After stroke,even high-functioning individuals may experience compromised bimanual coordination and fine motor dexterity,leading to reduced functional independence.Bilateral arm training has been proposed as a promisi...After stroke,even high-functioning individuals may experience compromised bimanual coordination and fine motor dexterity,leading to reduced functional independence.Bilateral arm training has been proposed as a promising intervention to address these deficits.However,the neural basis of the impairment of functional fine motor skills and their relationship to bimanual coordination performance in stroke patients remains unclear,limiting the development of more targeted interventions.To address this gap,our study employed functional near-infrared spectroscopy to investigate cortical responses in patients after stroke as they perform functional tasks that engage fine motor control and coordination.Twenty-four high-functioning patients with ischemic stroke(7 women,17 men;mean age 64.75±10.84 years)participated in this cross-sectional observational study and completed four subtasks from the Purdue Pegboard Test,which measures unimanual and bimanual finger and hand dexterity.We found significant bilateral activation of the sensorimotor cortices during all Purdue Pegboard Test subtasks,with bimanual tasks inducing higher cortical activation than the assembly subtask.Importantly,patients with better bimanual coordination exhibited lower cortical activation during the other three Purdue Pegboard Test subtasks.Notably,the observed neural response patterns varied depending on the specific subtask.In the unaffected hand task,the differences were primarily observed in the ipsilesional hemisphere.In contrast,the bilateral sensorimotor cortices and the contralesional hemisphere played a more prominent role in the bimanual task and assembly task,respectively.While significant correlations were found between cortical activation and unimanual tasks,no significant correlations were observed with bimanual tasks.This study provides insights into the neural basis of bimanual coordination and fine motor skills in high-functioning patients after stroke,highlighting task-dependent neural responses.The findings also suggest that patients who exhibit better bimanual performance demonstrate more efficient cortical activation.Therefore,incorporating bilateral arm training in post-stroke rehabilitation is important for better outcomes.The combination of functional near-infrared spectroscopy with functional motor paradigms is valuable for assessing skills and developing targeted interventions in stroke rehabilitation.展开更多
BACKGROUND Acute appendicitis is the most common abdominal emergency.At present,the main treatments for periappendiceal abscess include antibiotics and surgery.However,the complications and mortality of emergency surg...BACKGROUND Acute appendicitis is the most common abdominal emergency.At present,the main treatments for periappendiceal abscess include antibiotics and surgery.However,the complications and mortality of emergency surgery are high.The preferred therapy is conservative treatment with antibiotics first,ultrasound-guided puncture drainage or surgical treatment is followed when necessary.Endoscopic retrograde appendicitis therapy(ERAT)for acute uncomplicated appendicitis have been proved clinically effective,but it is rarely used in periap-pendiceal abscess.CASE SUMMARY We report a patient admitted to hospital because of“right lower abdominal pain for six days”.The computerized tomography(CT)of patient showed that appendicitis with fecaliths and abscess in the pelvis.The patient was treated by CT-guided puncture and drainage of abdominal abscess combined with ERAT to remove appendiceal fecaliths,irrigation and stent placement.CONCLUSION The patient did not receive surgery because of impoverished family.Abdominal pain did not recur during the follow-up period.This case confirms the value of ERAT in the treatment of periappendiceal abscess.展开更多
BACKGROUND Although the past decade has seen remarkable advances in treatment options for hepatocellular carcinoma(HCC),the dismal overall prognosis still envelops HCC patients.Several comparative trials have been con...BACKGROUND Although the past decade has seen remarkable advances in treatment options for hepatocellular carcinoma(HCC),the dismal overall prognosis still envelops HCC patients.Several comparative trials have been conducted to study whether transarterial chemoembolization(TACE)could improve clinical outcomes in patients receiving sorafenib for advanced HCC;however,the findings have been inconsistent.AIM To study the potential synergies and safety of sorafenib plus TACE vs sorafenib alone for treating advanced HCC,by performing a systematic review and metaanalysis.METHODS This study was conducted following the PRISMA statement.A systematic literature search was conducted using the Cochrane Library,Embase,PubMed,and Web of Science databases.Data included in the present work were collected from patients diagnosed with advanced HCC receiving sorafenib plus TACE or sorafenib alone.Data synthesis and meta-analysis were conducted using Review Manager software.RESULTS The present study included 2780 patients from five comparative clinical trials(1 was randomized control trial and 4 were retrospective studies).It was found that patients receiving sorafenib plus TACE had better prognoses in terms of overall survival(OS),with a combined hazard ratio(HR)of 0.65[95%confidence interval(95%CI):0.46–0.93,P=0.02,n=2780].Consistently,progression free survival(PFS)and time to progression(TTP)differed significantly between the sorafenib plus TACE arm and sorafenib arm(PFS:HR=0.62,95%CI:0.40–0.96,P=0.03,n=443;TTP:HR=0.73,95%CI:0.64-0.83,P<0.00001,n=2451).Disease control rate(DCR)was also significantly increased by combination therapy(risk ratio=1.36,95%CI:1.02-1.81,P=0.04,n=641).Regarding safety,the incidence of any adverse event(AE)was increased due to the addition of TACE;however,no significant difference was found in grade≥3 AEs.CONCLUSION The combination of sorafenib with TACE has superior efficacy to sorafenib monotherapy,as evidenced by prolonged OS,PFS,and TTP,as well as increased DCR.Additional high-quality trials are essential to further validate the clinical benefit of this combination in the treatment of advanced HCC.展开更多
In this paper, we build on the concept of equivalent fundamental-mode source to propose using delayed neutrons as a neutron source in multiplication experiments to acquire the effective multiplication factor keffof su...In this paper, we build on the concept of equivalent fundamental-mode source to propose using delayed neutrons as a neutron source in multiplication experiments to acquire the effective multiplication factor keffof subcritical systems, which is difficult to acquire directly from conventional neutron source multiplication method. We analyzed the difference between a fundamental-mode fission source and delayed neutron source,then adopted a factor to convert delayed neutron distribution to an equivalent fundamental-mode source distribution, and employed Monte Carlo code to acquire this factor.The delayed neutron multiplication measurement method was established for the first time, and corresponding experiments were conducted in subcritical systems. The multiplication of delayed neutrons was measured based on Chinese Fast Burst Reactor-Ⅱ(CFBR-Ⅱ) at subcritical states, and keffwas acquired from delayed neutron multiplication successfully(0.9921 and 0.9969, respectively).The relative difference between k_(eff)obtained by the new method and previous values acquired by the positive period method is less than 1% for these two studied cases.展开更多
The Late Paleozoic and Mesozoic tectonic framework of the Nanpanjiang Basin has much been disputed.Herein,the middle-acid volcanic rock,dacite,exposed to the Zhesang gold district,southeast Yunnan Province,has been an...The Late Paleozoic and Mesozoic tectonic framework of the Nanpanjiang Basin has much been disputed.Herein,the middle-acid volcanic rock,dacite,exposed to the Zhesang gold district,southeast Yunnan Province,has been analyzed.The results show that the dacite belongs to a calc-alkaline series,SiO_(2)contents range from 62.79 to 76.66 wt%.Zircon SHRIMP U–Pb dating of dacite demonstrates that they were formed in the Early Triassic(247.8±1.7 Ma,MSWD=1.2).All samples exhibit enrichment in LILE(e.g.Rb,K,Th,and U),and depletion in HFSE(e.g.Nb,Ta,and Ti),which has the geochemical affinity of I-type granite.La–La/Sm and La–La/Yb discrimination diagrams show that the partial melting,mainly of the mafic lower crust,of rocks,plays a major role in the formation process.The dacite has low initial ^(87)Sr/^(86)Sr ratios(0.706954 to 0.708589)and negative ε_(Nd)(t)values(-11.77 to-10.88).Zircons in dacite have ε_(Hf)(t)values of-16.2 to-8.3,and the two-stage Hf model ages are 1799–2301 Ma,mostly concentrated between 1800 and 1900 Ma,indicating that the magma source area is the reconstructed ancient lower crust mixed with some mantle materials,and crystal fractionation process underwent in the late stage of magma migration.This study reveals that the arc-volcanic rocks of the Early Triassic in the southern margin of the Nanpanjiang Basin were formed by the subduction of the Late Paleozoic ocean basin within the border region between China and Vietnam.展开更多
BACKGROUND A foreign body in the digestive tract is a common disease in the clinic.However,it is rare for a foreign body to migrate into the liver.Most patients are diagnosed before or after perforation of the digesti...BACKGROUND A foreign body in the digestive tract is a common disease in the clinic.However,it is rare for a foreign body to migrate into the liver.Most patients are diagnosed before or after perforation of the digestive tract.Laparoscopic removal of intrahepatic foreign bodies is an effective treatment method.CASE SUMMARY A 55-year-old male patient was admitted to the hospital due to fever for 3 d,in addition to pain and discomfort in the right side of his waist.After admission,abdominal computed tomography showed a foreign body in the liver,and gastroscopy did not indicate obvious erosion or ulcers.The patient then underwent laparoscopic surgery.During the operation,an abscess was seen near the gastric antrum and between the caudate lobes of the liver.It was approximately 30 mm×31 mm×23 mm in size.The abscess was cut open,and a fish bone was found inside.The fish bone had penetrated the liver and was successfully removed.It was confirmed that the fish bone migrated from the stomach to the liver.CONCLUSION Although intrahepatic foreign bodies are rare,they should be diagnosed and treated as early as possible to avoid serious complications such as intrahepatic abscess,which may lead to liver resection and even life-threatening events.展开更多
BACKGROUND Pseudoaneurysms of the hepatic artery or its branches have been reported following abdominal trauma,iatrogenic injury at the time of many operations such as percutaneous transhepatic biliary drainage and ch...BACKGROUND Pseudoaneurysms of the hepatic artery or its branches have been reported following abdominal trauma,iatrogenic injury at the time of many operations such as percutaneous transhepatic biliary drainage and cholecystectomy.Hepatic artery pseudoaneurysms after endoscopic retrograde cholangiopancreatography(ERCP)are uncommon and potentially life threatening and should be identified and treated rapidly.CASE SUMMARY We report a case of intra-abdominal hemorrhage secondary to a left hepatic artery pseudoaneurysm resulting from guide wire injury at ERCP.The patient primary diagnosis was acute biliary pancreatitis with cholangitis,he underwent ERCP on the third day of admission.During ERCP,the left intrahepatic bile duct was cannulated three times.Over the sixth day,Contrast enhanced computed tomography scan demonstrated left hepatic lobe contusion and a pseudoaneurysm formation.The patient was successfully treated with the embolization of a small branch of left hepatic artery angiographically.CONCLUSION The common complications of ERCP are pancreatitis,bleeding and perforation.False aneurysms occur as a result of damage to the wall of an artery.As far as we know,it is rare complication has been reported following ERCP.We advise urgent referral for angiographic embolization in this situation to avoid aneurysm rupture.展开更多
In this paper,a finite element method(FEM)-based multi-phase problem based on a newly proposed thermal elastoplastic constitutive model for saturated/unsaturated geomaterial is discussed.A program of FEM named as SOFT...In this paper,a finite element method(FEM)-based multi-phase problem based on a newly proposed thermal elastoplastic constitutive model for saturated/unsaturated geomaterial is discussed.A program of FEM named as SOFT,adopting unified field equations for thermo-hydro-mechanical-air(THMA)behavior of geomaterial and using finite element-finite difference(FE-FD) scheme for soil-water-air three-phase coupling problem,is used in the numerical simulation.As an application of the newly proposed numerical method,two engineering problems,one for slope failure in unsaturated model ground and another for in situ heating test related to deep geological repository of high-level radioactive waste(HLRW),are simulated.The model tests on slope failure in unsaturated Shirasu ground,carried out by Kitamura et al.(2007),is simulated in the framework of soil-water-air three-phase coupling under the condition of constant temperature.While the in situ heating test reported by Munoz(2006) is simulated in the same framework under the conditions of variable temperature but constant air pressure.展开更多
BACKGROUND Gastroesophageal varices are a rare complication of essential thrombocythemia(ET).ET is a chronic myeloproliferative neoplasm(MPN)characterized by an increased number of blood platelets.CASE SUMMARY A 46-ye...BACKGROUND Gastroesophageal varices are a rare complication of essential thrombocythemia(ET).ET is a chronic myeloproliferative neoplasm(MPN)characterized by an increased number of blood platelets.CASE SUMMARY A 46-year-old woman,who denied a history of liver disease,was admitted to our hospital on presentation of hematemesis.Laboratory examination revealed a hemoglobin level of 83 g/L,and a platelet count of 397×109/L.The appearance of gastric and esophageal varices with red colored signs as displayed by an urgent endoscopy was followed by endoscopic variceal ligation and endoscopic tissue adhesive.Abdominal computed tomography revealed cirrhosis,marked splenomegaly,portal vein thrombosis and portal hypertension.In addition,bone marrow biopsy and evidence of mutated Janus kinase 2,substantiated the onset of ET.The patient was asymptomatic with regular routine blood testing during the 6-mo follow-up period.Therefore,in this case,gastroesophageal varices were induced by ET.CONCLUSION MPN should be given considerable attention when performing differential diagnoses in patients with gastroesophageal varices.An integrated approach such as laboratory tests,radiological examination,and pathological biopsy,should be included to allow optimal decisions and management.展开更多
BACKGROUND Acute pancreatitis is an uncommon complication of gastrointestinal endoscopy,especially if the patient has none of the common risk factors associated with pancreatitis;such as alcoholism,gallstones,hypertri...BACKGROUND Acute pancreatitis is an uncommon complication of gastrointestinal endoscopy,especially if the patient has none of the common risk factors associated with pancreatitis;such as alcoholism,gallstones,hypertriglyceridemia,hypercalcemia or the use of certain drugs.CASE SUMMARY A 56-year-old female patient developed abdominal pain immediately after the completion of an upper gastrointestinal endoscopy.The pain was predominantly in the upper and middle abdomen and was persistent and severe.The patient was diagnosed with acute pancreatitis.Treatment included complete fasting,octreotide injection prepared in a prefilled syringe to inhibit pancreatic enzymes secretion,ulinastatin injection to inhibit pancreatic enzymes activity,esomeprazole for gastric acid suppression,fluid replacement and nutritional support.Over the next 3 d,the patient's symptoms improved.The patient remained hemodynamically stable throughout hospitalization and was discharged home in a clinically stable state.CONCLUSION Pancreatitis should be considered in the differential diagnosis of abdominal pain after upper and lower gastrointestinal endoscopy.展开更多
Objective The aim of this study was to determine the prognostic significance of the C-reactive protein-toalbumin ratio (CRP/Alb) for stage IE/IIE upper aerodigestive tract extranodal NK/T cell lymphoma patients. Metho...Objective The aim of this study was to determine the prognostic significance of the C-reactive protein-toalbumin ratio (CRP/Alb) for stage IE/IIE upper aerodigestive tract extranodal NK/T cell lymphoma patients. Methods One hundred and fourteen patients diagnosed with extranodal NK/T cell lymphoma at Sichuan Cancer Hospital from September 2011 to November 2016 were retrospectively reviewed. An optimal cutoff value of CRP/Alb for overall survival rate as an endpoint was obtained using the receiver operating curve (ROC). Results The optimal cutoff value of CRP/Alb was 0.15. For the low CRP/Alb group, the 3-year progression-free survival (PFS) was 78.6% and the 3-year overall survival (OS) was 80.7%. The 3-year PFS and OS values for the high CRP/Alb group were 41.6% and 45.2%, respectively. Differences for PFS (P < 0.001) and OS (P < 0.001) between the two groups were statistically significant. Univariate analysis showed that ECOG, IPI, CRP, GPS, and CRP/Alb were significantly associated with PFS. Similarly, all five were also significantly associated with OS. Multivariate analysis further confirmed that ECOG and CRP/ Alb were independent prognostic factors for both PFS and OS. Moreover, the cutoff value of CRP/Alb showed superior prognostic ability in discriminating between patients with different outcomes in low-risk group based on GPS, IPI, and KPI scores. Conclusion CRP/Alb is a promising prognostic marker for early-stage extranodal NK/T cell lymphoma.展开更多
A 22-year-old man with a 2-year history of heroin vapor inhalation developed spongiform leukoencephalopathy and underwent clinical and home-based rehabilitative treatments. Activities of daily living were measured usi...A 22-year-old man with a 2-year history of heroin vapor inhalation developed spongiform leukoencephalopathy and underwent clinical and home-based rehabilitative treatments. Activities of daily living were measured using the Functional Independence Measure at discharge and at 6, 12, and 24 months after discharge. His neurological symptoms gradually disappeared with rehabilitative treatment, and the functional scale scores increased from 55 on admission to 105 at 24 months after discharge. These results suggest that home-based rehabilitation was effective in ameliorating the pathology and improving activities of daily living in this patient with heroin-induced spongiform leukoencephalopathy.展开更多
Synthetic studies on 4-demethyl-qinghaosu involving preparation of key intermediateolefin 5 and its photooxygenation were described. Experiment showed that rearrangement product 11was formed predominantly instead of t...Synthetic studies on 4-demethyl-qinghaosu involving preparation of key intermediateolefin 5 and its photooxygenation were described. Experiment showed that rearrangement product 11was formed predominantly instead of the desired allylic peroxide 4 during the photooxygenation.展开更多
BACKGROUND The nonspecific clinical,radiological and pathological characteristics of gastric syphilis can establish it as an imitator of other gastric diseases.The absence of primary or secondary lubricating lesions s...BACKGROUND The nonspecific clinical,radiological and pathological characteristics of gastric syphilis can establish it as an imitator of other gastric diseases.The absence of primary or secondary lubricating lesions should not prevent consideration of gastric syphilis.CASE SUMMARY A 63-year-old female patient presented to the hospital with dull pain in the middle and upper abdomen without apparent cause for one week,which was aggravated for two days.The patient had been sexually active with the same male partner for the past years,but her partner was promiscuous.Abdominal contrastenhanced computed tomography(CT)and positron emission tomography/CT suggested gastric cancer.The gastroscopy revealed an antral gastric ulcer with gastric retention,and also suggested gastric cancer.But no cancer cells were found in the biopsies taken during the two gastroscopies.Treponema pallidum(T.pallidum)antibodies:ELISA positive,rapid plasma reagin titer 1:16.Hematoxylin and eosin(HE)stain showed macrophage infiltration in the lamina propria.Numerous spirochetes were observed by immunohistochemical staining using a monoclonal antibody against T.pallidum.The patient was finally diagnosed with gastric syphilis.CONCLUSION Only a few cases of gastric syphilis have been misdiagnosed as gastric cancer.Penicillin can relieve symptoms of gastric syphilis.展开更多
Carbon fiber-reinforced SiC composites were prepared by precursor pyrolysis-hot pressing (PP-HP) and precursor impreg- nation-pyrolysis (PIP), respectively. The effect of fabrication methods on the microstructure and ...Carbon fiber-reinforced SiC composites were prepared by precursor pyrolysis-hot pressing (PP-HP) and precursor impreg- nation-pyrolysis (PIP), respectively. The effect of fabrication methods on the microstructure and mechanical properties of the compo- sites was investigated. It was found that the composite prepared by PP-HP exhibits a brittle fracture behavior, which is mainly as- cribed to a strongly bonded fiber/matrix interface and the degradation of the fibers caused by a higher processing temperature. On the contrary, the composite prepared by PIP shows a tough fracture behavior, which could be rationalized on the basis of a weakly bonded fiber/matrix interface as well as a higher strength retention of the fibers. As a result, in comparison with the composite pre- pared by PP-HP, the composite prepared by PIP achieves better mechanical properties with a flexural strength of 573.4 MPa and a fracture toughness of 17.2 MPa·m1/2.展开更多
Diabetic foot is one of the chronic complications of diabetes,which is serious and expensive to treat.As an effective method for treating diabetic foot,Chinese medicine plays an important role in improving the clinica...Diabetic foot is one of the chronic complications of diabetes,which is serious and expensive to treat.As an effective method for treating diabetic foot,Chinese medicine plays an important role in improving the clinical symptoms and reducing the suffering of diabetic foot patients.The methods of traditional Chinese medicine to treat diabetic foot include internal treatment method,external treatment method and comprehensive therapy.This article reviews the research results of traditional Chinese medicine treatment of diabetic foot in order to provide reference for the treatment of diabetic foot.展开更多
基金supported by the National Key R&D Program of China,No.2020YFC2004202(to DX).
文摘After stroke,even high-functioning individuals may experience compromised bimanual coordination and fine motor dexterity,leading to reduced functional independence.Bilateral arm training has been proposed as a promising intervention to address these deficits.However,the neural basis of the impairment of functional fine motor skills and their relationship to bimanual coordination performance in stroke patients remains unclear,limiting the development of more targeted interventions.To address this gap,our study employed functional near-infrared spectroscopy to investigate cortical responses in patients after stroke as they perform functional tasks that engage fine motor control and coordination.Twenty-four high-functioning patients with ischemic stroke(7 women,17 men;mean age 64.75±10.84 years)participated in this cross-sectional observational study and completed four subtasks from the Purdue Pegboard Test,which measures unimanual and bimanual finger and hand dexterity.We found significant bilateral activation of the sensorimotor cortices during all Purdue Pegboard Test subtasks,with bimanual tasks inducing higher cortical activation than the assembly subtask.Importantly,patients with better bimanual coordination exhibited lower cortical activation during the other three Purdue Pegboard Test subtasks.Notably,the observed neural response patterns varied depending on the specific subtask.In the unaffected hand task,the differences were primarily observed in the ipsilesional hemisphere.In contrast,the bilateral sensorimotor cortices and the contralesional hemisphere played a more prominent role in the bimanual task and assembly task,respectively.While significant correlations were found between cortical activation and unimanual tasks,no significant correlations were observed with bimanual tasks.This study provides insights into the neural basis of bimanual coordination and fine motor skills in high-functioning patients after stroke,highlighting task-dependent neural responses.The findings also suggest that patients who exhibit better bimanual performance demonstrate more efficient cortical activation.Therefore,incorporating bilateral arm training in post-stroke rehabilitation is important for better outcomes.The combination of functional near-infrared spectroscopy with functional motor paradigms is valuable for assessing skills and developing targeted interventions in stroke rehabilitation.
基金Supported by the Medical Health Science and Technology Project of Zhejiang Provincial Health Commission,No.2020KY1082 and No.2021KY1238.
文摘BACKGROUND Acute appendicitis is the most common abdominal emergency.At present,the main treatments for periappendiceal abscess include antibiotics and surgery.However,the complications and mortality of emergency surgery are high.The preferred therapy is conservative treatment with antibiotics first,ultrasound-guided puncture drainage or surgical treatment is followed when necessary.Endoscopic retrograde appendicitis therapy(ERAT)for acute uncomplicated appendicitis have been proved clinically effective,but it is rarely used in periap-pendiceal abscess.CASE SUMMARY We report a patient admitted to hospital because of“right lower abdominal pain for six days”.The computerized tomography(CT)of patient showed that appendicitis with fecaliths and abscess in the pelvis.The patient was treated by CT-guided puncture and drainage of abdominal abscess combined with ERAT to remove appendiceal fecaliths,irrigation and stent placement.CONCLUSION The patient did not receive surgery because of impoverished family.Abdominal pain did not recur during the follow-up period.This case confirms the value of ERAT in the treatment of periappendiceal abscess.
基金Supported by Sichuan Science and Technology Project,No.2021YJ0138Research Subject of Sichuan Provincial Health Commission,No.19PJ007Chengdu Science and Technology Project,No.2021-YF05-01788-SN.
文摘BACKGROUND Although the past decade has seen remarkable advances in treatment options for hepatocellular carcinoma(HCC),the dismal overall prognosis still envelops HCC patients.Several comparative trials have been conducted to study whether transarterial chemoembolization(TACE)could improve clinical outcomes in patients receiving sorafenib for advanced HCC;however,the findings have been inconsistent.AIM To study the potential synergies and safety of sorafenib plus TACE vs sorafenib alone for treating advanced HCC,by performing a systematic review and metaanalysis.METHODS This study was conducted following the PRISMA statement.A systematic literature search was conducted using the Cochrane Library,Embase,PubMed,and Web of Science databases.Data included in the present work were collected from patients diagnosed with advanced HCC receiving sorafenib plus TACE or sorafenib alone.Data synthesis and meta-analysis were conducted using Review Manager software.RESULTS The present study included 2780 patients from five comparative clinical trials(1 was randomized control trial and 4 were retrospective studies).It was found that patients receiving sorafenib plus TACE had better prognoses in terms of overall survival(OS),with a combined hazard ratio(HR)of 0.65[95%confidence interval(95%CI):0.46–0.93,P=0.02,n=2780].Consistently,progression free survival(PFS)and time to progression(TTP)differed significantly between the sorafenib plus TACE arm and sorafenib arm(PFS:HR=0.62,95%CI:0.40–0.96,P=0.03,n=443;TTP:HR=0.73,95%CI:0.64-0.83,P<0.00001,n=2451).Disease control rate(DCR)was also significantly increased by combination therapy(risk ratio=1.36,95%CI:1.02-1.81,P=0.04,n=641).Regarding safety,the incidence of any adverse event(AE)was increased due to the addition of TACE;however,no significant difference was found in grade≥3 AEs.CONCLUSION The combination of sorafenib with TACE has superior efficacy to sorafenib monotherapy,as evidenced by prolonged OS,PFS,and TTP,as well as increased DCR.Additional high-quality trials are essential to further validate the clinical benefit of this combination in the treatment of advanced HCC.
基金supported by the National Natural Science Foundation of China(Nos.11175164 and 91326109)
文摘In this paper, we build on the concept of equivalent fundamental-mode source to propose using delayed neutrons as a neutron source in multiplication experiments to acquire the effective multiplication factor keffof subcritical systems, which is difficult to acquire directly from conventional neutron source multiplication method. We analyzed the difference between a fundamental-mode fission source and delayed neutron source,then adopted a factor to convert delayed neutron distribution to an equivalent fundamental-mode source distribution, and employed Monte Carlo code to acquire this factor.The delayed neutron multiplication measurement method was established for the first time, and corresponding experiments were conducted in subcritical systems. The multiplication of delayed neutrons was measured based on Chinese Fast Burst Reactor-Ⅱ(CFBR-Ⅱ) at subcritical states, and keffwas acquired from delayed neutron multiplication successfully(0.9921 and 0.9969, respectively).The relative difference between k_(eff)obtained by the new method and previous values acquired by the positive period method is less than 1% for these two studied cases.
基金supported by the Open Fund for Sanjiang Key Laboratory of Mineralization and Resource Exploration and Utilization,Ministry of Natural Resources(ZRZYBSJSYS2021002)Yunnan Major Scientific and Technological Projects(Grant No.202202AG050006)+2 种基金the National Natural Science Foundation of China(No.41772070)supported by the National Research Center of Geoanalysis(NRCG)Chinese Academy of Geological Sciences(CAGS)。
文摘The Late Paleozoic and Mesozoic tectonic framework of the Nanpanjiang Basin has much been disputed.Herein,the middle-acid volcanic rock,dacite,exposed to the Zhesang gold district,southeast Yunnan Province,has been analyzed.The results show that the dacite belongs to a calc-alkaline series,SiO_(2)contents range from 62.79 to 76.66 wt%.Zircon SHRIMP U–Pb dating of dacite demonstrates that they were formed in the Early Triassic(247.8±1.7 Ma,MSWD=1.2).All samples exhibit enrichment in LILE(e.g.Rb,K,Th,and U),and depletion in HFSE(e.g.Nb,Ta,and Ti),which has the geochemical affinity of I-type granite.La–La/Sm and La–La/Yb discrimination diagrams show that the partial melting,mainly of the mafic lower crust,of rocks,plays a major role in the formation process.The dacite has low initial ^(87)Sr/^(86)Sr ratios(0.706954 to 0.708589)and negative ε_(Nd)(t)values(-11.77 to-10.88).Zircons in dacite have ε_(Hf)(t)values of-16.2 to-8.3,and the two-stage Hf model ages are 1799–2301 Ma,mostly concentrated between 1800 and 1900 Ma,indicating that the magma source area is the reconstructed ancient lower crust mixed with some mantle materials,and crystal fractionation process underwent in the late stage of magma migration.This study reveals that the arc-volcanic rocks of the Early Triassic in the southern margin of the Nanpanjiang Basin were formed by the subduction of the Late Paleozoic ocean basin within the border region between China and Vietnam.
基金Supported by Zhejiang Province Administration Foundation of Traditional Chinese Medicine,No.2020ZB305。
文摘BACKGROUND A foreign body in the digestive tract is a common disease in the clinic.However,it is rare for a foreign body to migrate into the liver.Most patients are diagnosed before or after perforation of the digestive tract.Laparoscopic removal of intrahepatic foreign bodies is an effective treatment method.CASE SUMMARY A 55-year-old male patient was admitted to the hospital due to fever for 3 d,in addition to pain and discomfort in the right side of his waist.After admission,abdominal computed tomography showed a foreign body in the liver,and gastroscopy did not indicate obvious erosion or ulcers.The patient then underwent laparoscopic surgery.During the operation,an abscess was seen near the gastric antrum and between the caudate lobes of the liver.It was approximately 30 mm×31 mm×23 mm in size.The abscess was cut open,and a fish bone was found inside.The fish bone had penetrated the liver and was successfully removed.It was confirmed that the fish bone migrated from the stomach to the liver.CONCLUSION Although intrahepatic foreign bodies are rare,they should be diagnosed and treated as early as possible to avoid serious complications such as intrahepatic abscess,which may lead to liver resection and even life-threatening events.
基金Supported by the Medical Health Science and Technology Project of Zhejiang Provincial Health Commission,No.2020KY1082and No.2021KY1238。
文摘BACKGROUND Pseudoaneurysms of the hepatic artery or its branches have been reported following abdominal trauma,iatrogenic injury at the time of many operations such as percutaneous transhepatic biliary drainage and cholecystectomy.Hepatic artery pseudoaneurysms after endoscopic retrograde cholangiopancreatography(ERCP)are uncommon and potentially life threatening and should be identified and treated rapidly.CASE SUMMARY We report a case of intra-abdominal hemorrhage secondary to a left hepatic artery pseudoaneurysm resulting from guide wire injury at ERCP.The patient primary diagnosis was acute biliary pancreatitis with cholangitis,he underwent ERCP on the third day of admission.During ERCP,the left intrahepatic bile duct was cannulated three times.Over the sixth day,Contrast enhanced computed tomography scan demonstrated left hepatic lobe contusion and a pseudoaneurysm formation.The patient was successfully treated with the embolization of a small branch of left hepatic artery angiographically.CONCLUSION The common complications of ERCP are pancreatitis,bleeding and perforation.False aneurysms occur as a result of damage to the wall of an artery.As far as we know,it is rare complication has been reported following ERCP.We advise urgent referral for angiographic embolization in this situation to avoid aneurysm rupture.
文摘In this paper,a finite element method(FEM)-based multi-phase problem based on a newly proposed thermal elastoplastic constitutive model for saturated/unsaturated geomaterial is discussed.A program of FEM named as SOFT,adopting unified field equations for thermo-hydro-mechanical-air(THMA)behavior of geomaterial and using finite element-finite difference(FE-FD) scheme for soil-water-air three-phase coupling problem,is used in the numerical simulation.As an application of the newly proposed numerical method,two engineering problems,one for slope failure in unsaturated model ground and another for in situ heating test related to deep geological repository of high-level radioactive waste(HLRW),are simulated.The model tests on slope failure in unsaturated Shirasu ground,carried out by Kitamura et al.(2007),is simulated in the framework of soil-water-air three-phase coupling under the condition of constant temperature.While the in situ heating test reported by Munoz(2006) is simulated in the same framework under the conditions of variable temperature but constant air pressure.
文摘BACKGROUND Gastroesophageal varices are a rare complication of essential thrombocythemia(ET).ET is a chronic myeloproliferative neoplasm(MPN)characterized by an increased number of blood platelets.CASE SUMMARY A 46-year-old woman,who denied a history of liver disease,was admitted to our hospital on presentation of hematemesis.Laboratory examination revealed a hemoglobin level of 83 g/L,and a platelet count of 397×109/L.The appearance of gastric and esophageal varices with red colored signs as displayed by an urgent endoscopy was followed by endoscopic variceal ligation and endoscopic tissue adhesive.Abdominal computed tomography revealed cirrhosis,marked splenomegaly,portal vein thrombosis and portal hypertension.In addition,bone marrow biopsy and evidence of mutated Janus kinase 2,substantiated the onset of ET.The patient was asymptomatic with regular routine blood testing during the 6-mo follow-up period.Therefore,in this case,gastroesophageal varices were induced by ET.CONCLUSION MPN should be given considerable attention when performing differential diagnoses in patients with gastroesophageal varices.An integrated approach such as laboratory tests,radiological examination,and pathological biopsy,should be included to allow optimal decisions and management.
基金Supported by Medical Health Science and Technology Project of Zhejiang Provincial Health Commission,No.2020ZH080the Medical and Health Care Project of Lishui,No.2021SJZC059.
文摘BACKGROUND Acute pancreatitis is an uncommon complication of gastrointestinal endoscopy,especially if the patient has none of the common risk factors associated with pancreatitis;such as alcoholism,gallstones,hypertriglyceridemia,hypercalcemia or the use of certain drugs.CASE SUMMARY A 56-year-old female patient developed abdominal pain immediately after the completion of an upper gastrointestinal endoscopy.The pain was predominantly in the upper and middle abdomen and was persistent and severe.The patient was diagnosed with acute pancreatitis.Treatment included complete fasting,octreotide injection prepared in a prefilled syringe to inhibit pancreatic enzymes secretion,ulinastatin injection to inhibit pancreatic enzymes activity,esomeprazole for gastric acid suppression,fluid replacement and nutritional support.Over the next 3 d,the patient's symptoms improved.The patient remained hemodynamically stable throughout hospitalization and was discharged home in a clinically stable state.CONCLUSION Pancreatitis should be considered in the differential diagnosis of abdominal pain after upper and lower gastrointestinal endoscopy.
基金Supported by a grant from the Sichuan Health and Family Planning Commission(No.16PJ041)
文摘Objective The aim of this study was to determine the prognostic significance of the C-reactive protein-toalbumin ratio (CRP/Alb) for stage IE/IIE upper aerodigestive tract extranodal NK/T cell lymphoma patients. Methods One hundred and fourteen patients diagnosed with extranodal NK/T cell lymphoma at Sichuan Cancer Hospital from September 2011 to November 2016 were retrospectively reviewed. An optimal cutoff value of CRP/Alb for overall survival rate as an endpoint was obtained using the receiver operating curve (ROC). Results The optimal cutoff value of CRP/Alb was 0.15. For the low CRP/Alb group, the 3-year progression-free survival (PFS) was 78.6% and the 3-year overall survival (OS) was 80.7%. The 3-year PFS and OS values for the high CRP/Alb group were 41.6% and 45.2%, respectively. Differences for PFS (P < 0.001) and OS (P < 0.001) between the two groups were statistically significant. Univariate analysis showed that ECOG, IPI, CRP, GPS, and CRP/Alb were significantly associated with PFS. Similarly, all five were also significantly associated with OS. Multivariate analysis further confirmed that ECOG and CRP/ Alb were independent prognostic factors for both PFS and OS. Moreover, the cutoff value of CRP/Alb showed superior prognostic ability in discriminating between patients with different outcomes in low-risk group based on GPS, IPI, and KPI scores. Conclusion CRP/Alb is a promising prognostic marker for early-stage extranodal NK/T cell lymphoma.
基金supported by Project of Science and Technology Department of Hunan Province, No. 2009SK3171
文摘A 22-year-old man with a 2-year history of heroin vapor inhalation developed spongiform leukoencephalopathy and underwent clinical and home-based rehabilitative treatments. Activities of daily living were measured using the Functional Independence Measure at discharge and at 6, 12, and 24 months after discharge. His neurological symptoms gradually disappeared with rehabilitative treatment, and the functional scale scores increased from 55 on admission to 105 at 24 months after discharge. These results suggest that home-based rehabilitation was effective in ameliorating the pathology and improving activities of daily living in this patient with heroin-induced spongiform leukoencephalopathy.
文摘Synthetic studies on 4-demethyl-qinghaosu involving preparation of key intermediateolefin 5 and its photooxygenation were described. Experiment showed that rearrangement product 11was formed predominantly instead of the desired allylic peroxide 4 during the photooxygenation.
基金the Medical Health Science and Technology Project of Zhejiang Provincial Health Commission,No.2020ZH080.
文摘BACKGROUND The nonspecific clinical,radiological and pathological characteristics of gastric syphilis can establish it as an imitator of other gastric diseases.The absence of primary or secondary lubricating lesions should not prevent consideration of gastric syphilis.CASE SUMMARY A 63-year-old female patient presented to the hospital with dull pain in the middle and upper abdomen without apparent cause for one week,which was aggravated for two days.The patient had been sexually active with the same male partner for the past years,but her partner was promiscuous.Abdominal contrastenhanced computed tomography(CT)and positron emission tomography/CT suggested gastric cancer.The gastroscopy revealed an antral gastric ulcer with gastric retention,and also suggested gastric cancer.But no cancer cells were found in the biopsies taken during the two gastroscopies.Treponema pallidum(T.pallidum)antibodies:ELISA positive,rapid plasma reagin titer 1:16.Hematoxylin and eosin(HE)stain showed macrophage infiltration in the lamina propria.Numerous spirochetes were observed by immunohistochemical staining using a monoclonal antibody against T.pallidum.The patient was finally diagnosed with gastric syphilis.CONCLUSION Only a few cases of gastric syphilis have been misdiagnosed as gastric cancer.Penicillin can relieve symptoms of gastric syphilis.
基金This research was financially supported by the National Natural Science Foundation of China (No. 50404012)
文摘Carbon fiber-reinforced SiC composites were prepared by precursor pyrolysis-hot pressing (PP-HP) and precursor impreg- nation-pyrolysis (PIP), respectively. The effect of fabrication methods on the microstructure and mechanical properties of the compo- sites was investigated. It was found that the composite prepared by PP-HP exhibits a brittle fracture behavior, which is mainly as- cribed to a strongly bonded fiber/matrix interface and the degradation of the fibers caused by a higher processing temperature. On the contrary, the composite prepared by PIP shows a tough fracture behavior, which could be rationalized on the basis of a weakly bonded fiber/matrix interface as well as a higher strength retention of the fibers. As a result, in comparison with the composite pre- pared by PP-HP, the composite prepared by PIP achieves better mechanical properties with a flexural strength of 573.4 MPa and a fracture toughness of 17.2 MPa·m1/2.
基金Natural science foundation project of Hebei province(No.H2019209565)Scientific research project of Hebei administration of traditional Chinese medicine(No.2018167)Scientific research project of north China university of science and technology.Chinese and western medicine for knee osteoarthritis.
文摘Diabetic foot is one of the chronic complications of diabetes,which is serious and expensive to treat.As an effective method for treating diabetic foot,Chinese medicine plays an important role in improving the clinical symptoms and reducing the suffering of diabetic foot patients.The methods of traditional Chinese medicine to treat diabetic foot include internal treatment method,external treatment method and comprehensive therapy.This article reviews the research results of traditional Chinese medicine treatment of diabetic foot in order to provide reference for the treatment of diabetic foot.
