Craniofacial development relies on the migration of cranial neural crest cells(CNCCs)to the first and second pharyngeal arches,followed by their differentiation into various cell types during embryogenesis.Although th...Craniofacial development relies on the migration of cranial neural crest cells(CNCCs)to the first and second pharyngeal arches,followed by their differentiation into various cell types during embryogenesis.Although the CNCC migration has been well-studied,the role of the niche in relation to CNCC remains unclear.Variants in FOXI3 have been implicated in craniofacial microsomia(CFM),yet the molecular mechanisms remain unexplored.FOXI3 is expressed in the ectoderm and auricle epidermis,but not in CNCCs or cartilage.Deletion of Foxi3 in the mouse CNCCs did not disrupt mandible and auricular development,further confirming that FOXI3 does not directly regulate CNCCs.However,Foxi3 deficiency in the ectoderm reduced the production of chondrogenesis-related cytokines derived from ectodermal cells,such as TGF-β1.This impairment affected CNCC proliferation through cell communication,subsequently altering the development of the mandible and auricle.These results emphasize the critical role of FOXI3 in establishing the microenvironment supporting CNCC function.Furthermore,FOXI3 directly regulates target genes associated with translation,thereby orchestrating cytokine production in epidermal cells.The validation using auricle sample from a CFM patient carrying FOXI3 mutation further supports our findings.These insights highlight the function of FOXI3 in creating the niche necessary for CNCC development and provide a basis for understanding the molecular mechanisms driving CFM pathogenesis.展开更多
1.Introduction.Pancreaticoduodenectomy is an essential surgical procedure for the treatment of malignant tumors in the pancreatic head,distal common bile duct,and duodenal papilla,and is widely used in clinical practi...1.Introduction.Pancreaticoduodenectomy is an essential surgical procedure for the treatment of malignant tumors in the pancreatic head,distal common bile duct,and duodenal papilla,and is widely used in clinical practice.One of the primary determinants of surgical success is the durability of the pancreaticojejunal anastomosis.展开更多
With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Lap...With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Laparoscopic-endoscopic cooperative surgery combined with sentinel lymph node navigation surgery(LECSSNNS)has drawn increasing interest because of its dual benefits of minimal invasiveness and organ function preservation.However,robust evidence-based support for guiding clinical implementation remains limited.To address this gap,we systematically evaluated available studies on the clinical application of LECS-SNNS in EGC and integrated expert insights to formulate 20 recommendations.These included preoperative assessment,surgical techniques,intraoperative endoscopic procedures,pathological evaluation,postoperative care,and follow-up.This consensus aimed to provide comprehensive guidance for the standardized application of LECS-SNNS,thereby advancing precise,minimally invasive,and function-preserving treatment for EGC.展开更多
Background:Lumbar disc degeneration(LDD)displays considerable heterogeneity in terms of clinical features and pathological changes.However,researchers have not clearly determined whether the transcriptome variations i...Background:Lumbar disc degeneration(LDD)displays considerable heterogeneity in terms of clinical features and pathological changes.However,researchers have not clearly determined whether the transcriptome variations in LDD could be used to identify or interpret the causes of heterogeneity in clinical features.This study aimed to identify the transcriptomic classification of degenerated discs in LDD patients and whether the molecular subtypes of LDD could be accurately predicted using clinical features.Methods:One hundred and twenty-two nucleus pulposus(NP)tissues from 108 patients were consecutively collected for bulk RNA sequencing(RNA-seq).An unsupervised clustering method was employed to analyze the bulk RNA matrix.Differential analysis was performed to characterize the transcriptional signatures and subtype-specific extracellular matrix(ECM)dysregulation.The cell subpopulation states of each subtype were inferred by integrating bulk and single-cell sequencing datasets.Transwell and dual-luciferase reporter gene assays were employed to investigate possible molecular mechanisms involved.Machine learning algorithm diagnostic prediction models were developed to correlate molecular classification with clinical features.Results:LDD was classified into 4 subtypes with distinct molecular signatures and ECM remodeling:C1 with collagenesis,C2 with ossification,C3 with low chondrogenesis,and C4 with fibrogenesis.Chond1-3 in C1 dominated disc collagenesis via the activation of the mechanosensors TRPV4 and PIEZO1;NP progenitor cells in C2 exhibited chondrogenic and osteogenic phenotypes;Chond1 in C3 was linked to a disrupted hypoxic microenvironment leading to reduced chondrogenesis;Macrophages in C4 played a crucial role in disc fibrogenesis via the secretion of tumor necrosis factor-α(TNF-α).Furthermore,the random forest diagnostic prediction model was proven to have a robust performance[area under the receiver operating characteristic(ROC)curve:0.9312;accuracy:0.84]in stratifying the molecular subtypes of LDD based on 12 clinical features.Conclusions:Our study delineates 4 distinct molecular subtypes of LDD that can be accurately stratified on the basis of clinical features.The identification of these subtypes would facilitate precise diagnostics and guide the development of personalized treatment strategies for LDD.展开更多
Portal vein thrombosis(PVT)is one of the most common serious complications in patients with liver cirrhosis.The occurrence of PVT not only aggravates the condition of liver cirrhosis but can also cause several serious...Portal vein thrombosis(PVT)is one of the most common serious complications in patients with liver cirrhosis.The occurrence of PVT not only aggravates the condition of liver cirrhosis but can also cause several serious complications,such as portal hypertension,esophagogastric variceal bleeding,and refractory ascites.All these factors have a serious impact on patients’quality of life and prognosis.This article evaluates the current evidence on the management of PVT in cirrhosis and explores the role of direct oral anticoagulants,but data on individualized anticoagulation strategies are limited and lacking for the treatment of PVT in cirrhosis,and it is hoped that it will inform a broad range of clinicians on the treatment of cirrhosis combined with PVT.展开更多
BACKGROUND Intraoperative and postoperative biliary injuries remain significant complications of laparoscopic common bile duct exploration(LCBDE).Indocyanine green(ICG)has been shown to significantly reduce injuries c...BACKGROUND Intraoperative and postoperative biliary injuries remain significant complications of laparoscopic common bile duct exploration(LCBDE).Indocyanine green(ICG)has been shown to significantly reduce injuries caused by intraoperative operational errors.We found that the J-tube can reduce postoperative strictures and injuries to the common bile duct.At this moment,we aim to analyze and compare the complications,efficacy,short-term outcomes,and feasibility of these two adjunctive tools for LCBDE.AIM To evaluate the efficacy of ICG fluorescence imaging In LCBDE and J-tube drainage for patients with common bile duct stones.METHODS We retrospectively collected the clinical case data of patients who were treated at the Hepatobiliary Surgery Department of the Third People’s Hospital of Nantong,affiliated with Nantong University,from January 2016 to January 2021 due to gallbladder stones with choledocholithiasis and who underwent LCBDE combined with a primary suture and either J-tube or T-tube drainage.The patients were divided into groups:Traditional white-light laparoscopy+T-tube group(WL+T-tube),traditional WL+J-tube group,fluorescent laparoscopy+T-tube group(ICG+T-tube)and fluorescent laparoscopy+J-tube group(ICG+J-tube).The preoperative and postoperative clinical case data,laboratory examination data,and intraoperative and postoperative complications(including postoperative bile leakage,electrolyte disturbances,biliary peritonitis,and postoperative infections)and other relevant indicators were compared.RESULTS A total of 198 patients(112 males and 86 females)were included in the study,with 74 patients in the WL+T-tube,47 in the WL+J-tube,42 in the ICG+T-tube,and 35 in the ICG+J-tube.Compared with the other groups,the ICG+J had significantly shorter operation time(114 minutes,P=0.001),less blood loss(42 mL,P=0.02),shorter postoperative hospital stays(7 days,P=0.038),and lower surgical costs(China yuan 30178,P=0.001).Furthermore,patients were subdivided into two groups based on whether a T-tube or J-tube was placed during the surgery.By the third postoperative day,the aspartate transaminase,glutamic pyruvic transaminase,total bilirubin,and direct bilirubin levels were lower in the J-tube group than in the T-tube group(P<0.001).At last,follow-up observations showed that the incidence of biliary strictures at three months postoperatively was significantly lower in the J-tube group than in the T-tube group(P=0.002).CONCLUSION ICG fluorescence imaging in laparoscopic cholecystectomy with common bile duct exploration and J-tube drainage facilitates rapid identification of biliary anatomy and variations,reducing intraoperative bile duct injury,blood loss,surgery duration,and postoperative bile duct stenosis rates,supporting its clinical adoption.展开更多
BACKGROUND Chronic hepatitis B virus(HBV)infection acquired in childhood frequently presents with mild or nonspecific symptoms,yet a distinct subset of pediatric patients develops rapid progression to liver cirrhosis(...BACKGROUND Chronic hepatitis B virus(HBV)infection acquired in childhood frequently presents with mild or nonspecific symptoms,yet a distinct subset of pediatric patients develops rapid progression to liver cirrhosis(LC)before adulthood.AIM To identify clinical and pathological characteristics of pediatric HBV-related LC.METHODS A total of 1332 pediatric patients with chronic HBV infection from the Fifth Medical Center of PLA General Hospital from January 2010 to January 2023 were included in this study.We identified 62 pediatric HBV-related LC by liver biopsy from the group.Subsequently,we described the clinical and pathological characteristics of pediatric LC.And 64 pediatric chronic hepatitis B(CHB;age and sex were matched with pediatric LC group)and 69 adult HBV-related LC(sex were matched with pediatric LC group)were enrolled to further demonstrate clinical and pathological differences between pediatric LC,pediatric CHB and adult LC.RESULTS We enrolled 62 pediatric LC,including 54(87.1%)males and 8(12.9%)females.The median age was 11(4-14)years old.The pediatric LC group showed significantly lower median quantitative HBV DNA loads(log10IU/mL:6.3 vs 17.4,P<0.001),reduced HBsAg titers(log10IU/mL:3.11 vs 8.956,P<0.0001),and diminished hepatitis B e antigen-positive positive rate(81.4%vs 93.8%,P<0.05)compared with pediatric CHB.A higher proportion of pediatric patients were asymptomatic(77.4%)compared to adult patients(11.6%)as they first diagnosed as LC,pediatric LC showed milder initial symptoms compared with adult patients such as fatigue(4.8%vs 27.5%),abdominal discomfort(9.7%vs 23.2%),nausea(0%vs 10.1%),and poor appetite(6.5%vs 8.7%;all P<0.0001).Notably,pediatric LC can achieve a significant percentage of functional cure compared with adult LC as 17.4%and 0%.The incidence of progression of LC in children after antiviral therapy continues to be much lower than that in adult LC(hazard ratio=6.102,95%confidence interval:1.72-21.65,P=0.00051).While the incidence of LC remission in children after antiviral therapy continues to be much higher than that in adult LC(hazard ratio=0.055,95%confidence interval:0.07128-0.2802,P<0.0001).CONCLUSION Pediatric patients with HBV-related cirrhosis exhibit elevated virological parameters and heightened transaminase levels than adult patients.However,the frequent paucity of overt clinical symptoms contributes to diagnostic challenges.Notably,early initiation of antiviral therapy in this population substantially improved clinical outcomes.展开更多
The Leprdb/db mouse is a common and well-studied model of type II diabetes mel-litus that is often employed in biomedical research.Despite being one of the most commonly used models for the investigation of diabetic w...The Leprdb/db mouse is a common and well-studied model of type II diabetes mel-litus that is often employed in biomedical research.Despite being one of the most commonly used models for the investigation of diabetic wound healing,there are a few specific guidelines for its husbandry,and wound complications such as infection and expansion are common.This study presents a modified animal husbandry ap-proach for the Leprdb/db mouse to reduce the incidence of complications during wound healing experiments.Compared to standard rodent housing protocols,the use of this modified protocol leads to decreased rates of complications among experimental animals across several experiments.The protocol includes increased cage size,de-creased housing density,and more frequent cage replacements.The use of improved husbandry for the Leprdb/db mouse decreases the total number of animals required,minimizes harm during experimentation,and improves the consistency and reproduc-ibility of wound healing studies.展开更多
The slow phase transition from formⅡto formⅠhas always been an important factor that restricts the processing and application of polybutene-1(PB-1).After extensive efforts,a set of effective methods for promoting th...The slow phase transition from formⅡto formⅠhas always been an important factor that restricts the processing and application of polybutene-1(PB-1).After extensive efforts,a set of effective methods for promoting the phase transition rate in PB-1 was established by adjusting the crystallization,nucleation,and growth temperatures.Nevertheless,low-molecular-weight PB-1(LMWPB-1)faces challenges because this method requires a low crystallization temperature,which is difficult to achieve during extrusion processing.In this study,we attempted to increase the phase transition rate in PB-1 by changing the annealing temperature after processing rather than the crystallization temperature in the classical scheme.The results indicated that regardless of low-or high-molecular-weight PB-1,repeated annealing between 0 and 90℃could also promote formⅡto formⅠphase transition.The initial content of formⅠincreased with the heating and cooling cycles.The half-time of the phase transition(t_(1/2))was also shortened after heating/cooling.After 100 heating/cooling cycles,t_(1/2) was reduced to one-quarter of that without annealing,which had almost the same effect as the crystallization temperature at 25℃in promoting the phase transition.This study indicates that annealing after processing is also an important factor affecting the phase transition of PB-1,and should receive sufficient attention.展开更多
Al_(2)O_(3)scale-forming materials are highly desirable for high-temperature oxidation resistance,and the for-mation of α-Al_(2)O_(3)scales with low-angle grain boundaries(LAGBs)will increase their service lifetime.H...Al_(2)O_(3)scale-forming materials are highly desirable for high-temperature oxidation resistance,and the for-mation of α-Al_(2)O_(3)scales with low-angle grain boundaries(LAGBs)will increase their service lifetime.However,the synthesis of LAGBs is a considerable challenge.Herein,a novel methodology for engineering in situ α-Al_(2)O_(3)with LAGBs is designed,capitalizing on preferential nucleation.This approach employs a dual-stage preoxidation process,initiating with the selective nucleation of α-Al_(2)O_(3)under extremely low oxygen partial pressures,followed by the growth of these nuclei into a dense,protective oxide layer un-der marginally higher oxygen partial pressures.Based on this method,an α-Al_(2)O_(3)film with LAGBs is finally obtained,which significantly improves the oxidation resistance.This study not only paves the way for advanced materials to improve durability in high-temperature environments but also provides novel insight into the mechanisms of α-Al_(2)O_(3)film formation and growth under controlled oxidative conditions.展开更多
This paper focuses on the design of pocket parks against the background of urban microrenewal.Taking the“Qingshuitang”Pocket Park in Macheng Economic Development Zone as an example,it explores how to activate idle u...This paper focuses on the design of pocket parks against the background of urban microrenewal.Taking the“Qingshuitang”Pocket Park in Macheng Economic Development Zone as an example,it explores how to activate idle urban spaces through small-scale and incremental transformation.Based on the practical experience of Macheng City’s“San Chang Yi Zhuang Yi Yuan”(three plazas,one parking lot,one park)micro-renewal project,this paper analyzes the design strategies of pocket parks in terms of functional integration,cultural integration,and community participation,so as to provide references for similar projects.展开更多
基金supported by the National Natural Science Foundation of China(No.82271889,82572117,82371173,and 82172105)the National Key Research and Development Program of China(No.2021YFC2701000)Shanghai Natural Science Foundation(23ZR1409400,24ZR1409400)。
文摘Craniofacial development relies on the migration of cranial neural crest cells(CNCCs)to the first and second pharyngeal arches,followed by their differentiation into various cell types during embryogenesis.Although the CNCC migration has been well-studied,the role of the niche in relation to CNCC remains unclear.Variants in FOXI3 have been implicated in craniofacial microsomia(CFM),yet the molecular mechanisms remain unexplored.FOXI3 is expressed in the ectoderm and auricle epidermis,but not in CNCCs or cartilage.Deletion of Foxi3 in the mouse CNCCs did not disrupt mandible and auricular development,further confirming that FOXI3 does not directly regulate CNCCs.However,Foxi3 deficiency in the ectoderm reduced the production of chondrogenesis-related cytokines derived from ectodermal cells,such as TGF-β1.This impairment affected CNCC proliferation through cell communication,subsequently altering the development of the mandible and auricle.These results emphasize the critical role of FOXI3 in establishing the microenvironment supporting CNCC function.Furthermore,FOXI3 directly regulates target genes associated with translation,thereby orchestrating cytokine production in epidermal cells.The validation using auricle sample from a CFM patient carrying FOXI3 mutation further supports our findings.These insights highlight the function of FOXI3 in creating the niche necessary for CNCC development and provide a basis for understanding the molecular mechanisms driving CFM pathogenesis.
文摘1.Introduction.Pancreaticoduodenectomy is an essential surgical procedure for the treatment of malignant tumors in the pancreatic head,distal common bile duct,and duodenal papilla,and is widely used in clinical practice.One of the primary determinants of surgical success is the durability of the pancreaticojejunal anastomosis.
基金supported by National Key Research and Development Program of China(No.2023YFC2507406)National Natural Science Foundation of China(No.82300646)+6 种基金Beijing Natural Science Foundation(No.7232334)Beijing Municipal Administration of Hospitals Incubating Program(No.PX2024002,PX2020001)Capital Fund for Health Development Scientific Research(No.2024-2-2028)Beijing Municipal Science&Technology Commission AI+Health Collaborative Innovation Cultivation Project(No.Z241100007724004)Research Ward Excellence Program of Beijing Municipal Health Commission(No.BRWEP2024W162020100,BRWEP2024W162020112,BRWEP2024W162020114)Excellent Plan for Capital Medicine Scientific and Technological Innovation Achievement Transformation Promotion Plan(No.YC202401QX0824)Clinical Scientific Research Fund of Beijing Integrated Medical Association[No.ZHKY-2025-1869(B012)]。
文摘With the advancement of surgical techniques and enhanced management of early gastric cancer(EGC),minimally invasive function-preserving surgical approaches have emerged as a common goal for patients and clinicians.Laparoscopic-endoscopic cooperative surgery combined with sentinel lymph node navigation surgery(LECSSNNS)has drawn increasing interest because of its dual benefits of minimal invasiveness and organ function preservation.However,robust evidence-based support for guiding clinical implementation remains limited.To address this gap,we systematically evaluated available studies on the clinical application of LECS-SNNS in EGC and integrated expert insights to formulate 20 recommendations.These included preoperative assessment,surgical techniques,intraoperative endoscopic procedures,pathological evaluation,postoperative care,and follow-up.This consensus aimed to provide comprehensive guidance for the standardized application of LECS-SNNS,thereby advancing precise,minimally invasive,and function-preserving treatment for EGC.
基金supported by the National Natural Science Foundation of China(32270887,82272507,32200654,82430079,and 82472519)the National Key Research and Development Program of China(2022YFA1103202)+7 种基金the Chongqing High-End Medical Talents for Middle-aged and Young(YXGD202408)the Army Scientific and Technological Innovation Talents Prioritized Suppor t Program(2023-124)the Natural Science Foundation of Chongqing(CSTB2023NSCQ-ZDJO008)the Postdoctoral Innovative Talent Support Program(BX20220397)the Open Project of State Key Laboratory of TraumaBurns and Combined Injury(SFLKF202201)the Project for Enhancing Innovation of Army Medical University(2023XJS39)the Talent Innovation Training Program at the Army Medical Center(ZXZYTSYS09)。
文摘Background:Lumbar disc degeneration(LDD)displays considerable heterogeneity in terms of clinical features and pathological changes.However,researchers have not clearly determined whether the transcriptome variations in LDD could be used to identify or interpret the causes of heterogeneity in clinical features.This study aimed to identify the transcriptomic classification of degenerated discs in LDD patients and whether the molecular subtypes of LDD could be accurately predicted using clinical features.Methods:One hundred and twenty-two nucleus pulposus(NP)tissues from 108 patients were consecutively collected for bulk RNA sequencing(RNA-seq).An unsupervised clustering method was employed to analyze the bulk RNA matrix.Differential analysis was performed to characterize the transcriptional signatures and subtype-specific extracellular matrix(ECM)dysregulation.The cell subpopulation states of each subtype were inferred by integrating bulk and single-cell sequencing datasets.Transwell and dual-luciferase reporter gene assays were employed to investigate possible molecular mechanisms involved.Machine learning algorithm diagnostic prediction models were developed to correlate molecular classification with clinical features.Results:LDD was classified into 4 subtypes with distinct molecular signatures and ECM remodeling:C1 with collagenesis,C2 with ossification,C3 with low chondrogenesis,and C4 with fibrogenesis.Chond1-3 in C1 dominated disc collagenesis via the activation of the mechanosensors TRPV4 and PIEZO1;NP progenitor cells in C2 exhibited chondrogenic and osteogenic phenotypes;Chond1 in C3 was linked to a disrupted hypoxic microenvironment leading to reduced chondrogenesis;Macrophages in C4 played a crucial role in disc fibrogenesis via the secretion of tumor necrosis factor-α(TNF-α).Furthermore,the random forest diagnostic prediction model was proven to have a robust performance[area under the receiver operating characteristic(ROC)curve:0.9312;accuracy:0.84]in stratifying the molecular subtypes of LDD based on 12 clinical features.Conclusions:Our study delineates 4 distinct molecular subtypes of LDD that can be accurately stratified on the basis of clinical features.The identification of these subtypes would facilitate precise diagnostics and guide the development of personalized treatment strategies for LDD.
基金Supported by the Postgraduate Research and Practice Innovation Program of Jiangsu Province,No.SJCX24_2067Chen Xiao-Ping Foundation for the Development of Science and Technology of Hubei Province,No.CXPJJH123009-079.
文摘Portal vein thrombosis(PVT)is one of the most common serious complications in patients with liver cirrhosis.The occurrence of PVT not only aggravates the condition of liver cirrhosis but can also cause several serious complications,such as portal hypertension,esophagogastric variceal bleeding,and refractory ascites.All these factors have a serious impact on patients’quality of life and prognosis.This article evaluates the current evidence on the management of PVT in cirrhosis and explores the role of direct oral anticoagulants,but data on individualized anticoagulation strategies are limited and lacking for the treatment of PVT in cirrhosis,and it is hoped that it will inform a broad range of clinicians on the treatment of cirrhosis combined with PVT.
文摘BACKGROUND Intraoperative and postoperative biliary injuries remain significant complications of laparoscopic common bile duct exploration(LCBDE).Indocyanine green(ICG)has been shown to significantly reduce injuries caused by intraoperative operational errors.We found that the J-tube can reduce postoperative strictures and injuries to the common bile duct.At this moment,we aim to analyze and compare the complications,efficacy,short-term outcomes,and feasibility of these two adjunctive tools for LCBDE.AIM To evaluate the efficacy of ICG fluorescence imaging In LCBDE and J-tube drainage for patients with common bile duct stones.METHODS We retrospectively collected the clinical case data of patients who were treated at the Hepatobiliary Surgery Department of the Third People’s Hospital of Nantong,affiliated with Nantong University,from January 2016 to January 2021 due to gallbladder stones with choledocholithiasis and who underwent LCBDE combined with a primary suture and either J-tube or T-tube drainage.The patients were divided into groups:Traditional white-light laparoscopy+T-tube group(WL+T-tube),traditional WL+J-tube group,fluorescent laparoscopy+T-tube group(ICG+T-tube)and fluorescent laparoscopy+J-tube group(ICG+J-tube).The preoperative and postoperative clinical case data,laboratory examination data,and intraoperative and postoperative complications(including postoperative bile leakage,electrolyte disturbances,biliary peritonitis,and postoperative infections)and other relevant indicators were compared.RESULTS A total of 198 patients(112 males and 86 females)were included in the study,with 74 patients in the WL+T-tube,47 in the WL+J-tube,42 in the ICG+T-tube,and 35 in the ICG+J-tube.Compared with the other groups,the ICG+J had significantly shorter operation time(114 minutes,P=0.001),less blood loss(42 mL,P=0.02),shorter postoperative hospital stays(7 days,P=0.038),and lower surgical costs(China yuan 30178,P=0.001).Furthermore,patients were subdivided into two groups based on whether a T-tube or J-tube was placed during the surgery.By the third postoperative day,the aspartate transaminase,glutamic pyruvic transaminase,total bilirubin,and direct bilirubin levels were lower in the J-tube group than in the T-tube group(P<0.001).At last,follow-up observations showed that the incidence of biliary strictures at three months postoperatively was significantly lower in the J-tube group than in the T-tube group(P=0.002).CONCLUSION ICG fluorescence imaging in laparoscopic cholecystectomy with common bile duct exploration and J-tube drainage facilitates rapid identification of biliary anatomy and variations,reducing intraoperative bile duct injury,blood loss,surgery duration,and postoperative bile duct stenosis rates,supporting its clinical adoption.
基金Supported by National Key R&D Program of China,No.2023YFC2308104Beijing Hospitals Authority Clinical Medicine Development of Special Funding Support,No.ZLRK202301National Natural Science Foundation of China,No.92159305.
文摘BACKGROUND Chronic hepatitis B virus(HBV)infection acquired in childhood frequently presents with mild or nonspecific symptoms,yet a distinct subset of pediatric patients develops rapid progression to liver cirrhosis(LC)before adulthood.AIM To identify clinical and pathological characteristics of pediatric HBV-related LC.METHODS A total of 1332 pediatric patients with chronic HBV infection from the Fifth Medical Center of PLA General Hospital from January 2010 to January 2023 were included in this study.We identified 62 pediatric HBV-related LC by liver biopsy from the group.Subsequently,we described the clinical and pathological characteristics of pediatric LC.And 64 pediatric chronic hepatitis B(CHB;age and sex were matched with pediatric LC group)and 69 adult HBV-related LC(sex were matched with pediatric LC group)were enrolled to further demonstrate clinical and pathological differences between pediatric LC,pediatric CHB and adult LC.RESULTS We enrolled 62 pediatric LC,including 54(87.1%)males and 8(12.9%)females.The median age was 11(4-14)years old.The pediatric LC group showed significantly lower median quantitative HBV DNA loads(log10IU/mL:6.3 vs 17.4,P<0.001),reduced HBsAg titers(log10IU/mL:3.11 vs 8.956,P<0.0001),and diminished hepatitis B e antigen-positive positive rate(81.4%vs 93.8%,P<0.05)compared with pediatric CHB.A higher proportion of pediatric patients were asymptomatic(77.4%)compared to adult patients(11.6%)as they first diagnosed as LC,pediatric LC showed milder initial symptoms compared with adult patients such as fatigue(4.8%vs 27.5%),abdominal discomfort(9.7%vs 23.2%),nausea(0%vs 10.1%),and poor appetite(6.5%vs 8.7%;all P<0.0001).Notably,pediatric LC can achieve a significant percentage of functional cure compared with adult LC as 17.4%and 0%.The incidence of progression of LC in children after antiviral therapy continues to be much lower than that in adult LC(hazard ratio=6.102,95%confidence interval:1.72-21.65,P=0.00051).While the incidence of LC remission in children after antiviral therapy continues to be much higher than that in adult LC(hazard ratio=0.055,95%confidence interval:0.07128-0.2802,P<0.0001).CONCLUSION Pediatric patients with HBV-related cirrhosis exhibit elevated virological parameters and heightened transaminase levels than adult patients.However,the frequent paucity of overt clinical symptoms contributes to diagnostic challenges.Notably,early initiation of antiviral therapy in this population substantially improved clinical outcomes.
基金Funding was provided by the following National Institutes of Health grants:F30-DK123989(May Barakat)R01-GM50875(Luisa A.DiPietro)+1 种基金R35-GM139603(Luisa A.DiPietro)R01-AR065941(Terry W.Moore).Additional funding was provided by the University of Illinois Chicago Chancellor's Translational Science Initiative Award.
文摘The Leprdb/db mouse is a common and well-studied model of type II diabetes mel-litus that is often employed in biomedical research.Despite being one of the most commonly used models for the investigation of diabetic wound healing,there are a few specific guidelines for its husbandry,and wound complications such as infection and expansion are common.This study presents a modified animal husbandry ap-proach for the Leprdb/db mouse to reduce the incidence of complications during wound healing experiments.Compared to standard rodent housing protocols,the use of this modified protocol leads to decreased rates of complications among experimental animals across several experiments.The protocol includes increased cage size,de-creased housing density,and more frequent cage replacements.The use of improved husbandry for the Leprdb/db mouse decreases the total number of animals required,minimizes harm during experimentation,and improves the consistency and reproduc-ibility of wound healing studies.
基金financially supported by the National Natural Science Foundation of China(No.22175183)。
文摘The slow phase transition from formⅡto formⅠhas always been an important factor that restricts the processing and application of polybutene-1(PB-1).After extensive efforts,a set of effective methods for promoting the phase transition rate in PB-1 was established by adjusting the crystallization,nucleation,and growth temperatures.Nevertheless,low-molecular-weight PB-1(LMWPB-1)faces challenges because this method requires a low crystallization temperature,which is difficult to achieve during extrusion processing.In this study,we attempted to increase the phase transition rate in PB-1 by changing the annealing temperature after processing rather than the crystallization temperature in the classical scheme.The results indicated that regardless of low-or high-molecular-weight PB-1,repeated annealing between 0 and 90℃could also promote formⅡto formⅠphase transition.The initial content of formⅠincreased with the heating and cooling cycles.The half-time of the phase transition(t_(1/2))was also shortened after heating/cooling.After 100 heating/cooling cycles,t_(1/2) was reduced to one-quarter of that without annealing,which had almost the same effect as the crystallization temperature at 25℃in promoting the phase transition.This study indicates that annealing after processing is also an important factor affecting the phase transition of PB-1,and should receive sufficient attention.
基金financially supported by the National Program for Support of Top-notch Young Professionals,the Natural Science Foundation of Shaanxi Province(No.2023JC-XJ-04)the Postdoc-toral Innovative Talent Support Program(No.BX2021238)the National Natural Science Foundation of China(No.U22A20110).
文摘Al_(2)O_(3)scale-forming materials are highly desirable for high-temperature oxidation resistance,and the for-mation of α-Al_(2)O_(3)scales with low-angle grain boundaries(LAGBs)will increase their service lifetime.However,the synthesis of LAGBs is a considerable challenge.Herein,a novel methodology for engineering in situ α-Al_(2)O_(3)with LAGBs is designed,capitalizing on preferential nucleation.This approach employs a dual-stage preoxidation process,initiating with the selective nucleation of α-Al_(2)O_(3)under extremely low oxygen partial pressures,followed by the growth of these nuclei into a dense,protective oxide layer un-der marginally higher oxygen partial pressures.Based on this method,an α-Al_(2)O_(3)film with LAGBs is finally obtained,which significantly improves the oxidation resistance.This study not only paves the way for advanced materials to improve durability in high-temperature environments but also provides novel insight into the mechanisms of α-Al_(2)O_(3)film formation and growth under controlled oxidative conditions.
文摘This paper focuses on the design of pocket parks against the background of urban microrenewal.Taking the“Qingshuitang”Pocket Park in Macheng Economic Development Zone as an example,it explores how to activate idle urban spaces through small-scale and incremental transformation.Based on the practical experience of Macheng City’s“San Chang Yi Zhuang Yi Yuan”(three plazas,one parking lot,one park)micro-renewal project,this paper analyzes the design strategies of pocket parks in terms of functional integration,cultural integration,and community participation,so as to provide references for similar projects.
