Background:Climate change profoundly shapes the population health at the global scale.However,there was still insufficient and inconsistent evidence for the association between heat exposure and chronic kidney disease...Background:Climate change profoundly shapes the population health at the global scale.However,there was still insufficient and inconsistent evidence for the association between heat exposure and chronic kidney disease(CKD).Methods:In the present study,we studied the association of heat exposure with hospitalizations for cause-specific CKD using a national inpatient database in China during the study period of hot season from 2015 to 2018.Standard time-series regression models and random-effects Meta-analysis were developed to estimate the city-specific and national averaged associations at a 7 lag-day span,respectively.Results:A total of 768,129 hospitalizations for CKD was recorded during the study period.The results showed that higher temperature was associated with elevated risk of hospitalizations for CKD,especially in sub-tropical cities.With a 1℃ increase in daily mean temperature,the cumulative relative risks(RR)over lag 0-7 d were 1.008[95% confidence interval(CI)1.003-1.012]for nationwide.The attributable fraction of CKD hospitalizations due to high temperatures was 5.50%.Stronger associations were observed among younger patients and those with obstructive nephropathy.Our study also found that exposure to heatwaves was associated with added risk of hospitalizations for CKD compared to non-heatwave days(RR=1.116,95%CI 1.069-1.166)above the effect of daily mean temperature.Conclusions:Short-term heat exposure may increase the risk of hospitalization for CKD.Our findings provide insights into the health effects of climate change and suggest the necessity of guided protection strategies against the adverse effects of high temperatures.展开更多
BACKGROUND Jianpi-Huatan-Huoxue-Anshen formula[Tzu-Chi cancer-antagonizing&lifeprotecting II decoction(TCCL)]is a Chinese medical formula that has been clinically shown to reduce the gastrointestinal side effects ...BACKGROUND Jianpi-Huatan-Huoxue-Anshen formula[Tzu-Chi cancer-antagonizing&lifeprotecting II decoction(TCCL)]is a Chinese medical formula that has been clinically shown to reduce the gastrointestinal side effects of chemotherapy in cancer patients and improve their quality of life.However,its effect and mechanism on the intestinal microecology after chemotherapy are not yet clear.AIM To discover the potential mechanisms of TCCL on gastrointestinal inflammation and microecological imbalance in chemotherapy-treated mice transplanted with hepatocellular carcinoma(HCC).METHODS Ninety-six mice were inoculated subcutaneously with HCC cells.One week later,the mice received a large dose of 5-fluorouracil by intraperitoneal injection to establish a HCC chemotherapy model.Thirty-six mice were randomly selected before administration,and feces,ileal tissue,and ileal contents were collected from each mouse.The remaining mice were randomized into normal saline,continuous chemotherapy,Yangzheng Xiaoji capsulestreated,and three TCCL-treated groups.After treatment,feces,tumors,liver,spleen,thymus,stomach,jejunum,ileum,and colon tissues,and ileal contents were collected.Morphological changes,serum levels of IL-1β,IL-6,IL-8,IL-10,IL-22,TNF-α,and TGF-β,intestinal SIgA,and protein and mRNA expression of ZO-1,NF-κB,Occludin,MUC-2,Claudin-1,and IκB-αin colon tissues were documented.The effect of TCCL on the abundance and diversity of intestinal flora was analyzed using 16S rDNA sequencing.RESULTS TCCL treatment improved thymus and spleen weight,thymus and spleen indexes,and body weight,decreased tumor volumes and tumor tissue cell density,and alleviated injury to gastric,ileal,and colonic mucosal tissues.Among proteins and genes associated with inflammation,IL-10,TGF-β,SIgA,ZO-1,MUC-2,and Occludin were upregulated,whereas NF-κB,IL-1β,IL-6,TNF-α,IL-22,IL-8,and IκB-αwere downregulated.Additionally,TCCL increased the proportions of fecal Actinobacteria,AF12,Adlercreutzia,Clostridium,Coriobacteriaceae,and Paraprevotella in the intermediate stage of treatment,decreased the proportions of Mucipirillum,Odoribacter,RF32,YS2,and Rikenellaceae but increased the proportions of p_Deferribacteres and Lactobacillus at the end of treatment.Studies on ileal mucosal microbiota showed similar findings.Moreover,TCCL improved community richness,evenness,and the diversity of fecal and ileal mucosal flora.CONCLUSION TCCL relieves pathological changes in tumor tissue and chemotherapy-induced gastrointestinal injury,potentially by reducing the release of pro-inflammatory factors to repair the gastrointestinal mucosa,enhancing intestinal barrier function,and maintaining gastrointestinal microecological balance.Hence,TCCL is a very effective adjuvant to chemotherapy.展开更多
Background:In traditional Chinese medicine,You-Gui-Wan(YGW)is typically used to treat osteoporosis associated with kidney-yang deficiency.However,there have been few mechanistic studies on the effectiveness of kidney-...Background:In traditional Chinese medicine,You-Gui-Wan(YGW)is typically used to treat osteoporosis associated with kidney-yang deficiency.However,there have been few mechanistic studies on the effectiveness of kidney-yang deficiency-type osteoporosis with YGW.To further clarify the role of YGW in the effect of osteoporosis with kidney-yang deficiency,the study analyzed the therapeutic advantages of YGW by comparing the therapeutic effects of YGW and alendronate(ALN)on osteoporosis with kidney-yang deficiency.Methods:SPF female SD rats were randomly divided into control,osteoporosis,osteoporosis with kidney-yang deficiency,osteoporosis with kidney-yang deficiency+YGW and osteoporosis with kidney-yang deficiency+ALN groups.Except for the control group,osteoporosis was induced by the removal of bilateral ovaries.After 12 weeks,rats with osteoporosis in the kidney-yang deficiency group had kidney-yang deficiency syndrome triggered by hydrocortisone for 14 days.Rats were treated with YGW or ALN for 12 weeks.The weights of rats were recorded.Hematoxylin-eosin staining staining was used to observe pathological changes in bone trabeculae,liver,spleen,and kidneys of rats.Depletion of the growth plate cartilage of rats in different groups was observed by safranine-O staining.The expression of osteoclast key indices(ACP)and osteoblast key indices(ALP)in the bone tissue of rats in the different groups was observed by immunohistochemical staining.The expression of bone resorption-related indicators(TRAP and NXT-1),bone formation-related indicators(BALP,BGP,and P1NP),and major indicators of kidney-yang deficiency(ACTH,T3,T4,cAMP,and cGMP)were observed using an ELISA detection kit.The expression levels of the main indices of liver function(ALT and AST)were detected in different groups.Results:The differences between the osteoporosis with kidney-yang deficiency group and osteoporosis group were that the weight of rats and the expression of ACTH,T3,T4,and cAMP decreased significantly,and the expression of cGMP increased in the osteoporosis with kidney-yang deficiency group.Moreover,both YGW and ALN effectively improved the symptoms of osteoporosis,including the injury of bone trabeculae and growth plates,as well as the expression of bone metabolism-related indicators.However,unlike ALN,YGW simultaneously ameliorated the expression of key indicators of kidney-yang deficiency and prevented weight loss in rats.In addition,YGW caused no obvious damage to the liver,spleen,or kidney,whereas ALN led to liver cirrhosis.Conclusion:The results reveal that YGW plays a crucial part in osteoporosis with kidney-yang deficiency,increases bone mineral density,and improves bone metabolism indicators,and is safe and efficient for the efficacy of osteoporosis with kidney-yang deficiency.YGW might have a better therapeutic effect on osteoporosis in patients with kidney-yang deficiency.Therefore,alendronate should be used cautiously in patients with osteoporosis and poor liver function.展开更多
Introduction: Brain metastasis is common in relapsed neuroblastoma patients, but the characteristics of brain metastasis remain largely unknown. This study aimed to investigate the status of brain metastasis with neur...Introduction: Brain metastasis is common in relapsed neuroblastoma patients, but the characteristics of brain metastasis remain largely unknown. This study aimed to investigate the status of brain metastasis with neuroblastoma in South China.Methods: In this retrospective case?based study, 106 patients with stage 4 neuroblastoma from the Department of Pediatric Oncology in Sun Yat?sen University Cancer Center between January 2004 and May 2013 were included. The incidence, risk factors, and survival status of these patients were reviewed and analyzed.Results: Of the 106 patients, 11(10.4%) developed brain metastasis, accounting for 20.0% of 55 patients with relapse or progression. The age at initial diagnosis of the 11 patients ranged from 2 to 10 years(median 4 years), which was younger than that of the patients without brain metastasis(median 5 years, range 1–10 years, P = 0.073). The male to female ratio of the 11 patients was 8:3, which was not signiicantly diferent from that of the patients with?out brain metastasis(P = 0.86). Patients with brain metastasis had higher lactate dehydrogenase levels than those without brain metastasis, but the diferences were not signiicant(P initial diagnosis to the develo= 0.076). Eight patients died, and 3 patients survived. The median interval from thepment of brain metastasis was 18 months(range 6–32 months). The median survival was 4 months(range 1 day to 29 months) after the diagnosis of brain metastasis. The median interval from the manifestation of brain metastasis to death was 3 months(range 1 day to 11 months).Conclusions: High?risk factors for brain metastasis in cases of neuroblastoma include bone marrow involvement and a younger age at initial diagnosis. Nevertheless, multiple treatment modalities can improve disease?free survival.展开更多
Primary central nervous system germ cell tumors(CNS-GCTs) in children and adolescents have unique clinical features and methods of treatment compared with those in adults. There is little information about Chinese chi...Primary central nervous system germ cell tumors(CNS-GCTs) in children and adolescents have unique clinical features and methods of treatment compared with those in adults. There is little information about Chinese children and adolescents with CNS-GCTs. Therefore, in this study we retrospectively analyzed the clinical features and treatment outcome of Chinese children and adolescents with primary CNS-GCTs. Between January 2002 and December 2012, 57 untreated patients from a single institution were enrolled. They were diagnosed with CNS-GCTs after pathologic or clinical assessment. Of the 57 patients, 41 were males and 16 were females, with a median age of 12.8 years(range, 2.7 to 18.0 years) at diagnosis; 43(75.4%) had non-germinomatous germ cell tumors(NGGCTs) and 14(24.6%) had germinomas; 44(77.2%) had localized disease and 13(22.8%) had extensive lesions. Fifty-three patients completed the prescribed treatment, of which 18 underwent monotherapy of surgery, radiotherapy, or chemotherapy, and 35 underwent multimodality therapies that included radiotherapy combined with chemotherapy or surgery combined with chemotherapy and/or radiotherapy. PEB(cisplatin, etoposide, and bleomycin) protocol was the major chemotherapy regimen. The median follow-up time was 32.3 months(range, 1.2 to 139 months). Fourteen patients died of relapse or disease progression. The 3-year event-free survival(EFS) and overall survival rates for all patients were 72.2% and 73.8%, respectively. The 3-year EFS was 92.9% for germinomas and 64.8% for NGGCTs(P = 0.064). The 3-year EFS rates for patients with NGGCTs who underwent monotherapy and multimodality therapies were 50.6% and 73.5%, respectively(P = 0.042). Our results indicate that multimodality therapies including chemotherapy plus radiotherapy were better treatment option for children and adolescents with CNS-GCTs.展开更多
Pediatric diffuse large B-cell lymphoma(DLBCL)is a highly aggressive disease with unique clinical characteristics.This study analyzed the germinal-center type B-cell(GCB)classification and clinical characteristics of ...Pediatric diffuse large B-cell lymphoma(DLBCL)is a highly aggressive disease with unique clinical characteristics.This study analyzed the germinal-center type B-cell(GCB)classification and clinical characteristics of Chinese pediatric DLBCL.A total of 76 patients with DLBCL newly diagnosed in Sun Yatsen University Cancer Center between February 2000 and May 2011,with an age younger than 18 years,were included in the analysis.The male/female ratio was 3.47:1.The median age was 12 years(range,2 to 18 years),and 47(61.8%)patients were at least 10 years old.Of the 76 patients,48(63.2%)had stage III/IV disease,9(11.8%)had bone marrow involvement,1(1.3%)had central nervous system(CNS)involvement,and 5(6.6%)had bone involvement.The GCB classification was assessed in 45 patients:26(57.8%)were classified as GCB subtype,and 19(42.2%)were classified as non-GCB subtype.The modified B-NHL-BFM-90/95 regimen was administered to 50 patients,and the 4-year event-free survival(EFS)rate was 85.8%.Among these 50 patients,31 were assessed for the GCB classification:17(54.8%)were classified as GCB subtype,with a 4-year EFS rate of 88.2%;14(45.2%)were classified as non-GCB subtype,with a 4-year EFS rate of 92.9%.Our data indicate that bone marrow involvement and stage III/IV disease are common in Chinese pediatric DLBCL patients,whereas the percentage of patients with the GCB subtype is similar to that of patients with the non-GCB subtype.The modified B-NHL-BFM-90/95protocol is an active and effective treatment protocol for Chinese pediatric patients with DLBCL.展开更多
Electroacupuncture（EA） has anti-oxidative and anti-inflammatory actions,but whether the neuroprotective effect of EA against cerebral ischemia-reperfusion（I/R） injury involves modulation of the extracellular regul...Electroacupuncture（EA） has anti-oxidative and anti-inflammatory actions,but whether the neuroprotective effect of EA against cerebral ischemia-reperfusion（I/R） injury involves modulation of the extracellular regulated kinase 1/2（ERK1/2） signaling pathway is unclear.Middle cerebral artery occlusion（MCAO） was performed in Sprague-Dawley rats for 2 hours followed by reperfusion for 24 hours.A 30-minute period of EA stimulation was applied to both Baihui（DU20） and Dazhui（DU14） acupoints in each rat（10 mm EA penetration depth,continuous wave with a frequency of 3 Hz,and a current intensity of 1–3 m A） when reperfusion was initiated.EA significantly reduced infarct volume,alleviated neuronal injury,and improved neurological function in rats with MCAO.Furthermore,high m RNA expression of Bax and low m RNA expression of Bcl-2 induced by MCAO was prevented by EA.EA substantially restored total glutathione reductase（GR）,glutathione（GSH） and glutathione peroxidase（GSH-Px） levels.Additionally,Nrf2 and glutamylcysteine synthetase（GCS） expression levels were markedly increased by EA.Interestingly,the neuroprotective effects of EA were attenuated when ERK1/2 activity was blocked by PD98059（a specific MEK inhibitor）.Collectively,our findings indicate that activation of the ERK1/2 signaling pathway contributes to the neuroprotective effects of EA.Our study provides a better understanding of the regulatory mechanisms underlying the therapeutic effectiveness of EA.展开更多
We mainly investigate the variable-coefficient 3-coupled nonlinear Schrodinger(NLS)system,which describes soli- ton dynamics in the three-spineα-helical protein with inhomogeneous effect.The variable-coefficient NLS ...We mainly investigate the variable-coefficient 3-coupled nonlinear Schrodinger(NLS)system,which describes soli- ton dynamics in the three-spineα-helical protein with inhomogeneous effect.The variable-coefficient NLS equation is transformed into the constant coefficient NLS equation by similarity transformation firstly.The Hirota method is used to solve the constant coefficient NLS equation,and then we get the one-and two-breather solutions of the variable-coefficient NLS equation.The results show that,in the background of plane waves and periodic waves,the breather can be transformed into some forms of combined soliton solutions.The influence of different parameters on the soliton solution and the collision between two solitons are discussed by some graphs in detail.Our results are helpful to study the soliton dynamics inα-helical protein.展开更多
BACKGROUND Although skin avulsions to male external genitalia are rare, they can be both physically and psychologically traumatic. Thus, the necessity for judicious management poses significant challenges to surgeons ...BACKGROUND Although skin avulsions to male external genitalia are rare, they can be both physically and psychologically traumatic. Thus, the necessity for judicious management poses significant challenges to surgeons in order to avoid potential permanent disabilities. We report a case of massive penoscrotal skin avulsion and a composite graft was creatively applied to cover the defect which achieved good results. We believe that this case is of great reference value for fellow surgeons.CASE SUMMARY A 52-year-old male presented with massive traumatic avulsion of the penile and scrotal skin following mishandling of an electric drill. The avulsed skin was missing. The patient was diagnosed with massive skin avulsion of external genitalia. Following initial complete debridement of devitalized or infected tissues, Pelnac dermal substitute was secured to the defect with the assistance of negative-pressure wound closure. In the final step, the silicone layer of Pelnac was removed and a split-thickness skin graft was applied. The defect had healed at the two-month follow-up. The patient now has normal erections and satisfactory sexual function.CONCLUSION Our experience with this wound repair demonstrated that the combination of a dermal regeneration template and a split-thickness skin graft with vacuumassisted closure is a safe, well-tolerated and efficient solution for the reconstruction of massive penoscrotal skin defects.展开更多
A reliable multiphase flow simulator is an important tool to improve wellbore integrity and production decision-making.To develop a multiphase flow model with high adaptability and high accuracy,we first build a multi...A reliable multiphase flow simulator is an important tool to improve wellbore integrity and production decision-making.To develop a multiphase flow model with high adaptability and high accuracy,we first build a multiphase flow database with 3561 groups of data and developed a drift closure relationship with stable continuity and high adaptability.Second,a high-order numerical scheme with strong fault capture ability is constructed by effectively combining MUSCL technology,van Albada slope limiter and AUSMV numerical scheme.Finally,the energy equation is coupled into the AUSMV numerical scheme of the drift flow model in the form of finite difference.A transient non-isothermal wellbore multiphase flow model with wide applicability is formed by integrating the three technologies,and the effects of various factors on the calculation accuracy are studied.The accuracy of the simulator is verified by comparing the measurement results with the blowout experiment of a full-scale experimental well.展开更多
The simulation of the artillery interior and intermediate ballistics problem is performed to investigate the influence of a gas dynamics device,muzzle brake,on the muzzle hazard phenomena,such as flash and blast waves...The simulation of the artillery interior and intermediate ballistics problem is performed to investigate the influence of a gas dynamics device,muzzle brake,on the muzzle hazard phenomena,such as flash and blast waves.The correlation of the chemical reactions with the characteristics of the muzzle flow field is analyzed by the simulation for a further understanding of the secondary combustion phenomenon of the muzzle flow.The novel structure of muzzle flow caused by the muzzle brake is presented by the simultaneous solution of the interior ballistics model and multi-species Navier-Stokes equations in order to analyze the influence of the muzzle brake structure on the chemical reactions.The secondary combustion of the muzzle flow due to the oxygen-supplement chemical reactions is obtained by the chemical reaction kinetic model.The interaction of the blast waves released from the muzzle brake is illustrated in detail and the mechanism of the formation of muzzle flash is analyzed.This research provides a reference for the studies on the suppression of the muzzle flash.展开更多
BACKGROUND About 20%-30%of newly diagnosed hepatocellular carcinoma(HCC)patients are surgically feasible due to a variety of reasons.Active conversion therapy may provide opportunities of surgery for these patients.Ne...BACKGROUND About 20%-30%of newly diagnosed hepatocellular carcinoma(HCC)patients are surgically feasible due to a variety of reasons.Active conversion therapy may provide opportunities of surgery for these patients.Nevertheless,the choice of surgical procedure is controversial after successful conversion therapy.We report a patient with HCC who underwent successful laparoscopic right trisectionectomy after conversion therapy with portal vein embolization and transarterial chemoembolization.CASE SUMMARY A 67-year-old male patient presented to our hospital with epigastric distention/discomfort and nausea/vomiting for more than 1 mo.Contrast-enhanced computed tomography scan of the abdomen demonstrated multiple tumors(the largest was≥10 cm in diameter)located in the right liver and left medial lobe,and the left lateral lobe was normal.The future remnant liver(FRL)of the left lateral lobe accounted for only 18%of total liver volume after virtual resection on the three-dimensional liver model.Conversion therapy was adopted after orally administered entecavir for antiviral treatment.First,the right portal vein was embolized.Then tumor embolization was performed via the variant hepatic arteries.After 3 wk,the FRL of the left lateral lobe accounted for nearly 30%of the total liver volume.Totally laparoscopic right trisectionectomy was performed under combined epidural and general anesthesia.The in situ resection was performed via an anterior approach.The operating time was 240 min.No clamping was required during the surgery,and the intraoperative blood loss was 300 mL.There were no postoperative complications such as bile leakage,and the incision healed well.The patient was discharged on the 8th postoperative day.During the 3-mo follow-up,there was no recurrence and obvious hyperplasia of residual liver was observed.Alpha-fetoprotein decreased significantly and tended to be normal.CONCLUSION Due to the different biological characteristics of the liver cancer and the pathophysiological features of the liver from other organs,the conversion treatment should take into account both the feasibility of tumor downstaging and the volume and function of the remnant liver.Our case provides a reference for clinicians in terms of both conversion therapy and laparoscopic right trisectionectomy.展开更多
BACKGROUND Squamous cell carcinoma(SCC)of the nail bed is a poorly reported malignant subungual tumor.Because it presents with nonspecific symptoms and signs,it is frequently misdiagnosed by dermatologists or surgeons...BACKGROUND Squamous cell carcinoma(SCC)of the nail bed is a poorly reported malignant subungual tumor.Because it presents with nonspecific symptoms and signs,it is frequently misdiagnosed by dermatologists or surgeons.A delay in diagnosis and/or wrong treatment might increase the possibility of disease progression.Thus,new perspectives are needed to assist dermatologists and surgeons with diagnosing and treating SCC.This rare case presented with a 2-year delay in the diagnosis of SCC teaches a valuable lesson.CASE SUMMARY A 62-year-old female presented with a non-healing subungual growth in the nail bed of the right middle finger for 2 years.The lesion was first medicated with iodine by the patient herself without any relief.Twenty months later,a dermatologist diagnosed the lesion as paronychia and treated it with nail avulsions repeatedly with no obvious alleviation.A lesionectomy confirmed the lesion was SCC.An extended excision of the tumor with amputation of the distal interphalangeal joint was subsequently performed.A biopsy of sentinel lymph nodes was negative.Due to the result of preoperative positron emission tomography-computed tomography scanning,sweeping of axillary lymph nodes was considered dispensable and was skipped.At the 2-year follow-up,the patient showed a quick recovery and no sign of recurrence.CONCLUSION Our successful diagnosis and treatment of the case highlights the need for additional attention to long-standing non-healing lesions of the nail bed and the necessity for discreet evaluation and customization of surgical interventions.展开更多
LetΩbe a bounded smooth domain in RN(N≥3).Assuming that 0<s<1,1<p,q≤N+2s/N-2s with(p,q)≠(N+2s/N-2s,N+2s/N-2s),and a,b>0 are constants,we consider the existence results for positive solutions of a class...LetΩbe a bounded smooth domain in RN(N≥3).Assuming that 0<s<1,1<p,q≤N+2s/N-2s with(p,q)≠(N+2s/N-2s,N+2s/N-2s),and a,b>0 are constants,we consider the existence results for positive solutions of a class of fractional elliptic system below,{(a+b[u]^(2)_(s))(-Δ)^(s)u=vp+h_(1)(x,u,v,▽u,▽v),x∈Ω,(-Δ)^(s)v=u^(q)+h_(2)(x,u,▽,▽u,▽v),x∈Q,u,v>0,x∈Ω,u=v=0,x∈RN\Ω.Under some assumptions of hi(x,u,v,▽u,▽v)(i=1,2),we get a priori bounds of the positive solutions to the problem(1.1)by the blow-up methods and rescaling argument.Based on these estimates and degree theory,we establish the existence of positive solutions to problem(1.1).展开更多
This paper focuses on the ground settlement induced by the construction of a curved shield tunnel.Ground loss and construction loadings are the two factors causing ground settlement,and two corresponding analytical mo...This paper focuses on the ground settlement induced by the construction of a curved shield tunnel.Ground loss and construction loadings are the two factors causing ground settlement,and two corresponding analytical models were developed.First,the ground settlement due to ground loss was analyzed based on 3D image theory.The"integrative gap at shield tail"(IGST)and overcutting gap of a curved tunnel were considered.Second,the ground settlement due to construction loadings was analyzed by modifying Mindlin's solutions.The additional thrust,frictional force,and grouting pressure were considered.Subsequently,a case study and a parameter analysis were conducted.Finally,the obtained solutions were compared with a classical analytical solution,numerical simulations,and monitored results.The proposed model could effectively predict the ground settlement in-duced during curved shield tunneling.展开更多
基金This study was supported by the National Natural Science Foundation of China(82003529,72125009)the National Key Research and Development Program of the Ministry of Science and Technology of China(2019YFC2005000)+4 种基金the Chinese Scientific and Technical Innovation Project 2030(2018AAA0102100)the National High Level Hospital Clinical Research Funding(“Star of Outlook”Scientific Research Project of Peking University First Hospital,2022XW06)the CAMS Innovation Fund for Medical Sciences(2019-I2M-5-046)the Young Elite Scientists Sponsorship Program by CAST(2022QNRC001)the PKU-Baidu Fund(2020BD004,2020BD005 and 2020BD032).
文摘Background:Climate change profoundly shapes the population health at the global scale.However,there was still insufficient and inconsistent evidence for the association between heat exposure and chronic kidney disease(CKD).Methods:In the present study,we studied the association of heat exposure with hospitalizations for cause-specific CKD using a national inpatient database in China during the study period of hot season from 2015 to 2018.Standard time-series regression models and random-effects Meta-analysis were developed to estimate the city-specific and national averaged associations at a 7 lag-day span,respectively.Results:A total of 768,129 hospitalizations for CKD was recorded during the study period.The results showed that higher temperature was associated with elevated risk of hospitalizations for CKD,especially in sub-tropical cities.With a 1℃ increase in daily mean temperature,the cumulative relative risks(RR)over lag 0-7 d were 1.008[95% confidence interval(CI)1.003-1.012]for nationwide.The attributable fraction of CKD hospitalizations due to high temperatures was 5.50%.Stronger associations were observed among younger patients and those with obstructive nephropathy.Our study also found that exposure to heatwaves was associated with added risk of hospitalizations for CKD compared to non-heatwave days(RR=1.116,95%CI 1.069-1.166)above the effect of daily mean temperature.Conclusions:Short-term heat exposure may increase the risk of hospitalization for CKD.Our findings provide insights into the health effects of climate change and suggest the necessity of guided protection strategies against the adverse effects of high temperatures.
基金Supported by Natural Science Foundation of Xiamen,China,No.3502Z20227171the Young Investigator Research Program of Xiang’an Hospital of Xiamen University,No.XAH23005+2 种基金the Traditional Chinese Medicine Foundation of Xiamen,No.XWZY-2023-0103Natural Science Foundation of Fujian,China,No.2018J01136National Natural Science Foundation of China,No.81202659.
文摘BACKGROUND Jianpi-Huatan-Huoxue-Anshen formula[Tzu-Chi cancer-antagonizing&lifeprotecting II decoction(TCCL)]is a Chinese medical formula that has been clinically shown to reduce the gastrointestinal side effects of chemotherapy in cancer patients and improve their quality of life.However,its effect and mechanism on the intestinal microecology after chemotherapy are not yet clear.AIM To discover the potential mechanisms of TCCL on gastrointestinal inflammation and microecological imbalance in chemotherapy-treated mice transplanted with hepatocellular carcinoma(HCC).METHODS Ninety-six mice were inoculated subcutaneously with HCC cells.One week later,the mice received a large dose of 5-fluorouracil by intraperitoneal injection to establish a HCC chemotherapy model.Thirty-six mice were randomly selected before administration,and feces,ileal tissue,and ileal contents were collected from each mouse.The remaining mice were randomized into normal saline,continuous chemotherapy,Yangzheng Xiaoji capsulestreated,and three TCCL-treated groups.After treatment,feces,tumors,liver,spleen,thymus,stomach,jejunum,ileum,and colon tissues,and ileal contents were collected.Morphological changes,serum levels of IL-1β,IL-6,IL-8,IL-10,IL-22,TNF-α,and TGF-β,intestinal SIgA,and protein and mRNA expression of ZO-1,NF-κB,Occludin,MUC-2,Claudin-1,and IκB-αin colon tissues were documented.The effect of TCCL on the abundance and diversity of intestinal flora was analyzed using 16S rDNA sequencing.RESULTS TCCL treatment improved thymus and spleen weight,thymus and spleen indexes,and body weight,decreased tumor volumes and tumor tissue cell density,and alleviated injury to gastric,ileal,and colonic mucosal tissues.Among proteins and genes associated with inflammation,IL-10,TGF-β,SIgA,ZO-1,MUC-2,and Occludin were upregulated,whereas NF-κB,IL-1β,IL-6,TNF-α,IL-22,IL-8,and IκB-αwere downregulated.Additionally,TCCL increased the proportions of fecal Actinobacteria,AF12,Adlercreutzia,Clostridium,Coriobacteriaceae,and Paraprevotella in the intermediate stage of treatment,decreased the proportions of Mucipirillum,Odoribacter,RF32,YS2,and Rikenellaceae but increased the proportions of p_Deferribacteres and Lactobacillus at the end of treatment.Studies on ileal mucosal microbiota showed similar findings.Moreover,TCCL improved community richness,evenness,and the diversity of fecal and ileal mucosal flora.CONCLUSION TCCL relieves pathological changes in tumor tissue and chemotherapy-induced gastrointestinal injury,potentially by reducing the release of pro-inflammatory factors to repair the gastrointestinal mucosa,enhancing intestinal barrier function,and maintaining gastrointestinal microecological balance.Hence,TCCL is a very effective adjuvant to chemotherapy.
基金supported by the National Natural Science Foundation of China(Grant No.81673996,81904220)the Jiangmen Association for Science and Technology-Youth science and technology talent lifting project(Grant No.2022-2023).
文摘Background:In traditional Chinese medicine,You-Gui-Wan(YGW)is typically used to treat osteoporosis associated with kidney-yang deficiency.However,there have been few mechanistic studies on the effectiveness of kidney-yang deficiency-type osteoporosis with YGW.To further clarify the role of YGW in the effect of osteoporosis with kidney-yang deficiency,the study analyzed the therapeutic advantages of YGW by comparing the therapeutic effects of YGW and alendronate(ALN)on osteoporosis with kidney-yang deficiency.Methods:SPF female SD rats were randomly divided into control,osteoporosis,osteoporosis with kidney-yang deficiency,osteoporosis with kidney-yang deficiency+YGW and osteoporosis with kidney-yang deficiency+ALN groups.Except for the control group,osteoporosis was induced by the removal of bilateral ovaries.After 12 weeks,rats with osteoporosis in the kidney-yang deficiency group had kidney-yang deficiency syndrome triggered by hydrocortisone for 14 days.Rats were treated with YGW or ALN for 12 weeks.The weights of rats were recorded.Hematoxylin-eosin staining staining was used to observe pathological changes in bone trabeculae,liver,spleen,and kidneys of rats.Depletion of the growth plate cartilage of rats in different groups was observed by safranine-O staining.The expression of osteoclast key indices(ACP)and osteoblast key indices(ALP)in the bone tissue of rats in the different groups was observed by immunohistochemical staining.The expression of bone resorption-related indicators(TRAP and NXT-1),bone formation-related indicators(BALP,BGP,and P1NP),and major indicators of kidney-yang deficiency(ACTH,T3,T4,cAMP,and cGMP)were observed using an ELISA detection kit.The expression levels of the main indices of liver function(ALT and AST)were detected in different groups.Results:The differences between the osteoporosis with kidney-yang deficiency group and osteoporosis group were that the weight of rats and the expression of ACTH,T3,T4,and cAMP decreased significantly,and the expression of cGMP increased in the osteoporosis with kidney-yang deficiency group.Moreover,both YGW and ALN effectively improved the symptoms of osteoporosis,including the injury of bone trabeculae and growth plates,as well as the expression of bone metabolism-related indicators.However,unlike ALN,YGW simultaneously ameliorated the expression of key indicators of kidney-yang deficiency and prevented weight loss in rats.In addition,YGW caused no obvious damage to the liver,spleen,or kidney,whereas ALN led to liver cirrhosis.Conclusion:The results reveal that YGW plays a crucial part in osteoporosis with kidney-yang deficiency,increases bone mineral density,and improves bone metabolism indicators,and is safe and efficient for the efficacy of osteoporosis with kidney-yang deficiency.YGW might have a better therapeutic effect on osteoporosis in patients with kidney-yang deficiency.Therefore,alendronate should be used cautiously in patients with osteoporosis and poor liver function.
文摘Introduction: Brain metastasis is common in relapsed neuroblastoma patients, but the characteristics of brain metastasis remain largely unknown. This study aimed to investigate the status of brain metastasis with neuroblastoma in South China.Methods: In this retrospective case?based study, 106 patients with stage 4 neuroblastoma from the Department of Pediatric Oncology in Sun Yat?sen University Cancer Center between January 2004 and May 2013 were included. The incidence, risk factors, and survival status of these patients were reviewed and analyzed.Results: Of the 106 patients, 11(10.4%) developed brain metastasis, accounting for 20.0% of 55 patients with relapse or progression. The age at initial diagnosis of the 11 patients ranged from 2 to 10 years(median 4 years), which was younger than that of the patients without brain metastasis(median 5 years, range 1–10 years, P = 0.073). The male to female ratio of the 11 patients was 8:3, which was not signiicantly diferent from that of the patients with?out brain metastasis(P = 0.86). Patients with brain metastasis had higher lactate dehydrogenase levels than those without brain metastasis, but the diferences were not signiicant(P initial diagnosis to the develo= 0.076). Eight patients died, and 3 patients survived. The median interval from thepment of brain metastasis was 18 months(range 6–32 months). The median survival was 4 months(range 1 day to 29 months) after the diagnosis of brain metastasis. The median interval from the manifestation of brain metastasis to death was 3 months(range 1 day to 11 months).Conclusions: High?risk factors for brain metastasis in cases of neuroblastoma include bone marrow involvement and a younger age at initial diagnosis. Nevertheless, multiple treatment modalities can improve disease?free survival.
文摘Primary central nervous system germ cell tumors(CNS-GCTs) in children and adolescents have unique clinical features and methods of treatment compared with those in adults. There is little information about Chinese children and adolescents with CNS-GCTs. Therefore, in this study we retrospectively analyzed the clinical features and treatment outcome of Chinese children and adolescents with primary CNS-GCTs. Between January 2002 and December 2012, 57 untreated patients from a single institution were enrolled. They were diagnosed with CNS-GCTs after pathologic or clinical assessment. Of the 57 patients, 41 were males and 16 were females, with a median age of 12.8 years(range, 2.7 to 18.0 years) at diagnosis; 43(75.4%) had non-germinomatous germ cell tumors(NGGCTs) and 14(24.6%) had germinomas; 44(77.2%) had localized disease and 13(22.8%) had extensive lesions. Fifty-three patients completed the prescribed treatment, of which 18 underwent monotherapy of surgery, radiotherapy, or chemotherapy, and 35 underwent multimodality therapies that included radiotherapy combined with chemotherapy or surgery combined with chemotherapy and/or radiotherapy. PEB(cisplatin, etoposide, and bleomycin) protocol was the major chemotherapy regimen. The median follow-up time was 32.3 months(range, 1.2 to 139 months). Fourteen patients died of relapse or disease progression. The 3-year event-free survival(EFS) and overall survival rates for all patients were 72.2% and 73.8%, respectively. The 3-year EFS was 92.9% for germinomas and 64.8% for NGGCTs(P = 0.064). The 3-year EFS rates for patients with NGGCTs who underwent monotherapy and multimodality therapies were 50.6% and 73.5%, respectively(P = 0.042). Our results indicate that multimodality therapies including chemotherapy plus radiotherapy were better treatment option for children and adolescents with CNS-GCTs.
文摘Pediatric diffuse large B-cell lymphoma(DLBCL)is a highly aggressive disease with unique clinical characteristics.This study analyzed the germinal-center type B-cell(GCB)classification and clinical characteristics of Chinese pediatric DLBCL.A total of 76 patients with DLBCL newly diagnosed in Sun Yatsen University Cancer Center between February 2000 and May 2011,with an age younger than 18 years,were included in the analysis.The male/female ratio was 3.47:1.The median age was 12 years(range,2 to 18 years),and 47(61.8%)patients were at least 10 years old.Of the 76 patients,48(63.2%)had stage III/IV disease,9(11.8%)had bone marrow involvement,1(1.3%)had central nervous system(CNS)involvement,and 5(6.6%)had bone involvement.The GCB classification was assessed in 45 patients:26(57.8%)were classified as GCB subtype,and 19(42.2%)were classified as non-GCB subtype.The modified B-NHL-BFM-90/95 regimen was administered to 50 patients,and the 4-year event-free survival(EFS)rate was 85.8%.Among these 50 patients,31 were assessed for the GCB classification:17(54.8%)were classified as GCB subtype,with a 4-year EFS rate of 88.2%;14(45.2%)were classified as non-GCB subtype,with a 4-year EFS rate of 92.9%.Our data indicate that bone marrow involvement and stage III/IV disease are common in Chinese pediatric DLBCL patients,whereas the percentage of patients with the GCB subtype is similar to that of patients with the non-GCB subtype.The modified B-NHL-BFM-90/95protocol is an active and effective treatment protocol for Chinese pediatric patients with DLBCL.
基金supported by the National Natural Science Foundation of China,No.81373748,81171659,11574156 and 81403136a grant from the 333 Project of Jiangsu Province in China No.BRA2014341a grant from the Jiangsu Province Science and Technology Support Project in China,No.BE2010769
文摘Electroacupuncture（EA） has anti-oxidative and anti-inflammatory actions,but whether the neuroprotective effect of EA against cerebral ischemia-reperfusion（I/R） injury involves modulation of the extracellular regulated kinase 1/2（ERK1/2） signaling pathway is unclear.Middle cerebral artery occlusion（MCAO） was performed in Sprague-Dawley rats for 2 hours followed by reperfusion for 24 hours.A 30-minute period of EA stimulation was applied to both Baihui（DU20） and Dazhui（DU14） acupoints in each rat（10 mm EA penetration depth,continuous wave with a frequency of 3 Hz,and a current intensity of 1–3 m A） when reperfusion was initiated.EA significantly reduced infarct volume,alleviated neuronal injury,and improved neurological function in rats with MCAO.Furthermore,high m RNA expression of Bax and low m RNA expression of Bcl-2 induced by MCAO was prevented by EA.EA substantially restored total glutathione reductase（GR）,glutathione（GSH） and glutathione peroxidase（GSH-Px） levels.Additionally,Nrf2 and glutamylcysteine synthetase（GCS） expression levels were markedly increased by EA.Interestingly,the neuroprotective effects of EA were attenuated when ERK1/2 activity was blocked by PD98059（a specific MEK inhibitor）.Collectively,our findings indicate that activation of the ERK1/2 signaling pathway contributes to the neuroprotective effects of EA.Our study provides a better understanding of the regulatory mechanisms underlying the therapeutic effectiveness of EA.
基金supported by the Scientific and Technological Innovation Programs of Higher Education Institution in Shanxi,China(Grant Nos.2020L0525 and 2019L0782)the National Natural Science Foundation of China(Grant Nos.11805141 and 12075210)+2 种基金Applied Basic Research Program of Shanxi Province,China(Grant No.201901D211424)“1331 Project”Key Innovative Research Team of Taiyuan Normal University(Grant No.I0190364)Key Research and Development program of Shanxi Province,China(Grant No.201903D421042).
文摘We mainly investigate the variable-coefficient 3-coupled nonlinear Schrodinger(NLS)system,which describes soli- ton dynamics in the three-spineα-helical protein with inhomogeneous effect.The variable-coefficient NLS equation is transformed into the constant coefficient NLS equation by similarity transformation firstly.The Hirota method is used to solve the constant coefficient NLS equation,and then we get the one-and two-breather solutions of the variable-coefficient NLS equation.The results show that,in the background of plane waves and periodic waves,the breather can be transformed into some forms of combined soliton solutions.The influence of different parameters on the soliton solution and the collision between two solitons are discussed by some graphs in detail.Our results are helpful to study the soliton dynamics inα-helical protein.
基金Supported by National Natural Science Foundation of China,No.81702135Zhejiang Traditional Chinese Medicine Research Program,No.2016ZA124 and No.2017ZB057+1 种基金Zhejiang Medicine and Hygiene Research Program,No.2016KYB101 and No.2015KYA100Zhejiang Medical Association Clinical Scientific Research Program,No.2013ZYC-A19 and No.2015ZYC-A12
文摘BACKGROUND Although skin avulsions to male external genitalia are rare, they can be both physically and psychologically traumatic. Thus, the necessity for judicious management poses significant challenges to surgeons in order to avoid potential permanent disabilities. We report a case of massive penoscrotal skin avulsion and a composite graft was creatively applied to cover the defect which achieved good results. We believe that this case is of great reference value for fellow surgeons.CASE SUMMARY A 52-year-old male presented with massive traumatic avulsion of the penile and scrotal skin following mishandling of an electric drill. The avulsed skin was missing. The patient was diagnosed with massive skin avulsion of external genitalia. Following initial complete debridement of devitalized or infected tissues, Pelnac dermal substitute was secured to the defect with the assistance of negative-pressure wound closure. In the final step, the silicone layer of Pelnac was removed and a split-thickness skin graft was applied. The defect had healed at the two-month follow-up. The patient now has normal erections and satisfactory sexual function.CONCLUSION Our experience with this wound repair demonstrated that the combination of a dermal regeneration template and a split-thickness skin graft with vacuumassisted closure is a safe, well-tolerated and efficient solution for the reconstruction of massive penoscrotal skin defects.
基金The work was supported by the National Natural Science Foundation of China(No.51874045)National Natural Science Foundation-Youth Foundation(52104056)+2 种基金Department of Natural Resources of Guangdong Province(GDNRC[2021]56)Postdoctoral innovative talents support program in China(BX2021374)Scientific Research Program of Hubei Provincial Department of Education(T2021004).
文摘A reliable multiphase flow simulator is an important tool to improve wellbore integrity and production decision-making.To develop a multiphase flow model with high adaptability and high accuracy,we first build a multiphase flow database with 3561 groups of data and developed a drift closure relationship with stable continuity and high adaptability.Second,a high-order numerical scheme with strong fault capture ability is constructed by effectively combining MUSCL technology,van Albada slope limiter and AUSMV numerical scheme.Finally,the energy equation is coupled into the AUSMV numerical scheme of the drift flow model in the form of finite difference.A transient non-isothermal wellbore multiphase flow model with wide applicability is formed by integrating the three technologies,and the effects of various factors on the calculation accuracy are studied.The accuracy of the simulator is verified by comparing the measurement results with the blowout experiment of a full-scale experimental well.
文摘The simulation of the artillery interior and intermediate ballistics problem is performed to investigate the influence of a gas dynamics device,muzzle brake,on the muzzle hazard phenomena,such as flash and blast waves.The correlation of the chemical reactions with the characteristics of the muzzle flow field is analyzed by the simulation for a further understanding of the secondary combustion phenomenon of the muzzle flow.The novel structure of muzzle flow caused by the muzzle brake is presented by the simultaneous solution of the interior ballistics model and multi-species Navier-Stokes equations in order to analyze the influence of the muzzle brake structure on the chemical reactions.The secondary combustion of the muzzle flow due to the oxygen-supplement chemical reactions is obtained by the chemical reaction kinetic model.The interaction of the blast waves released from the muzzle brake is illustrated in detail and the mechanism of the formation of muzzle flash is analyzed.This research provides a reference for the studies on the suppression of the muzzle flash.
基金Supported by the Inner Mongolia Autonomous Region Grassland Talent Cultivation Program,No.CYYC2012040.
文摘BACKGROUND About 20%-30%of newly diagnosed hepatocellular carcinoma(HCC)patients are surgically feasible due to a variety of reasons.Active conversion therapy may provide opportunities of surgery for these patients.Nevertheless,the choice of surgical procedure is controversial after successful conversion therapy.We report a patient with HCC who underwent successful laparoscopic right trisectionectomy after conversion therapy with portal vein embolization and transarterial chemoembolization.CASE SUMMARY A 67-year-old male patient presented to our hospital with epigastric distention/discomfort and nausea/vomiting for more than 1 mo.Contrast-enhanced computed tomography scan of the abdomen demonstrated multiple tumors(the largest was≥10 cm in diameter)located in the right liver and left medial lobe,and the left lateral lobe was normal.The future remnant liver(FRL)of the left lateral lobe accounted for only 18%of total liver volume after virtual resection on the three-dimensional liver model.Conversion therapy was adopted after orally administered entecavir for antiviral treatment.First,the right portal vein was embolized.Then tumor embolization was performed via the variant hepatic arteries.After 3 wk,the FRL of the left lateral lobe accounted for nearly 30%of the total liver volume.Totally laparoscopic right trisectionectomy was performed under combined epidural and general anesthesia.The in situ resection was performed via an anterior approach.The operating time was 240 min.No clamping was required during the surgery,and the intraoperative blood loss was 300 mL.There were no postoperative complications such as bile leakage,and the incision healed well.The patient was discharged on the 8th postoperative day.During the 3-mo follow-up,there was no recurrence and obvious hyperplasia of residual liver was observed.Alpha-fetoprotein decreased significantly and tended to be normal.CONCLUSION Due to the different biological characteristics of the liver cancer and the pathophysiological features of the liver from other organs,the conversion treatment should take into account both the feasibility of tumor downstaging and the volume and function of the remnant liver.Our case provides a reference for clinicians in terms of both conversion therapy and laparoscopic right trisectionectomy.
基金Supported by the National Natural Science Foundation of China,No.81702135Zhejiang Medical Association Clinical Scientific Research Program,No.2013ZYCA19 and 2015ZYC-A12+1 种基金Zhejiang Medicine and Hygiene Research Program,No.2016KYB101 and 2015KYA100Zhejiang Traditional Chinese Medicine Research Program,No.2016ZA124 and 2017ZB057
文摘BACKGROUND Squamous cell carcinoma(SCC)of the nail bed is a poorly reported malignant subungual tumor.Because it presents with nonspecific symptoms and signs,it is frequently misdiagnosed by dermatologists or surgeons.A delay in diagnosis and/or wrong treatment might increase the possibility of disease progression.Thus,new perspectives are needed to assist dermatologists and surgeons with diagnosing and treating SCC.This rare case presented with a 2-year delay in the diagnosis of SCC teaches a valuable lesson.CASE SUMMARY A 62-year-old female presented with a non-healing subungual growth in the nail bed of the right middle finger for 2 years.The lesion was first medicated with iodine by the patient herself without any relief.Twenty months later,a dermatologist diagnosed the lesion as paronychia and treated it with nail avulsions repeatedly with no obvious alleviation.A lesionectomy confirmed the lesion was SCC.An extended excision of the tumor with amputation of the distal interphalangeal joint was subsequently performed.A biopsy of sentinel lymph nodes was negative.Due to the result of preoperative positron emission tomography-computed tomography scanning,sweeping of axillary lymph nodes was considered dispensable and was skipped.At the 2-year follow-up,the patient showed a quick recovery and no sign of recurrence.CONCLUSION Our successful diagnosis and treatment of the case highlights the need for additional attention to long-standing non-healing lesions of the nail bed and the necessity for discreet evaluation and customization of surgical interventions.
基金supported by National Natural Science Foundation of China (No.11761030)Hubei Provincial Natural Science Foundation of China (No.2022CFC016)Cultivation Project for High-Level Scientific Research Achievements of Hubei Minzu University (No.PY20002)。
文摘LetΩbe a bounded smooth domain in RN(N≥3).Assuming that 0<s<1,1<p,q≤N+2s/N-2s with(p,q)≠(N+2s/N-2s,N+2s/N-2s),and a,b>0 are constants,we consider the existence results for positive solutions of a class of fractional elliptic system below,{(a+b[u]^(2)_(s))(-Δ)^(s)u=vp+h_(1)(x,u,v,▽u,▽v),x∈Ω,(-Δ)^(s)v=u^(q)+h_(2)(x,u,▽,▽u,▽v),x∈Q,u,v>0,x∈Ω,u=v=0,x∈RN\Ω.Under some assumptions of hi(x,u,v,▽u,▽v)(i=1,2),we get a priori bounds of the positive solutions to the problem(1.1)by the blow-up methods and rescaling argument.Based on these estimates and degree theory,we establish the existence of positive solutions to problem(1.1).
基金the National Natural Science Foundation of China(Nos.51738010,51978018,and 51978019)。
文摘This paper focuses on the ground settlement induced by the construction of a curved shield tunnel.Ground loss and construction loadings are the two factors causing ground settlement,and two corresponding analytical models were developed.First,the ground settlement due to ground loss was analyzed based on 3D image theory.The"integrative gap at shield tail"(IGST)and overcutting gap of a curved tunnel were considered.Second,the ground settlement due to construction loadings was analyzed by modifying Mindlin's solutions.The additional thrust,frictional force,and grouting pressure were considered.Subsequently,a case study and a parameter analysis were conducted.Finally,the obtained solutions were compared with a classical analytical solution,numerical simulations,and monitored results.The proposed model could effectively predict the ground settlement in-duced during curved shield tunneling.
