近。因此,ERA5-ZTD/PWV在中国区域内具有较高的精度,ZTD和PWV可作为重要气象因子为台风的预警预报研究提供重要参考。

基于ERA5再分析数据的伊犁河流域干旱灾害风险评估与区划

依据ERA5再分析数据的分布特点,以0.25°×0.25°的网格为旱灾风险评估的基本单元,从危险性、脆弱性、易损性和防灾减灾能力4个方面选取12个指标,采用AHP-熵值法确定指标权重,对基础数据资料匮乏的伊犁河流域构建干旱灾害风险指数模型,进行干旱灾害风险评估与区划。结果表明,分时段校正后的ERA5再分析降水数据精度显著提高,可用于干旱灾害风险评估;次高、高危险性区域主要分布在研究区西北部和东北部,次高、高脆弱性区域主要分布在海拔较高的山区,次高、高易损性区域主要分布在伊宁市及周边地区,次高、高防灾减灾能力主要分布在研究区西北部,分别占研究区总面积的33.45%、31.04%、16.13%、15.09%;旱灾风险区划图显示,低、次低风险区主要分布在研究区西南部,次高、高风险区主要分布在研究区西北部,分别占研究区总面积的44.69%、22.53%。