Objective: By observing the treatment and nursing care of a patient with Grade IV capsular contracture following breast cancer expander implantation and subsequent Stage II reconstruction, we aim to analyze the reason...Objective: By observing the treatment and nursing care of a patient with Grade IV capsular contracture following breast cancer expander implantation and subsequent Stage II reconstruction, we aim to analyze the reasons for the formation of capsular contracture after Stage I expander implantation and prevent its recurrence following Stage II reconstruction. Methods: In May 2020, the patient noticed an increase in the size of a breast mass. In August, she underwent AC-THP neoadjuvant chemotherapy, followed by a “right breast-conserving nipple-areolar subglandular excision + right axillary lymph node dissection + expander implantation” surgery in November 2020. Radiation therapy began in January 2021. During radiation therapy, the patient experienced severe breast hardening, distortion, tenderness, and was diagnosed with Grade IV capsular contracture. To relieve the capsular contracture, the patient underwent a “contracted capsule incision and release procedure + removal of the right breast expander + right breast implantation” surgery in July 2021. Postoperatively, measures were taken to prevent incision infection, emphasizing aseptic techniques, ensuring smooth negative pressure drainage, reducing skin flap tension, monitoring skin flap blood supply, actively preventing subcutaneous effusion and hematoma, and applying appropriate compression dressings. Results: The patient was discharged after the removal of the drainage tube. During the postoperative follow-up at 3 and 6 months, there was no recurrence of capsular contracture, and the breast appeared full, upright, and relatively soft. There were no complications such as hematoma, infection, breast implant rupture, breast sagging, or displacement. The patient had a good outcome without additional financial or surgical burdens. Conclusion: The occurrence of Grade IV capsular contracture in the patient is generally related to infection after Stage I expander implantation, improper compression dressing, excessive saline injection causing content infiltration, and radiation therapy. Therefore, it is recommended to enhance the intraoperative and postoperative prophylactic use of antibiotics after Stage I expander implantation. Intermittent saline injection after surgery, with the amount of saline gradually increasing rather than filling all at once, is advisable. This helps the breast tissue gradually adapt to expansion, reducing the risk of capsular contracture. Postoperatively, patients should be instructed to wear pressure garments and breast elastic bandages while intensifying breast monitoring during radiation therapy and increasing postoperative follow-up.展开更多
Lake is an important part of the natural ecosystem, and its morphological characteristics reflect the capacity of lake regulation and storage, the strength of material migration, and the characteristics of shoreline d...Lake is an important part of the natural ecosystem, and its morphological characteristics reflect the capacity of lake regulation and storage, the strength of material migration, and the characteristics of shoreline development. In most existing studies, remote sensing images are used to quantify the morphological characteristics of lakes. However, the extraction accuracy of lake water is greatly affected by cloud cover and vegetation cover, and the inversion accuracy of lake elevation data is poor, which cannot accurately describe the response relationship of lake landscape morphology with water level change. Therefore, this paper takes Tonle Sap Lake as the research object, which is the largest natural freshwater lake in Southeast Asia. DEM is constructed based on high-resolution measured topographic data, and morphological indicators such as lake area, lake shoreline length, perimeter area ratio, longest axis length, maximum width, shoreline development index, lake shape complexity, compactness ratio and form ratio are adopted to researching the evolution law of high water overflows and low water outbursts quantitatively, and clarifying the variation characteristics of landscape morphology with water level gradient in Tonle Sap Lake. The research results have important theoretical significance for the scientific utilization of Tonle Sap Lake water resources and the protection of the lake ecosystem.展开更多
Artificial intelligence can be indirectly applied to the repair of peripheral nerve injury.Specifically,it can be used to analyze and process data regarding peripheral nerve injury and repair,while study findings on p...Artificial intelligence can be indirectly applied to the repair of peripheral nerve injury.Specifically,it can be used to analyze and process data regarding peripheral nerve injury and repair,while study findings on peripheral nerve injury and repair can provide valuable data to enrich artificial intelligence algorithms.To investigate advances in the use of artificial intelligence in the diagnosis,rehabilitation,and scientific examination of peripheral nerve injury,we used CiteSpace and VOSviewer software to analyze the relevant literature included in the Web of Science from 1994–2023.We identified the following research hotspots in peripheral nerve injury and repair:(1)diagnosis,classification,and prognostic assessment of peripheral nerve injury using neuroimaging and artificial intelligence techniques,such as corneal confocal microscopy and coherent anti-Stokes Raman spectroscopy;(2)motion control and rehabilitation following peripheral nerve injury using artificial neural networks and machine learning algorithms,such as wearable devices and assisted wheelchair systems;(3)improving the accuracy and effectiveness of peripheral nerve electrical stimulation therapy using artificial intelligence techniques combined with deep learning,such as implantable peripheral nerve interfaces;(4)the application of artificial intelligence technology to brain-machine interfaces for disabled patients and those with reduced mobility,enabling them to control devices such as networked hand prostheses;(5)artificial intelligence robots that can replace doctors in certain procedures during surgery or rehabilitation,thereby reducing surgical risk and complications,and facilitating postoperative recovery.Although artificial intelligence has shown many benefits and potential applications in peripheral nerve injury and repair,there are some limitations to this technology,such as the consequences of missing or imbalanced data,low data accuracy and reproducibility,and ethical issues(e.g.,privacy,data security,research transparency).Future research should address the issue of data collection,as large-scale,high-quality clinical datasets are required to establish effective artificial intelligence models.Multimodal data processing is also necessary,along with interdisciplinary collaboration,medical-industrial integration,and multicenter,large-sample clinical studies.展开更多
Time-frequency analysis is a successfully used tool for analyzing the local features of seismic data.However,it suffers from several inevitable limitations,such as the restricted time-frequency resolution,the difficul...Time-frequency analysis is a successfully used tool for analyzing the local features of seismic data.However,it suffers from several inevitable limitations,such as the restricted time-frequency resolution,the difficulty in selecting parameters,and the low computational efficiency.Inspired by deep learning,we suggest a deep learning-based workflow for seismic time-frequency analysis.The sparse S transform network(SSTNet)is first built to map the relationship between synthetic traces and sparse S transform spectra,which can be easily pre-trained by using synthetic traces and training labels.Next,we introduce knowledge distillation(KD)based transfer learning to re-train SSTNet by using a field data set without training labels,which is named the sparse S transform network with knowledge distillation(KD-SSTNet).In this way,we can effectively calculate the sparse time-frequency spectra of field data and avoid the use of field training labels.To test the availability of the suggested KD-SSTNet,we apply it to field data to estimate seismic attenuation for reservoir characterization and make detailed comparisons with the traditional time-frequency analysis methods.展开更多
The d-d orbital coupling induced by crystal-phase engineering can effectively adjust the electronic structure of electrocatalysts,thus showing significant catalytic performance,while it has been rarely explored in ele...The d-d orbital coupling induced by crystal-phase engineering can effectively adjust the electronic structure of electrocatalysts,thus showing significant catalytic performance,while it has been rarely explored in electrochemical acetonitrile reduction reaction(ARR)to date.Herein,we successfully realize the structural transformation of Pd Cu metallic aerogels(MAs)from face-centered cubic(FCC)to body-centered cubic(BCC)through annealing treatment.Specifically,the BCC Pd Cu MAs exhibit excellent ARR performance with high ethylamine selectivity of 90.91%,Faradaic efficiency of 88.60%,yield rate of 316.0 mmol h^(-1)g^(-1)_(Pd+Cu)and long-term stability for consecutive electrolysis within 20 h at-0.55 V vs.reversible hydrogen electrode,outperforming than those of FCC Pd Cu MAs.Under the membrane electrode assembly system,BCC Pd Cu MAs also demonstrate excellent ethylamine yield rate of 389.5 mmol h^(-1)g^(-1)_(Pd+Cu).Density functional theory calculation reveals that the d-d orbital coupling in BCC Pd Cu MAs results in an evident correlation effect for the interaction of Pd and Cu sites,which boosts up the Cu sites electronic activities to enhance ARR performance.Our work opens a new route to develop efficient ARR electrocatalysts from the perspective of crystalline structure transformation.展开更多
Naringin exists in a wide range of Chinese herbal medicine and has proven to possess several pharmacological properties.In this study,PC12,HepG2 cells,and female Drosophila melanogaster were used to investigate the an...Naringin exists in a wide range of Chinese herbal medicine and has proven to possess several pharmacological properties.In this study,PC12,HepG2 cells,and female Drosophila melanogaster were used to investigate the antioxidative and anti-aging effects of naringin and explore the underlying mechanisms.The results showed that naringin inhibited H_(2)O_(2)-induced decline in cell viability and decreased,the content of reactive oxygen species in cells.Meanwhile,naringin prolonged the lifespan of flies,enhanced the abilities of climbing and the resistance to stress,improved the activities of antioxidant enzymes,and decreased malondialdehyde content.Naringin also improved intestinal barrier dysfunction and reduced abnormal proliferation of intestinal stem cells.Moreover,naringin down-regulated the mRNA expressions of inr,chico,pi 3k,and akt-1,and up-regulated the mRNA expressions of dilp2,dilp3,dilp5,and foxo,thereby activating autophagy-related genes and increasing the number of lysosomes.Furthermore,the mutant stocks assays and computer molecular simulation results further indicated that naringin delayed aging by inhibiting the insulin signaling(IIS)pathway and activating the autophagy pathway,which was consistent with the result of network pharmacological predictions.展开更多
For improving the actuation performance at low electric fields of dielectric elastomers,achieving high dielectric constant(εr)and low modulus(Y)simultaneously has been targeted in the past decades,but there are few w...For improving the actuation performance at low electric fields of dielectric elastomers,achieving high dielectric constant(εr)and low modulus(Y)simultaneously has been targeted in the past decades,but there are few ways to accomplish both.In contrast to the classical strategies such as incorporating plasticizers or ceramic to prepare the silicon-based dielectric elastomers,here,blending an amino-complexed hybrid(polyethyleneimine(PEI)-Ag)with polydimethylsiloxane(PDMS)elastomer is reported as an alternative strategy to tailor theεr and Y.PEI-Ag not only exhibits excellent dielectric enhancement properties but also minimizes the PDMS crosslinking through amino-complexed reaction between PEI and Pt catalysts.The prepared dielectric elastomers have aεr of 7.2@10^(3)Hz and Y of 1.14 MPa,leading to an actuation strain of 22.27%at 35 V/μm.Hence,incorporating such novel hybrids based on dual amino-complexed effect on both matrix and particles sufficiently promotes the actuated performance of dielectric elastomers.展开更多
BACKGROUND Herba Patriniae and Coix seed(HC)constitute a widely utilized drug combination in the clinical management of colorectal cancer(CRC)that is known for its diuretic,anti-inflammatory,and swelling-reducing prop...BACKGROUND Herba Patriniae and Coix seed(HC)constitute a widely utilized drug combination in the clinical management of colorectal cancer(CRC)that is known for its diuretic,anti-inflammatory,and swelling-reducing properties.Although its efficacy has been demonstrated in a clinical setting,the active compounds and their mechanisms of action in CRC treatment remain to be fully elucidated.AIM To identify the active,CRC-targeting components of HC and to elucidate the mechanisms of action involved.METHODS Active HC components were identified and screened using databases.Targets for each component were predicted.CRC-related targets were obtained from human gene databases.Interaction targets between HC and CRC were identified.A“drug-ingredient-target”network was created to identify the core components and targets involved.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)analyses were conducted to elucidate the key pathways involved.Molecular docking between core targets and key components was executed.In vitro experiments validated core monomers.RESULTS Nineteen active components of HC were identified,with acacetin as the primary active compound.The predictive analysis identified 454 targets of the active compounds in HC.Intersection mapping with 2685 CRC-related targets yielded 171 intervention targets,including 30 core targets.GO and KEGG analyses indicated that HC may influence the phosphoinositide 3-kinase(PI3K)/Akt signaling pathway.Molecular docking showed that acacetin exhibited an optimal interaction with AKT1,identifying PI3K,AKT,and P53 as key genes likely targeted by HC during CRC treatment.Acacetin inhibited HT-29 cell proliferation and migration,as well as promoted apoptosis,in vitro.Western blotting analysis revealed increased p53 and cleaved caspase-3 expression and decreased levels of p-PI3K,p-Akt,and survivin,which likely contributed to CRC apoptosis.CONCLUSION Acacetin,the principal active compound in the HC pair,inhibited the proliferation and migration of HT-29 cells and promoted apoptosis through the PI3K/Akt/p53 signaling pathway.展开更多
The Industrial Internet of Things(IIoT)consists of massive devices in different management domains,and the lack of trust among cross-domain entities leads to risks of data security and privacy leakage during informati...The Industrial Internet of Things(IIoT)consists of massive devices in different management domains,and the lack of trust among cross-domain entities leads to risks of data security and privacy leakage during information exchange.To address the above challenges,a viable solution that combines Certificateless Public Key Cryptography(CL-PKC)with blockchain technology can be utilized.However,as many existing schemes rely on a single Key Generation Center(KGC),they are prone to problems such as single points of failure and high computational overhead.In this case,this paper proposes a novel blockchain-based certificateless cross-domain authentication scheme,that integrates the threshold secret sharing mechanism without a trusted center,meanwhile,adopts blockchain technology to enable cross-domain entities to authenticate with each other and to negotiate session keys securely.This scheme also supports the dynamic joining and removing of multiple KGCs,ensuring secure and efficient cross-domain authentication and key negotiation.Comparative analysiswith other protocols demonstrates that the proposed cross-domain authentication protocol can achieve high security with relatively lowcomputational overhead.Moreover,this paper evaluates the scheme based on Hyperledger Fabric blockchain environment and simulates the performance of the certificateless scheme under different threshold parameters,and the simulation results show that the scheme has high performance.展开更多
To enhance the efficiency and expediency of issuing e-licenses within the power sector, we must confront thechallenge of managing the surging demand for data traffic. Within this realm, the network imposes stringentQu...To enhance the efficiency and expediency of issuing e-licenses within the power sector, we must confront thechallenge of managing the surging demand for data traffic. Within this realm, the network imposes stringentQuality of Service (QoS) requirements, revealing the inadequacies of traditional routing allocation mechanismsin accommodating such extensive data flows. In response to the imperative of handling a substantial influx of datarequests promptly and alleviating the constraints of existing technologies and network congestion, we present anarchitecture forQoS routing optimizationwith in SoftwareDefinedNetwork (SDN), leveraging deep reinforcementlearning. This innovative approach entails the separation of SDN control and transmission functionalities, centralizingcontrol over data forwardingwhile integrating deep reinforcement learning for informed routing decisions. Byfactoring in considerations such as delay, bandwidth, jitter rate, and packet loss rate, we design a reward function toguide theDeepDeterministic PolicyGradient (DDPG) algorithmin learning the optimal routing strategy to furnishsuperior QoS provision. In our empirical investigations, we juxtapose the performance of Deep ReinforcementLearning (DRL) against that of Shortest Path (SP) algorithms in terms of data packet transmission delay. Theexperimental simulation results show that our proposed algorithm has significant efficacy in reducing networkdelay and improving the overall transmission efficiency, which is superior to the traditional methods.展开更多
Protein C(PC)is a key component of the vitamin K-dependent coagulation pathway.It exerts anticoagulant effects by inactivating factors V and VIII.Acquired or inherited PC deficiency results in a prothrombotic state,wi...Protein C(PC)is a key component of the vitamin K-dependent coagulation pathway.It exerts anticoagulant effects by inactivating factors V and VIII.Acquired or inherited PC deficiency results in a prothrombotic state,with presentations varying from asymptomatic to venous thromboembolism.However,there has been an increasing number of reports linking PC deficiency to arterial thromboembolic events,such as myocardial infarction and ischemic stroke.This editorial focuses on the association between PC deficiency and thromboembolism,which may provide some insights for treatment strategy and scientific research.展开更多
BACKGROUND Numerous studies have assessed the efficacy and safety of fecal microbiota transplantation(FMT)as a therapy for ulcerative colitis(UC).However,the treatment processes and outcomes of these studies vary.AIM ...BACKGROUND Numerous studies have assessed the efficacy and safety of fecal microbiota transplantation(FMT)as a therapy for ulcerative colitis(UC).However,the treatment processes and outcomes of these studies vary.AIM To evaluate the efficacy and safety of FMT for treating UC by conducting a systematic meta-analysis.METHODS The inclusion criteria involved reports of adult patients with UC treated with FMT,while studies that did not report clinical outcomes or that included patients with infection were excluded.Clinical remission(CR)and endoscopic remission(ER)were the primary and secondary outcomes,respectively.RESULTS We included nine studies retrieved from five electronic databases.The FMT group had better CR than the control group[relative risk(RR)=1.53;95%confidence interval(CI):1.19-1.94;P<0.0008].ER was statistically significantly different between the two groups(RR=2.80;95%CI:1.93-4.05;P<0.00001).Adverse events did not differ significantly between the two groups.CONCLUSION FMT demonstrates favorable performance and safety;however,well-designed randomized clinical trials are still needed before the widespread use of FMT can be recommended.Furthermore,standardizing the FMT process is urgently needed for improved safety and efficacy.展开更多
BACKGROUND Meniscus extrusion occurs in most elderly individuals and most patients after meniscus allograft transplantation.The risk factors and correlative factors of meniscus extrusion have been extensively studied....BACKGROUND Meniscus extrusion occurs in most elderly individuals and most patients after meniscus allograft transplantation.The risk factors and correlative factors of meniscus extrusion have been extensively studied.However,for using tendon autograft for meniscus reconstruction,both graft type and surgical method are different from those in previous studies on meniscus extrusion.AIM To identify predictive factors for coronal and sagittal graft extrusion length after using tendon autograft for medial meniscus reconstruction.METHODS Ten patients who underwent medial meniscus reconstruction with tendon autograft were selected for this retrospective observational study.The graft extrusions and potential factors were measured and correlation and regression analyses were performed to analyze their relationships.RESULTS The medial graft extrusion correlated with the preoperative bilateral hip-kneeankle angle difference,preoperative Kellgren-Lawrence grade,preoperative relative joint space width,and preoperative bilateral medial edge incline angle difference.The anterior graft correlated with the anterior tunnel edge distance at 1 week after operation.The posterior graft extrusion correlated with the preoperative bilateral hip-knee-ankle angle difference,preoperative relative joint space width,and posterior tunnel edge distance at 1 week after operation.The mean graft extrusion correlated with the preoperative bilateral hip-knee-ankle angle difference and preoperative relative joint space width.The preoperative joint space width and anterior and posterior tunnel edge distance at 1 week can be used to predict the medial,anterior,posterior,and mean graft extrusion length.CONCLUSION The preoperative joint space width and tunnel position can be used to predict the coronal and sagittal graft extrusion length after using tendon autograft for medial meniscus reconstruction.展开更多
BACKGROUND Autism spectrum disorder(ASD)is a developmental disorder characterized by social deficits and repetitive behavior.Gastrointestinal(GI)problems,such as constipation,diarrhea,and inflammatory bowel disease,co...BACKGROUND Autism spectrum disorder(ASD)is a developmental disorder characterized by social deficits and repetitive behavior.Gastrointestinal(GI)problems,such as constipation,diarrhea,and inflammatory bowel disease,commonly occur in patients with ASD.Previously,GI problems of ASD patients were attributed to intestinal inflammation and vertical mother-to-infant microbiome transmission.AIM To explore whether GI problems in ASD are related to maternal intestinal inflam-mation and gut microbiota abnormalities.METHODS An ASD rat model was developed using valproic acid(VPA).Enzyme-linked immunosorbent assay and fecal 16S rRNA sequencing were used to test GI changes.RESULTS VPA exposure during pregnancy led to pathological maternal intestinal changes,resulting in alterations in maternal gut microbiota.Additionally,the levels of inflammatory factors also increased.Moreover,prenatal exposure to VPA resulted in impaired duodenal motility in the offspring as well as increased levels of infla-mmatory factors.CONCLUSION GI problems in ASD may be associated with maternal intestinal inflammation and microbiota abnormality.Future research is required to find more evidence on the etiology and treatment of GI problems in ASD.展开更多
Understanding the dominant force responsible for supercontinent breakup is crucial for establishing Earth＇s geodynamic evolution that includes supercontinent cycles and plate tectonics. Conventionally,two forces have...Understanding the dominant force responsible for supercontinent breakup is crucial for establishing Earth＇s geodynamic evolution that includes supercontinent cycles and plate tectonics. Conventionally,two forces have been considered： the push by mantle plumes from the sub-continental mantle which is called the active force for breakup, and the dragging force from oceanic subduction retreat which is called the passive force for breakup. However, the relative importance of these two forces is unclear. Here we model the supercontinent breakup coupled with global mantle convection in order to address this question. Our global model features a spherical harmonic degree-2 structure, which includes a major subduction girdle and two large upwelling（superplume） systems. Based on this global mantle structure,we examine the distribution of extensional stress applied to the supercontinent by both subsupercontinent mantle upwellings and subduction retreat at the supercontinent peripheral. Our results show that：（1） at the center half of the supercontinent, plume push stress is ～3 times larger than the stress induced by subduction retreat;（2） an average hot anomaly of no higher than 50 K beneath the supercontinent can produce a push force strong enough to cause the initialization of supercontinent breakup;（3） the extensional stress induced by subduction retreat concentrates on a ～600 km wide zone on the boundary of the supercontinent, but has far less impact to the interior of the supercontinent. We therefore conclude that although circum-supercontinent subduction retreat assists supercontinent breakup, sub-supercontinent mantle upwelling is the essential force.展开更多
BACKGROUND Clinical reports of multiple primary malignant tumors(MPMTs)in the digestive system are increasing.In China,although the survival rate of patients with MPMTs is increasing,the quality of life is very low.Ma...BACKGROUND Clinical reports of multiple primary malignant tumors(MPMTs)in the digestive system are increasing.In China,although the survival rate of patients with MPMTs is increasing,the quality of life is very low.Many patients have reached the advanced stage when the second primary tumor is found,resulting in no early intervention and treatment.This is due to the misunderstanding of MPMTs by clinicians,who treat such tumors as metastases.Therefore,before a patient has a second primary tumor,doctors should understand some common combinations of digestive system MPMTs to provide clinical guidance to the patient.AIM To explore the high incidence combination of digestive system MPMTs under heterochronism and synchronization.METHODS A total of 1902 patients with MPMTs at Peking Union Medical College Hospital were analyzed retrospectively.They were divided into metachronous MPMT and synchronous MPMT groups,and then the high incidence combinations of the first primary cancer and the second primary cancer in metachronous cancer and synchronous cancer were sorted.Sex and age differences between metachronous and synchronous tumors were tested by the chi square test and t test,respectively.A P value<0.05 was considered as statistically significant,and SPSS version 26.0(SPSS Inc.,Chicago,Illinois,United States)was used for statistical analysis.RESULTS Among the 1902 patients with MPMTs confirmed by pathology,1811(95.2%)cases were secondary primary cancers,89(4.7%)cases were tertiary primary cancers,and 2(0.1%)cases were quaternary primary cancers.Most(88.2%)of the secondary primary cancers were identified as metachronous multiple primary cancers six months after diagnosis of the first primary cancer.The top ten most common MPMTs in the first primary cancer group ranged from high to low as follows:Breast cancer,thyroid cancer,nonuterine cancer,lung cancer,colon cancer,kidney cancer,uterine cancer,bladder cancer,rectal cancer,and gastric cancer.The highest incidence rate of the first primary cancer in male metachronous cancer was lung cancer(11.6%),the highest incidence rate of the second primary cancer was still lung cancer(24.9%),the highest incidence rate of the first primary cancer in female metachronous cancer was breast cancer(32.7%),and the highest incidence rate of the second primary cancer was lung cancer(20.8%).Among them,breast cancer,nonuterine cancer and uterine cancer were female-specific malignant tumor types,and thyroid cancer also accounted for 79.6%of female patients.The top five metachronous cancer combinations,independent of female-specific malignant tumor types and thyroid cancer,were colon cancer and lung cancer(26 cases),kidney cancer and lung cancer(25 cases),rectal cancer and lung cancer(20 cases),gastric cancer and lung cancer(17 cases),and bladder cancer and lung cancer(17 cases).The most common synchronous cancer combination was colon cancer and rectal cancer(15 cases).CONCLUSION Screening for lung cancer should be performed six months after the detection of colon cancer while rectal cancer screening should be performed within six months.展开更多
文摘Objective: By observing the treatment and nursing care of a patient with Grade IV capsular contracture following breast cancer expander implantation and subsequent Stage II reconstruction, we aim to analyze the reasons for the formation of capsular contracture after Stage I expander implantation and prevent its recurrence following Stage II reconstruction. Methods: In May 2020, the patient noticed an increase in the size of a breast mass. In August, she underwent AC-THP neoadjuvant chemotherapy, followed by a “right breast-conserving nipple-areolar subglandular excision + right axillary lymph node dissection + expander implantation” surgery in November 2020. Radiation therapy began in January 2021. During radiation therapy, the patient experienced severe breast hardening, distortion, tenderness, and was diagnosed with Grade IV capsular contracture. To relieve the capsular contracture, the patient underwent a “contracted capsule incision and release procedure + removal of the right breast expander + right breast implantation” surgery in July 2021. Postoperatively, measures were taken to prevent incision infection, emphasizing aseptic techniques, ensuring smooth negative pressure drainage, reducing skin flap tension, monitoring skin flap blood supply, actively preventing subcutaneous effusion and hematoma, and applying appropriate compression dressings. Results: The patient was discharged after the removal of the drainage tube. During the postoperative follow-up at 3 and 6 months, there was no recurrence of capsular contracture, and the breast appeared full, upright, and relatively soft. There were no complications such as hematoma, infection, breast implant rupture, breast sagging, or displacement. The patient had a good outcome without additional financial or surgical burdens. Conclusion: The occurrence of Grade IV capsular contracture in the patient is generally related to infection after Stage I expander implantation, improper compression dressing, excessive saline injection causing content infiltration, and radiation therapy. Therefore, it is recommended to enhance the intraoperative and postoperative prophylactic use of antibiotics after Stage I expander implantation. Intermittent saline injection after surgery, with the amount of saline gradually increasing rather than filling all at once, is advisable. This helps the breast tissue gradually adapt to expansion, reducing the risk of capsular contracture. Postoperatively, patients should be instructed to wear pressure garments and breast elastic bandages while intensifying breast monitoring during radiation therapy and increasing postoperative follow-up.
文摘Lake is an important part of the natural ecosystem, and its morphological characteristics reflect the capacity of lake regulation and storage, the strength of material migration, and the characteristics of shoreline development. In most existing studies, remote sensing images are used to quantify the morphological characteristics of lakes. However, the extraction accuracy of lake water is greatly affected by cloud cover and vegetation cover, and the inversion accuracy of lake elevation data is poor, which cannot accurately describe the response relationship of lake landscape morphology with water level change. Therefore, this paper takes Tonle Sap Lake as the research object, which is the largest natural freshwater lake in Southeast Asia. DEM is constructed based on high-resolution measured topographic data, and morphological indicators such as lake area, lake shoreline length, perimeter area ratio, longest axis length, maximum width, shoreline development index, lake shape complexity, compactness ratio and form ratio are adopted to researching the evolution law of high water overflows and low water outbursts quantitatively, and clarifying the variation characteristics of landscape morphology with water level gradient in Tonle Sap Lake. The research results have important theoretical significance for the scientific utilization of Tonle Sap Lake water resources and the protection of the lake ecosystem.
基金supported by the Capital’s Funds for Health Improvement and Research,No.2022-2-2072(to YG).
文摘Artificial intelligence can be indirectly applied to the repair of peripheral nerve injury.Specifically,it can be used to analyze and process data regarding peripheral nerve injury and repair,while study findings on peripheral nerve injury and repair can provide valuable data to enrich artificial intelligence algorithms.To investigate advances in the use of artificial intelligence in the diagnosis,rehabilitation,and scientific examination of peripheral nerve injury,we used CiteSpace and VOSviewer software to analyze the relevant literature included in the Web of Science from 1994–2023.We identified the following research hotspots in peripheral nerve injury and repair:(1)diagnosis,classification,and prognostic assessment of peripheral nerve injury using neuroimaging and artificial intelligence techniques,such as corneal confocal microscopy and coherent anti-Stokes Raman spectroscopy;(2)motion control and rehabilitation following peripheral nerve injury using artificial neural networks and machine learning algorithms,such as wearable devices and assisted wheelchair systems;(3)improving the accuracy and effectiveness of peripheral nerve electrical stimulation therapy using artificial intelligence techniques combined with deep learning,such as implantable peripheral nerve interfaces;(4)the application of artificial intelligence technology to brain-machine interfaces for disabled patients and those with reduced mobility,enabling them to control devices such as networked hand prostheses;(5)artificial intelligence robots that can replace doctors in certain procedures during surgery or rehabilitation,thereby reducing surgical risk and complications,and facilitating postoperative recovery.Although artificial intelligence has shown many benefits and potential applications in peripheral nerve injury and repair,there are some limitations to this technology,such as the consequences of missing or imbalanced data,low data accuracy and reproducibility,and ethical issues(e.g.,privacy,data security,research transparency).Future research should address the issue of data collection,as large-scale,high-quality clinical datasets are required to establish effective artificial intelligence models.Multimodal data processing is also necessary,along with interdisciplinary collaboration,medical-industrial integration,and multicenter,large-sample clinical studies.
基金supported by the National Natural Science Foundation of China (42274144,42304122,and 41974155)the Key Research and Development Program of Shaanxi (2023-YBGY-076)+1 种基金the National Key R&D Program of China (2020YFA0713404)the China Uranium Industry and East China University of Technology Joint Innovation Fund (NRE202107)。
文摘Time-frequency analysis is a successfully used tool for analyzing the local features of seismic data.However,it suffers from several inevitable limitations,such as the restricted time-frequency resolution,the difficulty in selecting parameters,and the low computational efficiency.Inspired by deep learning,we suggest a deep learning-based workflow for seismic time-frequency analysis.The sparse S transform network(SSTNet)is first built to map the relationship between synthetic traces and sparse S transform spectra,which can be easily pre-trained by using synthetic traces and training labels.Next,we introduce knowledge distillation(KD)based transfer learning to re-train SSTNet by using a field data set without training labels,which is named the sparse S transform network with knowledge distillation(KD-SSTNet).In this way,we can effectively calculate the sparse time-frequency spectra of field data and avoid the use of field training labels.To test the availability of the suggested KD-SSTNet,we apply it to field data to estimate seismic attenuation for reservoir characterization and make detailed comparisons with the traditional time-frequency analysis methods.
基金financially supported by the National Natural Science Foundation of China(Grant Nos.52161135302,22105087)the Postdoctoral Research Foundation of China(Grant No.2022M721360)the Natural Science Foundation of Jiangsu Province(Grant No.BK20210446)。
文摘The d-d orbital coupling induced by crystal-phase engineering can effectively adjust the electronic structure of electrocatalysts,thus showing significant catalytic performance,while it has been rarely explored in electrochemical acetonitrile reduction reaction(ARR)to date.Herein,we successfully realize the structural transformation of Pd Cu metallic aerogels(MAs)from face-centered cubic(FCC)to body-centered cubic(BCC)through annealing treatment.Specifically,the BCC Pd Cu MAs exhibit excellent ARR performance with high ethylamine selectivity of 90.91%,Faradaic efficiency of 88.60%,yield rate of 316.0 mmol h^(-1)g^(-1)_(Pd+Cu)and long-term stability for consecutive electrolysis within 20 h at-0.55 V vs.reversible hydrogen electrode,outperforming than those of FCC Pd Cu MAs.Under the membrane electrode assembly system,BCC Pd Cu MAs also demonstrate excellent ethylamine yield rate of 389.5 mmol h^(-1)g^(-1)_(Pd+Cu).Density functional theory calculation reveals that the d-d orbital coupling in BCC Pd Cu MAs results in an evident correlation effect for the interaction of Pd and Cu sites,which boosts up the Cu sites electronic activities to enhance ARR performance.Our work opens a new route to develop efficient ARR electrocatalysts from the perspective of crystalline structure transformation.
基金supported by the open project of the Key Laboratory of Environmental Pollution Monitoring and Disease Control,Ministry of Education,Guizhou Medical University,China (GMU-2022-HJZ-06)。
文摘Naringin exists in a wide range of Chinese herbal medicine and has proven to possess several pharmacological properties.In this study,PC12,HepG2 cells,and female Drosophila melanogaster were used to investigate the antioxidative and anti-aging effects of naringin and explore the underlying mechanisms.The results showed that naringin inhibited H_(2)O_(2)-induced decline in cell viability and decreased,the content of reactive oxygen species in cells.Meanwhile,naringin prolonged the lifespan of flies,enhanced the abilities of climbing and the resistance to stress,improved the activities of antioxidant enzymes,and decreased malondialdehyde content.Naringin also improved intestinal barrier dysfunction and reduced abnormal proliferation of intestinal stem cells.Moreover,naringin down-regulated the mRNA expressions of inr,chico,pi 3k,and akt-1,and up-regulated the mRNA expressions of dilp2,dilp3,dilp5,and foxo,thereby activating autophagy-related genes and increasing the number of lysosomes.Furthermore,the mutant stocks assays and computer molecular simulation results further indicated that naringin delayed aging by inhibiting the insulin signaling(IIS)pathway and activating the autophagy pathway,which was consistent with the result of network pharmacological predictions.
基金supported by Sichuan Science and Technology Program(2022ZHCG0122)the NSAF project(U2230120)+1 种基金Youth Science and Technology Innovation Team of Sichuan Province of Functional Polymer Composites(2021JDTD0009)the Key Researched Development Program of Sichuan Province(2022YFG0271).
文摘For improving the actuation performance at low electric fields of dielectric elastomers,achieving high dielectric constant(εr)and low modulus(Y)simultaneously has been targeted in the past decades,but there are few ways to accomplish both.In contrast to the classical strategies such as incorporating plasticizers or ceramic to prepare the silicon-based dielectric elastomers,here,blending an amino-complexed hybrid(polyethyleneimine(PEI)-Ag)with polydimethylsiloxane(PDMS)elastomer is reported as an alternative strategy to tailor theεr and Y.PEI-Ag not only exhibits excellent dielectric enhancement properties but also minimizes the PDMS crosslinking through amino-complexed reaction between PEI and Pt catalysts.The prepared dielectric elastomers have aεr of 7.2@10^(3)Hz and Y of 1.14 MPa,leading to an actuation strain of 22.27%at 35 V/μm.Hence,incorporating such novel hybrids based on dual amino-complexed effect on both matrix and particles sufficiently promotes the actuated performance of dielectric elastomers.
基金Supported by the National Natural Science Foundation of China,No.82174464China Academy of Traditional Chinese Medicine Science and Technology Innovation Project,No.CI2021A01806Central High Level Traditional Chinese Medicine Hospital Clinical Research and Achievement Transformation Ability Enhancement Project,No.HLCMHPP2023085.
文摘BACKGROUND Herba Patriniae and Coix seed(HC)constitute a widely utilized drug combination in the clinical management of colorectal cancer(CRC)that is known for its diuretic,anti-inflammatory,and swelling-reducing properties.Although its efficacy has been demonstrated in a clinical setting,the active compounds and their mechanisms of action in CRC treatment remain to be fully elucidated.AIM To identify the active,CRC-targeting components of HC and to elucidate the mechanisms of action involved.METHODS Active HC components were identified and screened using databases.Targets for each component were predicted.CRC-related targets were obtained from human gene databases.Interaction targets between HC and CRC were identified.A“drug-ingredient-target”network was created to identify the core components and targets involved.Gene Ontology(GO)and Kyoto Encyclopedia of Genes and Genomes(KEGG)analyses were conducted to elucidate the key pathways involved.Molecular docking between core targets and key components was executed.In vitro experiments validated core monomers.RESULTS Nineteen active components of HC were identified,with acacetin as the primary active compound.The predictive analysis identified 454 targets of the active compounds in HC.Intersection mapping with 2685 CRC-related targets yielded 171 intervention targets,including 30 core targets.GO and KEGG analyses indicated that HC may influence the phosphoinositide 3-kinase(PI3K)/Akt signaling pathway.Molecular docking showed that acacetin exhibited an optimal interaction with AKT1,identifying PI3K,AKT,and P53 as key genes likely targeted by HC during CRC treatment.Acacetin inhibited HT-29 cell proliferation and migration,as well as promoted apoptosis,in vitro.Western blotting analysis revealed increased p53 and cleaved caspase-3 expression and decreased levels of p-PI3K,p-Akt,and survivin,which likely contributed to CRC apoptosis.CONCLUSION Acacetin,the principal active compound in the HC pair,inhibited the proliferation and migration of HT-29 cells and promoted apoptosis through the PI3K/Akt/p53 signaling pathway.
基金supported in part by the Fundamental Research Funds for the Central Universities(Nos.3282024052,3282024058)the“Advanced and Sophisticated”Discipline Construction Project of Universities in Beijing(No.20210013Z0401).
文摘The Industrial Internet of Things(IIoT)consists of massive devices in different management domains,and the lack of trust among cross-domain entities leads to risks of data security and privacy leakage during information exchange.To address the above challenges,a viable solution that combines Certificateless Public Key Cryptography(CL-PKC)with blockchain technology can be utilized.However,as many existing schemes rely on a single Key Generation Center(KGC),they are prone to problems such as single points of failure and high computational overhead.In this case,this paper proposes a novel blockchain-based certificateless cross-domain authentication scheme,that integrates the threshold secret sharing mechanism without a trusted center,meanwhile,adopts blockchain technology to enable cross-domain entities to authenticate with each other and to negotiate session keys securely.This scheme also supports the dynamic joining and removing of multiple KGCs,ensuring secure and efficient cross-domain authentication and key negotiation.Comparative analysiswith other protocols demonstrates that the proposed cross-domain authentication protocol can achieve high security with relatively lowcomputational overhead.Moreover,this paper evaluates the scheme based on Hyperledger Fabric blockchain environment and simulates the performance of the certificateless scheme under different threshold parameters,and the simulation results show that the scheme has high performance.
基金State Grid Corporation of China Science and Technology Project“Research andApplication of Key Technologies for Trusted Issuance and Security Control of Electronic Licenses for Power Business”(5700-202353318A-1-1-ZN).
文摘To enhance the efficiency and expediency of issuing e-licenses within the power sector, we must confront thechallenge of managing the surging demand for data traffic. Within this realm, the network imposes stringentQuality of Service (QoS) requirements, revealing the inadequacies of traditional routing allocation mechanismsin accommodating such extensive data flows. In response to the imperative of handling a substantial influx of datarequests promptly and alleviating the constraints of existing technologies and network congestion, we present anarchitecture forQoS routing optimizationwith in SoftwareDefinedNetwork (SDN), leveraging deep reinforcementlearning. This innovative approach entails the separation of SDN control and transmission functionalities, centralizingcontrol over data forwardingwhile integrating deep reinforcement learning for informed routing decisions. Byfactoring in considerations such as delay, bandwidth, jitter rate, and packet loss rate, we design a reward function toguide theDeepDeterministic PolicyGradient (DDPG) algorithmin learning the optimal routing strategy to furnishsuperior QoS provision. In our empirical investigations, we juxtapose the performance of Deep ReinforcementLearning (DRL) against that of Shortest Path (SP) algorithms in terms of data packet transmission delay. Theexperimental simulation results show that our proposed algorithm has significant efficacy in reducing networkdelay and improving the overall transmission efficiency, which is superior to the traditional methods.
文摘Protein C(PC)is a key component of the vitamin K-dependent coagulation pathway.It exerts anticoagulant effects by inactivating factors V and VIII.Acquired or inherited PC deficiency results in a prothrombotic state,with presentations varying from asymptomatic to venous thromboembolism.However,there has been an increasing number of reports linking PC deficiency to arterial thromboembolic events,such as myocardial infarction and ischemic stroke.This editorial focuses on the association between PC deficiency and thromboembolism,which may provide some insights for treatment strategy and scientific research.
基金the Tianjin Health Science and Technology Project,No.TJWJ2021MS011.
文摘BACKGROUND Numerous studies have assessed the efficacy and safety of fecal microbiota transplantation(FMT)as a therapy for ulcerative colitis(UC).However,the treatment processes and outcomes of these studies vary.AIM To evaluate the efficacy and safety of FMT for treating UC by conducting a systematic meta-analysis.METHODS The inclusion criteria involved reports of adult patients with UC treated with FMT,while studies that did not report clinical outcomes or that included patients with infection were excluded.Clinical remission(CR)and endoscopic remission(ER)were the primary and secondary outcomes,respectively.RESULTS We included nine studies retrieved from five electronic databases.The FMT group had better CR than the control group[relative risk(RR)=1.53;95%confidence interval(CI):1.19-1.94;P<0.0008].ER was statistically significantly different between the two groups(RR=2.80;95%CI:1.93-4.05;P<0.00001).Adverse events did not differ significantly between the two groups.CONCLUSION FMT demonstrates favorable performance and safety;however,well-designed randomized clinical trials are still needed before the widespread use of FMT can be recommended.Furthermore,standardizing the FMT process is urgently needed for improved safety and efficacy.
文摘BACKGROUND Meniscus extrusion occurs in most elderly individuals and most patients after meniscus allograft transplantation.The risk factors and correlative factors of meniscus extrusion have been extensively studied.However,for using tendon autograft for meniscus reconstruction,both graft type and surgical method are different from those in previous studies on meniscus extrusion.AIM To identify predictive factors for coronal and sagittal graft extrusion length after using tendon autograft for medial meniscus reconstruction.METHODS Ten patients who underwent medial meniscus reconstruction with tendon autograft were selected for this retrospective observational study.The graft extrusions and potential factors were measured and correlation and regression analyses were performed to analyze their relationships.RESULTS The medial graft extrusion correlated with the preoperative bilateral hip-kneeankle angle difference,preoperative Kellgren-Lawrence grade,preoperative relative joint space width,and preoperative bilateral medial edge incline angle difference.The anterior graft correlated with the anterior tunnel edge distance at 1 week after operation.The posterior graft extrusion correlated with the preoperative bilateral hip-knee-ankle angle difference,preoperative relative joint space width,and posterior tunnel edge distance at 1 week after operation.The mean graft extrusion correlated with the preoperative bilateral hip-knee-ankle angle difference and preoperative relative joint space width.The preoperative joint space width and anterior and posterior tunnel edge distance at 1 week can be used to predict the medial,anterior,posterior,and mean graft extrusion length.CONCLUSION The preoperative joint space width and tunnel position can be used to predict the coronal and sagittal graft extrusion length after using tendon autograft for medial meniscus reconstruction.
基金Supported by the National Natural Science Foundation of China,No.82305035.
文摘BACKGROUND Autism spectrum disorder(ASD)is a developmental disorder characterized by social deficits and repetitive behavior.Gastrointestinal(GI)problems,such as constipation,diarrhea,and inflammatory bowel disease,commonly occur in patients with ASD.Previously,GI problems of ASD patients were attributed to intestinal inflammation and vertical mother-to-infant microbiome transmission.AIM To explore whether GI problems in ASD are related to maternal intestinal inflam-mation and gut microbiota abnormalities.METHODS An ASD rat model was developed using valproic acid(VPA).Enzyme-linked immunosorbent assay and fecal 16S rRNA sequencing were used to test GI changes.RESULTS VPA exposure during pregnancy led to pathological maternal intestinal changes,resulting in alterations in maternal gut microbiota.Additionally,the levels of inflammatory factors also increased.Moreover,prenatal exposure to VPA resulted in impaired duodenal motility in the offspring as well as increased levels of infla-mmatory factors.CONCLUSION GI problems in ASD may be associated with maternal intestinal inflammation and microbiota abnormality.Future research is required to find more evidence on the etiology and treatment of GI problems in ASD.
基金supported by Australian Research Council Australian Laureate Fellowship grant to ZXL (FL150100133)by China’s Thousand Talents Plan (2015)+2 种基金NSFC41674098 to NZsupported by resources provided by the High-performance Computing Platform of Peking Universitythe Pawsey Supercomputing Centre with funding from the Australian Government and the Government of Western Australia
文摘Understanding the dominant force responsible for supercontinent breakup is crucial for establishing Earth＇s geodynamic evolution that includes supercontinent cycles and plate tectonics. Conventionally,two forces have been considered： the push by mantle plumes from the sub-continental mantle which is called the active force for breakup, and the dragging force from oceanic subduction retreat which is called the passive force for breakup. However, the relative importance of these two forces is unclear. Here we model the supercontinent breakup coupled with global mantle convection in order to address this question. Our global model features a spherical harmonic degree-2 structure, which includes a major subduction girdle and two large upwelling（superplume） systems. Based on this global mantle structure,we examine the distribution of extensional stress applied to the supercontinent by both subsupercontinent mantle upwellings and subduction retreat at the supercontinent peripheral. Our results show that：（1） at the center half of the supercontinent, plume push stress is ～3 times larger than the stress induced by subduction retreat;（2） an average hot anomaly of no higher than 50 K beneath the supercontinent can produce a push force strong enough to cause the initialization of supercontinent breakup;（3） the extensional stress induced by subduction retreat concentrates on a ～600 km wide zone on the boundary of the supercontinent, but has far less impact to the interior of the supercontinent. We therefore conclude that although circum-supercontinent subduction retreat assists supercontinent breakup, sub-supercontinent mantle upwelling is the essential force.
基金the CAMS Innovation Fund for Medical Sciences,No.2021-I2M-1-061 and 2021-1-I2M-003CSCOhengrui Cancer Research Fund,No.Y-HR2019-0239+1 种基金CSCO-MSD Cancer Research Fund,No.Y-MSDZD2021-0213National Ten-thousand Talent Program。
文摘BACKGROUND Clinical reports of multiple primary malignant tumors(MPMTs)in the digestive system are increasing.In China,although the survival rate of patients with MPMTs is increasing,the quality of life is very low.Many patients have reached the advanced stage when the second primary tumor is found,resulting in no early intervention and treatment.This is due to the misunderstanding of MPMTs by clinicians,who treat such tumors as metastases.Therefore,before a patient has a second primary tumor,doctors should understand some common combinations of digestive system MPMTs to provide clinical guidance to the patient.AIM To explore the high incidence combination of digestive system MPMTs under heterochronism and synchronization.METHODS A total of 1902 patients with MPMTs at Peking Union Medical College Hospital were analyzed retrospectively.They were divided into metachronous MPMT and synchronous MPMT groups,and then the high incidence combinations of the first primary cancer and the second primary cancer in metachronous cancer and synchronous cancer were sorted.Sex and age differences between metachronous and synchronous tumors were tested by the chi square test and t test,respectively.A P value<0.05 was considered as statistically significant,and SPSS version 26.0(SPSS Inc.,Chicago,Illinois,United States)was used for statistical analysis.RESULTS Among the 1902 patients with MPMTs confirmed by pathology,1811(95.2%)cases were secondary primary cancers,89(4.7%)cases were tertiary primary cancers,and 2(0.1%)cases were quaternary primary cancers.Most(88.2%)of the secondary primary cancers were identified as metachronous multiple primary cancers six months after diagnosis of the first primary cancer.The top ten most common MPMTs in the first primary cancer group ranged from high to low as follows:Breast cancer,thyroid cancer,nonuterine cancer,lung cancer,colon cancer,kidney cancer,uterine cancer,bladder cancer,rectal cancer,and gastric cancer.The highest incidence rate of the first primary cancer in male metachronous cancer was lung cancer(11.6%),the highest incidence rate of the second primary cancer was still lung cancer(24.9%),the highest incidence rate of the first primary cancer in female metachronous cancer was breast cancer(32.7%),and the highest incidence rate of the second primary cancer was lung cancer(20.8%).Among them,breast cancer,nonuterine cancer and uterine cancer were female-specific malignant tumor types,and thyroid cancer also accounted for 79.6%of female patients.The top five metachronous cancer combinations,independent of female-specific malignant tumor types and thyroid cancer,were colon cancer and lung cancer(26 cases),kidney cancer and lung cancer(25 cases),rectal cancer and lung cancer(20 cases),gastric cancer and lung cancer(17 cases),and bladder cancer and lung cancer(17 cases).The most common synchronous cancer combination was colon cancer and rectal cancer(15 cases).CONCLUSION Screening for lung cancer should be performed six months after the detection of colon cancer while rectal cancer screening should be performed within six months.
