Thrombotic thrombocytopenic purpura(TTP)is a rare and life-threatening form of thrombotic microangiopathy,primarily caused by a deficiency of ADAMTS-13 activity.Immune-related adverse events(irAEs)are autoimmune toxic...Thrombotic thrombocytopenic purpura(TTP)is a rare and life-threatening form of thrombotic microangiopathy,primarily caused by a deficiency of ADAMTS-13 activity.Immune-related adverse events(irAEs)are autoimmune toxicities mediated by the use of immune checkpoint inhibitors(ICIs).Here,the study reports a case of thrombotic thrombocytopenic purpura that developed in a patient with renal cell carcinoma and vertebral metastasis following combined treatment with Toripalimab and Pazopanib.The patient received Toripalimab in combination with Pazopanib after undergoing radical nephrectomy for right renal cell carcinoma.Five days later,a generalized erythematous rash appeared,partly confluent,accompanied by congestion and swelling of both palpebral and bulbar conjunctiva.Based on the clinical presentation and laboratory results showing thrombocytopenia and hemolytic anemia,the diagnosis of TTP was established.The condition was considered an adverse effect associated with the combination therapy of Toripalimab and Pazopanib.Plasma exchange and high-dose intravenous immunoglobulin therapy were promptly initiated.The treatment regimen was subsequently modified to Axitinib combined with radiotherapy,leading to a gradual recovery of platelet counts.This report highlights the potential risk of TTP associated with combined ICI and TKI therapy,and underscores the importance of early recognition and timely management of this potentially fatal complication.展开更多
Objectives:To compare the clinical outcomes in terms of structure and function between the insertion of a transjugular intrahepatic portosystemic shunt(TIPS) created with the Viabahn ePTFE covered stent/bare metal ste...Objectives:To compare the clinical outcomes in terms of structure and function between the insertion of a transjugular intrahepatic portosystemic shunt(TIPS) created with the Viabahn ePTFE covered stent/bare metal stent(BMS) combination and the Fluency ePTFE covered stent/BMS combination.Methods:A total of 101 consecutive patients who received a TIPS from February 2016 to August 2018 in our center were retrospectively analyzed.Sixty-four subjects were enrolled in the Viabahn group and 37 were enrolled in the Fluency group.The geometry characteristics of the TIPS were calculated,and the associated occurrence of shunt dysfunction,survival,overt hepatic encephalopathy,and variceal rebleeding were evaluated.Results:The technical success rate was 100%.After the insertion of the TIPS,the rate of shunt dysfunction during the first 3 months was significantly different between the Viabahn and Fluency groups(1.6% and 13.5%,respectively;p=0.024).Multivariate analysis indicated that the angle of portal venous inflow(α) was the only independent risk factor for shunt dysfunction(hazard ratio=1.060,95% confidence interval=1.009-1.112,p=0.020).In addition,3 months after the TIPS insertion,the a angle distinctly increased from 20.9°±14.3°-26.9°±20.1°(p=0.005) in the Fluency group but did not change significantly in the Viabahn group(from 21.9°±15.1°-22.9°± 17.6°,p=0.798).Conclusions:Shunt dysfunction was related to the a angle owing to the slight effect on the a angle after the implantation of the TIPS.The Viabahn ePTFE covered stent/BMS combination was more stable in structure and promised higher short-term stent patency compared with the Fluency ePTFE covered stent/BMS combination.展开更多
AIM:To clarify the clinicopathologic significance of COX-2 expression in human colorectal cancer.METHODS:A total of 128 surgically resected colorectal cancer specimens were immunohistochemically analyzed with the use ...AIM:To clarify the clinicopathologic significance of COX-2 expression in human colorectal cancer.METHODS:A total of 128 surgically resected colorectal cancer specimens were immunohistochemically analyzed with the use of anti-COX-2,anti-VEGF and anti-MMP-2 antibodies.The relationship between the cyclooxygenase-2 expression in primary lesions of colorectal cancer and clinicopathoiogic parameters was evaluated by chi-square test.RESULTS:Among 128 cases of colorectal cancer,87(67.9%)were positive for cyclooxygenase-2.The expression of cyclooxygenase-2 was significantly correlated with the depth of invasion,stage of disease,and metastasis(lymph node and liver).Patients in T3-T4,stagesⅢ-Ⅳand with metastasis had much higher expression of cyclooxygenase-2 than ones in T1-T2,stagesⅠ-Ⅱand without metastasis(P<0.05).Among 45 cases of colorectal cancer with lymph node metastasis,the COX-2-positive rate was 86.7%(39/45)for primary lesions and diffuse cytoplasmic staining for COX-2 protein was detected in cancer cells in 100%of metastatic lesions of the lymph nodes.VEGF expression was detected in 49 tumors(38.3%),and VEGF expression was closely correlated with COX-2 expression.The positive expression rate of VEGF(81.6%)in the cyclooxygenase-2-positive group was higher than that in the cyclooxygenase-2-negative group(18.4%,P<0.05).MMP-2 expression was detected in 88 tumors(68.8%),and MMP-2 expression was closely correlated with COX-2 expression.The positive expression rate of MMP-2(79.6%)in the positive COX-2 group was higher than that in the negative COX-2 group(20.4%,P<0.05).CONCLUSION:Cyclooxygenase-2 may be associated with tumor progression by modulating the angiogenesis and cancer cell motility and invasive potential in colorectal cancer and it can be used as a possible biomarker.展开更多
OBJECTIVE： To observe the influence of Sijunzi decoction and Yupingfeng powder on the expression of the relevant DNAs of janus kinase （JAK）-signal transducer and activator of transcription （STAT） sig- nal pathway...OBJECTIVE： To observe the influence of Sijunzi decoction and Yupingfeng powder on the expression of the relevant DNAs of janus kinase （JAK）-signal transducer and activator of transcription （STAT） sig- nal pathway of the brain in spleen-deficiency mod- el rats. METHODS： Eighty male Wistar rats of sanitary degree were divided randomly into four groups： nor- mal group, model group, treatment group 1, treatment group 2. Besides the rats in the normal group, all the rats in other 3 groups were prepared as spleen deficiency model. The treatment group 1 were treated with Sijunzi decoction and the treat- ment group 2 were treated with Yupingfeng powder. After treatment for 6 weeks, perfusion was given and the brain was taken for detection of the ex- pression of the relevant DNAs of JAK-STAT signal pathwayofthe brain in SD rats bygene chip method. RESULTS： Spleen deficiency could lead to increase expression of JAKI, STATI and Interleukin 4 （IL-4） in the brain, but the decrease expression of Suppres- sor of cytokine signaling I （SOCSI）, prolactin recep- tor （PRLR） and binding protein 3 （GATA 3）. Sijunzi decoction could increase expression of STAT3, Pro- lactin （PRL） and GATA3, but decrease expression of JAKI, STAT, STAT4, Interleukin 10 receptor, alpha （ILIORA）, Coagulation factor II （F2）, PRLR, MAD homolog 3 （SMAD3） and IL-4. Yupingfeng powder could decrease expression of JAKI, STATI, STAT4, SOCS4_ predicted, Epidermal growth factor receptor （EGFR）, PRLR, High mobility group AT-hook I （HMGAI 0）, IL-4. CONCLUSION： Sijunzi decoction and Yupingfeng powder can improve immune function of the rat through influencing the genetic expression of JAK-STAT signal pathway.展开更多
AIM:To rapidly detect molecular alterations in different malignancies and investigate the possible role of Tp53,C-myc,and CCND1 genes in development of tumors in human organs and their adjacent normal tissues,as well ...AIM:To rapidly detect molecular alterations in different malignancies and investigate the possible role of Tp53,C-myc,and CCND1 genes in development of tumors in human organs and their adjacent normal tissues,as well as the possible relation between well-and poorly-differentiated tumors.METHODS:A tissue array consisting of seven different tumors was generated.The tissue array included 120 points of esophagus,120 points of stomach,80 points of rectum,60 points of thyroid gland,100 points of mammary gland,80 points of liver,and 80 points of colon.Expressions of Tp53,C-myc,and CCND1 were determined by RNA in situ hybridization.3' terminal digoxin-labeled anti-sense single stranded oligonucleotide and locked nucleic acid modifying probe were used.RESULTS:The expression level of Tp53 gene was higher in six different carcinoma tissue samples than in paracancerous tissue samples with the exception in colon carcinoma tissue samples(P < 0.05).The expression level of CCND1 gene was significantly different in different carcinoma tissue samples with the exception in esophagus and colon carcinoma tissue samples.The expression level of C-myc gene was different in esophagus carcinoma tissue samples(c2 = 18.495,P = 0.000),stomach carcinoma tissue samples(c2 = 23.750,P = 0.000),and thyroid gland tissue samples(c2 = 10.999,P = 0.004).The intensity of signals was also different in different carcinoma tissue samples and paracancerous tissue samples.CONCLUSION:Over-expression of the Tp53,CCND1,and C-myc genes appears to play a role in development of human cancer by regulating the expression of mRNA.Tp53,CCND1 and C-myc genes are significantly correlated with the development of different carcinomas.展开更多
Background： The ACTS-GC study had shown postoperative adiuvant therapy with S-1 improved survival of patients with locally advanced gastric cancer. Addition of oxaliplatin to S-1 is considered to be acceptable as one...Background： The ACTS-GC study had shown postoperative adiuvant therapy with S-1 improved survival of patients with locally advanced gastric cancer. Addition of oxaliplatin to S-1 is considered to be acceptable as one of the treatment options for gastric cancer patients after radical gastrectomy with D2 lymph node excision. Methods： We have commenced a randomized phase III trial in December 2016 to evaluate S-I plus oxaliplatin compared with S-1 alone in the adjuvant setting for locally advanced gastric cancer. A total of 564 patients will be accrued from 13 Chinese institutions in two years. The primary endpoint is 3-year relapse-free survival. The secondary endpoints are 5-year overall survival, proportion of patients who complete the postoperative chemotherapy and incidence of adverse events. Ethic and dissemination： The trial has been approved by the institutional review board of each participating institution and it was activated on December, 2016. The enrollment will be finished in December, 2018. Patient＇s follow-up will be ended until December, 2023. Trial registration： ClinicalTrials.gov, identifier： NCT02867839. Registered on August 4, 2016.展开更多
Hemangioma is the most common benign hepatic tumor.Although spontaneous rupture is rare,the mortality rate ranges from 60 to 75%.Only 34 cases have been reported in the literature,with only one report using transcathe...Hemangioma is the most common benign hepatic tumor.Although spontaneous rupture is rare,the mortality rate ranges from 60 to 75%.Only 34 cases have been reported in the literature,with only one report using transcatheter arterial embolization(TAE) alone as treatment.We report a case of spontaneous rupture with "flowering sign" of a giant hepatic hemangioma,presenting with acute abdominal pain and shock,while the volume of the hemangioma and blood loss were similar.The patient was successfully managed by transarterial chemoembolization(TACE) alone,which has an operative mortality rate of up to 36.4%.展开更多
Purpose:To analyze causes of acute nonvariceal gastrointestinal bleeding(GIB)with negative digital subtraction angiography(DSA)results.Materials and methods:The clinical and follow-up data of 133 patients-recruited be...Purpose:To analyze causes of acute nonvariceal gastrointestinal bleeding(GIB)with negative digital subtraction angiography(DSA)results.Materials and methods:The clinical and follow-up data of 133 patients-recruited between February 2008 and November 2016-with acute nonvariceal GIB and negative DSA results were included in this study.DSA results,diagnoses,and clinical outcomes were recorded.Results:The DSA results were negative in all 133 patients.Of the total,55 patients(41.4%)chose to undergo surgery and 78(58.6%)opted for conservative treatment.Within 30 days,there was no significant difference in the rebleeding or mortality rates between the two groups(P<.05).Of all 133 patients,76(57.1%)had upper GIB and 57(42.9%)had lower GIB;within 30 days,the rebleeding rate in the upper GIB group(44.7%,34/76)was significantly higher than that in the lower GIB group(26.3%,15/57).There was no significant statistical difference(P<.05)within 30 days in the mortality rates between the two groups.Among patients with upper GIB,26(34.2%,26/76)opted to undergo surgery and 50(65.8%,50/76)chose conservative treatment;within 30 days,the rebleeding rate in the group that chose surgery(61.5%,16/26)was higher than that in the conservative treatment group(36%,18/50).There was no significant difference(P<.05)within 30 days in the mortality rate between the two groups.Among the patients with lower GIB,29(50.9%,29/57)chose to undergo surgery and 28(49.1%,28/57)opted for conservative treatment.Within 30 days,the rebleeding rate in the surgery group(13.8%,4/29)was lower than that in conservative treatment group(39.3%,11/28).There was no significant difference(P<.05)within 30 days in the mortality rate between the two groups.Sixteen patients underwent prophylactic arterial embolization;in 6 of these,bleeding was stopped for 30 days.DSA was then repeated in these 16 patients after a median interval of 1 day,and a positive bleeding site was found in 9 of the 16.Causes of bleeding were found in 111 patients by surgery or endoscopy,whereas the causes remained unknown in 22 patients.Conclusions:Upper GIB with negative DSA results was stopped by conservative treatment,whereas lower GIB required surgery to detect the culprit bleeding site.Rare causes of GIB should be considered and appropriate management selected in a timely manner in order to detect unusual causes.展开更多
BACKGROUND Situs inversus totalis(SIT)is a rare condition in which the positions of abdominal and thoracic organs present a“mirror image”of the normal ones in the median sagittal plane.Although minimally invasive su...BACKGROUND Situs inversus totalis(SIT)is a rare condition in which the positions of abdominal and thoracic organs present a“mirror image”of the normal ones in the median sagittal plane.Although minimally invasive surgery has evolved to achieve laparoscopic gastrectomy for gastric cancer(GC)patients with SIT,it is difficult to perform lymphadenectomy(LND)in such a transposed anatomical condition.Herein,we report the cases of two patients with SIT who successfully underwent laparoscopy-assisted gastrectomy(LAG)with D2 LND.CASE SUMMARY Case 1:A 65-year-old man was admitted for intermittent abdominal pain and distension,occasional belching,and acid reflux for 4 mo.He was diagnosed with GC(cT3N1-2M0)with SIT.Before surgery,he had undergone four cycles of neoadjuvant chemotherapy and immunotherapy.Then,the patient was evaluated as having a partial response,and laparoscopy-assisted distal gastrectomy with D2 LND and Billroth II reconstruction were performed.The operation was performed successfully within 240 min with an estimated blood loss of 50 mL and no severe complications.The patient was discharged on postoperative day(POD)9.Case 2:A 55-year-old man was admitted for upper abdominal distension with pain and discomfort after eating for 3 mo.He was diagnosed with GC(cT3N1M0)with SIT.He had a history of hypertension for more than 10 years;however,his blood pressure was well-controlled via regular medication.We performed laparoscopy-assisted total gastrectomy with D2 LND and Roux-en-Y reconstruction.The operation was performed successfully within 168 min with an estimated blood loss of 50 mL and no severe complications.The patient was discharged on POD 10.CONCLUSION LAG with D2 LND could be considered an accessible,safe,and curative procedure for advanced GC patients with SIT.展开更多
Purpose: To evaluate the short-term and intermediate-to long-term efficacy and safety of carotid artery stenting(CAS) compared with carotid endarterectomy(CEA). Materials and Methods: The published literature was elec...Purpose: To evaluate the short-term and intermediate-to long-term efficacy and safety of carotid artery stenting(CAS) compared with carotid endarterectomy(CEA). Materials and Methods: The published literature was electronically searched for randomized controlled trials(RCTs) between CAS and CEA for the treatment of carotid stenosis performed from January 2000 to January 2017. The short-term and intermediate-to long-term outcomes were evaluated. Results: We identified 10 RCTs including 7,183 participants with symptomatic or asymptomatic carotid stenosis. Our meta-analysis found different results between the patients with and those without symptoms. In patients with symptomatic carotid stenosis, the total stroke incidence in the CAS group was significantly higher than that in the CEA group within the 30-day periprocedural period(p<0.001); however, the myocardial infarction incidence in the CAS group was significantly lower than that in the CEA group(p<0.05). There was no significant difference between the two groups in the mortality within 30 days post-procedure, but the intermediate-to long-term incidence of stroke or death in the CAS group was higher than that of the CEA group(p<0.05). In contrast, for asymptomatic patients, there were no significant differences between the CAS and CEA groups in the short-and intermediate-to long-term outcomes. Conclusion: For patients with symptomatic carotid stenosis, CEA is associated with an increased risk of myocardial infarction, whereas CAS is correlated with an increased risk of procedurally related strokes. However, for patients with asymptomatic carotid stenosis, no significant difference was found in the efficacy or safety between CAS and CEA.展开更多
Purpose:To evaluate the dynamic changes in liver function after transjugular intrahepatic portosystemic shunt(TIPS)creation in patients with cirrhosis and to explore its association with clinical outcomes.Methods:This...Purpose:To evaluate the dynamic changes in liver function after transjugular intrahepatic portosystemic shunt(TIPS)creation in patients with cirrhosis and to explore its association with clinical outcomes.Methods:This retrospective study included patients who underwent TIPS between August 2016 and December2020.Liver function was primarily evaluated using the model for end-stage liver disease(MELD)score,which was analyzed at baseline,1 week,1 month,3 months,6 months,and 12 months using one-way repeated measures ANOVA.The Kaplan-Meier method,log-rank test,and multivariate analysis were used as appropriate.Results:In total,235 patients were included in this study.The MELD score was significantly higher at 1 week(11.8±3.1 vs 13.5±3.5,p<0.05)and 1 month(11.8±3.1 vs 13.2±4.6,p<0.05)than the baseline level and recovered at 3 months(11.8±3.1 vs 11.9±3.9,p>0.05).At 12 months,the MELD score was higher than the baseline level(11.8±3.1 vs 12.4±3.2,p<0.05).Patients with a recovery of the MELD score(n=151)at 3 months had a lower probability of overt and severe HE(log-rank p=0.015 and p=0.027,respectively)than those without recovery(n=84).Logistic regression analysis revealed that albumin(odds ratio[OR],0.926;95%confidence interval[CI],0.863–0.992;p=0.029)and platelet count(OR,0.993;95%CI,0.987–0.999;p=0.033)were independent predictive factors for non-recovery of the MELD score at 3 months.Conclusions:Liver function after TIPS creation showed a trend of deterioration at first,followed by recovery.Recovery of liver function at three months was associated with reduced overt and severe HE.展开更多
BACKGROUND The effectiveness of adjunctive corticosteroid use in patients with coronavirus disease 2019(COVID-19)remains inconclusive.AIM To investigate the effectiveness of adjunctive corticosteroid therapy in patien...BACKGROUND The effectiveness of adjunctive corticosteroid use in patients with coronavirus disease 2019(COVID-19)remains inconclusive.AIM To investigate the effectiveness of adjunctive corticosteroid therapy in patients with severe COVID-19.METHODS We conducted a retrospective analysis of the difference in several outcomes between patients with severe COVID-19 who received corticosteroid therapy(the corticosteroid group)and patients with severe COVID-19 who did not receive corticosteroid therapy(the non-corticosteroid group).RESULTS Seventy-five patients were included in this study.Of these,47 patients were in the corticosteroid group and 28 patients were in the non-corticosteroid group.There were no differences between the two groups in the total length of hospital stay,the length of intensive care unit stay,high-flow oxygen days,non-invasive ventilator days,invasive ventilation days,and mortality rate.Total lesion volume ratio,consolidation volume ratio and ground-glass opacity volume ratio in the corticosteroid group decreased significantly on day 14,while those in the noncorticosteroid group did not show a significant decrease.CONCLUSION Our results show that adjunctive corticosteroid use did not significantly improveclinical outcomes in severe COVID-19 patients,but might promote the absorptionof pulmonary lesions.Larger multicenter randomized controlled studies may beneeded to confirm this.展开更多
Purpose: This study aimed to report our 10-year experience with the management of iatrogenic(penetrating trauma) and traumatic(blunt or penetrating trauma) peripheral artery pseudoaneurysms, based on data from a terti...Purpose: This study aimed to report our 10-year experience with the management of iatrogenic(penetrating trauma) and traumatic(blunt or penetrating trauma) peripheral artery pseudoaneurysms, based on data from a tertiary referral center.Methods: From January 2012 to December 2021, the medical records of consecutive patients with iatrogenic and traumatic peripheral artery pseudoaneurysms were retrospectively reviewed. Patient demographics, clinical features, imaging data, treatment details, and follow-up results were analyzed.Results: Sixty-one consecutive patients were included in this study;48(79%) were men and 13(21%) women,with a mean age of 49.4 ± 13.4 years(range 24–73 years). There were 42 patients(69%) who underwent open surgery, 18(29%) undergoing endovascular embolization or stent implantation, and one(2%) undergoing ultrasound-guided thrombin injection. All patients successfully underwent open or interventional treatment. The median follow-up was 46.8 months(2.5–117.9 months), and the overall reintervention rate was 10%. Of these,one(5%) patient in the interventional treatment group and five(12%) patients in the open surgery group underwent reintervention. The overall complication rate was 8%, with complications occurring only in the open surgery group. No deaths occurred in the peri-operative period. No late complications, such as thrombosis or pseudoaneurysm recurrence, were observed.Conclusion: Peripheral artery pseudoaneurysms arising from iatrogenic or traumatic causes can be effectively treated by both open surgery and interventional procedures in selected patients with acceptable mid-and long-term outcomes.展开更多
Purpose: To investigate the feasibility and effectiveness of in situ formation of the loop snare technique for retrieval of foreign bodies from vessels. Materials and methods: We retrospectively reviewed in situ forma...Purpose: To investigate the feasibility and effectiveness of in situ formation of the loop snare technique for retrieval of foreign bodies from vessels. Materials and methods: We retrospectively reviewed in situ formation of the loop snare technique for retrieval of foreign bodies in 6 patients. After placing the guide wire and the loop of the gooseneck snare on each side of the tubes, the soft tip of the guide wire was caught with the gooseneck snare to form a new loop structure. The foreign body was retrieved with the new loop snare by combining the gooseneck snare and the guide wire. We reviewed the application of this technique in 6 patients with fractured central venous catheters without free ends. Results: With in situ formation of the loop snare technique, the internal ruptured catheter was successfully removed from all of the 6 patients in about 2 to 4 min. There were no complications such as arrhythmia or heart valve injury in the 6 patients with the distal end of the fragment in the pulmonary artery or right atrium. Conclusion: The in situ formation loop snare technique is an effective and fast means of retrieving tubular foreign bodies without free ends from vessels. Further research is needed to investigate the practical utility of the method for retrieval of all kinds of foreign bodies.展开更多
Background:Severe portal hypertension is life-threatening and can bring adverse complications such as ascites,gastroesophageal varices,and edema.It can,even cause variceal hemorrhage,which may lead to a high risk of d...Background:Severe portal hypertension is life-threatening and can bring adverse complications such as ascites,gastroesophageal varices,and edema.It can,even cause variceal hemorrhage,which may lead to a high risk of death.There is a rare incidence in bleeding of hemorrhoids caused by severe ectopic varices.Case presentation:We report the case of a female patient with a 20-year history of hepatitis B virus infection who presented with repeated bleeding of hemorrhoids caused by severe portal hypertension with ectopic varices that is connection between the superior mesenteric vein and rectal venous plexus.Laboratory results revealed a hemoglobin level of 74 g/L.Finally,the patient was successfully treated with transjugular intrahepatic portosystemic shunt(TIPSS)placement without variceal embolization after a multidisciplinary comprehensive opinion.In the two-month follow-up period,the patient had failed to develop hepatic encephalopathy or hematochezia,and computed tomography venography(CTV)indicated that the stent was unobstructed and ascites disappeared.Conclusions:TIPSS placement is effective for the case,and we hope this case can help improve clinicians’awareness of hemorrhoidal bleeding with severe portal hypertension.Portal hypertension should also be considered during the diagnosis and treatment,as opposed to hemorrhoidal bleeding alone.Moreover,abdominal CTV is recommended as an effective imaging examination method to determine the stent status after operation.展开更多
A divalent ion doped LiNi0.8Co0.2O2 solid solution, LiNi0.79Co0.20Ca0.01O2, was synthesized in air at 720℃. The structure and electrochemical property as cathode material of lithium ion batteries were measured by XRD...A divalent ion doped LiNi0.8Co0.2O2 solid solution, LiNi0.79Co0.20Ca0.01O2, was synthesized in air at 720℃. The structure and electrochemical property as cathode material of lithium ion batteries were measured by XRD and charge-discharge system. The solid solution showed high capacity and good cycle-ability. The second discharged capacity reached 190 mAh穏-1 at the current density of 100 mA穏-1.展开更多
Earthquake data include informative seismic phases that require identification for imaging the Earth's structural interior.In order to identify the phases,we created a numerical method to calculate the traveltimes...Earthquake data include informative seismic phases that require identification for imaging the Earth's structural interior.In order to identify the phases,we created a numerical method to calculate the traveltimes and raypaths by a shooting technique based upon the IASP91 Earth model,and it can calculate the traveltimes and raypaths for not only the seismic phases in the traditional traveltime tables such as IASP91,AK135,but also some phases such as pPcP,pPKIKP,and PPPPP.It is not necessary for this method to mesh the Earth model,and the results from the numerical modeling and its application show that the absolute differences between the calculated and theoretical traveltimes from the ISAP91 tables are less than 0.1 s.Thus,it is simple in manipulation and fast in computation,and can provide a reliable theoretical prediction for the identification of a seismic phase within the acquired earthquake data.展开更多
We report two cases of hepatic encephalopathy caused by molecular targeted drugs after the Transjugular intrahepatic portosystemic shunt(TIPS)procedure in our center.The liver toxicities and anti-angiogenic effects in...We report two cases of hepatic encephalopathy caused by molecular targeted drugs after the Transjugular intrahepatic portosystemic shunt(TIPS)procedure in our center.The liver toxicities and anti-angiogenic effects induced by targeted drugs may generate an imbalance in ammonia metabolism,elevating blood ammonia levels.TIPS diverts partial blood supply from the liver,aggravates liver impairment,and shunts ammonia-rich blood from the intestine into the systemic circulation.These may be the mechanisms leading to hepatic encephalopathy caused by molecular targeted drugs following TIPS.When clinicians choose molecular targeted therapy as the second or third targeted therapy for patients who have undergone TIPS,the consequence of drug-induced hepatic encephalopathy should also be considered.展开更多
The shrink fit retaining ring is currently the easiest to install and the most widely used end fixed for structure AC excitation variable speed generator-motor rotor end windings.However,the current research on the ef...The shrink fit retaining ring is currently the easiest to install and the most widely used end fixed for structure AC excitation variable speed generator-motor rotor end windings.However,the current research on the effect of high strength sealing on the ventilation and heat dissipation performance of the end is not enough.In this paper,based on the actual structural parameters and periodic symmetry simplification,the three-dimensional coupled calculation model of fluid field and temperature field is established.After solving the fluid and thermal equations,the influence of the length of rotor support block,the height of rotor support block,and the number of rotor support block on the fluid flow and temperature distribution in the rotor end region of generator-motor is studied using the finite volume method.The rheological characteristics of the air in the rotor domain,such as velocity and inter-winding flow,are analyzed.The law of temperature variation with local structure in the computational domain is studied.The variation law of cooling medium performance inside the large variable speed power generator motor is revealed.展开更多
基金Natural Science Foundation of Gansu Province(Project No.:24JRRA615)Outstanding Talent Recruitment Program and the Doctoral Start-up Fund of Gansu Provincial Central Hospital(Project No.:GMCCH2024-2-6)。
文摘Thrombotic thrombocytopenic purpura(TTP)is a rare and life-threatening form of thrombotic microangiopathy,primarily caused by a deficiency of ADAMTS-13 activity.Immune-related adverse events(irAEs)are autoimmune toxicities mediated by the use of immune checkpoint inhibitors(ICIs).Here,the study reports a case of thrombotic thrombocytopenic purpura that developed in a patient with renal cell carcinoma and vertebral metastasis following combined treatment with Toripalimab and Pazopanib.The patient received Toripalimab in combination with Pazopanib after undergoing radical nephrectomy for right renal cell carcinoma.Five days later,a generalized erythematous rash appeared,partly confluent,accompanied by congestion and swelling of both palpebral and bulbar conjunctiva.Based on the clinical presentation and laboratory results showing thrombocytopenia and hemolytic anemia,the diagnosis of TTP was established.The condition was considered an adverse effect associated with the combination therapy of Toripalimab and Pazopanib.Plasma exchange and high-dose intravenous immunoglobulin therapy were promptly initiated.The treatment regimen was subsequently modified to Axitinib combined with radiotherapy,leading to a gradual recovery of platelet counts.This report highlights the potential risk of TTP associated with combined ICI and TKI therapy,and underscores the importance of early recognition and timely management of this potentially fatal complication.
基金supported by the National Natural Science Foundation of China (No. 81873917)。
文摘Objectives:To compare the clinical outcomes in terms of structure and function between the insertion of a transjugular intrahepatic portosystemic shunt(TIPS) created with the Viabahn ePTFE covered stent/bare metal stent(BMS) combination and the Fluency ePTFE covered stent/BMS combination.Methods:A total of 101 consecutive patients who received a TIPS from February 2016 to August 2018 in our center were retrospectively analyzed.Sixty-four subjects were enrolled in the Viabahn group and 37 were enrolled in the Fluency group.The geometry characteristics of the TIPS were calculated,and the associated occurrence of shunt dysfunction,survival,overt hepatic encephalopathy,and variceal rebleeding were evaluated.Results:The technical success rate was 100%.After the insertion of the TIPS,the rate of shunt dysfunction during the first 3 months was significantly different between the Viabahn and Fluency groups(1.6% and 13.5%,respectively;p=0.024).Multivariate analysis indicated that the angle of portal venous inflow(α) was the only independent risk factor for shunt dysfunction(hazard ratio=1.060,95% confidence interval=1.009-1.112,p=0.020).In addition,3 months after the TIPS insertion,the a angle distinctly increased from 20.9°±14.3°-26.9°±20.1°(p=0.005) in the Fluency group but did not change significantly in the Viabahn group(from 21.9°±15.1°-22.9°± 17.6°,p=0.798).Conclusions:Shunt dysfunction was related to the a angle owing to the slight effect on the a angle after the implantation of the TIPS.The Viabahn ePTFE covered stent/BMS combination was more stable in structure and promised higher short-term stent patency compared with the Fluency ePTFE covered stent/BMS combination.
基金Supported by Hubei Province Natural Science Foundation,No.2000J054
文摘AIM:To clarify the clinicopathologic significance of COX-2 expression in human colorectal cancer.METHODS:A total of 128 surgically resected colorectal cancer specimens were immunohistochemically analyzed with the use of anti-COX-2,anti-VEGF and anti-MMP-2 antibodies.The relationship between the cyclooxygenase-2 expression in primary lesions of colorectal cancer and clinicopathoiogic parameters was evaluated by chi-square test.RESULTS:Among 128 cases of colorectal cancer,87(67.9%)were positive for cyclooxygenase-2.The expression of cyclooxygenase-2 was significantly correlated with the depth of invasion,stage of disease,and metastasis(lymph node and liver).Patients in T3-T4,stagesⅢ-Ⅳand with metastasis had much higher expression of cyclooxygenase-2 than ones in T1-T2,stagesⅠ-Ⅱand without metastasis(P<0.05).Among 45 cases of colorectal cancer with lymph node metastasis,the COX-2-positive rate was 86.7%(39/45)for primary lesions and diffuse cytoplasmic staining for COX-2 protein was detected in cancer cells in 100%of metastatic lesions of the lymph nodes.VEGF expression was detected in 49 tumors(38.3%),and VEGF expression was closely correlated with COX-2 expression.The positive expression rate of VEGF(81.6%)in the cyclooxygenase-2-positive group was higher than that in the cyclooxygenase-2-negative group(18.4%,P<0.05).MMP-2 expression was detected in 88 tumors(68.8%),and MMP-2 expression was closely correlated with COX-2 expression.The positive expression rate of MMP-2(79.6%)in the positive COX-2 group was higher than that in the negative COX-2 group(20.4%,P<0.05).CONCLUSION:Cyclooxygenase-2 may be associated with tumor progression by modulating the angiogenesis and cancer cell motility and invasive potential in colorectal cancer and it can be used as a possible biomarker.
基金Supported by State Natural Science Fund (No. 30772685)
文摘OBJECTIVE： To observe the influence of Sijunzi decoction and Yupingfeng powder on the expression of the relevant DNAs of janus kinase （JAK）-signal transducer and activator of transcription （STAT） sig- nal pathway of the brain in spleen-deficiency mod- el rats. METHODS： Eighty male Wistar rats of sanitary degree were divided randomly into four groups： nor- mal group, model group, treatment group 1, treatment group 2. Besides the rats in the normal group, all the rats in other 3 groups were prepared as spleen deficiency model. The treatment group 1 were treated with Sijunzi decoction and the treat- ment group 2 were treated with Yupingfeng powder. After treatment for 6 weeks, perfusion was given and the brain was taken for detection of the ex- pression of the relevant DNAs of JAK-STAT signal pathwayofthe brain in SD rats bygene chip method. RESULTS： Spleen deficiency could lead to increase expression of JAKI, STATI and Interleukin 4 （IL-4） in the brain, but the decrease expression of Suppres- sor of cytokine signaling I （SOCSI）, prolactin recep- tor （PRLR） and binding protein 3 （GATA 3）. Sijunzi decoction could increase expression of STAT3, Pro- lactin （PRL） and GATA3, but decrease expression of JAKI, STAT, STAT4, Interleukin 10 receptor, alpha （ILIORA）, Coagulation factor II （F2）, PRLR, MAD homolog 3 （SMAD3） and IL-4. Yupingfeng powder could decrease expression of JAKI, STATI, STAT4, SOCS4_ predicted, Epidermal growth factor receptor （EGFR）, PRLR, High mobility group AT-hook I （HMGAI 0）, IL-4. CONCLUSION： Sijunzi decoction and Yupingfeng powder can improve immune function of the rat through influencing the genetic expression of JAK-STAT signal pathway.
基金Supported by Foundation of Xiamen Science and Technology Bureau,Fujian Province,China,No.3502Z20074023
文摘AIM:To rapidly detect molecular alterations in different malignancies and investigate the possible role of Tp53,C-myc,and CCND1 genes in development of tumors in human organs and their adjacent normal tissues,as well as the possible relation between well-and poorly-differentiated tumors.METHODS:A tissue array consisting of seven different tumors was generated.The tissue array included 120 points of esophagus,120 points of stomach,80 points of rectum,60 points of thyroid gland,100 points of mammary gland,80 points of liver,and 80 points of colon.Expressions of Tp53,C-myc,and CCND1 were determined by RNA in situ hybridization.3' terminal digoxin-labeled anti-sense single stranded oligonucleotide and locked nucleic acid modifying probe were used.RESULTS:The expression level of Tp53 gene was higher in six different carcinoma tissue samples than in paracancerous tissue samples with the exception in colon carcinoma tissue samples(P < 0.05).The expression level of CCND1 gene was significantly different in different carcinoma tissue samples with the exception in esophagus and colon carcinoma tissue samples.The expression level of C-myc gene was different in esophagus carcinoma tissue samples(c2 = 18.495,P = 0.000),stomach carcinoma tissue samples(c2 = 23.750,P = 0.000),and thyroid gland tissue samples(c2 = 10.999,P = 0.004).The intensity of signals was also different in different carcinoma tissue samples and paracancerous tissue samples.CONCLUSION:Over-expression of the Tp53,CCND1,and C-myc genes appears to play a role in development of human cancer by regulating the expression of mRNA.Tp53,CCND1 and C-myc genes are significantly correlated with the development of different carcinomas.
基金supported by the National Science Foundation of China (No. 81374016 and 81402308)Beijing Municipal Science & Technology Commission (No. D141100000414002)
文摘Background： The ACTS-GC study had shown postoperative adiuvant therapy with S-1 improved survival of patients with locally advanced gastric cancer. Addition of oxaliplatin to S-1 is considered to be acceptable as one of the treatment options for gastric cancer patients after radical gastrectomy with D2 lymph node excision. Methods： We have commenced a randomized phase III trial in December 2016 to evaluate S-I plus oxaliplatin compared with S-1 alone in the adjuvant setting for locally advanced gastric cancer. A total of 564 patients will be accrued from 13 Chinese institutions in two years. The primary endpoint is 3-year relapse-free survival. The secondary endpoints are 5-year overall survival, proportion of patients who complete the postoperative chemotherapy and incidence of adverse events. Ethic and dissemination： The trial has been approved by the institutional review board of each participating institution and it was activated on December, 2016. The enrollment will be finished in December, 2018. Patient＇s follow-up will be ended until December, 2023. Trial registration： ClinicalTrials.gov, identifier： NCT02867839. Registered on August 4, 2016.
文摘Hemangioma is the most common benign hepatic tumor.Although spontaneous rupture is rare,the mortality rate ranges from 60 to 75%.Only 34 cases have been reported in the literature,with only one report using transcatheter arterial embolization(TAE) alone as treatment.We report a case of spontaneous rupture with "flowering sign" of a giant hepatic hemangioma,presenting with acute abdominal pain and shock,while the volume of the hemangioma and blood loss were similar.The patient was successfully managed by transarterial chemoembolization(TACE) alone,which has an operative mortality rate of up to 36.4%.
文摘Purpose:To analyze causes of acute nonvariceal gastrointestinal bleeding(GIB)with negative digital subtraction angiography(DSA)results.Materials and methods:The clinical and follow-up data of 133 patients-recruited between February 2008 and November 2016-with acute nonvariceal GIB and negative DSA results were included in this study.DSA results,diagnoses,and clinical outcomes were recorded.Results:The DSA results were negative in all 133 patients.Of the total,55 patients(41.4%)chose to undergo surgery and 78(58.6%)opted for conservative treatment.Within 30 days,there was no significant difference in the rebleeding or mortality rates between the two groups(P<.05).Of all 133 patients,76(57.1%)had upper GIB and 57(42.9%)had lower GIB;within 30 days,the rebleeding rate in the upper GIB group(44.7%,34/76)was significantly higher than that in the lower GIB group(26.3%,15/57).There was no significant statistical difference(P<.05)within 30 days in the mortality rates between the two groups.Among patients with upper GIB,26(34.2%,26/76)opted to undergo surgery and 50(65.8%,50/76)chose conservative treatment;within 30 days,the rebleeding rate in the group that chose surgery(61.5%,16/26)was higher than that in the conservative treatment group(36%,18/50).There was no significant difference(P<.05)within 30 days in the mortality rate between the two groups.Among the patients with lower GIB,29(50.9%,29/57)chose to undergo surgery and 28(49.1%,28/57)opted for conservative treatment.Within 30 days,the rebleeding rate in the surgery group(13.8%,4/29)was lower than that in conservative treatment group(39.3%,11/28).There was no significant difference(P<.05)within 30 days in the mortality rate between the two groups.Sixteen patients underwent prophylactic arterial embolization;in 6 of these,bleeding was stopped for 30 days.DSA was then repeated in these 16 patients after a median interval of 1 day,and a positive bleeding site was found in 9 of the 16.Causes of bleeding were found in 111 patients by surgery or endoscopy,whereas the causes remained unknown in 22 patients.Conclusions:Upper GIB with negative DSA results was stopped by conservative treatment,whereas lower GIB required surgery to detect the culprit bleeding site.Rare causes of GIB should be considered and appropriate management selected in a timely manner in order to detect unusual causes.
基金Supported by National Natural Science Foundation of China,No.81401515Zhongnan Hospital of Wuhan University Science Technology and Innovation Seed Fund,No.znpy2018030“351Talent Project(Luojia Young Scholars)”of Wuhan University.
文摘BACKGROUND Situs inversus totalis(SIT)is a rare condition in which the positions of abdominal and thoracic organs present a“mirror image”of the normal ones in the median sagittal plane.Although minimally invasive surgery has evolved to achieve laparoscopic gastrectomy for gastric cancer(GC)patients with SIT,it is difficult to perform lymphadenectomy(LND)in such a transposed anatomical condition.Herein,we report the cases of two patients with SIT who successfully underwent laparoscopy-assisted gastrectomy(LAG)with D2 LND.CASE SUMMARY Case 1:A 65-year-old man was admitted for intermittent abdominal pain and distension,occasional belching,and acid reflux for 4 mo.He was diagnosed with GC(cT3N1-2M0)with SIT.Before surgery,he had undergone four cycles of neoadjuvant chemotherapy and immunotherapy.Then,the patient was evaluated as having a partial response,and laparoscopy-assisted distal gastrectomy with D2 LND and Billroth II reconstruction were performed.The operation was performed successfully within 240 min with an estimated blood loss of 50 mL and no severe complications.The patient was discharged on postoperative day(POD)9.Case 2:A 55-year-old man was admitted for upper abdominal distension with pain and discomfort after eating for 3 mo.He was diagnosed with GC(cT3N1M0)with SIT.He had a history of hypertension for more than 10 years;however,his blood pressure was well-controlled via regular medication.We performed laparoscopy-assisted total gastrectomy with D2 LND and Roux-en-Y reconstruction.The operation was performed successfully within 168 min with an estimated blood loss of 50 mL and no severe complications.The patient was discharged on POD 10.CONCLUSION LAG with D2 LND could be considered an accessible,safe,and curative procedure for advanced GC patients with SIT.
基金This work was supported by grant from the National Science Foundation of China(No.81371662 and No.81601578)
文摘Purpose: To evaluate the short-term and intermediate-to long-term efficacy and safety of carotid artery stenting(CAS) compared with carotid endarterectomy(CEA). Materials and Methods: The published literature was electronically searched for randomized controlled trials(RCTs) between CAS and CEA for the treatment of carotid stenosis performed from January 2000 to January 2017. The short-term and intermediate-to long-term outcomes were evaluated. Results: We identified 10 RCTs including 7,183 participants with symptomatic or asymptomatic carotid stenosis. Our meta-analysis found different results between the patients with and those without symptoms. In patients with symptomatic carotid stenosis, the total stroke incidence in the CAS group was significantly higher than that in the CEA group within the 30-day periprocedural period(p<0.001); however, the myocardial infarction incidence in the CAS group was significantly lower than that in the CEA group(p<0.05). There was no significant difference between the two groups in the mortality within 30 days post-procedure, but the intermediate-to long-term incidence of stroke or death in the CAS group was higher than that of the CEA group(p<0.05). In contrast, for asymptomatic patients, there were no significant differences between the CAS and CEA groups in the short-and intermediate-to long-term outcomes. Conclusion: For patients with symptomatic carotid stenosis, CEA is associated with an increased risk of myocardial infarction, whereas CAS is correlated with an increased risk of procedurally related strokes. However, for patients with asymptomatic carotid stenosis, no significant difference was found in the efficacy or safety between CAS and CEA.
基金National Natural Science Foundation of China(81873917)
文摘Purpose:To evaluate the dynamic changes in liver function after transjugular intrahepatic portosystemic shunt(TIPS)creation in patients with cirrhosis and to explore its association with clinical outcomes.Methods:This retrospective study included patients who underwent TIPS between August 2016 and December2020.Liver function was primarily evaluated using the model for end-stage liver disease(MELD)score,which was analyzed at baseline,1 week,1 month,3 months,6 months,and 12 months using one-way repeated measures ANOVA.The Kaplan-Meier method,log-rank test,and multivariate analysis were used as appropriate.Results:In total,235 patients were included in this study.The MELD score was significantly higher at 1 week(11.8±3.1 vs 13.5±3.5,p<0.05)and 1 month(11.8±3.1 vs 13.2±4.6,p<0.05)than the baseline level and recovered at 3 months(11.8±3.1 vs 11.9±3.9,p>0.05).At 12 months,the MELD score was higher than the baseline level(11.8±3.1 vs 12.4±3.2,p<0.05).Patients with a recovery of the MELD score(n=151)at 3 months had a lower probability of overt and severe HE(log-rank p=0.015 and p=0.027,respectively)than those without recovery(n=84).Logistic regression analysis revealed that albumin(odds ratio[OR],0.926;95%confidence interval[CI],0.863–0.992;p=0.029)and platelet count(OR,0.993;95%CI,0.987–0.999;p=0.033)were independent predictive factors for non-recovery of the MELD score at 3 months.Conclusions:Liver function after TIPS creation showed a trend of deterioration at first,followed by recovery.Recovery of liver function at three months was associated with reduced overt and severe HE.
文摘BACKGROUND The effectiveness of adjunctive corticosteroid use in patients with coronavirus disease 2019(COVID-19)remains inconclusive.AIM To investigate the effectiveness of adjunctive corticosteroid therapy in patients with severe COVID-19.METHODS We conducted a retrospective analysis of the difference in several outcomes between patients with severe COVID-19 who received corticosteroid therapy(the corticosteroid group)and patients with severe COVID-19 who did not receive corticosteroid therapy(the non-corticosteroid group).RESULTS Seventy-five patients were included in this study.Of these,47 patients were in the corticosteroid group and 28 patients were in the non-corticosteroid group.There were no differences between the two groups in the total length of hospital stay,the length of intensive care unit stay,high-flow oxygen days,non-invasive ventilator days,invasive ventilation days,and mortality rate.Total lesion volume ratio,consolidation volume ratio and ground-glass opacity volume ratio in the corticosteroid group decreased significantly on day 14,while those in the noncorticosteroid group did not show a significant decrease.CONCLUSION Our results show that adjunctive corticosteroid use did not significantly improveclinical outcomes in severe COVID-19 patients,but might promote the absorptionof pulmonary lesions.Larger multicenter randomized controlled studies may beneeded to confirm this.
文摘Purpose: This study aimed to report our 10-year experience with the management of iatrogenic(penetrating trauma) and traumatic(blunt or penetrating trauma) peripheral artery pseudoaneurysms, based on data from a tertiary referral center.Methods: From January 2012 to December 2021, the medical records of consecutive patients with iatrogenic and traumatic peripheral artery pseudoaneurysms were retrospectively reviewed. Patient demographics, clinical features, imaging data, treatment details, and follow-up results were analyzed.Results: Sixty-one consecutive patients were included in this study;48(79%) were men and 13(21%) women,with a mean age of 49.4 ± 13.4 years(range 24–73 years). There were 42 patients(69%) who underwent open surgery, 18(29%) undergoing endovascular embolization or stent implantation, and one(2%) undergoing ultrasound-guided thrombin injection. All patients successfully underwent open or interventional treatment. The median follow-up was 46.8 months(2.5–117.9 months), and the overall reintervention rate was 10%. Of these,one(5%) patient in the interventional treatment group and five(12%) patients in the open surgery group underwent reintervention. The overall complication rate was 8%, with complications occurring only in the open surgery group. No deaths occurred in the peri-operative period. No late complications, such as thrombosis or pseudoaneurysm recurrence, were observed.Conclusion: Peripheral artery pseudoaneurysms arising from iatrogenic or traumatic causes can be effectively treated by both open surgery and interventional procedures in selected patients with acceptable mid-and long-term outcomes.
基金funded by the National Natural Science Foundation of China(No.81471766)
文摘Purpose: To investigate the feasibility and effectiveness of in situ formation of the loop snare technique for retrieval of foreign bodies from vessels. Materials and methods: We retrospectively reviewed in situ formation of the loop snare technique for retrieval of foreign bodies in 6 patients. After placing the guide wire and the loop of the gooseneck snare on each side of the tubes, the soft tip of the guide wire was caught with the gooseneck snare to form a new loop structure. The foreign body was retrieved with the new loop snare by combining the gooseneck snare and the guide wire. We reviewed the application of this technique in 6 patients with fractured central venous catheters without free ends. Results: With in situ formation of the loop snare technique, the internal ruptured catheter was successfully removed from all of the 6 patients in about 2 to 4 min. There were no complications such as arrhythmia or heart valve injury in the 6 patients with the distal end of the fragment in the pulmonary artery or right atrium. Conclusion: The in situ formation loop snare technique is an effective and fast means of retrieving tubular foreign bodies without free ends from vessels. Further research is needed to investigate the practical utility of the method for retrieval of all kinds of foreign bodies.
基金supported by the National Natural Science Foundation of China(No.81873917)
文摘Background:Severe portal hypertension is life-threatening and can bring adverse complications such as ascites,gastroesophageal varices,and edema.It can,even cause variceal hemorrhage,which may lead to a high risk of death.There is a rare incidence in bleeding of hemorrhoids caused by severe ectopic varices.Case presentation:We report the case of a female patient with a 20-year history of hepatitis B virus infection who presented with repeated bleeding of hemorrhoids caused by severe portal hypertension with ectopic varices that is connection between the superior mesenteric vein and rectal venous plexus.Laboratory results revealed a hemoglobin level of 74 g/L.Finally,the patient was successfully treated with transjugular intrahepatic portosystemic shunt(TIPSS)placement without variceal embolization after a multidisciplinary comprehensive opinion.In the two-month follow-up period,the patient had failed to develop hepatic encephalopathy or hematochezia,and computed tomography venography(CTV)indicated that the stent was unobstructed and ascites disappeared.Conclusions:TIPSS placement is effective for the case,and we hope this case can help improve clinicians’awareness of hemorrhoidal bleeding with severe portal hypertension.Portal hypertension should also be considered during the diagnosis and treatment,as opposed to hemorrhoidal bleeding alone.Moreover,abdominal CTV is recommended as an effective imaging examination method to determine the stent status after operation.
基金supported by the National Natural Science Foundation of China(No.29971024)
文摘A divalent ion doped LiNi0.8Co0.2O2 solid solution, LiNi0.79Co0.20Ca0.01O2, was synthesized in air at 720℃. The structure and electrochemical property as cathode material of lithium ion batteries were measured by XRD and charge-discharge system. The solid solution showed high capacity and good cycle-ability. The second discharged capacity reached 190 mAh穏-1 at the current density of 100 mA穏-1.
文摘Earthquake data include informative seismic phases that require identification for imaging the Earth's structural interior.In order to identify the phases,we created a numerical method to calculate the traveltimes and raypaths by a shooting technique based upon the IASP91 Earth model,and it can calculate the traveltimes and raypaths for not only the seismic phases in the traditional traveltime tables such as IASP91,AK135,but also some phases such as pPcP,pPKIKP,and PPPPP.It is not necessary for this method to mesh the Earth model,and the results from the numerical modeling and its application show that the absolute differences between the calculated and theoretical traveltimes from the ISAP91 tables are less than 0.1 s.Thus,it is simple in manipulation and fast in computation,and can provide a reliable theoretical prediction for the identification of a seismic phase within the acquired earthquake data.
基金funded by the National Natural Science Foundation of China(81873917)。
文摘We report two cases of hepatic encephalopathy caused by molecular targeted drugs after the Transjugular intrahepatic portosystemic shunt(TIPS)procedure in our center.The liver toxicities and anti-angiogenic effects induced by targeted drugs may generate an imbalance in ammonia metabolism,elevating blood ammonia levels.TIPS diverts partial blood supply from the liver,aggravates liver impairment,and shunts ammonia-rich blood from the intestine into the systemic circulation.These may be the mechanisms leading to hepatic encephalopathy caused by molecular targeted drugs following TIPS.When clinicians choose molecular targeted therapy as the second or third targeted therapy for patients who have undergone TIPS,the consequence of drug-induced hepatic encephalopathy should also be considered.
基金This research was funded by Dongfang Electric Machinery Co., Ltd.
文摘The shrink fit retaining ring is currently the easiest to install and the most widely used end fixed for structure AC excitation variable speed generator-motor rotor end windings.However,the current research on the effect of high strength sealing on the ventilation and heat dissipation performance of the end is not enough.In this paper,based on the actual structural parameters and periodic symmetry simplification,the three-dimensional coupled calculation model of fluid field and temperature field is established.After solving the fluid and thermal equations,the influence of the length of rotor support block,the height of rotor support block,and the number of rotor support block on the fluid flow and temperature distribution in the rotor end region of generator-motor is studied using the finite volume method.The rheological characteristics of the air in the rotor domain,such as velocity and inter-winding flow,are analyzed.The law of temperature variation with local structure in the computational domain is studied.The variation law of cooling medium performance inside the large variable speed power generator motor is revealed.
