BACKGROUND Percutaneous transhepatic stent placement has become a common strategy for the postoperative treatment of portal vein(PV)/superior mesenteric veins(SMV)stenosis/occlusion.It has been widely used after liver...BACKGROUND Percutaneous transhepatic stent placement has become a common strategy for the postoperative treatment of portal vein(PV)/superior mesenteric veins(SMV)stenosis/occlusion.It has been widely used after liver transplantation surgery;however,reports on stent placement for acute PV/SMV stenosis after pancreatic surgery within postoperative 3 d are rare.CASE SUMMARY Herein,we reported a case of intestinal edema and SMV stenosis 2 d after pancreatic surgery.The patient was successfully treated using stent grafts.Although the stenosis resolved after stent placement,complications,including bleeding,pancreatic fistula,bile leakage,and infection,made the treatment highly challenging.The use of anticoagulants was adjusted multiple times to prevent venous thromboembolism and the risk of bleeding.After careful treatment,the patient stabilized,and stent placement effectively managed postoperative PV/SMV stenosis.CONCLUSION Stent placement is effective and feasible for treating acute PV/SMV stenosis after pancreatic surgery even within postoperative 3 d.展开更多
AIM: To investigate the influence of high dose of dexamethasone on inflammatory mediators and apoptosis of rats with severe acute pancreatitis (SAP). METHODS: SAP rats were randomly assigned to the model group and tre...AIM: To investigate the influence of high dose of dexamethasone on inflammatory mediators and apoptosis of rats with severe acute pancreatitis (SAP). METHODS: SAP rats were randomly assigned to the model group and treatment group while the normal rats were assigned to the sham operation group. The mortality,ascite volumes,ascites/body weight ratio and pancreas pathological changes of all rats were observed at 3,6 and 12 h after operation. Their contents of amylase and endotoxin in plasma and contents of tumor necrosis factor (TNF-α),phospholipase A2 (PLA2) and IL-6 in serum were also determined. The microarray sections of their pancreatic tissues were prepared,terminal transferase dUTP nick end labeling (TUNEL) staining was performed and apoptotic indexes were calculated. RESULTS: There was no marked difference between treatment group and model group in survival. The contents of amylase and endotoxin in plasma and contents of TNF-α,PLA2 and IL-6 in serum,ascite volumes,ascites/body weight ratio and pancreas pathological scores were all lower in treatment group than in model group to different extents at different time points P < 0.05,58.3 (26.4) ng/L vs 77.535 (42.157) ng/L in TNF-α content,8.00 (2.00) points vs 9.00 (2.00) points in pathological score of pancreas respectively; P < 0.01,0.042 (0.018) EU/mL vs 0.056 (0.0195) EU/mL in endotoxin content,7791 (1863) U/L vs 9195 (1298) U/L in plasma amylase content,1.53 (0.79) vs 2.38 (1.10) in ascites/body weight ratio,8.00 (1.00) points vs 11.00 (1.50) points in pathological score of pancreas; P < 0.001,3.36 (1.56) ng/L vs 5.65 (1.08) ng/L in IL-6 content,4.50 (2.00) vs 7.20 (2.00),4.20 (1.60) vs 6.40 (2.30),3.40 (2.70) vs 7.90 (1.70) in ascite volumes,respectively. The apoptotic indexes of pancreas head and pancreas tail were all higher in treatment group than in model group at 6 h P < 0.01,0.00 (2.00)% vs 0.00 (0.00)%,0.20 (1.80) vs 0.00 (0.00) in apoptosis indexes,respectively. CONCLUSION: The mechanism of dexamethasone treatment in acute pancreatitis is related to its inhibition of inflammatory mediator generation and induction of pancreatic acinar cell apoptosis.展开更多
Objective To evaluate the efficacy and safety of uterine artery embolization(UAE) in the management of primary postpartum hemorrhage associated with placenta accreta. Methods We retrospectively reviewed the medical re...Objective To evaluate the efficacy and safety of uterine artery embolization(UAE) in the management of primary postpartum hemorrhage associated with placenta accreta. Methods We retrospectively reviewed the medical records of patients with placenta accreta between January 2010 and August 2014. Totally 18 women(mean age 30.8±4.2 years) of primary massive postpartum hemorrhage with diagnosis of placenta accrete received treatment of UAE after delivery. Images of DSA and medical records were reviewed. Technical success was defined as control of bleeding after embolization. The complications, control of hemorrhage and recurrent bleeding of the placenta left inside the uterus were retrospectively collected for assessment. Results All patients underwent transcatheter embolization of bilateral uterine arteries. The technical success rate of embolization was 100%. Bleeding was controlled in 17 of 18 patients(94%) during follow-up period(median 18 months, 3-31months) without further bleeding recurred. One patient with placenta percreta undertook an emergent hysterectomy along with surgical bladder repair after UAE because of persistent uterine bleeding. Eight patients had postembolization syndrome and no other complications occurred. Conclusion Uterine artery embolization is an effective and safe treatment for the management of primary postpartum massive hemorrhage associated with placenta accreta.展开更多
Objective To investigate the placement of a long tube into the small intestine under fluoroscopic guidance and to evaluate its decompression effect on early postoperative small bowel obstruction(EPSBO).Methods Fifty-f...Objective To investigate the placement of a long tube into the small intestine under fluoroscopic guidance and to evaluate its decompression effect on early postoperative small bowel obstruction(EPSBO).Methods Fifty-four patients with EPSBO requiring decompression between April 2010 and July 2014 were enrolled in the study.Insertion of a long tube was guided by fluoroscopy.We first used the guide wire to pass the pylorus and then used the 10 Fr feeding tube as an exchangeable tube to put the superstiff wire into the duodenum.Finally the long tube could be passed over the guide wire through the pylorus into the intestine.The total procedure time,the radiation exposure time,and the incidence of complications were evaluated.Results The long tubes passed into the jejunum on initial insertion for all patients,so the success rate of this technique was 100%.The long tube was inserted into ileum in 18 patients.The mean total procedure time was 34.4±8.6 minutes,and the mean radiation exposure time 18.9±6.8 minutes.A total of 47 patients(87%) experienced full recovery following long-tube decompression and without the need for surgical intervention.Conclusions Using the wire-exchange technique,it is easy to place a long tube into the small bowel under fluoroscopic guidance.This decompression method is safe and effective for management of EPSBO.展开更多
AIM: To summarize the operative experiences for giant leiomyoma of esophagus.METHODS: Eight cases of giant esophageal leiomyoma (GEL) whose tumors were bigger than 10 cm were treated surgically in our department from ...AIM: To summarize the operative experiences for giant leiomyoma of esophagus.METHODS: Eight cases of giant esophageal leiomyoma (GEL) whose tumors were bigger than 10 cm were treated surgically in our department from June 1980 to March 2004.and esophagoscopy. Leiomyoma located in upper thirds of the esophagus in one case, middle thirds of the esophagus in five cases, lower thirds of the esophagus in two cases. Resection of tumors was performed successfully in all of these cases. Operative methods included transthoracic extramucosal enucleation and buttressing the muscular defect with pedicled great omental flap (one case), esophagectomy and esophagogastrostomy above the arch of aorta (three cases), total esophagectomy and esophageal replacement with colon (four cases). Histological examination confirmed that all of these cases were leiomyoma.RESULTS: All of the eight patients recovered approvingly with no mortality and resumed normal diet after operation. Vomiting during meals occurred in one patient with esophagogastrostomy, and remained 1 mo. Reflux esophagitis occurred in one patient with esophagogastrostomy and was alleviated with medication. Thoracic colon syndrome (TCS) occurred in one patient with colon replacement at 15 mo postoperatively. No recurrence occurred in follow-up from 6 mo to 8 years.CONCLUSION: Surgical treatment for GEL is both safe and effective. The choices of operative methods mainly depend on the location and range of lesions. We prefer to treat GEL via esophagectomy combined with esophagogastrostomy or esophagus replacement with colon. The long-time quality of life is better in the latter.展开更多
BACKGROUND: Collateralized intraand extra-hepatic routes in patients with Budd-Chiari syndrome (BCS) were important. This study aimed to investigate the feasibility and clinical outcomes of the staged management of BC...BACKGROUND: Collateralized intraand extra-hepatic routes in patients with Budd-Chiari syndrome (BCS) were important. This study aimed to investigate the feasibility and clinical outcomes of the staged management of BCS based on the degree of compensation provided by intraor extra-hepatic collateral circulations. METHODS: A total of 103 adult patients with BCS caused by co-obstruction of the inferior vena cava (IVC) and main hepatic veins (MHVs) between March 2001 and October 2009 were enrolled in this study. Based on the pathological classification and degree of hemodynamic compensation by collateral circulations, treatment priority for IVC hypertension was determined in the first-stage treatment. Patients were deemed eligible for second-stage treatment when the first-stage treatment failed to relieve. RESULTS: Imaging results revealed that most patients had collateral circulations to different extents. Based on the degree of compensation provided by these collateral circulations, 74 patients underwent single-stage treatment for IVC hypertension, i.e., radiologic intervention (RI) for 61 patients and surgical procedures (SPs) for 13. One patient was treated for portal hypertension. Twenty-nine patients underwent second-stage treatment (25 underwent RI and SP, and 4 only SP). The general morbidity and mortality after all procedures were 8.3% and 1.5%, respectively. After a median follow-up of 35 months, 4 patients underwent second-stage treatment and 7 underwent recanalization of the IVC/MHVs. Two patients died of hepatocellular carcinoma and 1 died of graft obstruction. CONCLUSION: Staged management produces excellent outcomes for patients with BCS caused by co-obstruction of the IVC and MHVs.展开更多
We investigated 64 pairs of interacting-CME events identified from simultaneous observations by the SOHO and STEREO spacecraft from January 2010 to August 2014, to examine the relationship between large SEP events in ...We investigated 64 pairs of interacting-CME events identified from simultaneous observations by the SOHO and STEREO spacecraft from January 2010 to August 2014, to examine the relationship between large SEP events in the energy range of ～25 to～60 MeV and properties of the interacting CMEs.We found that during CME interactions, the large SEP events in this study were all generated by CMEs with the presence of enhanced type Ⅱ radio bursts, which also have wider longitudinal distributions compared to events without a type Ⅱ radio burst or its enhancement(almost always associated with small SEP events).It seems that the signature of type Ⅱ radio burst enhancement is a good discriminator between large SEP and small or no SEP event producers during CME interactions. The type Ⅱ radio burst enhancement is more likely to be generated by CME interactions, with the main CME having a larger speed(v), angular width(WD), mass(m) and kinetic energy(Ek), and taking over the preceding CMEs. The preceding CMEs in these instances have higher v, WD, m and Ekthan those in CME pairs missing type Ⅱ radio bursts or enhancements. Generally, the values of these properties in the type-Ⅱ-enhanced events are typically higher than the corresponding non-type-Ⅱ or non-type-Ⅱ-enhanced cases for both the main and preceding CMEs. Our analysis also revealed that the intensities of associated SEP events correlate negatively with the intersection height of the two CMEs. Moreover, the overlap width of two CMEs is typically larger in type-Ⅱ-enhanced events than in non-type-Ⅱ or non-type-Ⅱ-enhanced events. Most type-Ⅱ-enhanced events and SEP events are coincident and are almost always made by the fast and wide main CMEs that sweep fully over relatively slower and narrower preceding CMEs. We suggest that a fast CME with enough energy completely overtaking a relatively narrower preceding CME, especially at low height, can drive a more energetic shock signified by the enhanced type Ⅱ radio bursts. The shock may accelerate ambient particles(likely provided by the preceding CME) and lead to large SEP events more easily.展开更多
The microstructure and hardness of rheo-forming AZ91-Y alloy before and after solution treatment(ST) have been investigated by means of optical microscope(OM), scanning electron microscope(SEM) equipped with energy di...The microstructure and hardness of rheo-forming AZ91-Y alloy before and after solution treatment(ST) have been investigated by means of optical microscope(OM), scanning electron microscope(SEM) equipped with energy dispersive spectroscopy(EDS), X-ray diffraction(XRD) and Vickers. The experimental results showed that the β-Mg17Al12 phase of alloy was nearly dissolved after ST for 5 min. With the increasing of ST duration to 28 h, both the primary and secondarily solidified α-Mg grains faded away. At the same time, the alloy exhibited a much smoother surface due to the diffusion of solute atoms(Al). During ST, the thermal stable phase of Al2 Y produced by ultrasonic vibration retained its size and morphology. As the ST duration was increased, the alloy hardness decreased sharply at first, and then gradually reached a minimum level. The alloy's appropriate ST duration at 410 °C was approximately 28 h.展开更多
Objective To evaluate the role of multidetector computed tomography-angiography(MDCTA) for management of life-threatening spontaneous retroperitoneal haemorrhage(SRH).Methods A retrospective analysis of the medical re...Objective To evaluate the role of multidetector computed tomography-angiography(MDCTA) for management of life-threatening spontaneous retroperitoneal haemorrhage(SRH).Methods A retrospective analysis of the medical records of all SRH patients admitted to our hospital from January 1,2005 to November 31,2014 was performed.SRH was defined as unrelated to invasive procedures,surgery,trauma,abdominal tumor or aortic aneurysm.Life-threatening SRH was defined as hemodynamic instability with hypotension.Sixteen cases met the inclusive criteria.Patients' characteristics,clinical presentation,imaging of MDCTA,treatment modalities,morbidity,and follow-up data were analyzed.Results The group of 16 patients included 11 men and 5 women,with a mean age of 51.5 ± 16.4years.All patients underwent MDCTA scan examinations,and active contrast media(CM) extravasation were found in 9 patients.Angiography was performed for 8 patients in the CM extravasation group.Bleeding vessels were found in 7 patients who underwent successful embolization.One patient in the CM extravasation group did not undergo angiography and died of bleeding.Seven patients without active CM extravasation underwent conservative management.Bleeding was controlled for all these 7 patients,and 1 patient died of multiple organ failure.Fourteen patients survived from SRH were successfully discharged.One patient died of heart failure during follow-up.Conclusion MDCTA was useful in the diagnosis of SRH and proved to be predictive for the outcome of conservative treatment and early intervention.展开更多
This article mainly discussed bulk material prepared by powder metallurgy,and the commercial 2024 aluminum alloy powder and FeNiCrCoAl 3 high entropy alloy powder( both produced by argon gas atomization process) were ...This article mainly discussed bulk material prepared by powder metallurgy,and the commercial 2024 aluminum alloy powder and FeNiCrCoAl 3 high entropy alloy powder( both produced by argon gas atomization process) were ball-milled for different hours. The prepared powder was consolidated by hot extrusion method. The microstructures of the milled powder and bulk alloy were examined by X- Ray Diffraction( XRD), Scanning Electron Microscopy( SEM) and Transmission Electron Microscopy( TEM). The thermal stability was tested by differential scanning calorimetry( DSC). Mechanical properties of the extruded alloy were examined by Vickers hardness tester and mechanical testing machine. The results show that after milling,the mixed particle sizes and microstructures of the alloy powder change obviously. The compressive strength of the extruded alloy has reached 580 MPa under certain conditions of milling time and composition.展开更多
On 2012 March 7, the STEREO Ahead and Behind spacecraft, along with near-Earth spacecraft(e.g. SOHO, Wind) situated between the two STEREO spacecraft, observed an extremely large global solar energetic particle(SEP) e...On 2012 March 7, the STEREO Ahead and Behind spacecraft, along with near-Earth spacecraft(e.g. SOHO, Wind) situated between the two STEREO spacecraft, observed an extremely large global solar energetic particle(SEP) event in Solar Cycle 24. Two successive coronal mass ejections(CMEs) have been detected close in time. From the multi-point in-situ observations, it can be found that this SEP event was caused by the first CME, but the second one was not involved. Using velocity dispersion analysis(VDA),we find that for a well magnetically connected point, the energetic protons and electrons are released nearly at the same time. The path lengths to STEREO-B(STB) for protons and electrons have a distinct difference and deviate remarkably from the nominal Parker spiral path length, which is likely due to the presence of interplanetary magnetic structures situated between the source and STB. Also, the VDA method seems to only obtain reasonable results at well-connected locations and the inferred release times of energetic particles in different energy channels are similar. We suggest that good-connection is crucial for obtaining both an accurate release time and path length simultaneously, agreeing with the modeling result of Wang &Qin(2015).展开更多
BACKGROUND The posterior cruciate ligament(PCL) is important for cruciate-retaining(CR)total knee arthroplasty(TKA). Whether the entire PCL should be retained during CR-TKA is controversial.AIM To evaluate the clinica...BACKGROUND The posterior cruciate ligament(PCL) is important for cruciate-retaining(CR)total knee arthroplasty(TKA). Whether the entire PCL should be retained during CR-TKA is controversial.AIM To evaluate the clinical outcomes of PCL preservation in CR-TKA and the methods used to deal with the PCL during surgery.METHODS A retrospective review of patients with osteoarthritis undergoing primary CRTKA(176 patients, 205 knees) in our institution between March 2012 and March 2014 was performed. A PCL protector was used to preserve the intact PCL bone block. The status of the PCL was recorded during surgery. Intact PCL preserved,pie-crusting and repairing were used to balance the tension of the PCL. Range of motion(ROM) and the Knee Society Clinical Rating system(KSS) were evaluated preoperatively and at the endpoint of follow-up.RESULTS The mean ROM of the knee was 103.2 ± 17.2°, KSS clinical score was 47.6 ± 9.5 and KSS functional score was 46.3 ± 11.9 before surgery. The mean ROM of the knee was 117.5 ± 9.7°, KSS clinical score was 89.2 ± 3.6 and KSS functional score was 84.6 ± 9.8 at 5 years follow-up. ROM, KSS clinical scores and KSS functional scores were significantly improved after surgery(P < 0.01). Thirty-two(23.7%)TKAs involved PCL pie-crusting and 18(13.3%) involved PCL repair. Eighty-five(63.0%) TKAs applied standard operating procedures and preserved intact PCL.At 5 years follow-up, in the intact PCL group, the mean ROM of the knee was 118.0 ± 8.3°, KSS clinical score was 89.1 ± 3.7 and KSS functional score was 84.9 ±9.6. In the PCL pie-crusting group, mean ROM of the knee was 114.0 ± 13.5°, KSS clinical score was 88.8 ± 3.4 and KSS functional score was 83.8 ± 10.5. In the PCL repair group, mean ROM of the knee was 120.3 ± 7.0°, KSS clinical score was 89.0± 3.6 and KSS functional score was 89.4 ± 4.5. There were no significant differences in ROM, KSS clinical scores and KSS functional scores among the three groups(P > 0.05).CONCLUSION The clinical outcomes of preserving the PCL in CR-TKA are encouraging. Piecrusting and PCL repair do not affect the function. The PCL protector effectively protected the PCL bone block.展开更多
Objective To evaluate the image quality (IQ) and radiation dose of 128-slice dual-source computed tomography (DSCT) coronary angiography using prospectively electrocardiogram (ECG)-triggered sequential scan mode compa...Objective To evaluate the image quality (IQ) and radiation dose of 128-slice dual-source computed tomography (DSCT) coronary angiography using prospectively electrocardiogram (ECG)-triggered sequential scan mode compared with ECG-gated spiral scan mode in a population with atrial fibrillation. Methods Thirty-two patients with suspected coronary artery disease and permanent atrial fibrillation referred for a second-generation 128-slice DSCT coronary angiography were included in the prospective study. Of them, 17 patients (sequential group) were randomly selected to use a prospectively ECG-triggered sequential scan, while the other 15 patients (spiral group) used a retrospectively ECG-gated spiral scan. The IQ was assessed by two readers independently, using a four-point grading scale from excellent (grade 1) to non-assessable (grade 4), based on the American Heart Association 15-segment model. IQ of each segment and effective dose of each patient were compared between the two groups. Results The mean heart rate (HR) of the sequential group was 96±27 beats per minute (bpm) with a variation range of 73±25 bpm, while the mean HR of the spiral group was 86±22 bpm with a variationrange of 65±24 bpm. Both of the mean HR (t=1.91, P=0.243) and HR variation range (t=0.950, P=0.350) had no significant difference between the two groups. In per-segment analysis, IQ of the sequential group vs. spiral group was rated as excellent (grade 1) in 190/244 (78%) vs. 177/217 (82%) by reader1 and 197/245 (80%) vs. 174/214 (81%) by reader2, as non-assessable (grade 4) in 4/244 (2%) vs. 2/217 (1%) by reader1 and 6/245 (2%) vs. 4/214 (2%) by reader2. Overall averaged IQ per-patient in the sequential and spiral group showed equally good (1.27±0.19 vs. 1.25±0.22, Z=-0.834, P=0.404). The effective radiation dose of the sequential group reduced significantly compared with the spiral group (4.88±1.77 mSv vs. 10.20±3.64 mSv; t=-5.372, P=0.000). Conclusion Compared with retrospectively ECG-gated spiral scan, prospectively ECG-triggered sequential DSCT coronary angiography provides similarly diagnostically valuable images in patients with atrial fibrillation and significantly reduces radiation dose.展开更多
BACKGROUND Duodenal obstruction is a common clinical scenario that can either be mechanical or a pseudo-obstruction.Clinical management of intestinal obstruction starts from localization and proceeds to histological e...BACKGROUND Duodenal obstruction is a common clinical scenario that can either be mechanical or a pseudo-obstruction.Clinical management of intestinal obstruction starts from localization and proceeds to histological examination of the stenotic intestine.Systemic factors and dysfunction of distant organs might contribute to the development of intestinal obstruction.Here,we report a unique case of idiopathic mechanical duodenal obstruction,which resolved spontaneously after 3 mo of conservative treatment,but was followed by intestinal pseudo-obstruction.CASE SUMMARY An 84-year-old woman presented with worsened postprandial vomiting accompanied by prolonged pneumonia.Thorough noninvasive investigations revealed complete circumferential stenosis in the descending duodenum without known cause.Exploratory surgery was postponed due to septic shock and possible pulmonary fungal infection.Conservative treatment for 3 mo for ileus and control of pulmonary infection resolved the intestinal obstruction completely.Unfortunately,2 wk later,she had regurgitation and postprandial vomiting again,complicated by deteriorating wheezing and dyspnea.Computed tomography revealed a dilated stomach and proximal duodenum without new intestinal stricture or pulmonary infiltration.The patient fully recovered after combined treatment with antireflux agents,enema,prokinetics,and bronchodilators.CONCLUSION This complicated case highlights the inter-relationship of local and systemic contributions to ileus and gut dysfunction,which requires multidisciplinary treatment.展开更多
BACKGROUND The endovascular repair of juxtarenal abdominal aortic aneurysms(JAAA)usually requires combination treatment with various stent graft modifications to preserve side branch patency.As a feasible technique,ac...BACKGROUND The endovascular repair of juxtarenal abdominal aortic aneurysms(JAAA)usually requires combination treatment with various stent graft modifications to preserve side branch patency.As a feasible technique,according to the situation,antegrade in situ laser fenestration still needs to be improved.CASE SUMMARY This report describes a case that was successfully treated with endovascular repair facilitated by antegrade in situ laser fenestration while maintaining renal arterial flow.Laser fenestration was performed using a steerable sheath positioned in the stent graft lumen in front of the renal artery ostium.With the bare stent region unreleased,renal artery perfusion could be maintained and accurate positioning could be achieved by angiography in real time.CONCLUSION This study suggests the feasibility and short-term safety of this novel antegrade in situ laser fenestration technique for select JAAA patients.展开更多
Carbon nitride has been extensively used as a visible-light photocatalyst,but it has the disadvantages of a low specific surface area,rapid electron-hole recombination,and relatively low light absorbance.In this study...Carbon nitride has been extensively used as a visible-light photocatalyst,but it has the disadvantages of a low specific surface area,rapid electron-hole recombination,and relatively low light absorbance.In this study,single-atom Ag was successfully anchored on ultrathin carbon nitride(UTCN)via thermal polymerization,the catalyst obtained is called AgUTCN.The Ag hardly changed the carbon nitride's layered and porous physical structure.AgUTCN exhibited efficient visible-light photocatalytic performances in the degradation of various recalcitrant pollutants,eliminations of 85% were achieved by visible-light irradiation for 1hr.Doping with Ag improved the photocatalytic performance of UTCN by narrowing the forbidden band gap from 2.49 to 2.36 e V and suppressing electron-hole pair recombination.In addition,Ag doping facilitated O_(2) adsorption on UTCN by decreasing the adsorption energy from -0.2 to -2.22 e V and favored the formation of O_(2)^(·-).Electron spin resonance and radical-quenching experiments showed that O_(2)^(·-)was the major reactive species in the degradation of Acetaminophen(paracetamol,APAP).展开更多
Objective:To investigate the therapeutic effects and mechanisms of Salvia miltiorrhizae(Danshen) in the treatment of severe acute pancreatitis(SAP)-or obstructive jaundice(OJ)-induced heart injury. Methods:A total of ...Objective:To investigate the therapeutic effects and mechanisms of Salvia miltiorrhizae(Danshen) in the treatment of severe acute pancreatitis(SAP)-or obstructive jaundice(OJ)-induced heart injury. Methods:A total of 288 rats were used for SAP(n=108) and OJ-associated(n=180) experiments. The rats were randomly divided into sham-operated,model control,and Salvia miltiorrhizae-treated groups. According to the difference of time points after operation,SAP rats in each group were subdivided into 3,6 and 12 h subgroups(n=12),whereas OJ rats were subdivided into 7,14,21,and 28 d subgroups(n=15). At the corresponding time points after operation,the mortality rates of the rats,the contents of endotoxin and phospholipase A2(PLA2) in blood,and pathological changes of the hearts were investigated. Results:The numbers of dead SAP and OJ rats in the treated groups declined as compared with those in the model control group,but not significantly(P>0.05). The contents of endotoxin(at 6 and 12 h in SAP rats and on 7,14,21,and 28 d in OJ rats,respectively) and PLA2(at 6 and 12 h in SAP rats and on 28 d in OJ rats,respectively) in the treated group were significantly lower than those in the model control group(P<0.01 and P<0.001,respectively). Besides,myocardial pathological injuries were mitigated in SAP and OJ rats. Conclusion:In this study,we found that Salvia miltiorrhizae improved myocardial pathological changes,reduced the content of PLA2 in blood,and decreased the mortality rates of SAP and OJ rats,exerting protective effects on the hearts of the rats.展开更多
A series of random terpolymers P2-P5 were designed and synthesized by randomly embedding 5 mol%, 10 mol%, 15 mol%and 25 mol% feed ratios of low cost 2,2-bithiophene as the third monomer to the famous donor-acceptor(D-...A series of random terpolymers P2-P5 were designed and synthesized by randomly embedding 5 mol%, 10 mol%, 15 mol%and 25 mol% feed ratios of low cost 2,2-bithiophene as the third monomer to the famous donor-acceptor(D-A) type copolymer PTB7-Th(P1). All polymers showed similar molecular weight with number-average molecular weight(Mn) and weight-average molecular weight(Mw) in the range of(59-74) and(93-114) kg·mol^(-1), respectively, to ensure a fair comparison on the structure-property relationships.Compared with the control copolymer PTB7-Th, the random terpolymers exhibited enhanced absorption intensity in a wide range from400 nm to 650 nm in both solution and film as well as in polymer/PC71 BM blends. From grazing incident wide-angle X-ray diffraction(GIWAXS), compared with the regularly alternated copolymer PTB7-Th, the random terpolymers demonstrated mild structural disorder with reduced(100) lamellar stacking and slightly weakened(010) π-π stacking for the polymers as well as slightly reduced PC71 BM aggregation in polymer/PC71 BM blends. However, the measured hole mobility for terpolymers((1.20-3.73) × 104-cm2·V-1·s^(-1)) was evaluated to be comparable or even higher than 1.35 × 10^(-4) cm^2·V^(-1)·s-1 of the alternative copolymer. Enhanced average power conversion efficiency(PCE) from 7.35% to 8.11% and 7.79% to 8.37% was observed in both conventional and inverted device architectures from copolymer P1 to terpolymers P4, while further increasing the 2,2-bithiophene feed ratio decreased the PCE.展开更多
High-entropy alloys(HEAs) are a new class of materials with a potential engineering application,but how to obtain ultrafine or nano-sized crystal structures of HEAs has been a challenge.Here,we first presented an equi...High-entropy alloys(HEAs) are a new class of materials with a potential engineering application,but how to obtain ultrafine or nano-sized crystal structures of HEAs has been a challenge.Here,we first presented an equiatomic CoCrFeNiCu HEA with excellent mechanical properties obtained via friction stir processing(FSP).After FSP,the Cu element segregation in the cast CoCrFeNiCu HEA was almost eliminated,and the cast coarse two-phase structure(several micrometers) was changed into an ultrafine-grained single-phase structure(150 nm) with a large fraction of high-angle grain boundaries and nanoscale deformation twins.This unique microstructure was mainly attributed to the severe plastic deformation during FSP,and the sluggish diffusion effect in dynamics and the lattice distortion effect in crystallography for HEAs.Furthermore,FSP largely improved the hardness and yield strength of the CoCrFeNiCu HEA with a value of 380 HV and more than 1150 MPa,respectively,which were> 1.5 times higher than those of the base material.The great strengthening after FSP was mainly attributed to the significant grain refinement with large lattice distortion and nano-twins.This study provides a new method to largely refine the microstructure and improve the strength of cast CoCrFeNiCu HEAs.展开更多
基金Supported by the National Natural Science Foundation of China,No.82173074the Beijing Natural Science Foundation,No.7232127+3 种基金the National High Level Hospital Clinical Research Funding,No.2022-PUMCH-D-001 and No.2022-PUMCH-B-004the CAMS Innovation Fund for Medical Sciences,No.2021-I2M-1-002the Nonprofit Central Research Institute Fund of Chinese Academy of Medical Sciences,No.2018PT32014Fundamental Research Funds for the Central Universities,No.3332019025.
文摘BACKGROUND Percutaneous transhepatic stent placement has become a common strategy for the postoperative treatment of portal vein(PV)/superior mesenteric veins(SMV)stenosis/occlusion.It has been widely used after liver transplantation surgery;however,reports on stent placement for acute PV/SMV stenosis after pancreatic surgery within postoperative 3 d are rare.CASE SUMMARY Herein,we reported a case of intestinal edema and SMV stenosis 2 d after pancreatic surgery.The patient was successfully treated using stent grafts.Although the stenosis resolved after stent placement,complications,including bleeding,pancreatic fistula,bile leakage,and infection,made the treatment highly challenging.The use of anticoagulants was adjusted multiple times to prevent venous thromboembolism and the risk of bleeding.After careful treatment,the patient stabilized,and stent placement effectively managed postoperative PV/SMV stenosis.CONCLUSION Stent placement is effective and feasible for treating acute PV/SMV stenosis after pancreatic surgery even within postoperative 3 d.
基金Supported by Grants for Traditional Chinese Medicine Science of Zhejiang Province,and Medical Science and Technology of Zhejiang Province and Hangzhou
文摘AIM: To investigate the influence of high dose of dexamethasone on inflammatory mediators and apoptosis of rats with severe acute pancreatitis (SAP). METHODS: SAP rats were randomly assigned to the model group and treatment group while the normal rats were assigned to the sham operation group. The mortality,ascite volumes,ascites/body weight ratio and pancreas pathological changes of all rats were observed at 3,6 and 12 h after operation. Their contents of amylase and endotoxin in plasma and contents of tumor necrosis factor (TNF-α),phospholipase A2 (PLA2) and IL-6 in serum were also determined. The microarray sections of their pancreatic tissues were prepared,terminal transferase dUTP nick end labeling (TUNEL) staining was performed and apoptotic indexes were calculated. RESULTS: There was no marked difference between treatment group and model group in survival. The contents of amylase and endotoxin in plasma and contents of TNF-α,PLA2 and IL-6 in serum,ascite volumes,ascites/body weight ratio and pancreas pathological scores were all lower in treatment group than in model group to different extents at different time points P < 0.05,58.3 (26.4) ng/L vs 77.535 (42.157) ng/L in TNF-α content,8.00 (2.00) points vs 9.00 (2.00) points in pathological score of pancreas respectively; P < 0.01,0.042 (0.018) EU/mL vs 0.056 (0.0195) EU/mL in endotoxin content,7791 (1863) U/L vs 9195 (1298) U/L in plasma amylase content,1.53 (0.79) vs 2.38 (1.10) in ascites/body weight ratio,8.00 (1.00) points vs 11.00 (1.50) points in pathological score of pancreas; P < 0.001,3.36 (1.56) ng/L vs 5.65 (1.08) ng/L in IL-6 content,4.50 (2.00) vs 7.20 (2.00),4.20 (1.60) vs 6.40 (2.30),3.40 (2.70) vs 7.90 (1.70) in ascite volumes,respectively. The apoptotic indexes of pancreas head and pancreas tail were all higher in treatment group than in model group at 6 h P < 0.01,0.00 (2.00)% vs 0.00 (0.00)%,0.20 (1.80) vs 0.00 (0.00) in apoptosis indexes,respectively. CONCLUSION: The mechanism of dexamethasone treatment in acute pancreatitis is related to its inhibition of inflammatory mediator generation and induction of pancreatic acinar cell apoptosis.
文摘Objective To evaluate the efficacy and safety of uterine artery embolization(UAE) in the management of primary postpartum hemorrhage associated with placenta accreta. Methods We retrospectively reviewed the medical records of patients with placenta accreta between January 2010 and August 2014. Totally 18 women(mean age 30.8±4.2 years) of primary massive postpartum hemorrhage with diagnosis of placenta accrete received treatment of UAE after delivery. Images of DSA and medical records were reviewed. Technical success was defined as control of bleeding after embolization. The complications, control of hemorrhage and recurrent bleeding of the placenta left inside the uterus were retrospectively collected for assessment. Results All patients underwent transcatheter embolization of bilateral uterine arteries. The technical success rate of embolization was 100%. Bleeding was controlled in 17 of 18 patients(94%) during follow-up period(median 18 months, 3-31months) without further bleeding recurred. One patient with placenta percreta undertook an emergent hysterectomy along with surgical bladder repair after UAE because of persistent uterine bleeding. Eight patients had postembolization syndrome and no other complications occurred. Conclusion Uterine artery embolization is an effective and safe treatment for the management of primary postpartum massive hemorrhage associated with placenta accreta.
文摘Objective To investigate the placement of a long tube into the small intestine under fluoroscopic guidance and to evaluate its decompression effect on early postoperative small bowel obstruction(EPSBO).Methods Fifty-four patients with EPSBO requiring decompression between April 2010 and July 2014 were enrolled in the study.Insertion of a long tube was guided by fluoroscopy.We first used the guide wire to pass the pylorus and then used the 10 Fr feeding tube as an exchangeable tube to put the superstiff wire into the duodenum.Finally the long tube could be passed over the guide wire through the pylorus into the intestine.The total procedure time,the radiation exposure time,and the incidence of complications were evaluated.Results The long tubes passed into the jejunum on initial insertion for all patients,so the success rate of this technique was 100%.The long tube was inserted into ileum in 18 patients.The mean total procedure time was 34.4±8.6 minutes,and the mean radiation exposure time 18.9±6.8 minutes.A total of 47 patients(87%) experienced full recovery following long-tube decompression and without the need for surgical intervention.Conclusions Using the wire-exchange technique,it is easy to place a long tube into the small bowel under fluoroscopic guidance.This decompression method is safe and effective for management of EPSBO.
基金Supported by the Science and Technology Foundation of Hubei Province, No. 992P1203
文摘AIM: To summarize the operative experiences for giant leiomyoma of esophagus.METHODS: Eight cases of giant esophageal leiomyoma (GEL) whose tumors were bigger than 10 cm were treated surgically in our department from June 1980 to March 2004.and esophagoscopy. Leiomyoma located in upper thirds of the esophagus in one case, middle thirds of the esophagus in five cases, lower thirds of the esophagus in two cases. Resection of tumors was performed successfully in all of these cases. Operative methods included transthoracic extramucosal enucleation and buttressing the muscular defect with pedicled great omental flap (one case), esophagectomy and esophagogastrostomy above the arch of aorta (three cases), total esophagectomy and esophageal replacement with colon (four cases). Histological examination confirmed that all of these cases were leiomyoma.RESULTS: All of the eight patients recovered approvingly with no mortality and resumed normal diet after operation. Vomiting during meals occurred in one patient with esophagogastrostomy, and remained 1 mo. Reflux esophagitis occurred in one patient with esophagogastrostomy and was alleviated with medication. Thoracic colon syndrome (TCS) occurred in one patient with colon replacement at 15 mo postoperatively. No recurrence occurred in follow-up from 6 mo to 8 years.CONCLUSION: Surgical treatment for GEL is both safe and effective. The choices of operative methods mainly depend on the location and range of lesions. We prefer to treat GEL via esophagectomy combined with esophagogastrostomy or esophagus replacement with colon. The long-time quality of life is better in the latter.
基金supported by grants from the National Natural Science Foundation of China (81100304)the Projects of Ministry of Public Health (201002015)
文摘BACKGROUND: Collateralized intraand extra-hepatic routes in patients with Budd-Chiari syndrome (BCS) were important. This study aimed to investigate the feasibility and clinical outcomes of the staged management of BCS based on the degree of compensation provided by intraor extra-hepatic collateral circulations. METHODS: A total of 103 adult patients with BCS caused by co-obstruction of the inferior vena cava (IVC) and main hepatic veins (MHVs) between March 2001 and October 2009 were enrolled in this study. Based on the pathological classification and degree of hemodynamic compensation by collateral circulations, treatment priority for IVC hypertension was determined in the first-stage treatment. Patients were deemed eligible for second-stage treatment when the first-stage treatment failed to relieve. RESULTS: Imaging results revealed that most patients had collateral circulations to different extents. Based on the degree of compensation provided by these collateral circulations, 74 patients underwent single-stage treatment for IVC hypertension, i.e., radiologic intervention (RI) for 61 patients and surgical procedures (SPs) for 13. One patient was treated for portal hypertension. Twenty-nine patients underwent second-stage treatment (25 underwent RI and SP, and 4 only SP). The general morbidity and mortality after all procedures were 8.3% and 1.5%, respectively. After a median follow-up of 35 months, 4 patients underwent second-stage treatment and 7 underwent recanalization of the IVC/MHVs. Two patients died of hepatocellular carcinoma and 1 died of graft obstruction. CONCLUSION: Staged management produces excellent outcomes for patients with BCS caused by co-obstruction of the IVC and MHVs.
基金supported at NUIST by the National Natural Science Foundation of China (NSFC) (Grant Nos. U1731105 and 41304150)the Natural Science Foundation of Jiangsu Province of China (No. BK20171456)+3 种基金sponsored also by the Qing Lan Project of Jiangsu Province for L.G. Ding (2016)supported by NSFC (Grant Nos.11522328, 11473070 and 11427803)the Youth Innovation Promotion Associationthe specialized research fund from the State Key Laboratory of Space Weather for financial support
文摘We investigated 64 pairs of interacting-CME events identified from simultaneous observations by the SOHO and STEREO spacecraft from January 2010 to August 2014, to examine the relationship between large SEP events in the energy range of ～25 to～60 MeV and properties of the interacting CMEs.We found that during CME interactions, the large SEP events in this study were all generated by CMEs with the presence of enhanced type Ⅱ radio bursts, which also have wider longitudinal distributions compared to events without a type Ⅱ radio burst or its enhancement(almost always associated with small SEP events).It seems that the signature of type Ⅱ radio burst enhancement is a good discriminator between large SEP and small or no SEP event producers during CME interactions. The type Ⅱ radio burst enhancement is more likely to be generated by CME interactions, with the main CME having a larger speed(v), angular width(WD), mass(m) and kinetic energy(Ek), and taking over the preceding CMEs. The preceding CMEs in these instances have higher v, WD, m and Ekthan those in CME pairs missing type Ⅱ radio bursts or enhancements. Generally, the values of these properties in the type-Ⅱ-enhanced events are typically higher than the corresponding non-type-Ⅱ or non-type-Ⅱ-enhanced cases for both the main and preceding CMEs. Our analysis also revealed that the intensities of associated SEP events correlate negatively with the intersection height of the two CMEs. Moreover, the overlap width of two CMEs is typically larger in type-Ⅱ-enhanced events than in non-type-Ⅱ or non-type-Ⅱ-enhanced events. Most type-Ⅱ-enhanced events and SEP events are coincident and are almost always made by the fast and wide main CMEs that sweep fully over relatively slower and narrower preceding CMEs. We suggest that a fast CME with enough energy completely overtaking a relatively narrower preceding CME, especially at low height, can drive a more energetic shock signified by the enhanced type Ⅱ radio bursts. The shock may accelerate ambient particles(likely provided by the preceding CME) and lead to large SEP events more easily.
基金financially supported by the National Science Foundation of China(51165032)Ministry of Education Special Research Fund of the Doctoral Program for Higher Education(20133601110001)+1 种基金Innovative Group of Science and Technology of College of Jiangxi Province(00008713)the Production,Teaching and Research Cooperation Plan of Nanchang Non-party Experts and Doctors(2012-CYH-DW-XCL-002)
文摘The microstructure and hardness of rheo-forming AZ91-Y alloy before and after solution treatment(ST) have been investigated by means of optical microscope(OM), scanning electron microscope(SEM) equipped with energy dispersive spectroscopy(EDS), X-ray diffraction(XRD) and Vickers. The experimental results showed that the β-Mg17Al12 phase of alloy was nearly dissolved after ST for 5 min. With the increasing of ST duration to 28 h, both the primary and secondarily solidified α-Mg grains faded away. At the same time, the alloy exhibited a much smoother surface due to the diffusion of solute atoms(Al). During ST, the thermal stable phase of Al2 Y produced by ultrasonic vibration retained its size and morphology. As the ST duration was increased, the alloy hardness decreased sharply at first, and then gradually reached a minimum level. The alloy's appropriate ST duration at 410 °C was approximately 28 h.
文摘Objective To evaluate the role of multidetector computed tomography-angiography(MDCTA) for management of life-threatening spontaneous retroperitoneal haemorrhage(SRH).Methods A retrospective analysis of the medical records of all SRH patients admitted to our hospital from January 1,2005 to November 31,2014 was performed.SRH was defined as unrelated to invasive procedures,surgery,trauma,abdominal tumor or aortic aneurysm.Life-threatening SRH was defined as hemodynamic instability with hypotension.Sixteen cases met the inclusive criteria.Patients' characteristics,clinical presentation,imaging of MDCTA,treatment modalities,morbidity,and follow-up data were analyzed.Results The group of 16 patients included 11 men and 5 women,with a mean age of 51.5 ± 16.4years.All patients underwent MDCTA scan examinations,and active contrast media(CM) extravasation were found in 9 patients.Angiography was performed for 8 patients in the CM extravasation group.Bleeding vessels were found in 7 patients who underwent successful embolization.One patient in the CM extravasation group did not undergo angiography and died of bleeding.Seven patients without active CM extravasation underwent conservative management.Bleeding was controlled for all these 7 patients,and 1 patient died of multiple organ failure.Fourteen patients survived from SRH were successfully discharged.One patient died of heart failure during follow-up.Conclusion MDCTA was useful in the diagnosis of SRH and proved to be predictive for the outcome of conservative treatment and early intervention.
文摘This article mainly discussed bulk material prepared by powder metallurgy,and the commercial 2024 aluminum alloy powder and FeNiCrCoAl 3 high entropy alloy powder( both produced by argon gas atomization process) were ball-milled for different hours. The prepared powder was consolidated by hot extrusion method. The microstructures of the milled powder and bulk alloy were examined by X- Ray Diffraction( XRD), Scanning Electron Microscopy( SEM) and Transmission Electron Microscopy( TEM). The thermal stability was tested by differential scanning calorimetry( DSC). Mechanical properties of the extruded alloy were examined by Vickers hardness tester and mechanical testing machine. The results show that after milling,the mixed particle sizes and microstructures of the alloy powder change obviously. The compressive strength of the extruded alloy has reached 580 MPa under certain conditions of milling time and composition.
基金supported at NUIST by the National Natural Science Foundation of China(NSFC)-41304150 for Ding L.G.at CMA by NSFC-41274193 and 41474166 for Le G.M
文摘On 2012 March 7, the STEREO Ahead and Behind spacecraft, along with near-Earth spacecraft(e.g. SOHO, Wind) situated between the two STEREO spacecraft, observed an extremely large global solar energetic particle(SEP) event in Solar Cycle 24. Two successive coronal mass ejections(CMEs) have been detected close in time. From the multi-point in-situ observations, it can be found that this SEP event was caused by the first CME, but the second one was not involved. Using velocity dispersion analysis(VDA),we find that for a well magnetically connected point, the energetic protons and electrons are released nearly at the same time. The path lengths to STEREO-B(STB) for protons and electrons have a distinct difference and deviate remarkably from the nominal Parker spiral path length, which is likely due to the presence of interplanetary magnetic structures situated between the source and STB. Also, the VDA method seems to only obtain reasonable results at well-connected locations and the inferred release times of energetic particles in different energy channels are similar. We suggest that good-connection is crucial for obtaining both an accurate release time and path length simultaneously, agreeing with the modeling result of Wang &Qin(2015).
文摘BACKGROUND The posterior cruciate ligament(PCL) is important for cruciate-retaining(CR)total knee arthroplasty(TKA). Whether the entire PCL should be retained during CR-TKA is controversial.AIM To evaluate the clinical outcomes of PCL preservation in CR-TKA and the methods used to deal with the PCL during surgery.METHODS A retrospective review of patients with osteoarthritis undergoing primary CRTKA(176 patients, 205 knees) in our institution between March 2012 and March 2014 was performed. A PCL protector was used to preserve the intact PCL bone block. The status of the PCL was recorded during surgery. Intact PCL preserved,pie-crusting and repairing were used to balance the tension of the PCL. Range of motion(ROM) and the Knee Society Clinical Rating system(KSS) were evaluated preoperatively and at the endpoint of follow-up.RESULTS The mean ROM of the knee was 103.2 ± 17.2°, KSS clinical score was 47.6 ± 9.5 and KSS functional score was 46.3 ± 11.9 before surgery. The mean ROM of the knee was 117.5 ± 9.7°, KSS clinical score was 89.2 ± 3.6 and KSS functional score was 84.6 ± 9.8 at 5 years follow-up. ROM, KSS clinical scores and KSS functional scores were significantly improved after surgery(P < 0.01). Thirty-two(23.7%)TKAs involved PCL pie-crusting and 18(13.3%) involved PCL repair. Eighty-five(63.0%) TKAs applied standard operating procedures and preserved intact PCL.At 5 years follow-up, in the intact PCL group, the mean ROM of the knee was 118.0 ± 8.3°, KSS clinical score was 89.1 ± 3.7 and KSS functional score was 84.9 ±9.6. In the PCL pie-crusting group, mean ROM of the knee was 114.0 ± 13.5°, KSS clinical score was 88.8 ± 3.4 and KSS functional score was 83.8 ± 10.5. In the PCL repair group, mean ROM of the knee was 120.3 ± 7.0°, KSS clinical score was 89.0± 3.6 and KSS functional score was 89.4 ± 4.5. There were no significant differences in ROM, KSS clinical scores and KSS functional scores among the three groups(P > 0.05).CONCLUSION The clinical outcomes of preserving the PCL in CR-TKA are encouraging. Piecrusting and PCL repair do not affect the function. The PCL protector effectively protected the PCL bone block.
文摘Objective To evaluate the image quality (IQ) and radiation dose of 128-slice dual-source computed tomography (DSCT) coronary angiography using prospectively electrocardiogram (ECG)-triggered sequential scan mode compared with ECG-gated spiral scan mode in a population with atrial fibrillation. Methods Thirty-two patients with suspected coronary artery disease and permanent atrial fibrillation referred for a second-generation 128-slice DSCT coronary angiography were included in the prospective study. Of them, 17 patients (sequential group) were randomly selected to use a prospectively ECG-triggered sequential scan, while the other 15 patients (spiral group) used a retrospectively ECG-gated spiral scan. The IQ was assessed by two readers independently, using a four-point grading scale from excellent (grade 1) to non-assessable (grade 4), based on the American Heart Association 15-segment model. IQ of each segment and effective dose of each patient were compared between the two groups. Results The mean heart rate (HR) of the sequential group was 96±27 beats per minute (bpm) with a variation range of 73±25 bpm, while the mean HR of the spiral group was 86±22 bpm with a variationrange of 65±24 bpm. Both of the mean HR (t=1.91, P=0.243) and HR variation range (t=0.950, P=0.350) had no significant difference between the two groups. In per-segment analysis, IQ of the sequential group vs. spiral group was rated as excellent (grade 1) in 190/244 (78%) vs. 177/217 (82%) by reader1 and 197/245 (80%) vs. 174/214 (81%) by reader2, as non-assessable (grade 4) in 4/244 (2%) vs. 2/217 (1%) by reader1 and 6/245 (2%) vs. 4/214 (2%) by reader2. Overall averaged IQ per-patient in the sequential and spiral group showed equally good (1.27±0.19 vs. 1.25±0.22, Z=-0.834, P=0.404). The effective radiation dose of the sequential group reduced significantly compared with the spiral group (4.88±1.77 mSv vs. 10.20±3.64 mSv; t=-5.372, P=0.000). Conclusion Compared with retrospectively ECG-gated spiral scan, prospectively ECG-triggered sequential DSCT coronary angiography provides similarly diagnostically valuable images in patients with atrial fibrillation and significantly reduces radiation dose.
基金Peking Union Medical College Hospital Science Fund for Junior Faculty,No.pumch-2016-2.13.
文摘BACKGROUND Duodenal obstruction is a common clinical scenario that can either be mechanical or a pseudo-obstruction.Clinical management of intestinal obstruction starts from localization and proceeds to histological examination of the stenotic intestine.Systemic factors and dysfunction of distant organs might contribute to the development of intestinal obstruction.Here,we report a unique case of idiopathic mechanical duodenal obstruction,which resolved spontaneously after 3 mo of conservative treatment,but was followed by intestinal pseudo-obstruction.CASE SUMMARY An 84-year-old woman presented with worsened postprandial vomiting accompanied by prolonged pneumonia.Thorough noninvasive investigations revealed complete circumferential stenosis in the descending duodenum without known cause.Exploratory surgery was postponed due to septic shock and possible pulmonary fungal infection.Conservative treatment for 3 mo for ileus and control of pulmonary infection resolved the intestinal obstruction completely.Unfortunately,2 wk later,she had regurgitation and postprandial vomiting again,complicated by deteriorating wheezing and dyspnea.Computed tomography revealed a dilated stomach and proximal duodenum without new intestinal stricture or pulmonary infiltration.The patient fully recovered after combined treatment with antireflux agents,enema,prokinetics,and bronchodilators.CONCLUSION This complicated case highlights the inter-relationship of local and systemic contributions to ileus and gut dysfunction,which requires multidisciplinary treatment.
文摘BACKGROUND The endovascular repair of juxtarenal abdominal aortic aneurysms(JAAA)usually requires combination treatment with various stent graft modifications to preserve side branch patency.As a feasible technique,according to the situation,antegrade in situ laser fenestration still needs to be improved.CASE SUMMARY This report describes a case that was successfully treated with endovascular repair facilitated by antegrade in situ laser fenestration while maintaining renal arterial flow.Laser fenestration was performed using a steerable sheath positioned in the stent graft lumen in front of the renal artery ostium.With the bare stent region unreleased,renal artery perfusion could be maintained and accurate positioning could be achieved by angiography in real time.CONCLUSION This study suggests the feasibility and short-term safety of this novel antegrade in situ laser fenestration technique for select JAAA patients.
基金supported by the Shenzhen Science,Technology and Innovation Commission(No.JCYJ20200109142829123)the National Natural Science Foundation of China(No.52022049)。
文摘Carbon nitride has been extensively used as a visible-light photocatalyst,but it has the disadvantages of a low specific surface area,rapid electron-hole recombination,and relatively low light absorbance.In this study,single-atom Ag was successfully anchored on ultrathin carbon nitride(UTCN)via thermal polymerization,the catalyst obtained is called AgUTCN.The Ag hardly changed the carbon nitride's layered and porous physical structure.AgUTCN exhibited efficient visible-light photocatalytic performances in the degradation of various recalcitrant pollutants,eliminations of 85% were achieved by visible-light irradiation for 1hr.Doping with Ag improved the photocatalytic performance of UTCN by narrowing the forbidden band gap from 2.49 to 2.36 e V and suppressing electron-hole pair recombination.In addition,Ag doping facilitated O_(2) adsorption on UTCN by decreasing the adsorption energy from -0.2 to -2.22 e V and favored the formation of O_(2)^(·-).Electron spin resonance and radical-quenching experiments showed that O_(2)^(·-)was the major reactive species in the degradation of Acetaminophen(paracetamol,APAP).
基金supported by the Technological Foundation Project of Traditional Chinese Medicine Science of Zhejiang Province (Nos. 2003C130 and 2004C142)the Grave Foundation Project for Technological and Development of Hangzhou City (No. 2003123B19)the Intensive Foundation Project for Technology of Hangzhou City (No. 2004Z006), China
文摘Objective:To investigate the therapeutic effects and mechanisms of Salvia miltiorrhizae(Danshen) in the treatment of severe acute pancreatitis(SAP)-or obstructive jaundice(OJ)-induced heart injury. Methods:A total of 288 rats were used for SAP(n=108) and OJ-associated(n=180) experiments. The rats were randomly divided into sham-operated,model control,and Salvia miltiorrhizae-treated groups. According to the difference of time points after operation,SAP rats in each group were subdivided into 3,6 and 12 h subgroups(n=12),whereas OJ rats were subdivided into 7,14,21,and 28 d subgroups(n=15). At the corresponding time points after operation,the mortality rates of the rats,the contents of endotoxin and phospholipase A2(PLA2) in blood,and pathological changes of the hearts were investigated. Results:The numbers of dead SAP and OJ rats in the treated groups declined as compared with those in the model control group,but not significantly(P>0.05). The contents of endotoxin(at 6 and 12 h in SAP rats and on 7,14,21,and 28 d in OJ rats,respectively) and PLA2(at 6 and 12 h in SAP rats and on 28 d in OJ rats,respectively) in the treated group were significantly lower than those in the model control group(P<0.01 and P<0.001,respectively). Besides,myocardial pathological injuries were mitigated in SAP and OJ rats. Conclusion:In this study,we found that Salvia miltiorrhizae improved myocardial pathological changes,reduced the content of PLA2 in blood,and decreased the mortality rates of SAP and OJ rats,exerting protective effects on the hearts of the rats.
基金financially supported by the the National Natural Science Foundation of China(No.61761136013)the Natural Science Foundation of Jiangsu Province(Nos.BK20160042 and BK20160990)+1 种基金DFG(392306670)the CSC for financial support
文摘A series of random terpolymers P2-P5 were designed and synthesized by randomly embedding 5 mol%, 10 mol%, 15 mol%and 25 mol% feed ratios of low cost 2,2-bithiophene as the third monomer to the famous donor-acceptor(D-A) type copolymer PTB7-Th(P1). All polymers showed similar molecular weight with number-average molecular weight(Mn) and weight-average molecular weight(Mw) in the range of(59-74) and(93-114) kg·mol^(-1), respectively, to ensure a fair comparison on the structure-property relationships.Compared with the control copolymer PTB7-Th, the random terpolymers exhibited enhanced absorption intensity in a wide range from400 nm to 650 nm in both solution and film as well as in polymer/PC71 BM blends. From grazing incident wide-angle X-ray diffraction(GIWAXS), compared with the regularly alternated copolymer PTB7-Th, the random terpolymers demonstrated mild structural disorder with reduced(100) lamellar stacking and slightly weakened(010) π-π stacking for the polymers as well as slightly reduced PC71 BM aggregation in polymer/PC71 BM blends. However, the measured hole mobility for terpolymers((1.20-3.73) × 104-cm2·V-1·s^(-1)) was evaluated to be comparable or even higher than 1.35 × 10^(-4) cm^2·V^(-1)·s-1 of the alternative copolymer. Enhanced average power conversion efficiency(PCE) from 7.35% to 8.11% and 7.79% to 8.37% was observed in both conventional and inverted device architectures from copolymer P1 to terpolymers P4, while further increasing the 2,2-bithiophene feed ratio decreased the PCE.
基金supported by the National Natural Science Foundation of China under Grant Nos. 51601194, 51975553, 51575362the IMR SYNL-T.S. Kê Research Fellowship。
文摘High-entropy alloys(HEAs) are a new class of materials with a potential engineering application,but how to obtain ultrafine or nano-sized crystal structures of HEAs has been a challenge.Here,we first presented an equiatomic CoCrFeNiCu HEA with excellent mechanical properties obtained via friction stir processing(FSP).After FSP,the Cu element segregation in the cast CoCrFeNiCu HEA was almost eliminated,and the cast coarse two-phase structure(several micrometers) was changed into an ultrafine-grained single-phase structure(150 nm) with a large fraction of high-angle grain boundaries and nanoscale deformation twins.This unique microstructure was mainly attributed to the severe plastic deformation during FSP,and the sluggish diffusion effect in dynamics and the lattice distortion effect in crystallography for HEAs.Furthermore,FSP largely improved the hardness and yield strength of the CoCrFeNiCu HEA with a value of 380 HV and more than 1150 MPa,respectively,which were> 1.5 times higher than those of the base material.The great strengthening after FSP was mainly attributed to the significant grain refinement with large lattice distortion and nano-twins.This study provides a new method to largely refine the microstructure and improve the strength of cast CoCrFeNiCu HEAs.
