This editorial comments on the review by Da Silva et al,published in the World Journal of Clinical Oncology which focuses on the molecular perspectives of lung cancer.With the rapid development of molecular technology...This editorial comments on the review by Da Silva et al,published in the World Journal of Clinical Oncology which focuses on the molecular perspectives of lung cancer.With the rapid development of molecular technology,new diagnostic methods are constantly emerging,including liquid biopsy,the identification of gene mutations,and the monitoring biomarkers,thus providing precise in-formation with which to identify the occurrence and development of lung cancer.Biomarkers,such as circulating tumor cells,circulating tumor DNA,and cir-culating RNA can provide helpful information for clinical application.Common types of genetic mutations and immune checkpoints include epidermal growth factor receptor,anaplastic lymphoma kinase,c-ROS proto-oncogene 1,progra-mmed death-1 and cytotoxic T-lymphocyte-associated protein.According to specific biomarkers,targeted therapy and immunotherapy can improve survival outcomes based on the types of gene mutation and immune checkpoints.The application of molecular approaches can facilitate our ability to control the progression of disease and select appropriate therapeutic strategies for patients with lung cancer.展开更多
Severe lithium dendrite growth and elevated thermal runaway risks pose significant hurdles for fast-charging lithium metal batteries(LMBs)This study reports a polydopamine-functionalized hydroxyapatite/aramid(PDA@HA)h...Severe lithium dendrite growth and elevated thermal runaway risks pose significant hurdles for fast-charging lithium metal batteries(LMBs)This study reports a polydopamine-functionalized hydroxyapatite/aramid(PDA@HA)hybrid nanofibers separator to synchronously improve th fast-charging LMB's stability and safety.(1)The separator's surface,enriched with lithiophilic carbonyl and hydroxyl groups,accelerates Li~+ion desolvation,while electrophilic imine groups impede anion movement.This dual mechanism optimizes the Li^(+)-ion flux distribution on th anode,mitigating dendrite formation.(2)The polar PDA modification layer fosters the development of a Li_(3)N/LiF-rich solid electrolyt interface,further enhancing Li anode stability.Consequently,Li//Li symmetric cells with PDA@HA separators exhibit extended cycle life in L plating/stripping tests:5000 h at 1 mA cm^(-2)and 700 h at 20 mA cm^(-2),respectively,outperforming PP separators(80 h and 8 h).In LiFePO_(4)(LFP,^(2.1)mg cm^(-2))//Li full cell evaluation,the PDA@HA separator enables stable operation for 11,000 cycles at 18.2C with 87%capacity retention,significantly outperforming existing fast-charging LMB counterparts in literature.At a high LFP loading of 15.5 mg cm^(-2),the cel maintains 137.6 mAh g^(-1)(2.13 mAh cm^(-2))over 250 cycles at 3C,achieving 98%capacity retention.Moreover,the PDA@HA separato increases threshold temperature for thermal runaway and reduces the exothermic rate,intensifying the battery's thermal safety.This research underscores the importance of functional separator design in improving Li metal anode reversibility,fast-charging performance,and therma safety of LMBs.展开更多
Poor Li plating reversibility and high thermal runaway risks are key challenges for fast charging lithiumion batteries with graphite anodes.Herein,a dielectric and fire-resistant separator based on hybrid nanofibers o...Poor Li plating reversibility and high thermal runaway risks are key challenges for fast charging lithiumion batteries with graphite anodes.Herein,a dielectric and fire-resistant separator based on hybrid nanofibers of barium sulfate(BS)and bacterial cellulose(BC)is developed to synchronously enhance the battery's fast charging and thermal-safety performances.The regulation mechanism of the dielectric BS/BC separator in enhancing the Li^(+)ion transport and Li plating reversibility is revealed.(1)The Max-Wagner polarization electric field of the dielectric BS/BC separator can accelerate the desolvation of solvated Li^(+)ions,enhancing their transport kinetics.(2)Moreover,due to the charge balancing effect,the dielectric BS/BC separator homogenizes the electric field/Li^(+)ion flux at the graphite anode-separator interface,facilitating uniform Li plating and suppressing Li dendrite growth.Consequently,the fast-charge graphite anode with the BS/BC separator shows higher Coulombic efficiency(99.0%vs.96.9%)and longer cycling lifespan(100 cycles vs.59 cycles)than that with the polypropylene(PP)separator in the constantlithiation cycling test at 2 mA cm^(-2).The high-loading LiFePO4(15.5 mg cm^(-2))//graphite(7.5 mg cm^(-2))full cell with the BS/BC separator exhibits excellent fast charging performance,retaining 70%of its capacity after 500 cycles at a high rate of 2C,which is significantly better than that of the cell with the PP separator(retaining only 27%of its capacity after 500 cycles).More importantly,the thermally stable BS/BC separator effectively elevates the critical temperature and reduces the heat release rate during thermal runaway,thereby significantly enhancing the battery's safety.展开更多
ⅢThe superior adaptability of Prussian blue analogues(PBAs)in interacting with potassium ions has shifted research focus toward their potential application as cathodes of potassium-ion batteries(PIBs).The large inter...ⅢThe superior adaptability of Prussian blue analogues(PBAs)in interacting with potassium ions has shifted research focus toward their potential application as cathodes of potassium-ion batteries(PIBs).The large interstitial space formed between metal ions and–C≡N–in PBAs can accommodate large-radius K^(+).However,the rapid nucleation in the co-precipitation synthesis process of PBAs induces many lattice defects of[M(CN)_(6)]^(4-)vacancies(V_([M–C≡N])),interstitial and coordinated H_(2)O molecules,which will directly lead to performance degradation.Moreover,originating from various transition metal elements in low/high-spin electron configuration states,PBAs exhibit diverse electrochemical behaviors,such as low reaction kinetics of low-spin iron(Ⅱ),Jahn-Teller distortion and dissolution of manganese(Ⅲ),and electrochemical inertness of nickel(Ⅱ)and copper(Ⅱ).Here,we summarize recently reported structures and properties of PBAs,classifying them based on the types of transition metals(iron,cobalt,manganese,copper,nickel)employed.Advanced synthesis strategies,including control engineering of crystallinity based on H_(2)O molecules and V_([M–C≡N]),were discussed.Also,the approaches for enhancing the electrochemical performance of PBAs were highlighted.Finally,the challenges and prospects towards the future development of PBAs are put forward.The review is expected to provide technical and theoretical support for the design of high-performance PBAs.展开更多
The technology of carbon dioxide(CO_(2))enhanced hydrocarbon recovery is favored over other Carbon Capture,Utilization,and Sequestration(CCUS)methods for achieving the"double carbon"goal in China due to its ...The technology of carbon dioxide(CO_(2))enhanced hydrocarbon recovery is favored over other Carbon Capture,Utilization,and Sequestration(CCUS)methods for achieving the"double carbon"goal in China due to its ability to sequester CO_(2) geologically while enhancing the recovery rates of oil and gas resources.However,current technologies face significant challenges,such as limited recovery enhancement capacity,as well as high costs and low efficiency in carbon utilization and sequestration.To address these issues,an innovative carbon-negative technology termed Carbon Capture,Circular Utilization,and Sequestration(CCCUS)is proposed.This technology integrates CO_(2)-microbial enhanced hydrocarbon recovery,CO_(2) underground bio-methanation,and CO_(2) sequestration in depleted hydrocarbon reservoirs.Compared to conventional CCUS technologies,CCCUS stands out through both its modes of carbon utilization and the forms in which carbon exists,by cyclically biochemically converting endogenous and exogenous CO_(2) into renewable natural gas(RNG).A preliminary assessment indicates that CCCUS holds significant developmental potential in China,with 661 million tonnes of CO_(2) utilized per cycle and 3.47 billion tonnes ultimately sequestered.However,there is a significant lack of research on the core technology of CCCUS,specifically CO_(2) underground bio-methanation,in China.To bridge this gap and mitigate potential challenges during the development of CCCUS,targeted proposals have been formulated.This paper provides new insights into advancing the development of a circular carbon economy and accelerating the achievement of carbon neutrality in China.展开更多
Solid-state polymer electrolytes are crucial for advancing solid-state lithium-metal batteries owing to their flexibility,excellent manufacturability,and strong interfacial compatibility.However,their widespread appli...Solid-state polymer electrolytes are crucial for advancing solid-state lithium-metal batteries owing to their flexibility,excellent manufacturability,and strong interfacial compatibility.However,their widespread applications are hindered by low ionic conductivity at room temperature and lithium dendrite growth.Herein,we report a novel solid-state composite membrane electrolyte design that combines the vertically aligned channel structure and copolymer with a radial gradient composition.Within the vertically aligned channels,the composition of poly(vinyl ethylene carbonate-co-poly(ethylene glycol)diacrylate)(P(VEC-PEGDA)varies in a gradient along the radial direction:from the center to the wall of vertically aligned channels,the proportion of vinyl ethylene carbonate(VEC)in the copolymer decreases,while the proportion of poly(ethylene glycol)diacrylate(PEGDA)increases accordingly.It can be functionally divided into a mechanical-reinforcement layer and a fast-ion-conducting layer.The resulting solid-state composite membrane electrolyte achieves a high critical current density of 1.2 mA cm^(-2)and high ionic conductivity of 2.03 mS cm^(-1)at room temperature.Employing this composite membrane electrolyte,a Li//Li symmetric cell exhibits stable cycling for over 1850 h at 0.2 m A cm^(-2)/0.2 m A h cm^(-2),and a Li//LiFePO4(LFP)battery maintains 77.3% capacity retention at 2 C after 300 cycles.Our work provides insight into the rational design of safer and more efficient solidstate batteries through electrolyte structural engineering.展开更多
Despite the promising outcomes observed in individual applications of biochar and polyvinyl alcohol(PVA)in soil,the impact of their combined usage remains inadequately understood.This study systematically explores the...Despite the promising outcomes observed in individual applications of biochar and polyvinyl alcohol(PVA)in soil,the impact of their combined usage remains inadequately understood.This study systematically explores the effects of concurrent biochar and PVA application on key soil parameters,including pH,water-holding capacity(WHC),and dynamic moisture content(MC),and the photosynthetic resilience and growth of the cyanobacterium Microcoleus vaginatus in a desert soil.Biochars,generated at different pyrolysis temperatures(300-600℃),were applied to the soil at varying rates(1%-6%),while PVA was introduced at a mass percentage of 0.05%.The photosynthetic resilience and biomass accumulation of M.vaginatus in different treatments were examined every 7 d during the 28-d exposure to dry conditions after 60-d water supply.The combined application of biochar and PVA resulted in a reduction of soil pH,coupled with significant improvements in WHC and dynamic MC.Moreover,this combined approach exhibited superior effects on the photosynthetic resilience and crust thickness(0.9-3.5 mm)of M.vaginatus compared to the application of biochar and PVA in isolation.Incremental increase in biochar application rate from 0% to 6% demonstrated a notable enhancement in the chlorophyll a content of M.vaginatus.Cyanobacterial crust thickness and exopolysaccharide content exhibited positive correlations with biochar application rate.Thus,combined application of biochar and PVA is cost-effective for enhancing soil properties and cyanobacterial biomass,which is of significance for combating desertification.展开更多
Background:Hemorrhage remains a formidable complication of severe acute pancreatitis(SAP),with a high mortality rate.However,there is currently no effective method for identifying SAP patients who are at high risk for...Background:Hemorrhage remains a formidable complication of severe acute pancreatitis(SAP),with a high mortality rate.However,there is currently no effective method for identifying SAP patients who are at high risk for massive bleeding.The present study aimed to explore risk factors for predicting massive bleeding in SAP patients and to develop a predictive nomogram,which could facilitate early prediction,and timely appropriate interventions.Methods:We conducted a multivariate logistic regression analysis to examine the relationship between massive bleeding and variables including patient demographics,disease severity,laboratory indexes and local pancreatic complications.A novel nomogram was constructed based on these factors,and was vali-dated both internally and externally assessing its discrimination,calibration,and clinical applicability.Results:The study involved 351 patients in the training cohort,104 patients in the internal validation cohort,and 123 patients in the external validation cohort.Logistic regression analysis identified several independent risk factors for massive bleeding,including computed tomography severity index score above 8 points,Acute Physiology and Chronic Health Evaluation II score greater than 16 points,abdominal com-partment syndrome,pancreatic fistula,and sepsis.The nomogram constructed from these factors yielded an area under the receiver operating characteristic curve(AUC)of 0.896 and a coefficient of determination(R²)of 0.093.The Hosmer-Lemeshow test indicated good model fitness(P=0.654).Furthermore,the nomogram demonstrated reliable performance in both validation cohorts.Conclusions:The nomogram showed strong predictive capability for massive bleeding and could be a valuable tool for clinicians in identifying SAP patients at high risk for this complication at an early stage.展开更多
文摘This editorial comments on the review by Da Silva et al,published in the World Journal of Clinical Oncology which focuses on the molecular perspectives of lung cancer.With the rapid development of molecular technology,new diagnostic methods are constantly emerging,including liquid biopsy,the identification of gene mutations,and the monitoring biomarkers,thus providing precise in-formation with which to identify the occurrence and development of lung cancer.Biomarkers,such as circulating tumor cells,circulating tumor DNA,and cir-culating RNA can provide helpful information for clinical application.Common types of genetic mutations and immune checkpoints include epidermal growth factor receptor,anaplastic lymphoma kinase,c-ROS proto-oncogene 1,progra-mmed death-1 and cytotoxic T-lymphocyte-associated protein.According to specific biomarkers,targeted therapy and immunotherapy can improve survival outcomes based on the types of gene mutation and immune checkpoints.The application of molecular approaches can facilitate our ability to control the progression of disease and select appropriate therapeutic strategies for patients with lung cancer.
基金supported by the National Natural Science Foundation of China(Grant No.52202328,52372099,52271222)the Shanghai Sailing Program(22YF1455500)。
文摘Severe lithium dendrite growth and elevated thermal runaway risks pose significant hurdles for fast-charging lithium metal batteries(LMBs)This study reports a polydopamine-functionalized hydroxyapatite/aramid(PDA@HA)hybrid nanofibers separator to synchronously improve th fast-charging LMB's stability and safety.(1)The separator's surface,enriched with lithiophilic carbonyl and hydroxyl groups,accelerates Li~+ion desolvation,while electrophilic imine groups impede anion movement.This dual mechanism optimizes the Li^(+)-ion flux distribution on th anode,mitigating dendrite formation.(2)The polar PDA modification layer fosters the development of a Li_(3)N/LiF-rich solid electrolyt interface,further enhancing Li anode stability.Consequently,Li//Li symmetric cells with PDA@HA separators exhibit extended cycle life in L plating/stripping tests:5000 h at 1 mA cm^(-2)and 700 h at 20 mA cm^(-2),respectively,outperforming PP separators(80 h and 8 h).In LiFePO_(4)(LFP,^(2.1)mg cm^(-2))//Li full cell evaluation,the PDA@HA separator enables stable operation for 11,000 cycles at 18.2C with 87%capacity retention,significantly outperforming existing fast-charging LMB counterparts in literature.At a high LFP loading of 15.5 mg cm^(-2),the cel maintains 137.6 mAh g^(-1)(2.13 mAh cm^(-2))over 250 cycles at 3C,achieving 98%capacity retention.Moreover,the PDA@HA separato increases threshold temperature for thermal runaway and reduces the exothermic rate,intensifying the battery's thermal safety.This research underscores the importance of functional separator design in improving Li metal anode reversibility,fast-charging performance,and therma safety of LMBs.
基金financially supported by the National Natural Science Foundation of China(Grant No.52202328,52372099)the Shanghai Sailing Program(22YF1455500).
文摘Poor Li plating reversibility and high thermal runaway risks are key challenges for fast charging lithiumion batteries with graphite anodes.Herein,a dielectric and fire-resistant separator based on hybrid nanofibers of barium sulfate(BS)and bacterial cellulose(BC)is developed to synchronously enhance the battery's fast charging and thermal-safety performances.The regulation mechanism of the dielectric BS/BC separator in enhancing the Li^(+)ion transport and Li plating reversibility is revealed.(1)The Max-Wagner polarization electric field of the dielectric BS/BC separator can accelerate the desolvation of solvated Li^(+)ions,enhancing their transport kinetics.(2)Moreover,due to the charge balancing effect,the dielectric BS/BC separator homogenizes the electric field/Li^(+)ion flux at the graphite anode-separator interface,facilitating uniform Li plating and suppressing Li dendrite growth.Consequently,the fast-charge graphite anode with the BS/BC separator shows higher Coulombic efficiency(99.0%vs.96.9%)and longer cycling lifespan(100 cycles vs.59 cycles)than that with the polypropylene(PP)separator in the constantlithiation cycling test at 2 mA cm^(-2).The high-loading LiFePO4(15.5 mg cm^(-2))//graphite(7.5 mg cm^(-2))full cell with the BS/BC separator exhibits excellent fast charging performance,retaining 70%of its capacity after 500 cycles at a high rate of 2C,which is significantly better than that of the cell with the PP separator(retaining only 27%of its capacity after 500 cycles).More importantly,the thermally stable BS/BC separator effectively elevates the critical temperature and reduces the heat release rate during thermal runaway,thereby significantly enhancing the battery's safety.
基金financially supported by research grants from Innovative Research Group Project of National Natural Science Foundation of China(No.52021004)National Key Research and Development Program of China(2022YFB3803300)+2 种基金National Natural Science Foundation of China(62474026 and 62074022)Natural Science Foundation of Chongqing(CSTB2024NSCQ-MSX1215,cstc2021jcyj-jqX0015 and CSTB2022NSCQ-MSX1183)the Youth Talent Support Program of Chongqing(CQYC2021059206).
文摘ⅢThe superior adaptability of Prussian blue analogues(PBAs)in interacting with potassium ions has shifted research focus toward their potential application as cathodes of potassium-ion batteries(PIBs).The large interstitial space formed between metal ions and–C≡N–in PBAs can accommodate large-radius K^(+).However,the rapid nucleation in the co-precipitation synthesis process of PBAs induces many lattice defects of[M(CN)_(6)]^(4-)vacancies(V_([M–C≡N])),interstitial and coordinated H_(2)O molecules,which will directly lead to performance degradation.Moreover,originating from various transition metal elements in low/high-spin electron configuration states,PBAs exhibit diverse electrochemical behaviors,such as low reaction kinetics of low-spin iron(Ⅱ),Jahn-Teller distortion and dissolution of manganese(Ⅲ),and electrochemical inertness of nickel(Ⅱ)and copper(Ⅱ).Here,we summarize recently reported structures and properties of PBAs,classifying them based on the types of transition metals(iron,cobalt,manganese,copper,nickel)employed.Advanced synthesis strategies,including control engineering of crystallinity based on H_(2)O molecules and V_([M–C≡N]),were discussed.Also,the approaches for enhancing the electrochemical performance of PBAs were highlighted.Finally,the challenges and prospects towards the future development of PBAs are put forward.The review is expected to provide technical and theoretical support for the design of high-performance PBAs.
基金funded by the European Union's“Horizon Europe programme”-LOC3G(Grant No.101129729)the Henan Center for Outstanding Overseas Scientists(Grant No.GZS2024001).
文摘The technology of carbon dioxide(CO_(2))enhanced hydrocarbon recovery is favored over other Carbon Capture,Utilization,and Sequestration(CCUS)methods for achieving the"double carbon"goal in China due to its ability to sequester CO_(2) geologically while enhancing the recovery rates of oil and gas resources.However,current technologies face significant challenges,such as limited recovery enhancement capacity,as well as high costs and low efficiency in carbon utilization and sequestration.To address these issues,an innovative carbon-negative technology termed Carbon Capture,Circular Utilization,and Sequestration(CCCUS)is proposed.This technology integrates CO_(2)-microbial enhanced hydrocarbon recovery,CO_(2) underground bio-methanation,and CO_(2) sequestration in depleted hydrocarbon reservoirs.Compared to conventional CCUS technologies,CCCUS stands out through both its modes of carbon utilization and the forms in which carbon exists,by cyclically biochemically converting endogenous and exogenous CO_(2) into renewable natural gas(RNG).A preliminary assessment indicates that CCCUS holds significant developmental potential in China,with 661 million tonnes of CO_(2) utilized per cycle and 3.47 billion tonnes ultimately sequestered.However,there is a significant lack of research on the core technology of CCCUS,specifically CO_(2) underground bio-methanation,in China.To bridge this gap and mitigate potential challenges during the development of CCCUS,targeted proposals have been formulated.This paper provides new insights into advancing the development of a circular carbon economy and accelerating the achievement of carbon neutrality in China.
基金supported by the National Natural Science Foundation of China(52372099,52202328,22461142135,22479046)the Shanghai Sailing Program(22YF1455500)the Shanghai Magnolia Talent Plan Pujiang Project(24PJD128)。
文摘Solid-state polymer electrolytes are crucial for advancing solid-state lithium-metal batteries owing to their flexibility,excellent manufacturability,and strong interfacial compatibility.However,their widespread applications are hindered by low ionic conductivity at room temperature and lithium dendrite growth.Herein,we report a novel solid-state composite membrane electrolyte design that combines the vertically aligned channel structure and copolymer with a radial gradient composition.Within the vertically aligned channels,the composition of poly(vinyl ethylene carbonate-co-poly(ethylene glycol)diacrylate)(P(VEC-PEGDA)varies in a gradient along the radial direction:from the center to the wall of vertically aligned channels,the proportion of vinyl ethylene carbonate(VEC)in the copolymer decreases,while the proportion of poly(ethylene glycol)diacrylate(PEGDA)increases accordingly.It can be functionally divided into a mechanical-reinforcement layer and a fast-ion-conducting layer.The resulting solid-state composite membrane electrolyte achieves a high critical current density of 1.2 mA cm^(-2)and high ionic conductivity of 2.03 mS cm^(-1)at room temperature.Employing this composite membrane electrolyte,a Li//Li symmetric cell exhibits stable cycling for over 1850 h at 0.2 m A cm^(-2)/0.2 m A h cm^(-2),and a Li//LiFePO4(LFP)battery maintains 77.3% capacity retention at 2 C after 300 cycles.Our work provides insight into the rational design of safer and more efficient solidstate batteries through electrolyte structural engineering.
基金the financial support from the National Natural Science Foundation of China(Nos.22378154 and 21975089)the Fundamental Research Funds for the Central Universities of China(No.2017KFKJFP002)。
文摘Despite the promising outcomes observed in individual applications of biochar and polyvinyl alcohol(PVA)in soil,the impact of their combined usage remains inadequately understood.This study systematically explores the effects of concurrent biochar and PVA application on key soil parameters,including pH,water-holding capacity(WHC),and dynamic moisture content(MC),and the photosynthetic resilience and growth of the cyanobacterium Microcoleus vaginatus in a desert soil.Biochars,generated at different pyrolysis temperatures(300-600℃),were applied to the soil at varying rates(1%-6%),while PVA was introduced at a mass percentage of 0.05%.The photosynthetic resilience and biomass accumulation of M.vaginatus in different treatments were examined every 7 d during the 28-d exposure to dry conditions after 60-d water supply.The combined application of biochar and PVA resulted in a reduction of soil pH,coupled with significant improvements in WHC and dynamic MC.Moreover,this combined approach exhibited superior effects on the photosynthetic resilience and crust thickness(0.9-3.5 mm)of M.vaginatus compared to the application of biochar and PVA in isolation.Incremental increase in biochar application rate from 0% to 6% demonstrated a notable enhancement in the chlorophyll a content of M.vaginatus.Cyanobacterial crust thickness and exopolysaccharide content exhibited positive correlations with biochar application rate.Thus,combined application of biochar and PVA is cost-effective for enhancing soil properties and cyanobacterial biomass,which is of significance for combating desertification.
基金supported by grants from the National Nature Science Foundation of China(82370651 and 82070657).
文摘Background:Hemorrhage remains a formidable complication of severe acute pancreatitis(SAP),with a high mortality rate.However,there is currently no effective method for identifying SAP patients who are at high risk for massive bleeding.The present study aimed to explore risk factors for predicting massive bleeding in SAP patients and to develop a predictive nomogram,which could facilitate early prediction,and timely appropriate interventions.Methods:We conducted a multivariate logistic regression analysis to examine the relationship between massive bleeding and variables including patient demographics,disease severity,laboratory indexes and local pancreatic complications.A novel nomogram was constructed based on these factors,and was vali-dated both internally and externally assessing its discrimination,calibration,and clinical applicability.Results:The study involved 351 patients in the training cohort,104 patients in the internal validation cohort,and 123 patients in the external validation cohort.Logistic regression analysis identified several independent risk factors for massive bleeding,including computed tomography severity index score above 8 points,Acute Physiology and Chronic Health Evaluation II score greater than 16 points,abdominal com-partment syndrome,pancreatic fistula,and sepsis.The nomogram constructed from these factors yielded an area under the receiver operating characteristic curve(AUC)of 0.896 and a coefficient of determination(R²)of 0.093.The Hosmer-Lemeshow test indicated good model fitness(P=0.654).Furthermore,the nomogram demonstrated reliable performance in both validation cohorts.Conclusions:The nomogram showed strong predictive capability for massive bleeding and could be a valuable tool for clinicians in identifying SAP patients at high risk for this complication at an early stage.
