The fructose-to-furfural transformation is facing major challenges in the selectivity and high efficiency. Herein, we have developed a simple and effective approach for the selective conversion of fructose to furfural...The fructose-to-furfural transformation is facing major challenges in the selectivity and high efficiency. Herein, we have developed a simple and effective approach for the selective conversion of fructose to furfural using Hβ zeolite modified by organic acids for dealuminization to regulate its textural and acidic properties. It was found that citric acid-dealuminized Hβ zeolite possessed high specific surface areas, wide channels and high Brønsted acid amount, which facilitated the selective conversion of fructose to furfural with a maximum yield of 76.2% at433 K for 1 h in the γ-butyrolactone(GBL)-H_(2)O system, as well as the concomitant formation of 83.0% formic acid. The^(13)C-isotope labelling experiments and the mechanism revealed that the selective cleavage of C1–C2 or C5–C6 bond on fructose was firstly occurred to form pentose or C5 intermediate by weak Brønsted acid, which was then dehydrated to furfural by strong Brønsted acid. Also this dealuminized Hβ catalyst showed the great recycling performance and was active for the conversion of glucose and mannose.展开更多
BACKGROUND Neoadjuvant chemotherapy(NAC)has become the standard care for advanced adenocarcinoma of esophagogastric junction(AEG),although a part of the patients cannot benefit from NAC.There are no models based on ba...BACKGROUND Neoadjuvant chemotherapy(NAC)has become the standard care for advanced adenocarcinoma of esophagogastric junction(AEG),although a part of the patients cannot benefit from NAC.There are no models based on baseline computed tomography(CT)to predict response of Siewert type II or III AEG to NAC with docetaxel,oxaliplatin and S-1(DOS).AIM To develop a CT-based nomogram to predict response of Siewert type II/III AEG to NAC with DOS.METHODS One hundred and twenty-eight consecutive patients with confirmed Siewert type II/III AEG underwent CT before and after three cycles of NAC with DOS,and were randomly and consecutively assigned to the training cohort(TC)(n=94)and the validation cohort(VC)(n=34).Therapeutic effect was assessed by disease-control rate and progressive disease according to the Response Evaluation Criteria in Solid Tumors(version 1.1)criteria.Possible prognostic factors associated with responses after DOS treatment including Siewert classification,gross tumor volume(GTV),and cT and cN stages were evaluated using pretherapeutic CT data in addition to sex and age.Univariate and multivariate analyses of CT and clinical features in the TC were performed to determine independent factors associated with response to DOS.A nomogram was established based on independent factors to predict the response.The predictive performance of the nomogram was evaluated by Concordance index(C-index),calibration and receiver operating characteristics curve in the TC and VC.RESULTS Univariate analysis showed that Siewert type(52/55 vs 29/39,P=0.005),pretherapeutic cT stage(57/62 vs 24/32,P=0.028),GTV(47.3±27.4 vs 73.2±54.3,P=0.040)were significantly associated with response to DOS in the TC.Multivariate analysis of the TC also showed that the pretherapeutic cT stage,GTV and Siewert type were independent predictive factors related to response to DOS(odds ratio=4.631,1.027 and 7.639,respectively;all P<0.05).The nomogram developed with these independent factors showed an excellent performance to predict response to DOS in the TC and VC(C-index:0.838 and 0.824),with area under the receiver operating characteristic curve of 0.838 and 0.824,respectively.The calibration curves showed that the practical and predicted response to DOS effectively coincided.CONCLUSION A novel nomogram developed with pretherapeutic cT stage,GTV and Siewert type predicted the response of Siewert type II/III AEG to NAC with DOS.展开更多
In riparian forests,litter decay provides essential energy and nutrients for both terrestrial and fluvial ecosystems.Litter mixing effects(LMEs)are crucial in regulating litter decay and nutrient dynamics,yet how LMEs...In riparian forests,litter decay provides essential energy and nutrients for both terrestrial and fluvial ecosystems.Litter mixing effects(LMEs)are crucial in regulating litter decay and nutrient dynamics,yet how LMEs change over time is unclear in riparian forests.In this study,leaf litter of three common species(Alnus sibirica Fisch.ex Turcz,Betula platyphylla Sukaczev,and Betula fruticosa Pall.)were mixed in an equal mass ratio and LMEs were measured for mass and nitrogen(N)remaining in whole litter mixtures over a 3-year period in a boreal riparian forest,northeastern China.LMEs were also assessed for component litter mass and N remaining by separating litter mixtures by species.During the decay of litter mixtures,antagonistic effects on mass and N remaining were dominant after one and two years of decay,whereas only additive effects were observed after three years.LMEs correlated negatively with functional diversity after the first and two years of decay but disappeared after three years.When sorting litter mixtures by species,non-additive LMEs on mass and N remaining decreased over incubation time.Moreover,non-additive LMEs were more frequent for litter of both B.platyphylla and B.fruticosa with lower N concentration than for A.sibirica litter with higher N concentration.These results indicate that incubation time is a key determinant of litter mixing effects during decay and highlight that late-stage litter mixture decay may be predicted from single litter decay dynamics in boreal riparian forests.展开更多
α-Keggin polyoxometalates(POMs)[XW_(12)O_(40)]^(n−)(X=Al,Si,P,S)are widely used in batteries owing to their remarkable redox activity.However,the mechanism underlying the applications appears inconsistent with the wi...α-Keggin polyoxometalates(POMs)[XW_(12)O_(40)]^(n−)(X=Al,Si,P,S)are widely used in batteries owing to their remarkable redox activity.However,the mechanism underlying the applications appears inconsistent with the widely accepted covalent bonding nature.Here,first-principles calculations show that XW_(12)are core–shell structures composed of a shell and an XO_(4)^(n−)core,both are stabilized by covalent interactions.Interestingly,owing to the presence of a substantial number of electrons in W_(12)O_(36)shell,the frontier molecular orbitals of XW_(12)are not only strongly delocalized but also exhibit superatomic properties with high-angular momentum electrons that do not conform to the Jellium model.Detailed analysis indicates that energetically high lying filled molecular orbitals(MOs)have reached unusually high-angular momentum characterized by quantum number K or higher,allowing for the accommodation of numerous electrons.This attribute confers strong electron acceptor ability and redox activity to XW_(12).Moreover,electrons added to XW_(12)still occupy the K orbitals and will not cause rearrangement of the MOs,thereby maintaining the stability of these structures.Our findings highlight the structure–activity relationship and provide a direction for tailor-made POMs with specific properties at atomic level.展开更多
The commercialization of lithium-sulfur(Li-S)batteries faces several challenges,including poor conductivity,unexpected volume expansion,and continuous sulfur loss from the cathode due to redox shuttling.In this study,...The commercialization of lithium-sulfur(Li-S)batteries faces several challenges,including poor conductivity,unexpected volume expansion,and continuous sulfur loss from the cathode due to redox shuttling.In this study,we introduce a novel polymer via a simple cross-linking between poly(ether-thioureas)(PETU)and poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate)(PEDOT:PSS)as a bifunctio nal binder for Li-S batteries(devotes as"PPTU").Compared to polyvinylidene fluoride(PVDF),as-prepared PPTU exhibits significantly higher electrical conductivity,facilitating electrochemical reactions.Additionally,PPTU demonstrates effective adsorption of lithium polysulfides,leading to improved cycling stability by suppressing the shuttling effect.We investigate this behavior by monitoring morphological changes at the cell interface using synchrotron X-ray tomography.Cells with PPTU binders exhibit remarkable rate performance,desired reversibility,and excellent cycling stability even under stringent bending and twisting conditions.Our work represents promising progress in functional polymer binder development for Li-S batteries.展开更多
The use of redox-active organic electrode materials in energy storage is restricted due to their inferior solvent resistance,abysmal conductivity,and the resultant low practical capacity.To address these issues,a clas...The use of redox-active organic electrode materials in energy storage is restricted due to their inferior solvent resistance,abysmal conductivity,and the resultant low practical capacity.To address these issues,a class of bipolar p-phenylenediimidazole-based small-molecule compounds are designed and fabricated.Theπ-conjugated backbone of these small molecules allows for electron delocalization on a big conjugation plane,endowing them with good conductivity and reaction reversibility.Furthermore,when the para-positions of phenylene are occupied by hydroxyl groups,as-formed intramolecular hydrogen bonds(N-H...O)between phenolic hydroxyl groups and the–NH groups of imidazole rings further enhance the structural planarity,resulting in higherπ-conjugation degree and better conductivity,and thus higher utilization of active sites and electrode capacity,proved by both experimental results and theoretical calculations.The optimized composite electrode DBNQ@rGO-45 shows a high specific capacity(∼308 mA h g^(−1)at 100 mA g^(−1))and a long cycling stability(112.9 mA h g^(−1)after 6000 cycles at 2000 mA g^(−1)).The significantly better electrochemical properties for hydroxyl group-containing compounds than those without hydroxyl groups attributed to intramolecular hydrogen bond-induced conjugation enhancement will inspire the structure design of organic electrodes for better energy storage.展开更多
BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and...BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.展开更多
Small-scale electromagnetic soft actuators are characterized by a fast response and simplecontrol,holding prospects in the field of soft and miniaturized robotics.The use of liquid metal(LM)to replace a rigid conducto...Small-scale electromagnetic soft actuators are characterized by a fast response and simplecontrol,holding prospects in the field of soft and miniaturized robotics.The use of liquid metal(LM)to replace a rigid conductor inside soft actuators can reduce the rigidity and enhance the actuation performance and robustness.Despite research efforts,challenges persist in the flexible fabrication of LM soft actuators and in the improvement of actuation performance.To address these challenges,we developed a fast and robust electromagnetic soft microplate actuator based on a laser-induced selective adhesion transfer method.Equipped with unprecedentedly thin LM circuit and customized low Young’s modulus silicone rubber(1.03 kPa),our actuator exhibits an excellent deformation angle(265.25?)and actuation bending angular velocity(284.66 rad·s^(-1)).Furthermore,multiple actuators have been combined to build an artificial gripper with a wide range of functionalities.Our actuator presents new possibilities for designing small-scaleartificial machines and supports advancements in ultrafast soft and miniaturized robotics.展开更多
BACKGROUND More and more evidence-based practices are emerging,but researchers mostly focus on short-term effects,resulting in evidence-based practices not being applied in the clinic in the long term.In this study,we...BACKGROUND More and more evidence-based practices are emerging,but researchers mostly focus on short-term effects,resulting in evidence-based practices not being applied in the clinic in the long term.In this study,we took the evidence-based practice of perioperative airway management in elderly fracture patients as an example and adopted a descriptive phenomenological approach to understand the influencing factors of its sustainability to provide a reference basis for promoting the continuity of evidence-based practice in the clinic.AIM To explore factors influencing the persistence of evidence-based practice in perioperative airway management in elderly patients with fractures.METHODS This study was qualitative research.Nine nurses who implemented evidencebased practice in the orthopedic ward of a tertiary comprehensive hospital in Shanghai from September 2023 to October 2023 were selected using purposive sampling as research subjects.Semi-structured interviews were conducted with them,and the data were analyzed using the Colaizzi phenomenological analysis method based on the three dimensions and ten factors of the NHS sustainability model.RESULTS Three main themes and ten subthemes were identified:Process aspects(benefits to patients,benefits to nurses,lack of follow-up,complex processes);staff aspects(insufficient human resources,inadequate training and education,lack of leadership support);and organizational environment aspects(inadequate infrastructure,poor patient compliance,poor doctor cooperation).CONCLUSION Human resources,training and education,leadership support,infrastructure,and patient-physician collaboration are important factors influencing the sustainability of evidence-based practice for perioperative airway management in older patients with fractures.展开更多
BACKGROUND This study adopts a descriptive phenomenological approach to investigate the facilitators and barriers of community nurses'abilities in managing critical and emergency conditions.With the transition of ...BACKGROUND This study adopts a descriptive phenomenological approach to investigate the facilitators and barriers of community nurses'abilities in managing critical and emergency conditions.With the transition of healthcare systems to the community,the evolution of nursing practices,and the attention from policies and practices,community nurses play a crucial role in the management of critical and emergency conditions.However,there is still a lack of comprehensive understanding regarding the factors that promote or hinder their capabilities in this area.AIM To understand the facilitators and barriers of community nurses in managing critical and emergency conditions,exploring the fundamental reasons and driving forces influencing their treatment capabilities.METHODS This study utilized the destination sampling method between May 2023 and July 2023.It employed a descriptive phenomenological approach within qualitative research methodologies.Through objective sampling,17 community nurses from 7 communities in Changning District,Shanghai,were selected as the study subjects.Semi-structured interviews were conducted to gather data,which were subsequently organized and analyzed using Colaizzi's seven-step analysis method,leading to the extraction of final themes.RESULTS The barrier factors identified from the interviews encompassed three topics:resource allocation,professional factors,and personal literacy.The facilitators comprised three themes:professionalism,management attention,and training and continuing education.We identified that the root causes of the barriers included the lack of practical treatment experience among community nurses,insufficient awareness of self-directed learning,and limited knowledge and technical proficiency.The professional quality of community nurses and management attention serve as motivation for them to enhance their treatment abilities.CONCLUSION To enhance the capability of community nurses in treating acute and critical patients,it is recommended to bolster training specifically tailored to acute and critical care,raise awareness of first aid practices,and elevate knowledge and skill levels.展开更多
BACKGROUND Older spine surgery patients have a high incidence of debilitation,which can be managed with certain exercises.AIM To investigate the current status and influencing factors related to the knowledge of exerc...BACKGROUND Older spine surgery patients have a high incidence of debilitation,which can be managed with certain exercises.AIM To investigate the current status and influencing factors related to the knowledge of exercise intervention among patients and professionals.METHODS Descriptive research methods were used to classify and summarize patients and professionals’perceptions and factors affecting exercise interventions.Data were analysed using the Colaizzi seven-step analysis method to distill and refine themes.RESULTS A total of 7 themes were identified:(1)The current status of patients'exercise is unsatisfactory;(2)patients'health literacy is low,coupled with a lack of social and family support;(3)there are numerous challenges with systematic exercise interventions;(4)healthcare professionals acknowledge the importance and need for exercise interventions;(5)there's a pronounced willingness among patients to participate in exercise intervention programs;(6)healthcare professionals believe that exercise interventions are beneficial;and(7)participants offered invaluable insights and suggestions on perioperative exercise during spinal surgery.CONCLUSION To investigate the current status and influencing factors related to the knowledge of exercise intervention among patients and the related healthcare professionals to provide a reference for the construction of exercise management programs for these patients.展开更多
BACKGROUND The bowel preparation process prior to colonoscopy determines the quality of the bowel preparation,which in turn affects the quality of the colonoscopy.Colono-scopy is an essential procedure for postoperati...BACKGROUND The bowel preparation process prior to colonoscopy determines the quality of the bowel preparation,which in turn affects the quality of the colonoscopy.Colono-scopy is an essential procedure for postoperative follow-up monitoring of colorec-tal cancer(CRC)patients.Previous studies have shown that advanced age and a history of colorectal resection are both risk factors for inadequate bowel prepara-tion.However,little attention has been paid to the bowel preparation experiences and needs of predominantly older adult postoperative CRC patients.AIM To explore the experiences and needs of older adult postoperative CRC patients during bowel preparation for follow-up colonoscopy.METHODS Fifteen older adult postoperative CRC patients who underwent follow-up colonoscopy at a tertiary hospital in Shanghai were selected using purposive sampling from August 2023 to November 2023.The phenomenological method in qualitative research was employed to construct an interview outline and conduct semi-structured interviews with the patients.Colaizzi's seven-step analysis was utilized to organize,code,categorize,summarize,and verify the interview data.RESULTS The results of this study were summarized into four themes and eight sub-themes:(1)Inadequate knowledge about bowel preparation;(2)Decreased physiological comfort during bowel preparation(gastrointestinal discomfort and sleep deprivation caused by bowel cleansing agents,and hunger caused by dietary restrictions);(3)Psychological changes during different stages of bowel preparation(pre-preparation:Fear and resistance due to previous experiences;during preparation:Irritation and helplessness caused by taking bowel cleansing agents,and post-preparation:Anxiety and worry while waiting for the colonoscopy);and(4)Needs related to bowel preparation(detailed instructions from healthcare professionals;more ideal bowel cleansing agents;and shortened waiting times for colonoscopy).CONCLUSION Older adult postoperative CRC patients'knowledge of bowel preparation is not adequate,and they may encounter numerous difficulties and challenges during the process.Healthcare professionals should place great emphasis on providing instruction for their bowel preparation.展开更多
BACKGROUND This study employs a descriptive phenomenological approach to investigate the challenges anesthesia nurses face in managing emergence delirium(ED),a common and complex postoperative complication in the post...BACKGROUND This study employs a descriptive phenomenological approach to investigate the challenges anesthesia nurses face in managing emergence delirium(ED),a common and complex postoperative complication in the post-anesthesia care unit.The role of nurses in managing ED is critical,yet research on their understanding and management strategies for ED is lacking.AIM To investigate anesthetic nurses’cognition and management experiences of ED in hopes of developing a standardized management protocol.METHODS This study employed a descriptive phenomenological approach from qualitative research methodologies.Purposeful sampling was utilized to select 12 anesthetic nurses from a tertiary hospital in Shanghai as research subjects.Semi-structured interviews were conducted,and the data were organized and analyzed using Colaizzi’s seven-step analysis method,from which the final themes were extracted.RESULTS After analyzing the interview content,four main themes and eight subthemes were distilled:Inefficient cognition hinders the identification of ED(conceptual ambiguity,empirical identification),managing diversity and challenges(patientcentered safe care,low level of medical-nursing collaboration),work responsibilities and pressure coexist(heavy work responsibilities,occupational risks and stress),demand for high-quality management(expecting the construction of predictive assessment tools and prevention strategies,and pursuing standardized management processes to enhance management effectiveness).CONCLUSION Nursing managers should prioritize the needs and suggestions of nurses in order to enhance their nursing capabilities and provide guidance for standardized management processes.展开更多
Succinylation is a highly conserved post-translational modication that is processed via enzymatic and non-enzymatic mechanisms.Succinylation exhibits strong effects on protein stability,enzyme activity,and transcripti...Succinylation is a highly conserved post-translational modication that is processed via enzymatic and non-enzymatic mechanisms.Succinylation exhibits strong effects on protein stability,enzyme activity,and transcriptional regulation.Protein succinylation is extensively present in the liver,and increasing evidence has demonstrated that succinylation is closely related to hepatic metabolism.For instance,histone acetyltransferase 1 promotes liver glycolysis,and the sirtuin 5-induced desuccinylation is involved in the regulation of the hepatic urea cycle and lipid metabolism.Therefore,the effects of succinylation on hepatic glucose,amino acid,and lipid metabolism under the action of various enzymes will be discussed in this work.In addition,how succinylases regulate the progression of different liver diseases will be reviewed,including the desuccinylation activity of sirtuin 7,which is closely associated with fatty liver disease and hepatitis,and the actions of lysine acetyltransferase 2A and histone acetyltransferase 1 that act as succinyltransferases to regulate the succinylation of target genes that influence the development of hepatocellular carcinoma.In view of the diversity and significance of protein succinylation,targeting the succinylation pathway may serve as an attractive direction for the treatment of liver diseases.展开更多
BACKGROUND Large abdominal wall defect(LAWD)measures>20 cm in width.LAWD can easily lead to intestinal necrosis,peritonitis,other complications,and even mul-tiple organ dysfunction syndrome.Multiple intestinal fist...BACKGROUND Large abdominal wall defect(LAWD)measures>20 cm in width.LAWD can easily lead to intestinal necrosis,peritonitis,other complications,and even mul-tiple organ dysfunction syndrome.Multiple intestinal fistulas are high-flow fis-tulas that can cause severe water–electrolyte imbalance and malnutrition,as well as inflammation,high metabolic status,and chronic intestinal failure caused by intestinal fluid corrosion in tissues around the orifice fistulas.CASE SUMMARY This article summarizes the nursing experience of a patient with sigmoid carci-noma who has LAWD with multiple intestinal fistula due to repeated operations for postoperative complications.The key points of care:Scientific assessment of nutritional status,dynamic adjustment of nutritional support programmes,com-prehensive adoption of enteral nutrition,parenteral nutrition and combined nut-rition of enteral and parenteral;taking good care of abdominal wall defects and intestinal fistulas;continuous flushing of the abdominal drainage tube and low negative pressure drainage;prevention of venous thrombosis;strengthening of physical exercise;implementation of positive psychological interventions.CONCLUSION After more than 7 months of careful care,the patient's physical fitness has been well recovered,local inflammation is well controlled,which wins the opportunity for the operation,and the postoperative recovery is good.展开更多
Objective Acute lung injury(ALI)is an acute clinical syndrome characterized by uncontrolled inflammation response,which causes high mortality and poor prognosis.The present study determined the protective effect and u...Objective Acute lung injury(ALI)is an acute clinical syndrome characterized by uncontrolled inflammation response,which causes high mortality and poor prognosis.The present study determined the protective effect and underlying mechanism of Periplaneta americana extract(PAE)against lipopolysaccharide(LPS)-induced ALI.Methods The viability of MH-S cells was measured by MTT.ALI was induced in BALB/c mice by intranasal administration of LPS(5 mg/kg),and the pathological changes,oxidative stress,myeloperoxidase activity,lactate dehydrogenase activity,inflammatory cytokine expression,edema formation,and signal pathway activation in lung tissues and bronchoalveolar lavage fluid(BALF)were examined by H&E staining,MDA,SOD and CAT assays,MPO assay,ELISA,wet/dry analysis,immunofluorescence staining and Western blotting,respectively.Results The results revealed that PAE obviously inhibited the release of proinflammatory TNF-α,IL-6 and IL-1βby suppressing the activation of MAPK/Akt/NF-κB signaling pathways in LPS-treated MH-S cells.Furthermore,PAE suppressed the neutrophil infiltration,permeability increase,pathological changes,cellular damage and death,pro-inflammatory cytokines expression,and oxidative stress upregulation,which was associated with its blockage of the MAPK/Akt/NF-κB pathway in lung tissues of ALI mice.Conclusion PAE may serve as a potential agent for ALI treatment due to its anti-inflammatory and anti-oxidative properties,which correlate to the blockage of the MAPK/NF-κB and AKT signaling pathways.展开更多
Because of its excellent dose distribution,proton therapy is becoming increasingly popular in the medical application of cancer treatment.A synchrotron-based proton therapy facility was designed and constructed in Sha...Because of its excellent dose distribution,proton therapy is becoming increasingly popular in the medical application of cancer treatment.A synchrotron-based proton therapy facility was designed and constructed in Shanghai.The synchrotron,beam delivery system,and other technical systems were commissioned and reached their expected performances.After a clinical trial of 47 patients was finished,the proton therapy facility obtained a registration certificate from the National Medical Products Administration.The characteristics of the accelerator and treatment systems are described in this article.展开更多
In this study,ferric nitrate modified carbon nanotube composites (FCNT) were prepared by isovolumetric impregnation using carbon nanotubes (CNTs) as the carrier and ferric nitrates the active agent.The batch experimen...In this study,ferric nitrate modified carbon nanotube composites (FCNT) were prepared by isovolumetric impregnation using carbon nanotubes (CNTs) as the carrier and ferric nitrates the active agent.The batch experiments showed that FCNT could effectively oxidize As(III) to As(V) and react with it to form stable iron arsenate precipitates.When the dosage of FCNT was 0.1 g·L^(–1),pH value was 5–6,reaction temperature was 35℃ and reaction time was 2 h,the best arsenic removal effect could be achieved,and the removal rate of As(V) could reach 99.1%,which was always higher than 90%under acidic conditions.The adsorption results of FCNT were found to be consistent with Langmuir adsorption by static adsorption isotherm fitting,and the maximum adsorption capacity reached 118.3 mg·g^(-1).The material phase and property analysis by scanning electron microscopy,Brunauer–Emmett–Teller,Fourier transform infrared spectoscopy,X-ray photoelectron spectroscopy and other characterization methods,as well as adsorption isotherm modeling,were used to explore the adsorption mechanism of FCNT on arsenic.It was found that FCNT has microporous structure and nanostructure,and iron nanoparticles are loosely distributed on CNTs,which makes the material have good oxidation,adsorption and magnetic separation properties.Arsenic migrates on the surface of FCNT composites is mainly removed by forming insoluble compounds and co-precipitation.All the results show that FCNT treats arsenic at low cost with high adsorption efficiency,and the results also provide the experimental data basis and theoretical basis for arsenic contamination in groundwater.展开更多
BACKGROUND:Rapid on-site triage is critical after mass-casualty incidents(MCIs)and other mass injury events.Unmanned aerial vehicles(UAVs)have been used in MCIs to search and rescue wounded individuals,but they mainly...BACKGROUND:Rapid on-site triage is critical after mass-casualty incidents(MCIs)and other mass injury events.Unmanned aerial vehicles(UAVs)have been used in MCIs to search and rescue wounded individuals,but they mainly depend on the UAV operator’s experience.We used UAVs and artificial intelligence(AI)to provide a new technique for the triage of MCIs and more efficient solutions for emergency rescue.METHODS:This was a preliminary experimental study.We developed an intelligent triage system based on two AI algorithms,namely OpenPose and YOLO.Volunteers were recruited to simulate the MCI scene and triage,combined with UAV and Fifth Generation(5G)Mobile Communication Technology real-time transmission technique,to achieve triage in the simulated MCI scene.RESULTS:Seven postures were designed and recognized to achieve brief but meaningful triage in MCIs.Eight volunteers participated in the MCI simulation scenario.The results of simulation scenarios showed that the proposed method was feasible in tasks of triage for MCIs.CONCLUSION:The proposed technique may provide an alternative technique for the triage of MCIs and is an innovative method in emergency rescue.展开更多
A perfect bidirectional broadband visible light absorber composed of titanium nitride and tungsten nanodisk arrays is proposed.The average absorption of the absorber exceeds 89%at 400 nm–800 nm when light is normally...A perfect bidirectional broadband visible light absorber composed of titanium nitride and tungsten nanodisk arrays is proposed.The average absorption of the absorber exceeds 89%at 400 nm–800 nm when light is normally incident on the front-side.Illumination from the opposite direction(back-side)results in absorption of more than 75%.Through the theoretical analysis of the electric and magnetic fields,the physical mechanism of the broadband perfect absorption is attributed to the synergy of localized surface plasmons,propagating surface plasmons,and plasmonic resonant cavity modes.Furthermore,the absorber also exhibits excellent polarization-independence performance and a high angular tolerance of~30°for both front-and back-side incidence.The designed bidirectional broadband visible light absorber here has wide application prospects in the fields of solar cells and ink-free printing.展开更多
基金supported by Program for National Natural Science Foundation of China(Nos.22178135,21978104 and 22278419)the National Key Research and Development Program of China(No.2021YFC2101601)。
文摘The fructose-to-furfural transformation is facing major challenges in the selectivity and high efficiency. Herein, we have developed a simple and effective approach for the selective conversion of fructose to furfural using Hβ zeolite modified by organic acids for dealuminization to regulate its textural and acidic properties. It was found that citric acid-dealuminized Hβ zeolite possessed high specific surface areas, wide channels and high Brønsted acid amount, which facilitated the selective conversion of fructose to furfural with a maximum yield of 76.2% at433 K for 1 h in the γ-butyrolactone(GBL)-H_(2)O system, as well as the concomitant formation of 83.0% formic acid. The^(13)C-isotope labelling experiments and the mechanism revealed that the selective cleavage of C1–C2 or C5–C6 bond on fructose was firstly occurred to form pentose or C5 intermediate by weak Brønsted acid, which was then dehydrated to furfural by strong Brønsted acid. Also this dealuminized Hβ catalyst showed the great recycling performance and was active for the conversion of glucose and mannose.
文摘BACKGROUND Neoadjuvant chemotherapy(NAC)has become the standard care for advanced adenocarcinoma of esophagogastric junction(AEG),although a part of the patients cannot benefit from NAC.There are no models based on baseline computed tomography(CT)to predict response of Siewert type II or III AEG to NAC with docetaxel,oxaliplatin and S-1(DOS).AIM To develop a CT-based nomogram to predict response of Siewert type II/III AEG to NAC with DOS.METHODS One hundred and twenty-eight consecutive patients with confirmed Siewert type II/III AEG underwent CT before and after three cycles of NAC with DOS,and were randomly and consecutively assigned to the training cohort(TC)(n=94)and the validation cohort(VC)(n=34).Therapeutic effect was assessed by disease-control rate and progressive disease according to the Response Evaluation Criteria in Solid Tumors(version 1.1)criteria.Possible prognostic factors associated with responses after DOS treatment including Siewert classification,gross tumor volume(GTV),and cT and cN stages were evaluated using pretherapeutic CT data in addition to sex and age.Univariate and multivariate analyses of CT and clinical features in the TC were performed to determine independent factors associated with response to DOS.A nomogram was established based on independent factors to predict the response.The predictive performance of the nomogram was evaluated by Concordance index(C-index),calibration and receiver operating characteristics curve in the TC and VC.RESULTS Univariate analysis showed that Siewert type(52/55 vs 29/39,P=0.005),pretherapeutic cT stage(57/62 vs 24/32,P=0.028),GTV(47.3±27.4 vs 73.2±54.3,P=0.040)were significantly associated with response to DOS in the TC.Multivariate analysis of the TC also showed that the pretherapeutic cT stage,GTV and Siewert type were independent predictive factors related to response to DOS(odds ratio=4.631,1.027 and 7.639,respectively;all P<0.05).The nomogram developed with these independent factors showed an excellent performance to predict response to DOS in the TC and VC(C-index:0.838 and 0.824),with area under the receiver operating characteristic curve of 0.838 and 0.824,respectively.The calibration curves showed that the practical and predicted response to DOS effectively coincided.CONCLUSION A novel nomogram developed with pretherapeutic cT stage,GTV and Siewert type predicted the response of Siewert type II/III AEG to NAC with DOS.
基金National Natural Science Foundation of China(41771108 and 31570479)the Natural Science Foundation of Jiangxi,China(20212ACB215002
文摘In riparian forests,litter decay provides essential energy and nutrients for both terrestrial and fluvial ecosystems.Litter mixing effects(LMEs)are crucial in regulating litter decay and nutrient dynamics,yet how LMEs change over time is unclear in riparian forests.In this study,leaf litter of three common species(Alnus sibirica Fisch.ex Turcz,Betula platyphylla Sukaczev,and Betula fruticosa Pall.)were mixed in an equal mass ratio and LMEs were measured for mass and nitrogen(N)remaining in whole litter mixtures over a 3-year period in a boreal riparian forest,northeastern China.LMEs were also assessed for component litter mass and N remaining by separating litter mixtures by species.During the decay of litter mixtures,antagonistic effects on mass and N remaining were dominant after one and two years of decay,whereas only additive effects were observed after three years.LMEs correlated negatively with functional diversity after the first and two years of decay but disappeared after three years.When sorting litter mixtures by species,non-additive LMEs on mass and N remaining decreased over incubation time.Moreover,non-additive LMEs were more frequent for litter of both B.platyphylla and B.fruticosa with lower N concentration than for A.sibirica litter with higher N concentration.These results indicate that incubation time is a key determinant of litter mixing effects during decay and highlight that late-stage litter mixture decay may be predicted from single litter decay dynamics in boreal riparian forests.
基金supported by the National Natural Science Foundation of China(under grant numbers 12174272 and 11974136)。
文摘α-Keggin polyoxometalates(POMs)[XW_(12)O_(40)]^(n−)(X=Al,Si,P,S)are widely used in batteries owing to their remarkable redox activity.However,the mechanism underlying the applications appears inconsistent with the widely accepted covalent bonding nature.Here,first-principles calculations show that XW_(12)are core–shell structures composed of a shell and an XO_(4)^(n−)core,both are stabilized by covalent interactions.Interestingly,owing to the presence of a substantial number of electrons in W_(12)O_(36)shell,the frontier molecular orbitals of XW_(12)are not only strongly delocalized but also exhibit superatomic properties with high-angular momentum electrons that do not conform to the Jellium model.Detailed analysis indicates that energetically high lying filled molecular orbitals(MOs)have reached unusually high-angular momentum characterized by quantum number K or higher,allowing for the accommodation of numerous electrons.This attribute confers strong electron acceptor ability and redox activity to XW_(12).Moreover,electrons added to XW_(12)still occupy the K orbitals and will not cause rearrangement of the MOs,thereby maintaining the stability of these structures.Our findings highlight the structure–activity relationship and provide a direction for tailor-made POMs with specific properties at atomic level.
基金supported by the Science and Technology Project of Jilin Provincial Education Department (JJKH20221160KJ)the Jilin Province Science and Technology Department (20230402059GH)the National Natural Science Foundation of China (22279014)。
文摘The commercialization of lithium-sulfur(Li-S)batteries faces several challenges,including poor conductivity,unexpected volume expansion,and continuous sulfur loss from the cathode due to redox shuttling.In this study,we introduce a novel polymer via a simple cross-linking between poly(ether-thioureas)(PETU)and poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate)(PEDOT:PSS)as a bifunctio nal binder for Li-S batteries(devotes as"PPTU").Compared to polyvinylidene fluoride(PVDF),as-prepared PPTU exhibits significantly higher electrical conductivity,facilitating electrochemical reactions.Additionally,PPTU demonstrates effective adsorption of lithium polysulfides,leading to improved cycling stability by suppressing the shuttling effect.We investigate this behavior by monitoring morphological changes at the cell interface using synchrotron X-ray tomography.Cells with PPTU binders exhibit remarkable rate performance,desired reversibility,and excellent cycling stability even under stringent bending and twisting conditions.Our work represents promising progress in functional polymer binder development for Li-S batteries.
基金the financial support by the National Natural Science Foundation of China (22371010, 21771017, and 51702009)the "Hundred Talents Program" of the Chinese Academy of Sciences, the Fundamental Research Funds for the Central Universities+1 种基金the Shenzhen Science and Technology Program (JCYJ20210324115412035, JCYJ2021-0324123202008, JCYJ20210 324122803009 and ZDSYS20210813095534001)the Guangdong Basic and Applied Basic Research Foundation (2021A1515110880)
文摘The use of redox-active organic electrode materials in energy storage is restricted due to their inferior solvent resistance,abysmal conductivity,and the resultant low practical capacity.To address these issues,a class of bipolar p-phenylenediimidazole-based small-molecule compounds are designed and fabricated.Theπ-conjugated backbone of these small molecules allows for electron delocalization on a big conjugation plane,endowing them with good conductivity and reaction reversibility.Furthermore,when the para-positions of phenylene are occupied by hydroxyl groups,as-formed intramolecular hydrogen bonds(N-H...O)between phenolic hydroxyl groups and the–NH groups of imidazole rings further enhance the structural planarity,resulting in higherπ-conjugation degree and better conductivity,and thus higher utilization of active sites and electrode capacity,proved by both experimental results and theoretical calculations.The optimized composite electrode DBNQ@rGO-45 shows a high specific capacity(∼308 mA h g^(−1)at 100 mA g^(−1))and a long cycling stability(112.9 mA h g^(−1)after 6000 cycles at 2000 mA g^(−1)).The significantly better electrochemical properties for hydroxyl group-containing compounds than those without hydroxyl groups attributed to intramolecular hydrogen bond-induced conjugation enhancement will inspire the structure design of organic electrodes for better energy storage.
基金The study was reviewed and approved by the Science and Research Office of Tong Ren Hospital(Shanghai), No. AF/SC-08/04.0.
文摘BACKGROUND This study employed a phenomenological research approach within qualitative research to explore the challenges encountered by elderly individuals with temporary colostomies in managing their daily lives and care needs.Protecting the anus surgery combined with temporary colostomy has emerged as a prevalent treatment modality for low rectal cancer.However,the ileostomy is susceptible to peri-stoma skin complications,as well as fluid,electrolyte,and nutritional imbalances,posing challenges to effective management.The successful selfmanagement of patients is intricately linked to their adjustment to temporary colostomy;nonetheless,there remains a dearth of research examining the factors influencing self-care among temporary colostomy patients and the obstacles they confront.AIM To investigate the lived experiences,perceptions,and care requirements of temporary colostomy patients within their home environment,with the ultimate goal of formulating a standardized management protocol.METHODS Over the period of June to August 2023,a purposive sampling technique was utilized to select 12 patients with temporary intestinal stomas from a tertiary hospital in Shanghai,China.Employing a phenomenological research approach,a semi-structured interview guide was developed,and qualitative interviews were conducted using in-depth interview techniques.The acquired data underwent coding,analysis,organization,and summarization following Colaizzi’s seven-step method.RESULTS The findings of this study revealed that the experiences and needs of patients with temporary intestinal stomas can be delineated into four principal themes:Firstly,Temporary colostomy patients bear various burdens and concerns about the uncertainty of disease progression;secondly,patients exhibit limited self-care capabilities and face information deficits,resulting in heightened reliance on healthcare professionals;thirdly,patients demonstrate the potential for internal motivation through proactive self-adjustment;and finally,patients express a significant need for emotional and social support.CONCLUSION Home-living patients with temporary intestinal stomas confront multifaceted challenges encompassing burdens,inadequate self-care abilities,informational deficits,and emotional needs.Identifying factors influencing patients’self-care at home and proposing strategies to mitigate barriers can serve as a foundational framework for developing and implementing nursing interventions tailored to the needs of patients with temporary intestinal stomas.
基金supported by the National Natural Science Foundation of China(Nos.52122511,61927814,and U20A20290)Anhui Provincial Natural Science Foundation(2308085QF218)+5 种基金China National Postdoctoral Program for Innovative Talents(BX20230351)China Postdoctoral Science Foundation(2023M733382)National Key R&D Program of China(2021YFF0502700)Major Scientific and Technological Projects in Anhui Province(202203a05020014)Fundamental Research Funds for the Central Universities(WK5290000003 and WK2090000058)Youth Innovation Promotion Association CAS(Y2021118)。
文摘Small-scale electromagnetic soft actuators are characterized by a fast response and simplecontrol,holding prospects in the field of soft and miniaturized robotics.The use of liquid metal(LM)to replace a rigid conductor inside soft actuators can reduce the rigidity and enhance the actuation performance and robustness.Despite research efforts,challenges persist in the flexible fabrication of LM soft actuators and in the improvement of actuation performance.To address these challenges,we developed a fast and robust electromagnetic soft microplate actuator based on a laser-induced selective adhesion transfer method.Equipped with unprecedentedly thin LM circuit and customized low Young’s modulus silicone rubber(1.03 kPa),our actuator exhibits an excellent deformation angle(265.25?)and actuation bending angular velocity(284.66 rad·s^(-1)).Furthermore,multiple actuators have been combined to build an artificial gripper with a wide range of functionalities.Our actuator presents new possibilities for designing small-scaleartificial machines and supports advancements in ultrafast soft and miniaturized robotics.
基金The study was reviewed and approved by the Ethics Committee of Shanghai Tongren Hospital(Approval Number:Tongren Lun Audit 2022-075-01).
文摘BACKGROUND More and more evidence-based practices are emerging,but researchers mostly focus on short-term effects,resulting in evidence-based practices not being applied in the clinic in the long term.In this study,we took the evidence-based practice of perioperative airway management in elderly fracture patients as an example and adopted a descriptive phenomenological approach to understand the influencing factors of its sustainability to provide a reference basis for promoting the continuity of evidence-based practice in the clinic.AIM To explore factors influencing the persistence of evidence-based practice in perioperative airway management in elderly patients with fractures.METHODS This study was qualitative research.Nine nurses who implemented evidencebased practice in the orthopedic ward of a tertiary comprehensive hospital in Shanghai from September 2023 to October 2023 were selected using purposive sampling as research subjects.Semi-structured interviews were conducted with them,and the data were analyzed using the Colaizzi phenomenological analysis method based on the three dimensions and ten factors of the NHS sustainability model.RESULTS Three main themes and ten subthemes were identified:Process aspects(benefits to patients,benefits to nurses,lack of follow-up,complex processes);staff aspects(insufficient human resources,inadequate training and education,lack of leadership support);and organizational environment aspects(inadequate infrastructure,poor patient compliance,poor doctor cooperation).CONCLUSION Human resources,training and education,leadership support,infrastructure,and patient-physician collaboration are important factors influencing the sustainability of evidence-based practice for perioperative airway management in older patients with fractures.
基金Supported by Key Joint Research Program of Scientific Research Project of Shanghai Changning District Health Commission in 2023,No.20234Y008.
文摘BACKGROUND This study adopts a descriptive phenomenological approach to investigate the facilitators and barriers of community nurses'abilities in managing critical and emergency conditions.With the transition of healthcare systems to the community,the evolution of nursing practices,and the attention from policies and practices,community nurses play a crucial role in the management of critical and emergency conditions.However,there is still a lack of comprehensive understanding regarding the factors that promote or hinder their capabilities in this area.AIM To understand the facilitators and barriers of community nurses in managing critical and emergency conditions,exploring the fundamental reasons and driving forces influencing their treatment capabilities.METHODS This study utilized the destination sampling method between May 2023 and July 2023.It employed a descriptive phenomenological approach within qualitative research methodologies.Through objective sampling,17 community nurses from 7 communities in Changning District,Shanghai,were selected as the study subjects.Semi-structured interviews were conducted to gather data,which were subsequently organized and analyzed using Colaizzi's seven-step analysis method,leading to the extraction of final themes.RESULTS The barrier factors identified from the interviews encompassed three topics:resource allocation,professional factors,and personal literacy.The facilitators comprised three themes:professionalism,management attention,and training and continuing education.We identified that the root causes of the barriers included the lack of practical treatment experience among community nurses,insufficient awareness of self-directed learning,and limited knowledge and technical proficiency.The professional quality of community nurses and management attention serve as motivation for them to enhance their treatment abilities.CONCLUSION To enhance the capability of community nurses in treating acute and critical patients,it is recommended to bolster training specifically tailored to acute and critical care,raise awareness of first aid practices,and elevate knowledge and skill levels.
文摘BACKGROUND Older spine surgery patients have a high incidence of debilitation,which can be managed with certain exercises.AIM To investigate the current status and influencing factors related to the knowledge of exercise intervention among patients and professionals.METHODS Descriptive research methods were used to classify and summarize patients and professionals’perceptions and factors affecting exercise interventions.Data were analysed using the Colaizzi seven-step analysis method to distill and refine themes.RESULTS A total of 7 themes were identified:(1)The current status of patients'exercise is unsatisfactory;(2)patients'health literacy is low,coupled with a lack of social and family support;(3)there are numerous challenges with systematic exercise interventions;(4)healthcare professionals acknowledge the importance and need for exercise interventions;(5)there's a pronounced willingness among patients to participate in exercise intervention programs;(6)healthcare professionals believe that exercise interventions are beneficial;and(7)participants offered invaluable insights and suggestions on perioperative exercise during spinal surgery.CONCLUSION To investigate the current status and influencing factors related to the knowledge of exercise intervention among patients and the related healthcare professionals to provide a reference for the construction of exercise management programs for these patients.
文摘BACKGROUND The bowel preparation process prior to colonoscopy determines the quality of the bowel preparation,which in turn affects the quality of the colonoscopy.Colono-scopy is an essential procedure for postoperative follow-up monitoring of colorec-tal cancer(CRC)patients.Previous studies have shown that advanced age and a history of colorectal resection are both risk factors for inadequate bowel prepara-tion.However,little attention has been paid to the bowel preparation experiences and needs of predominantly older adult postoperative CRC patients.AIM To explore the experiences and needs of older adult postoperative CRC patients during bowel preparation for follow-up colonoscopy.METHODS Fifteen older adult postoperative CRC patients who underwent follow-up colonoscopy at a tertiary hospital in Shanghai were selected using purposive sampling from August 2023 to November 2023.The phenomenological method in qualitative research was employed to construct an interview outline and conduct semi-structured interviews with the patients.Colaizzi's seven-step analysis was utilized to organize,code,categorize,summarize,and verify the interview data.RESULTS The results of this study were summarized into four themes and eight sub-themes:(1)Inadequate knowledge about bowel preparation;(2)Decreased physiological comfort during bowel preparation(gastrointestinal discomfort and sleep deprivation caused by bowel cleansing agents,and hunger caused by dietary restrictions);(3)Psychological changes during different stages of bowel preparation(pre-preparation:Fear and resistance due to previous experiences;during preparation:Irritation and helplessness caused by taking bowel cleansing agents,and post-preparation:Anxiety and worry while waiting for the colonoscopy);and(4)Needs related to bowel preparation(detailed instructions from healthcare professionals;more ideal bowel cleansing agents;and shortened waiting times for colonoscopy).CONCLUSION Older adult postoperative CRC patients'knowledge of bowel preparation is not adequate,and they may encounter numerous difficulties and challenges during the process.Healthcare professionals should place great emphasis on providing instruction for their bowel preparation.
文摘BACKGROUND This study employs a descriptive phenomenological approach to investigate the challenges anesthesia nurses face in managing emergence delirium(ED),a common and complex postoperative complication in the post-anesthesia care unit.The role of nurses in managing ED is critical,yet research on their understanding and management strategies for ED is lacking.AIM To investigate anesthetic nurses’cognition and management experiences of ED in hopes of developing a standardized management protocol.METHODS This study employed a descriptive phenomenological approach from qualitative research methodologies.Purposeful sampling was utilized to select 12 anesthetic nurses from a tertiary hospital in Shanghai as research subjects.Semi-structured interviews were conducted,and the data were organized and analyzed using Colaizzi’s seven-step analysis method,from which the final themes were extracted.RESULTS After analyzing the interview content,four main themes and eight subthemes were distilled:Inefficient cognition hinders the identification of ED(conceptual ambiguity,empirical identification),managing diversity and challenges(patientcentered safe care,low level of medical-nursing collaboration),work responsibilities and pressure coexist(heavy work responsibilities,occupational risks and stress),demand for high-quality management(expecting the construction of predictive assessment tools and prevention strategies,and pursuing standardized management processes to enhance management effectiveness).CONCLUSION Nursing managers should prioritize the needs and suggestions of nurses in order to enhance their nursing capabilities and provide guidance for standardized management processes.
文摘Succinylation is a highly conserved post-translational modication that is processed via enzymatic and non-enzymatic mechanisms.Succinylation exhibits strong effects on protein stability,enzyme activity,and transcriptional regulation.Protein succinylation is extensively present in the liver,and increasing evidence has demonstrated that succinylation is closely related to hepatic metabolism.For instance,histone acetyltransferase 1 promotes liver glycolysis,and the sirtuin 5-induced desuccinylation is involved in the regulation of the hepatic urea cycle and lipid metabolism.Therefore,the effects of succinylation on hepatic glucose,amino acid,and lipid metabolism under the action of various enzymes will be discussed in this work.In addition,how succinylases regulate the progression of different liver diseases will be reviewed,including the desuccinylation activity of sirtuin 7,which is closely associated with fatty liver disease and hepatitis,and the actions of lysine acetyltransferase 2A and histone acetyltransferase 1 that act as succinyltransferases to regulate the succinylation of target genes that influence the development of hepatocellular carcinoma.In view of the diversity and significance of protein succinylation,targeting the succinylation pathway may serve as an attractive direction for the treatment of liver diseases.
基金Supported by Youth Project of Anhui Provincial Health Commission T,No.AHWJ2023A30225.
文摘BACKGROUND Large abdominal wall defect(LAWD)measures>20 cm in width.LAWD can easily lead to intestinal necrosis,peritonitis,other complications,and even mul-tiple organ dysfunction syndrome.Multiple intestinal fistulas are high-flow fis-tulas that can cause severe water–electrolyte imbalance and malnutrition,as well as inflammation,high metabolic status,and chronic intestinal failure caused by intestinal fluid corrosion in tissues around the orifice fistulas.CASE SUMMARY This article summarizes the nursing experience of a patient with sigmoid carci-noma who has LAWD with multiple intestinal fistula due to repeated operations for postoperative complications.The key points of care:Scientific assessment of nutritional status,dynamic adjustment of nutritional support programmes,com-prehensive adoption of enteral nutrition,parenteral nutrition and combined nut-rition of enteral and parenteral;taking good care of abdominal wall defects and intestinal fistulas;continuous flushing of the abdominal drainage tube and low negative pressure drainage;prevention of venous thrombosis;strengthening of physical exercise;implementation of positive psychological interventions.CONCLUSION After more than 7 months of careful care,the patient's physical fitness has been well recovered,local inflammation is well controlled,which wins the opportunity for the operation,and the postoperative recovery is good.
基金This study was funded in part by the National Natural Science Foundation of China(Nos.31861143050,31772476 and 31911530077).
文摘Objective Acute lung injury(ALI)is an acute clinical syndrome characterized by uncontrolled inflammation response,which causes high mortality and poor prognosis.The present study determined the protective effect and underlying mechanism of Periplaneta americana extract(PAE)against lipopolysaccharide(LPS)-induced ALI.Methods The viability of MH-S cells was measured by MTT.ALI was induced in BALB/c mice by intranasal administration of LPS(5 mg/kg),and the pathological changes,oxidative stress,myeloperoxidase activity,lactate dehydrogenase activity,inflammatory cytokine expression,edema formation,and signal pathway activation in lung tissues and bronchoalveolar lavage fluid(BALF)were examined by H&E staining,MDA,SOD and CAT assays,MPO assay,ELISA,wet/dry analysis,immunofluorescence staining and Western blotting,respectively.Results The results revealed that PAE obviously inhibited the release of proinflammatory TNF-α,IL-6 and IL-1βby suppressing the activation of MAPK/Akt/NF-κB signaling pathways in LPS-treated MH-S cells.Furthermore,PAE suppressed the neutrophil infiltration,permeability increase,pathological changes,cellular damage and death,pro-inflammatory cytokines expression,and oxidative stress upregulation,which was associated with its blockage of the MAPK/Akt/NF-κB pathway in lung tissues of ALI mice.Conclusion PAE may serve as a potential agent for ALI treatment due to its anti-inflammatory and anti-oxidative properties,which correlate to the blockage of the MAPK/NF-κB and AKT signaling pathways.
文摘Because of its excellent dose distribution,proton therapy is becoming increasingly popular in the medical application of cancer treatment.A synchrotron-based proton therapy facility was designed and constructed in Shanghai.The synchrotron,beam delivery system,and other technical systems were commissioned and reached their expected performances.After a clinical trial of 47 patients was finished,the proton therapy facility obtained a registration certificate from the National Medical Products Administration.The characteristics of the accelerator and treatment systems are described in this article.
基金supported by the National Natural Science Foundation of China (NSFC) on the micro behavior of heavy metal migration and transformation in lead–zinc tailings and its nano micro scale high targeted stabilization mechanism (51968033)the National Key Research and Development Program “long-term solidification of heavy metal tailings pollution/environmental functional materials, technologies and equipment of stabilizers” (2018YFC1801702)。
文摘In this study,ferric nitrate modified carbon nanotube composites (FCNT) were prepared by isovolumetric impregnation using carbon nanotubes (CNTs) as the carrier and ferric nitrates the active agent.The batch experiments showed that FCNT could effectively oxidize As(III) to As(V) and react with it to form stable iron arsenate precipitates.When the dosage of FCNT was 0.1 g·L^(–1),pH value was 5–6,reaction temperature was 35℃ and reaction time was 2 h,the best arsenic removal effect could be achieved,and the removal rate of As(V) could reach 99.1%,which was always higher than 90%under acidic conditions.The adsorption results of FCNT were found to be consistent with Langmuir adsorption by static adsorption isotherm fitting,and the maximum adsorption capacity reached 118.3 mg·g^(-1).The material phase and property analysis by scanning electron microscopy,Brunauer–Emmett–Teller,Fourier transform infrared spectoscopy,X-ray photoelectron spectroscopy and other characterization methods,as well as adsorption isotherm modeling,were used to explore the adsorption mechanism of FCNT on arsenic.It was found that FCNT has microporous structure and nanostructure,and iron nanoparticles are loosely distributed on CNTs,which makes the material have good oxidation,adsorption and magnetic separation properties.Arsenic migrates on the surface of FCNT composites is mainly removed by forming insoluble compounds and co-precipitation.All the results show that FCNT treats arsenic at low cost with high adsorption efficiency,and the results also provide the experimental data basis and theoretical basis for arsenic contamination in groundwater.
基金Sanming Project of Medicine in Shenzhen(No.SZSM201911007)Shenzhen Stability Support Plan(20200824145152001)。
文摘BACKGROUND:Rapid on-site triage is critical after mass-casualty incidents(MCIs)and other mass injury events.Unmanned aerial vehicles(UAVs)have been used in MCIs to search and rescue wounded individuals,but they mainly depend on the UAV operator’s experience.We used UAVs and artificial intelligence(AI)to provide a new technique for the triage of MCIs and more efficient solutions for emergency rescue.METHODS:This was a preliminary experimental study.We developed an intelligent triage system based on two AI algorithms,namely OpenPose and YOLO.Volunteers were recruited to simulate the MCI scene and triage,combined with UAV and Fifth Generation(5G)Mobile Communication Technology real-time transmission technique,to achieve triage in the simulated MCI scene.RESULTS:Seven postures were designed and recognized to achieve brief but meaningful triage in MCIs.Eight volunteers participated in the MCI simulation scenario.The results of simulation scenarios showed that the proposed method was feasible in tasks of triage for MCIs.CONCLUSION:The proposed technique may provide an alternative technique for the triage of MCIs and is an innovative method in emergency rescue.
基金the National Key Research and Development Program(Grant No.2022YFB2804602)Shanghai Pujiang Program(Grant No.21PJD048).
文摘A perfect bidirectional broadband visible light absorber composed of titanium nitride and tungsten nanodisk arrays is proposed.The average absorption of the absorber exceeds 89%at 400 nm–800 nm when light is normally incident on the front-side.Illumination from the opposite direction(back-side)results in absorption of more than 75%.Through the theoretical analysis of the electric and magnetic fields,the physical mechanism of the broadband perfect absorption is attributed to the synergy of localized surface plasmons,propagating surface plasmons,and plasmonic resonant cavity modes.Furthermore,the absorber also exhibits excellent polarization-independence performance and a high angular tolerance of~30°for both front-and back-side incidence.The designed bidirectional broadband visible light absorber here has wide application prospects in the fields of solar cells and ink-free printing.
