Vitiligo has a significant impact on a substantial number of individuals worldwide.Traditional Chinese medicine has a long history of serving as a therapeutic treatment for vitiligo.Nevertheless,given the increasing v...Vitiligo has a significant impact on a substantial number of individuals worldwide.Traditional Chinese medicine has a long history of serving as a therapeutic treatment for vitiligo.Nevertheless,given the increasing volume of research on the utilization of traditional Chinese medicine for vitiligo treatment,it is imperative to conduct a comprehensive review that elucidates the efficacy of Chinese traditional medicine and other active ingredients in the treatment of vitiligo.This paper presents a comprehensive overview of the clinical preparations used to treat vitiligo,while also highlighting the potential monomers and extracts derived from traditional Chinese medicine for vitiligo treatment.A thorough analysis of the pharmacological effects of traditional Chinese medicine on vitiligo treatment will provide valuable insights and reliable information for the development of new treatment strategies.展开更多
OBJECTIVE To investigate the optimal duration of dual antiplatelet therapy(DAPT)in patients with diabetes mellitus(DM)requiring complex percutaneous coronary intervention(PCI).METHODS A total of 2403 patients with DM ...OBJECTIVE To investigate the optimal duration of dual antiplatelet therapy(DAPT)in patients with diabetes mellitus(DM)requiring complex percutaneous coronary intervention(PCI).METHODS A total of 2403 patients with DM who underwent complex PCI from January to December 2013 were consecutively enrolled in this observational cohort study and divided according to DAPT duration into a standard group(11-13 months,n=689)and two prolonged groups(13-24 months,n=1133;>24 months,n=581).RESULTS Baseline characteristics,angiographic findings,and complexity of PCI were comparable regardless of DAPT duration.The incidence of major adverse cardiac and cerebrovascular event was lower when DAPT was 13-24 months than when it was 11-13 months or>24 months(4.6%vs.8.1%vs.6.0%,P=0.008),as was the incidence of all-cause death(1.9%vs.4.6%vs.2.2%,P=0.002)and cardiac death(1.0%vs.3.0%vs.1.2%,P=0.002).After adjustment for confounders,DAPT for 13-24 months was associated with a lower risk of major adverse cardiac and cerebrovascular event[hazard ratio(HR)=0.544,95%CI:0.373-0.795]and all-cause death(HR=0.605,95%CI:0.387-0.944).DAPT for>24 months was associated with a lower risk of all-cause death(HR=0.681,95%CI:0.493-0.942)and cardiac death(HR=0.620,95%CI:0.403-0.952).The risk of major bleeding was not increased by prolonging DAPT to 13-24 months(HR=1.356,95%CI:0.766-2.401)or>24 months(HR=0.967,95%CI:0.682-1.371).CONCLUSIONS For patients with DM undergoing complex PCI,prolonging DAPT might improve the long-term prognosis by reducing the risk of adverse ischemic events without increasing the bleeding risk.展开更多
Ischemic accumulation of succinate causes cerebral damage by excess production of reactive oxygen species. However, it is unknown whether ischemic accumulation of succinate affects neural stem cell proliferation. In t...Ischemic accumulation of succinate causes cerebral damage by excess production of reactive oxygen species. However, it is unknown whether ischemic accumulation of succinate affects neural stem cell proliferation. In this study, we established a rat model of cerebral ischemia/reperfusion injury by occlusion of the middle cerebral artery. We found that succinate levels increased in serum and brain tissue(cortex and hippocampus) after ischemia/reperfusion injury. Oxygen-glucose deprivation and reoxygenation stimulated primary neural stem cells to produce abundant succinate. Succinate can be converted into diethyl succinate in cells. Exogenous diethyl succinate inhibited the proliferation of mouse-derived C17.2 neural stem cells and increased the infarct volume in the rat model of cerebral ischemia/reperfusion injury. Exogenous diethyl succinate also increased the succinylation of the Rho family GTPase Cdc42 but repressed Cdc42 GTPase activity in C17.2 cells. Increasing Cdc42 succinylation by knockdown of the desuccinylase Sirt5 also inhibited Cdc42 GTPase activity in C17.2 cells. Our findings suggest that ischemic accumulation of succinate decreases Cdc42 GTPase activity by induction of Cdc42 succinylation, which inhibits the proliferation of neural stem cells and aggravates cerebral ischemia/reperfusion injury.展开更多
BACKGROUND Heart failure(HF)often affects the progress of sepsis patients,although its impact on outcomes is inconsistent and inconclusive.AIM To conduct a systematic review and meta-analysis of the impact of HF on mo...BACKGROUND Heart failure(HF)often affects the progress of sepsis patients,although its impact on outcomes is inconsistent and inconclusive.AIM To conduct a systematic review and meta-analysis of the impact of HF on mortality in patients with sepsis.METHODS PubMed,Embase,Web of Science,and the Cochrane Library databases were searched to compare the outcomes of sepsis patients with HF.A random effect model was used to summarize the mortality data,and the odds ratio(OR)and 95%confidence interval(CI)were calculated as effect indicators.RESULTS Among 18001 records retrieved in the literature search,35712 patients from 10 separate studies were included.The results showed that sepsis patients with HF were associated with increased total mortality(OR=1.80,95%CI:1.34-2.43;I2=92.1%),with high heterogeneity between studies.Significant subgroup differences according to age,geographical location,and HF patient sample were observed.HF did not increase the 1-year mortality of patients(OR=1.11,95%CI:0.75-1.62;I2=93.2%),and the mortality of patients with isolated right ventricular dysfunction(OR=2.32,95%CI:1.29-4.14;I2=91.5%)increased significantly.CONCLUSION In patients with sepsis,HF is often associated with adverse outcomes and mortality.Our results call for more high-quality research and strategies to improve outcomes for sepsis patients with HF.展开更多
BACKGROUND:To investigate the most appropriate dual antiplatelet therapy(DAPT)duration for patients with acute coronary syndrome(ACS)after drug-eluting stent(DES)implantation in the largest cardiovascular center of Ch...BACKGROUND:To investigate the most appropriate dual antiplatelet therapy(DAPT)duration for patients with acute coronary syndrome(ACS)after drug-eluting stent(DES)implantation in the largest cardiovascular center of China.METHODS:We enrolled 5,187 consecutive patients with ACS who received DES from January to December 2013.Patients were divided into four groups based on DAPT duration:standard DAPT group(11-13 months,n=1,568)and prolonged DAPT groups(13-18 months[n=308],18-24 months[n=2,125],and>24 months[n=1,186]).Baseline characteristics and 5-year clinical outcomes were recorded.RESULTS:Baseline characteristics were similar across the four groups.Among the four groups,those with prolonged DAPT(18-24 months)had the lowest incidence of major adverse cardiovascular and cerebrovascular events(MACCEs)(14.1%vs.11.7%vs.9.6%vs.24.2%,P<0.001),all-cause death(4.8%vs.3.9%vs.2.1%vs.2.6%,P<0.001),cardiac death(3.1%vs.2.6%vs.1.4%vs.1.9%,P=0.004),and myocardial infarction(MI)(3.8%vs.4.2%vs.2.5%vs.5.8%,P<0.001).The incidence of bleeding was not different among the four groups(9.9%vs.9.4%vs.11.0%vs.9.4%,P=0.449).Cox multivariable analysis showed that prolonged DAPT(18-24 months)was an independent protective factor for MACCEs(hazard ratio[HR]0.802,95%confidence interval[CI]0.729-0.882,P<0.001),all-cause death(HR 0.660,95%CI 0.547-0.795,P<0.001),cardiac death(HR 0.663,95%CI 0.526-0.835,P<0.001),MI(HR 0.796,95%CI 0.662-0.957,P=0.015),and target vessel revascularization(HR 0.867,95%CI 0.755-0.996,P=0.044).Subgroup analysis for high bleeding risk showed that prolonged DAPT remained an independent protective factor for all-cause death and MACCEs.CONCLUSION:For patients with ACS after DES,appropriately prolonging the DAPT duration may be associated with a reduced risk of adverse ischemic events without increasing the bleeding risk.展开更多
Tissue engineering is an interdisciplinary field of bioengineering,cell biology,and biomaterials that seeks to create functional tissues for therapeutic purposes.It is a rapidly growing field of regenerative medicine ...Tissue engineering is an interdisciplinary field of bioengineering,cell biology,and biomaterials that seeks to create functional tissues for therapeutic purposes.It is a rapidly growing field of regenerative medicine that has the potential to revolutionize the treatment for many diseases and injuries.General research areas mainly include the engineering of the cardiovascular system,bone and cartilage,oral cavity and skin,and other tissues[1].Skin tissue engineering is one of the earliest clinically applied,most mature and widely used products in the field of tissue engineering[2].展开更多
Perivascular epithelioid cell tumor(PEComa) of the pancreas is an unusual tumor deriving from mesenchyma. This paper described a case of pancreatic PEComa, which was initially suspected as neuroendocrine carcinoma by ...Perivascular epithelioid cell tumor(PEComa) of the pancreas is an unusual tumor deriving from mesenchyma. This paper described a case of pancreatic PEComa, which was initially suspected as neuroendocrine carcinoma by biopsy, and therefore surgical treatment was recommended due to undetermined diagnosis. Examination of the surgical specimen under a microscope showed that the tumor cell's morphology was epithelioid or spindle-shaped, and ranged in a nested pattern. Additionally, these cells had a large extent of acidophilic cytoplasm, no mitotic figures, and expressed HMB-45, melan-p, and smooth muscle actin immunohistochemically. Pathological examination indicated that PEComa originated from the pancreas, but symptoms related to tuberous sclerosis were absent. Since PEComa is extremely rare in the pancreas, it is likely to be ignored in differential diagnosis. In conclusion, our article highlighted the clinicopathological features of PEComa, and we conducted a literature review focusing on PEComa so as to deepen the understanding of this tumor type.展开更多
A series of Bi2 S3-BiOCI composites with two-dimensional(2 D) square-like structures were prepared via a two-step anion exchange route.X-ray diffraction(XRD), scanning electron microscopy(SEM), transmission electron m...A series of Bi2 S3-BiOCI composites with two-dimensional(2 D) square-like structures were prepared via a two-step anion exchange route.X-ray diffraction(XRD), scanning electron microscopy(SEM), transmission electron microscopy(TEM), and diffuse reflectance spectra(DRS)were used to investigate the properties of the as-prepared Bi_2 S_3-BiOCI heterostructures. The coupling of BiOCl and Bi_2 S_3 induced enhanced photoabsorption efficiency and bandgap narrowing. A reactive brilliant red X-3 B dye was used as a contaminant to test the photocatalytic activity of the obtained Bi_2 S_3-BiOCl samples under visible light irradiation. The sample Bi_2 S_3-BiOCl with a mass ratio of 8:4 exhibited the highest photodegradation efficiency, which was six times higher than that of pure BiOCl. In addition, a mechanism for the enhancement of photocatalytic activity is proposed.展开更多
BACKGROUND: We aim to investigate effects of metabolic syndrome on onset age and long-termoutcomes in patients with acute coronary syndrome (ACS).METHODS: Patients with ACS (n=6,431) who underwent percutaneous coronar...BACKGROUND: We aim to investigate effects of metabolic syndrome on onset age and long-termoutcomes in patients with acute coronary syndrome (ACS).METHODS: Patients with ACS (n=6,431) who underwent percutaneous coronary interventionfrom January to December 2013 were enrolled. After excluding patients with previous coronary arterydisease, 1,558 patients were diagnosed with early-onset ACS (men aged ≤50 years;women aged≤60 years) and 3,044 patients with late-onset ACS. Baseline characteristics and five-year clinicaloutcomes were measured.RESULTS: Body mass index, triglyceride, low-density lipoprotein cholesterol, and uric acidconcentrations were significantly higher, while the high-density lipoprotein cholesterol (HDL-C)concentration was lower in the early-onset ACS group (P<0.001). Multivariate logistic regression revealedobesity (odds ratio [OR] 1.590, 95% confi dence interval [CI] 1.345–1.881), hypertriglyceridemia (OR 1.403,95% CI 1.185–1.660), and low HDL-C (OR 1.464, 95% CI 1.231–1.742) as independent risk factorsfor early-onset ACS (all P<0.001). The fi ve-year follow-up showed that the incidences of all cause death(1.5% vs. 3.8%, P<0.001), cardiac death (1.1% vs. 2.0%, P=0.023), and recurrent stroke (2.2% vs. 4.2%,P<0.001) were lower, while bleeding events were more frequent in the early-onset ACS group. A subgroupanalysis showed higher incidences of recurrent myocardial infarction (MI) and revascularization in patientswith early-onset ACS and metabolic syndrome.CONCLUSIONS: Obesity, hypertriglyceridemia, and lower HDL-C level are independent riskfactors for early-onset ACS, recurrent MI, and revascularization. The control of metabolic syndromemay reduce the incidence of early-onset ACS and improve the long-term prognosis.展开更多
We review the experimental and computational data about the propagation of neural signals in myelinated axons in mice,cats,rabbits,and frogs published in the past five decades.In contrast to the natural assumption tha...We review the experimental and computational data about the propagation of neural signals in myelinated axons in mice,cats,rabbits,and frogs published in the past five decades.In contrast to the natural assumption that neural signals occur one by one in time and in space,we figure out that neural signals are highly overlapped in time between neighboring nodes.This phenomenon was occasionally illustrated in some early reports,but seemed to have been overlooked for some time.The shift in time between two successive neural signals from neighboring nodes,defined as relay timeτ,was calculated to be only 16.3μs-87.0μs,i.e.,0.8%-4.4%of the average duration of an action potential peak(roughly 2 ms).We present a clearer picture of the exact physical process about how the information transmits along a myelinated axon,rather than a whole action potential peak,what is transmitted is only a rising electric field caused by transmembrane ion flows.Here in the paper,τrepresents the waiting time until the neighboring node senses an attenuated electric field reaching the threshold to trigger the open state.The mechanisms addressed in this work have the potential to be universal,and may hold clues to revealing the exact triggering processes of voltage-gated ion channels and various brain functions.展开更多
AIM: To explore a more accurate quantifying diagnosis method of diabetic macular edema(DME) by displaying detailed 3D morphometry beyond the gold-standard quantification indicator-central retinal thickness(CRT) and ap...AIM: To explore a more accurate quantifying diagnosis method of diabetic macular edema(DME) by displaying detailed 3D morphometry beyond the gold-standard quantification indicator-central retinal thickness(CRT) and apply it in follow-up of DME patients.METHODS: Optical coherence tomography(OCT) scans of 229 eyes from 160 patients were collected.We manually annotated cystoid macular edema(CME), subretinal fluid(SRF) and fovea as ground truths.Deep convolution neural networks(DCNNs) were constructed including U-Net, sASPP, HRNetV2-W48, and HRNetV2-W48+Object-Contextual Representation(OCR) for fluid(CME+SRF) segmentation and fovea detection respectively, based on which the thickness maps of CME, SRF and retina were generated and divided by Early Treatment Diabetic Retinopathy Study(ETDRS) grid.RESULTS: In fluid segmentation, with the best DCNN constructed and loss function, the dice similarity coefficients(DSC) of segmentation reached 0.78(CME), 0.82(SRF), and 0.95(retina).In fovea detection, the average deviation between the predicted fovea and the ground truth reached 145.7±117.8 μm.The generated macular edema thickness maps are able to discover center-involved DME by intuitive morphometry and fluid volume, which is ignored by the traditional definition of CRT>250 μm.Thickness maps could also help to discover fluid above or below the fovea center ignored or underestimated by a single OCT B-scan.CONCLUSION: Compared to the traditional unidimensional indicator-CRT, 3D macular edema thickness maps are able to display more intuitive morphometry and detailed statistics of DME, supporting more accurate diagnoses and follow-up of DME patients.展开更多
OBJECTIVE To determine whether high-risk patients with three-vessel disease(TVD)with and without prior stroke preferen-tially benefit from three strategies[percutaneous coronary intervention(PCI),coronary artery bypas...OBJECTIVE To determine whether high-risk patients with three-vessel disease(TVD)with and without prior stroke preferen-tially benefit from three strategies[percutaneous coronary intervention(PCI),coronary artery bypass grafting(CABG)and medical therapy(MT)].METHODS A total of 8943 patients with TVD were included in the study.Patients enrolled were stratified into two categories according to the presence or absence of prior stroke history.The primary endpoint was all-cause death.Secondary endpoints in-cluded stroke and major adverse cardiac and cerebrovascular event(MACCE),a composite of death,myocardial infarction(MI),unplanned revascularization and stroke.RESULTS Prior stroke was present in 888 patients(9.9%).These patients were older and had higher rates of comorbidities.Du-ring a median follow-up of 7.5 years,patients with prior stroke were strongly associated with increased risks of all-cause death,cardiac death,stroke and MACCE,even after adjusting for confounding variables and results been consistent across either treat-ment subgroup(PCI,CABG and MT)(all adjusted P<0.01).Notably,there was a significant interaction between prior stroke his-tory and treatment strategies.Revascularization strategy(PCI or CABG)was associated with a lower incidence of all-cause death and MACCE compared with MT alone,and favorable rates of MACCE,MI and unplanned revascularization in the CABG group compared with the PCI group,but with similar rate of all-cause death regardless of prior stroke history.The prevalence of stroke was significantly higher after CABG when compared with PCI or MT in no prior stroke patients[hazard ratio(HR)=1.429,95%CI:1.132-1.805 for CABG vs.MT;HR=1.703,95%CI:1.371-2.116 for CABG vs.PCI].CONCLUSIONS Patients with TVD and prior stroke have poor clinical outcomes.It is essential to balance benefit and risk when determining the optimal treatment strategy for TVD with and without prior stroke.展开更多
Background:It is currently unclear if fibrinogen is a risk factor for adverse events in patients receiving percutaneous coronary intervention(PCI)or merely serves as a marker of pre-existing comorbidities and other ca...Background:It is currently unclear if fibrinogen is a risk factor for adverse events in patients receiving percutaneous coronary intervention(PCI)or merely serves as a marker of pre-existing comorbidities and other causal factors.We therefore investigated the association between fibrinogen levels and 2-year all-cause mortality,and compared the additional predictive value of adding fibrinogen to a basic model including traditional risk factors in patients receiving contemporary PCI.Methods:A total of 6293 patients undergoing PCI with measured baseline fibrinogen levels were enrolied from January to December 2013 in Fuwai Hospital.Patients were divided into three groups according to tertiles of baseline fibrinogen levels:low fibrinogen,<2.98 g/L;medium fibrinogen,2.98 to 3.58 g/L;and high fibrinogen,≥3.58 g/L.Independent predictors of 2-year clinical outcomes were determined by multivariate Cox proportional hazards regression modeling.The increased discriminative value of fibrinogen for predicting all-cause mortality was assessed using the C-statistic and integrated discrimination improvement(IDI).Results:The 2-year all-cause mortality rate was 1.2%.It was significantly higher in the high fibrinogen compared with the low and medium fibrinogen groups according to Kaplan-Meier analyses(1.7%vs.0.9%and 1.7%vs.1.0%,respectively;log-rank,P=0.022).Fibrinogen was significantly associated with all-cause mortality according to multivariate Cox regression(hazard ratio 1.339,95%confidence interval:1.109-1.763,P=0.005),together with traditional risk factors including age,sex,diabetes mellitus,left ventricular ejection fraction,creatinine clearance,and low-density lipoprotein cholesterol.The area under the curve for all-cause mortality in the basic model including traditional risk factors was 0.776,and this value increased to 0.787 when fibrinogen was added to the model(IDI=0.003,Z=0.140,P=0.889).Conclusions:Fibrinogen is associated with 2-year all-cause mortality in patients receiving PCI,but provides no additional information over a model including traditional risk factors.展开更多
Background:The patterns of nonadherence to antiplatelet regimen in stented patients (PARIS)thrombotic risk score are a novel score for predicting the risk of coronary thrombotic events (CTEs)after percutaneous coronar...Background:The patterns of nonadherence to antiplatelet regimen in stented patients (PARIS)thrombotic risk score are a novel score for predicting the risk of coronary thrombotic events (CTEs)after percutaneous coronary intervention (PCI)with drug-eluting stents. However,the prognostic value of this score has not been fully evaluated in non-Euro-American PCI populations. Methods:We performed a prospective,observational study of 10,724 patients who underwent PCI in Fuwai hospital,China and evaluated the PARIS thrombotic risk score's predictive value of CTEs in the PCI population.The area under the receiver operating characteristic curve (AUROC)was used to assess the predictive value of the PARIS score for CTE. Results:Among 9782 patients without in-hospital events,a total of 95 CTEs occurred during the 2-year follow-up.The PARIS score was significantly higher in patients with CTEs (3.384-2.04)compared with patients without events (2.53±1.70,P <0.001). According to the risk stratification of the PARIS thrombotic score,the risk of CTEs in the high-risk group was 3.14 times higher than that in the low-risk group (hazard ratio [HR],3.14;95% confidence interval [CI],1.92-5.13;P <0.001).However,the risk of CTEs in the intermediate-risk and low-risk groups was not significant (HR,1.39;95% CI,[0.86-2.24];P =0.184).The PARIS score showed prognostic value in evaluating CTEs in the overall population (AUROC,0.621;95% CI,0.561-0.681),the acute coronary syndrome (ACS)population (AUROC,0.617;95% CI,0.534-0.700;P =0.003),and the non-ACS population (AUROC,0.647;95% CI,0.558-0.736;P =0.001). Conclusions:In a real-world Chinese population,the PARIS thrombotic risk score shows a modest prognostic value for CTEs in patients after PCI.This score also has a predictive value for CTEs in the ACS and non-ACS subgroup populations.展开更多
The mechanisms of magnetoreception have been proposed as the magnetitebased, the chemical radical-pair and biocompass model, in which magnetite particles, the cryptochrome (Cry) or iron-sulfur cluster assembly 1 (IscA...The mechanisms of magnetoreception have been proposed as the magnetitebased, the chemical radical-pair and biocompass model, in which magnetite particles, the cryptochrome (Cry) or iron-sulfur cluster assembly 1 (IscA1) may be involved. However, little is known about the association among the molecules. Here we investigated the molecular characterization and the mRNA expression of IscA1 in different developmental stages, tissues and magnetic fields in the migratory brown planthopper (BPH), Nilaparvata lugens. NlIscA1 contains an open reading frame of 390 bp, encoding amino acids of 129, with the predicted molecular weight of 14.0 kDa and the isoelectric point of 9.10. Well-conserved Fe-S cluster binding sites were observed in the predicted protein. Phylogenetic analysis demonstrated NlIscA1 to be clustered into the insect's IscA1. NlIscA1 showed up-regulated mRNA expression during the period of migration. The mRNA expression of NlIscA1 could be detected in all the three tissues of head, thorax and abdomen, with the highest expression level in the abdomen. For the macropterous migratory Nilaparvata lugens, mRNA expression of NlIscA1 and N. lugens cryptochromel (Nlcry1) were up-regulated under the magnetic fields of 5 Gauss and 10 Gauss in strength (vs. local geomagnetic field), while N. lugens cryptochrome 2 (Nlcry2) remained stable. For the brachyterous non-migratory Nilaparvata lugens, no significant changes were found in mRNA expression of NlIscA1, Nlcry1 and Nlcry2 among different magnetic fields. These findings preliminarily reveal that the expression of NlIscA1 and Nlcry1 exhibited coordinated responses to the magnetic field. It suggests some potential associations among the putative magneto-sensitive molecules of cryptochrome and iron-sulfur cluster assembly.展开更多
A highly active nitrogen-doped catalyst with a unique red-blood-cell(RBC) like structure is reported for oxygen reduction reaction(ORR).The catalyst Fe,N-C@carbon-900 was prepared by pyrolysis of the polyaniline(PANl)...A highly active nitrogen-doped catalyst with a unique red-blood-cell(RBC) like structure is reported for oxygen reduction reaction(ORR).The catalyst Fe,N-C@carbon-900 was prepared by pyrolysis of the polyaniline(PANl) and polystyrene(PS) composites with adsorption of ferric ion on the shell of sphere structure at 900℃.Fe,N-C@carbon-900 with a unique RBC-like structure provides plenty of catalytic sites combining the electrical conductivity of the carbon sphere with the catalytic activity of the nitrogen-doped layer.The four-electron reduction pathway is selected for the catalyst Fe,N-C@carbon-900.The catalyst exhibit the ORR E_(onset) at 0.87 V(potentials is versus to reversible hydrogen electrode(RHE)),E_(1/2) at 0.78 V and high diffusion-limiting current density(5.20mA/cm^2).Furthermore,this work indicates that both N and Fe accounted for high activity of the catalyst Fe,N-C@carbon-900 toward the oxygen reduction process.It is concluded that Fe and N exhibit synergistically promotion in the ORR activity for the catalyst Fe,N-C@carbon-900.We also provide a rational design of electrocatalysts with high ORR activity to further clarify the essential ORR sites of heteroatom doped carbon materials for fuel cells and metal-air battery applications.展开更多
基金supported by the National Natural Science Foundation of China(82003808)the Open Project of Jiangsu Provincial Science and Technology Resources(Clinical Resources)Coordination Service Platform(No.TC2022B015)the Shuangchuang Doctor Project of Jiangsu Province(No.JSSCBS20220147)。
文摘Vitiligo has a significant impact on a substantial number of individuals worldwide.Traditional Chinese medicine has a long history of serving as a therapeutic treatment for vitiligo.Nevertheless,given the increasing volume of research on the utilization of traditional Chinese medicine for vitiligo treatment,it is imperative to conduct a comprehensive review that elucidates the efficacy of Chinese traditional medicine and other active ingredients in the treatment of vitiligo.This paper presents a comprehensive overview of the clinical preparations used to treat vitiligo,while also highlighting the potential monomers and extracts derived from traditional Chinese medicine for vitiligo treatment.A thorough analysis of the pharmacological effects of traditional Chinese medicine on vitiligo treatment will provide valuable insights and reliable information for the development of new treatment strategies.
基金supported by the National High Level Hospital Clinical Research Fund(2022-GSP-QN-1)the Young Talent Program of the Academician Fund(YS-2022-002)+1 种基金the National Key Research and Development Program of China(2016YFC130130&2016YFC1301301)the National Clinical Research Center for Cardiovascular Diseases,Fuwai Hospital,Chinese Academy of Medical Sciences(NCRC2020013).
文摘OBJECTIVE To investigate the optimal duration of dual antiplatelet therapy(DAPT)in patients with diabetes mellitus(DM)requiring complex percutaneous coronary intervention(PCI).METHODS A total of 2403 patients with DM who underwent complex PCI from January to December 2013 were consecutively enrolled in this observational cohort study and divided according to DAPT duration into a standard group(11-13 months,n=689)and two prolonged groups(13-24 months,n=1133;>24 months,n=581).RESULTS Baseline characteristics,angiographic findings,and complexity of PCI were comparable regardless of DAPT duration.The incidence of major adverse cardiac and cerebrovascular event was lower when DAPT was 13-24 months than when it was 11-13 months or>24 months(4.6%vs.8.1%vs.6.0%,P=0.008),as was the incidence of all-cause death(1.9%vs.4.6%vs.2.2%,P=0.002)and cardiac death(1.0%vs.3.0%vs.1.2%,P=0.002).After adjustment for confounders,DAPT for 13-24 months was associated with a lower risk of major adverse cardiac and cerebrovascular event[hazard ratio(HR)=0.544,95%CI:0.373-0.795]and all-cause death(HR=0.605,95%CI:0.387-0.944).DAPT for>24 months was associated with a lower risk of all-cause death(HR=0.681,95%CI:0.493-0.942)and cardiac death(HR=0.620,95%CI:0.403-0.952).The risk of major bleeding was not increased by prolonging DAPT to 13-24 months(HR=1.356,95%CI:0.766-2.401)or>24 months(HR=0.967,95%CI:0.682-1.371).CONCLUSIONS For patients with DM undergoing complex PCI,prolonging DAPT might improve the long-term prognosis by reducing the risk of adverse ischemic events without increasing the bleeding risk.
基金supported by the National Natural Science Foundation of China,No. 81671164 (to SHQ)the Natural Science Foundation of Jiangsu Province of China,No. BK20211348 (to SHQ)Xuzhou Basic Research Program,No. KC21030 (to LYH)。
文摘Ischemic accumulation of succinate causes cerebral damage by excess production of reactive oxygen species. However, it is unknown whether ischemic accumulation of succinate affects neural stem cell proliferation. In this study, we established a rat model of cerebral ischemia/reperfusion injury by occlusion of the middle cerebral artery. We found that succinate levels increased in serum and brain tissue(cortex and hippocampus) after ischemia/reperfusion injury. Oxygen-glucose deprivation and reoxygenation stimulated primary neural stem cells to produce abundant succinate. Succinate can be converted into diethyl succinate in cells. Exogenous diethyl succinate inhibited the proliferation of mouse-derived C17.2 neural stem cells and increased the infarct volume in the rat model of cerebral ischemia/reperfusion injury. Exogenous diethyl succinate also increased the succinylation of the Rho family GTPase Cdc42 but repressed Cdc42 GTPase activity in C17.2 cells. Increasing Cdc42 succinylation by knockdown of the desuccinylase Sirt5 also inhibited Cdc42 GTPase activity in C17.2 cells. Our findings suggest that ischemic accumulation of succinate decreases Cdc42 GTPase activity by induction of Cdc42 succinylation, which inhibits the proliferation of neural stem cells and aggravates cerebral ischemia/reperfusion injury.
基金Supported by The National Natural Science Foundation of China,No.8186080205 and No.8226080303.
文摘BACKGROUND Heart failure(HF)often affects the progress of sepsis patients,although its impact on outcomes is inconsistent and inconclusive.AIM To conduct a systematic review and meta-analysis of the impact of HF on mortality in patients with sepsis.METHODS PubMed,Embase,Web of Science,and the Cochrane Library databases were searched to compare the outcomes of sepsis patients with HF.A random effect model was used to summarize the mortality data,and the odds ratio(OR)and 95%confidence interval(CI)were calculated as effect indicators.RESULTS Among 18001 records retrieved in the literature search,35712 patients from 10 separate studies were included.The results showed that sepsis patients with HF were associated with increased total mortality(OR=1.80,95%CI:1.34-2.43;I2=92.1%),with high heterogeneity between studies.Significant subgroup differences according to age,geographical location,and HF patient sample were observed.HF did not increase the 1-year mortality of patients(OR=1.11,95%CI:0.75-1.62;I2=93.2%),and the mortality of patients with isolated right ventricular dysfunction(OR=2.32,95%CI:1.29-4.14;I2=91.5%)increased significantly.CONCLUSION In patients with sepsis,HF is often associated with adverse outcomes and mortality.Our results call for more high-quality research and strategies to improve outcomes for sepsis patients with HF.
基金supported by the National High Level Hospital Clinical Research Funding(2022-GSP-QN-1)the National Clinical Research Center for Cardiovascular Diseases,Fuwai Hospital,Chinese Academy of Medical Sciences(NCRC2020013)+1 种基金the National Natural Science Foundation of China(81900323)China International Exchange and Promotion Association for Medical and Healthcare Investigator Sponsored Study(CN174125,DIREGL08735-DAPT)。
文摘BACKGROUND:To investigate the most appropriate dual antiplatelet therapy(DAPT)duration for patients with acute coronary syndrome(ACS)after drug-eluting stent(DES)implantation in the largest cardiovascular center of China.METHODS:We enrolled 5,187 consecutive patients with ACS who received DES from January to December 2013.Patients were divided into four groups based on DAPT duration:standard DAPT group(11-13 months,n=1,568)and prolonged DAPT groups(13-18 months[n=308],18-24 months[n=2,125],and>24 months[n=1,186]).Baseline characteristics and 5-year clinical outcomes were recorded.RESULTS:Baseline characteristics were similar across the four groups.Among the four groups,those with prolonged DAPT(18-24 months)had the lowest incidence of major adverse cardiovascular and cerebrovascular events(MACCEs)(14.1%vs.11.7%vs.9.6%vs.24.2%,P<0.001),all-cause death(4.8%vs.3.9%vs.2.1%vs.2.6%,P<0.001),cardiac death(3.1%vs.2.6%vs.1.4%vs.1.9%,P=0.004),and myocardial infarction(MI)(3.8%vs.4.2%vs.2.5%vs.5.8%,P<0.001).The incidence of bleeding was not different among the four groups(9.9%vs.9.4%vs.11.0%vs.9.4%,P=0.449).Cox multivariable analysis showed that prolonged DAPT(18-24 months)was an independent protective factor for MACCEs(hazard ratio[HR]0.802,95%confidence interval[CI]0.729-0.882,P<0.001),all-cause death(HR 0.660,95%CI 0.547-0.795,P<0.001),cardiac death(HR 0.663,95%CI 0.526-0.835,P<0.001),MI(HR 0.796,95%CI 0.662-0.957,P=0.015),and target vessel revascularization(HR 0.867,95%CI 0.755-0.996,P=0.044).Subgroup analysis for high bleeding risk showed that prolonged DAPT remained an independent protective factor for all-cause death and MACCEs.CONCLUSION:For patients with ACS after DES,appropriately prolonging the DAPT duration may be associated with a reduced risk of adverse ischemic events without increasing the bleeding risk.
基金the National Natural Science Foundation of China(82003808)the The Open Project of Jiangsu Provincial Science and Technology Resources(Clinical Resources)Coordination Service Platform(No.TC2022B015).
文摘Tissue engineering is an interdisciplinary field of bioengineering,cell biology,and biomaterials that seeks to create functional tissues for therapeutic purposes.It is a rapidly growing field of regenerative medicine that has the potential to revolutionize the treatment for many diseases and injuries.General research areas mainly include the engineering of the cardiovascular system,bone and cartilage,oral cavity and skin,and other tissues[1].Skin tissue engineering is one of the earliest clinically applied,most mature and widely used products in the field of tissue engineering[2].
文摘Perivascular epithelioid cell tumor(PEComa) of the pancreas is an unusual tumor deriving from mesenchyma. This paper described a case of pancreatic PEComa, which was initially suspected as neuroendocrine carcinoma by biopsy, and therefore surgical treatment was recommended due to undetermined diagnosis. Examination of the surgical specimen under a microscope showed that the tumor cell's morphology was epithelioid or spindle-shaped, and ranged in a nested pattern. Additionally, these cells had a large extent of acidophilic cytoplasm, no mitotic figures, and expressed HMB-45, melan-p, and smooth muscle actin immunohistochemically. Pathological examination indicated that PEComa originated from the pancreas, but symptoms related to tuberous sclerosis were absent. Since PEComa is extremely rare in the pancreas, it is likely to be ignored in differential diagnosis. In conclusion, our article highlighted the clinicopathological features of PEComa, and we conducted a literature review focusing on PEComa so as to deepen the understanding of this tumor type.
基金supported by the Natural Science Foundation of Jiangsu Province(Grant No.BK2012464)the Research Fellowship from the Jiangsu Overseas Research and Training Programfunded by the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)
文摘A series of Bi2 S3-BiOCI composites with two-dimensional(2 D) square-like structures were prepared via a two-step anion exchange route.X-ray diffraction(XRD), scanning electron microscopy(SEM), transmission electron microscopy(TEM), and diffuse reflectance spectra(DRS)were used to investigate the properties of the as-prepared Bi_2 S_3-BiOCI heterostructures. The coupling of BiOCl and Bi_2 S_3 induced enhanced photoabsorption efficiency and bandgap narrowing. A reactive brilliant red X-3 B dye was used as a contaminant to test the photocatalytic activity of the obtained Bi_2 S_3-BiOCl samples under visible light irradiation. The sample Bi_2 S_3-BiOCl with a mass ratio of 8:4 exhibited the highest photodegradation efficiency, which was six times higher than that of pure BiOCl. In addition, a mechanism for the enhancement of photocatalytic activity is proposed.
基金supported by the National Key Researchand Development Program of China (2016YFC130130 [Subtopic:2016YFC1301301]).
文摘BACKGROUND: We aim to investigate effects of metabolic syndrome on onset age and long-termoutcomes in patients with acute coronary syndrome (ACS).METHODS: Patients with ACS (n=6,431) who underwent percutaneous coronary interventionfrom January to December 2013 were enrolled. After excluding patients with previous coronary arterydisease, 1,558 patients were diagnosed with early-onset ACS (men aged ≤50 years;women aged≤60 years) and 3,044 patients with late-onset ACS. Baseline characteristics and five-year clinicaloutcomes were measured.RESULTS: Body mass index, triglyceride, low-density lipoprotein cholesterol, and uric acidconcentrations were significantly higher, while the high-density lipoprotein cholesterol (HDL-C)concentration was lower in the early-onset ACS group (P<0.001). Multivariate logistic regression revealedobesity (odds ratio [OR] 1.590, 95% confi dence interval [CI] 1.345–1.881), hypertriglyceridemia (OR 1.403,95% CI 1.185–1.660), and low HDL-C (OR 1.464, 95% CI 1.231–1.742) as independent risk factorsfor early-onset ACS (all P<0.001). The fi ve-year follow-up showed that the incidences of all cause death(1.5% vs. 3.8%, P<0.001), cardiac death (1.1% vs. 2.0%, P=0.023), and recurrent stroke (2.2% vs. 4.2%,P<0.001) were lower, while bleeding events were more frequent in the early-onset ACS group. A subgroupanalysis showed higher incidences of recurrent myocardial infarction (MI) and revascularization in patientswith early-onset ACS and metabolic syndrome.CONCLUSIONS: Obesity, hypertriglyceridemia, and lower HDL-C level are independent riskfactors for early-onset ACS, recurrent MI, and revascularization. The control of metabolic syndromemay reduce the incidence of early-onset ACS and improve the long-term prognosis.
基金Project supported by the National Key Research and Development Program of China(Grant Nos.2017YFA0701302 and 2016YFA0200802)the Fundamental Research Funds of Shandong University,China(Grant No.2018GN030)。
文摘We review the experimental and computational data about the propagation of neural signals in myelinated axons in mice,cats,rabbits,and frogs published in the past five decades.In contrast to the natural assumption that neural signals occur one by one in time and in space,we figure out that neural signals are highly overlapped in time between neighboring nodes.This phenomenon was occasionally illustrated in some early reports,but seemed to have been overlooked for some time.The shift in time between two successive neural signals from neighboring nodes,defined as relay timeτ,was calculated to be only 16.3μs-87.0μs,i.e.,0.8%-4.4%of the average duration of an action potential peak(roughly 2 ms).We present a clearer picture of the exact physical process about how the information transmits along a myelinated axon,rather than a whole action potential peak,what is transmitted is only a rising electric field caused by transmembrane ion flows.Here in the paper,τrepresents the waiting time until the neighboring node senses an attenuated electric field reaching the threshold to trigger the open state.The mechanisms addressed in this work have the potential to be universal,and may hold clues to revealing the exact triggering processes of voltage-gated ion channels and various brain functions.
文摘AIM: To explore a more accurate quantifying diagnosis method of diabetic macular edema(DME) by displaying detailed 3D morphometry beyond the gold-standard quantification indicator-central retinal thickness(CRT) and apply it in follow-up of DME patients.METHODS: Optical coherence tomography(OCT) scans of 229 eyes from 160 patients were collected.We manually annotated cystoid macular edema(CME), subretinal fluid(SRF) and fovea as ground truths.Deep convolution neural networks(DCNNs) were constructed including U-Net, sASPP, HRNetV2-W48, and HRNetV2-W48+Object-Contextual Representation(OCR) for fluid(CME+SRF) segmentation and fovea detection respectively, based on which the thickness maps of CME, SRF and retina were generated and divided by Early Treatment Diabetic Retinopathy Study(ETDRS) grid.RESULTS: In fluid segmentation, with the best DCNN constructed and loss function, the dice similarity coefficients(DSC) of segmentation reached 0.78(CME), 0.82(SRF), and 0.95(retina).In fovea detection, the average deviation between the predicted fovea and the ground truth reached 145.7±117.8 μm.The generated macular edema thickness maps are able to discover center-involved DME by intuitive morphometry and fluid volume, which is ignored by the traditional definition of CRT>250 μm.Thickness maps could also help to discover fluid above or below the fovea center ignored or underestimated by a single OCT B-scan.CONCLUSION: Compared to the traditional unidimensional indicator-CRT, 3D macular edema thickness maps are able to display more intuitive morphometry and detailed statistics of DME, supporting more accurate diagnoses and follow-up of DME patients.
基金supported by the National Key Research and Development Program of China (2016YFC 1301300 & 2016YFC1301301)National Clinical Research Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences (NCRC2020013)+1 种基金CAMS Innovation Fund for Medical Sciences (2020-I2M-C&T-B-049)the Young Scientists Fund of the National Natural Science Foundation of China (No.81900323)
文摘OBJECTIVE To determine whether high-risk patients with three-vessel disease(TVD)with and without prior stroke preferen-tially benefit from three strategies[percutaneous coronary intervention(PCI),coronary artery bypass grafting(CABG)and medical therapy(MT)].METHODS A total of 8943 patients with TVD were included in the study.Patients enrolled were stratified into two categories according to the presence or absence of prior stroke history.The primary endpoint was all-cause death.Secondary endpoints in-cluded stroke and major adverse cardiac and cerebrovascular event(MACCE),a composite of death,myocardial infarction(MI),unplanned revascularization and stroke.RESULTS Prior stroke was present in 888 patients(9.9%).These patients were older and had higher rates of comorbidities.Du-ring a median follow-up of 7.5 years,patients with prior stroke were strongly associated with increased risks of all-cause death,cardiac death,stroke and MACCE,even after adjusting for confounding variables and results been consistent across either treat-ment subgroup(PCI,CABG and MT)(all adjusted P<0.01).Notably,there was a significant interaction between prior stroke his-tory and treatment strategies.Revascularization strategy(PCI or CABG)was associated with a lower incidence of all-cause death and MACCE compared with MT alone,and favorable rates of MACCE,MI and unplanned revascularization in the CABG group compared with the PCI group,but with similar rate of all-cause death regardless of prior stroke history.The prevalence of stroke was significantly higher after CABG when compared with PCI or MT in no prior stroke patients[hazard ratio(HR)=1.429,95%CI:1.132-1.805 for CABG vs.MT;HR=1.703,95%CI:1.371-2.116 for CABG vs.PCI].CONCLUSIONS Patients with TVD and prior stroke have poor clinical outcomes.It is essential to balance benefit and risk when determining the optimal treatment strategy for TVD with and without prior stroke.
基金the National Key Technologies R&D Program in the 13th Five-Year Plan of China(No.2016YFC1301301)the National Natural Science Foundation of China(No.81770365).
文摘Background:It is currently unclear if fibrinogen is a risk factor for adverse events in patients receiving percutaneous coronary intervention(PCI)or merely serves as a marker of pre-existing comorbidities and other causal factors.We therefore investigated the association between fibrinogen levels and 2-year all-cause mortality,and compared the additional predictive value of adding fibrinogen to a basic model including traditional risk factors in patients receiving contemporary PCI.Methods:A total of 6293 patients undergoing PCI with measured baseline fibrinogen levels were enrolied from January to December 2013 in Fuwai Hospital.Patients were divided into three groups according to tertiles of baseline fibrinogen levels:low fibrinogen,<2.98 g/L;medium fibrinogen,2.98 to 3.58 g/L;and high fibrinogen,≥3.58 g/L.Independent predictors of 2-year clinical outcomes were determined by multivariate Cox proportional hazards regression modeling.The increased discriminative value of fibrinogen for predicting all-cause mortality was assessed using the C-statistic and integrated discrimination improvement(IDI).Results:The 2-year all-cause mortality rate was 1.2%.It was significantly higher in the high fibrinogen compared with the low and medium fibrinogen groups according to Kaplan-Meier analyses(1.7%vs.0.9%and 1.7%vs.1.0%,respectively;log-rank,P=0.022).Fibrinogen was significantly associated with all-cause mortality according to multivariate Cox regression(hazard ratio 1.339,95%confidence interval:1.109-1.763,P=0.005),together with traditional risk factors including age,sex,diabetes mellitus,left ventricular ejection fraction,creatinine clearance,and low-density lipoprotein cholesterol.The area under the curve for all-cause mortality in the basic model including traditional risk factors was 0.776,and this value increased to 0.787 when fibrinogen was added to the model(IDI=0.003,Z=0.140,P=0.889).Conclusions:Fibrinogen is associated with 2-year all-cause mortality in patients receiving PCI,but provides no additional information over a model including traditional risk factors.
基金We thank the staff in the Beijing READ BIO Bioinformatic Technology Company for their assistance in the phylogenetic inference and bioinformatic analysis of brown planthopper CRY proteins. This research was supported by the Key Program of National Natural Science of China （51037006）, the National Basic Research Program of China ＂973＂ （2010CB126200） and the National Nature Science Foundations of China （31170362, 31272051, 31470454 and 31070755）.
文摘Background:The patterns of nonadherence to antiplatelet regimen in stented patients (PARIS)thrombotic risk score are a novel score for predicting the risk of coronary thrombotic events (CTEs)after percutaneous coronary intervention (PCI)with drug-eluting stents. However,the prognostic value of this score has not been fully evaluated in non-Euro-American PCI populations. Methods:We performed a prospective,observational study of 10,724 patients who underwent PCI in Fuwai hospital,China and evaluated the PARIS thrombotic risk score's predictive value of CTEs in the PCI population.The area under the receiver operating characteristic curve (AUROC)was used to assess the predictive value of the PARIS score for CTE. Results:Among 9782 patients without in-hospital events,a total of 95 CTEs occurred during the 2-year follow-up.The PARIS score was significantly higher in patients with CTEs (3.384-2.04)compared with patients without events (2.53±1.70,P <0.001). According to the risk stratification of the PARIS thrombotic score,the risk of CTEs in the high-risk group was 3.14 times higher than that in the low-risk group (hazard ratio [HR],3.14;95% confidence interval [CI],1.92-5.13;P <0.001).However,the risk of CTEs in the intermediate-risk and low-risk groups was not significant (HR,1.39;95% CI,[0.86-2.24];P =0.184).The PARIS score showed prognostic value in evaluating CTEs in the overall population (AUROC,0.621;95% CI,0.561-0.681),the acute coronary syndrome (ACS)population (AUROC,0.617;95% CI,0.534-0.700;P =0.003),and the non-ACS population (AUROC,0.647;95% CI,0.558-0.736;P =0.001). Conclusions:In a real-world Chinese population,the PARIS thrombotic risk score shows a modest prognostic value for CTEs in patients after PCI.This score also has a predictive value for CTEs in the ACS and non-ACS subgroup populations.
基金the National Natural Science Foundation of China(31670855,31470454 and 31170362)the China Postdoctoral Scienee Foun?dation(2016M590470).
文摘The mechanisms of magnetoreception have been proposed as the magnetitebased, the chemical radical-pair and biocompass model, in which magnetite particles, the cryptochrome (Cry) or iron-sulfur cluster assembly 1 (IscA1) may be involved. However, little is known about the association among the molecules. Here we investigated the molecular characterization and the mRNA expression of IscA1 in different developmental stages, tissues and magnetic fields in the migratory brown planthopper (BPH), Nilaparvata lugens. NlIscA1 contains an open reading frame of 390 bp, encoding amino acids of 129, with the predicted molecular weight of 14.0 kDa and the isoelectric point of 9.10. Well-conserved Fe-S cluster binding sites were observed in the predicted protein. Phylogenetic analysis demonstrated NlIscA1 to be clustered into the insect's IscA1. NlIscA1 showed up-regulated mRNA expression during the period of migration. The mRNA expression of NlIscA1 could be detected in all the three tissues of head, thorax and abdomen, with the highest expression level in the abdomen. For the macropterous migratory Nilaparvata lugens, mRNA expression of NlIscA1 and N. lugens cryptochromel (Nlcry1) were up-regulated under the magnetic fields of 5 Gauss and 10 Gauss in strength (vs. local geomagnetic field), while N. lugens cryptochrome 2 (Nlcry2) remained stable. For the brachyterous non-migratory Nilaparvata lugens, no significant changes were found in mRNA expression of NlIscA1, Nlcry1 and Nlcry2 among different magnetic fields. These findings preliminarily reveal that the expression of NlIscA1 and Nlcry1 exhibited coordinated responses to the magnetic field. It suggests some potential associations among the putative magneto-sensitive molecules of cryptochrome and iron-sulfur cluster assembly.
基金partially supported by National Natural Science Foundation of China(Nos.51273158,21303131)
文摘A highly active nitrogen-doped catalyst with a unique red-blood-cell(RBC) like structure is reported for oxygen reduction reaction(ORR).The catalyst Fe,N-C@carbon-900 was prepared by pyrolysis of the polyaniline(PANl) and polystyrene(PS) composites with adsorption of ferric ion on the shell of sphere structure at 900℃.Fe,N-C@carbon-900 with a unique RBC-like structure provides plenty of catalytic sites combining the electrical conductivity of the carbon sphere with the catalytic activity of the nitrogen-doped layer.The four-electron reduction pathway is selected for the catalyst Fe,N-C@carbon-900.The catalyst exhibit the ORR E_(onset) at 0.87 V(potentials is versus to reversible hydrogen electrode(RHE)),E_(1/2) at 0.78 V and high diffusion-limiting current density(5.20mA/cm^2).Furthermore,this work indicates that both N and Fe accounted for high activity of the catalyst Fe,N-C@carbon-900 toward the oxygen reduction process.It is concluded that Fe and N exhibit synergistically promotion in the ORR activity for the catalyst Fe,N-C@carbon-900.We also provide a rational design of electrocatalysts with high ORR activity to further clarify the essential ORR sites of heteroatom doped carbon materials for fuel cells and metal-air battery applications.
