目的:评估超声内镜引导下细针穿刺(endoscopic ultrasound-guided fine needle aspiration,EUS-FNA)在胆管病变中的诊断效能和安全性,并探讨影响其准确性的因素。方法:回顾性分析2021年1月到2023年12月成都市第三人民医院因疑似胆管恶...目的:评估超声内镜引导下细针穿刺(endoscopic ultrasound-guided fine needle aspiration,EUS-FNA)在胆管病变中的诊断效能和安全性,并探讨影响其准确性的因素。方法:回顾性分析2021年1月到2023年12月成都市第三人民医院因疑似胆管恶性狭窄/占位而接受EUS-FNA的41例患者临床资料,其中男性22例,女性19例,平均年龄为65.9(35.0~89.0)岁。评估其诊断效能(敏感性、特异性、阳性预测值、阴性预测值和准确性)及影响因素。结果:EUS-FNA对于胆管病变的总体灵敏性为85%,特异性为100%,阳性预测值为100%,阴性预测值为33%,准确性为86%;25G穿刺针和是否存在实性占位是影响EUS-FNA诊断胆管病变准确性的重要因素,而穿刺部位并未对诊断效能产生影响,参与分析的41例患者在随访期间未发现与EUS-FNA相关不良事件。结论:EUS-FNA在诊断胆管病变时具有较高的准确性和安全性,特别是使用25G穿刺针及存在胆管实性占位时,EUSFNA的诊断准确性更高。展开更多
Hemoptysis is a severe complication of pulmonary hypertension (PH) with a low in- cidence of 6%-11%.^([1-4])Although occurring in all forms of PH,it is more commonly seen in pulmonary arterial hypertension (PAH),assoc...Hemoptysis is a severe complication of pulmonary hypertension (PH) with a low in- cidence of 6%-11%.^([1-4])Although occurring in all forms of PH,it is more commonly seen in pulmonary arterial hypertension (PAH),associated with congenital heart disease (PAH-CHD).^([5,6])Since enlarged bronchial arteries are a frequent source of pulmonary bleeding,the primary treatment focuses on bronchial artery embolization (BAE),especially for chronic thromboembolic pulmonary hypertension (CTEPH) patients^([7,8]).However,there is disagreement regarding medical therapy,which has received little attention in the recently published PH guidelines.^([5,6])展开更多
BACKGROUND The clinical application of doxorubicin(DOX)is limited by its potential to cause cardiac cardiotoxicity.AIM To investigate the correlation between calumenin(CALU)and mitochondrial kinetic-related proteins i...BACKGROUND The clinical application of doxorubicin(DOX)is limited by its potential to cause cardiac cardiotoxicity.AIM To investigate the correlation between calumenin(CALU)and mitochondrial kinetic-related proteins in rats with DOX cardiomyopathy.METHODS A rat model of DOX-induced cardiomyopathy was used to evaluate the effects of DOX.We observed the effect of DOX on electrical conduction in cardiomyocytes using the electromapping technique.Masson staining was performed to evaluate myocardium fibrosis.Electron microscopy was used to observe the changes in pathological ultrastructure of the myocardium.Western blotting and ELISAs were performed to detect protein levels and intracellular free Ca^(2+)concentration.RESULTS DOX slowed conduction and increased conduction dispersion in cardiomyocytes.The myocardial pathology in rats treated with DOX exhibited a significant deterioration,as demonstrated by an increase in mitochondrial Ca^(2+)concentration and a decrease in the expression of CALU,optic atrophy-1,and Bcl-2.Additionally,there was an increase in the expression of connexin 43(Cx43)and the mitochondrial mitotic proteins dynamin-related protein 1,CHOP,Cytochrome C,and Bax in DOX rats.Decreased expression of CALU in cardiomyocytes triggered an increase in cytoplasmic free calcium concentration,which would normally be taken up by mitochondria,but decreased expression of mitochondrial outer membrane fusion proteins triggered a decrease in mitochondrial Ca^(2+)uptake,and the increase in cytoplasmic free calcium concentration triggered cell apoptosis.CONCLUSION Increased cytoplasmic free calcium ion concentration induces calcium overload in ventricular myocytes,leading to decreased Cx43 protein,slowed conduction in myocytes,and increased conduction dispersion,resulting in arrhythmias.展开更多
Detecting Alzheimer’s disease is essential for patient care,as an accurate diagnosis influences treatment options.Classifying dementia from non-dementia in brain MRIs is challenging due to features such as hippocampa...Detecting Alzheimer’s disease is essential for patient care,as an accurate diagnosis influences treatment options.Classifying dementia from non-dementia in brain MRIs is challenging due to features such as hippocampal atrophy,while manual diagnosis is susceptible to error.Optimal computer-aided diagnosis(CAD)systems are essential for improving accuracy and reducing misclassification risks.This study proposes an optimized ensemble method(CEOE-Net)that initiates with the selection of pre-trained models,including DenseNet121,ResNet50V2,and ResNet152V2 for unique feature extraction.Each selected model is enhanced with the inclusion of a channel attention(CA)block to improve the feature extraction process.In addition,this study employs the Short Time Fourier transform(STFT)technique with each individual model for hierarchical feature extraction before making final predictions in classifying MRI images of dementia and non-demented individuals,considering them as backbone models for building the ensemble method.STFT highlights subtle differences in brain structure and activity,particularly when combined with CA mechanisms that emphasize relevant features by converting spatial data into the frequency domain.The predictions generated from these models are then processed by the Chaotic Evolution Optimization(CEO)algorithm,which determines the optimal weightage set for each backbone model to maximize their contribution.The CEO optimizer explores weight distribution to ensure the most effective combination of model predictions for enhancing classification accuracy,thus significantly improving overall ensemble performance.This study utilized three datasets for validation:two private clinical brain MRI datasets(OSASIS and ADNI)to test the proposed model’s effectiveness.Image augmentation techniques were also employed to enhance dataset diversity and improve classification performance.The proposed CEOE-Net outperforms conventional baseline models and existing methods by showing its effectiveness as a clinical tool for the accurate classification of dementia and non-dementia MRI brain images,as well as autistic and non-autistic facial features.It achieved consistent accuracies of 93.44%on OSASIS and 81.94%on ADNI.展开更多
Achieving high-efficiency photoluminescence in trivalent lanthanides(Ln^(3+))requires precise crystalfield perturbation to overcome parity-forbidden 4f-transitions and suppress nonradiative decay.However,realizing suc...Achieving high-efficiency photoluminescence in trivalent lanthanides(Ln^(3+))requires precise crystalfield perturbation to overcome parity-forbidden 4f-transitions and suppress nonradiative decay.However,realizing such control remains challenging,even in well-optimized Ln^(3+) -doped nanocrystals.Here,by exploiting the atomically precise structure of metal nanoclusters,we demonstrate symmetry engineering in the Eu_(2)Ti_(4) nanoclusters through stepwise ligand substitution(BA/Phen→FBA/Phen→FBA/Bpy.BA:benzoicacid;Phen:1,10-phenanthroline;FBA:p-fluorobenzoicacid;Bpy:2,2'-bipyridine).The incorporation of FBA effectively suppresses nonradiative relaxation,while the flexible Bpy ligand induces symmetry reduction from D_(2d) to C_(2v) through coordination modulation,yielding a high photoluminescence quantum yield(PLQY)of 91.2%in the Ln^(3+) cluster systems.The transient-absorption,Judd-Ofelt theory,crystal-field analysis,and temperature-dependent photophysical studies elucidated the underlying modulation mechanisms.Furthermore,these clusters exhibit promising potential for optoelectronic applications,offering a new design strategy for high-performance luminescent materials.展开更多
At low-Reynolds-number,the performance of airfoil is known to be greatly affected by the formation and burst of a laminar separation bubble(LSB),which requires a more precise simulation of the delicate flow structures...At low-Reynolds-number,the performance of airfoil is known to be greatly affected by the formation and burst of a laminar separation bubble(LSB),which requires a more precise simulation of the delicate flow structures.A framework based on the interior penalty discontinuous Galerkin method and large eddy simulation approach was adopted in the present study.The performances of various subgrid models,including the Smagorinsky(SM)model,the dynamic Smagorinsky(DSM)model,the wall-adapting local-eddy-viscosity(WALE)model,and the VREMAN model,have been analyzed through flow simulations of the SD7003 airfoil at a Reynolds number of 60000.It turns out that the SM model fails to predict the emergence of LSB,even modified by the Van-Driest damping function.On the contrary,the best agreement is generally achieved by the WALE model in terms of flow separation,reattachment,and transition locations,together with the aerodynamic loads.Furthermore,the influence of numerical dissipation has also been discussed through the comparison of skin friction and resolved Reynolds stresses.As numerical dissipation decreases,the prediction accuracy of the WALE model degrades.Meanwhile,nonlinear variation could be observed from the performances of the DSM model,which could be attributed to the interaction between the numerical dissipation and the subgrid model.展开更多
Harnessing solar energy to enhance the rechargeable zinc-air batteries(RZABs)performance is a promising avenue toward sustainable energy storage and conversion.Simultaneously enhancing light-absorption capacity and ca...Harnessing solar energy to enhance the rechargeable zinc-air batteries(RZABs)performance is a promising avenue toward sustainable energy storage and conversion.Simultaneously enhancing light-absorption capacity and carrier separation efficiency in nanomaterials,as well as improving electrical conductivity and configuration for electrocatalysis,presents a formidable challenge due to inherent trade-offs and interdependencies.Here,we have developed a Janus dual-atom catalyst(JDAC)with bifunctional centers for efficient charge separation and electrocatalytic performance through a bipolar doping strategy.The in situ X-ray absorption near-edge structure and Raman spectroscopy analyses demonstrated that the Ni and Fe centers in JDAC not only function as effective sites for oxygen evolution reaction and oxygen reduction reaction,respectively,but also serve as efficient hole and electron enrichment sites,effectively suppressing photoelectron recombination while enhancing photocurrent generation.As a result,the assembled JDAC-based lightassisted RZABs exhibited extraordinary stability at large current densities.This work delivers pivotal insight to design Janus dual-atom catalysts that efficiently convert solar energy into electric and chemical energy.展开更多
Algal copper uptake(i.e.,Cu bioavailability)in the euphotic zone plays a vital role in algal photosynthesis and respiration,affecting the primary productivity and the source and sink of atmospheric carbon.Algal Cu upt...Algal copper uptake(i.e.,Cu bioavailability)in the euphotic zone plays a vital role in algal photosynthesis and respiration,affecting the primary productivity and the source and sink of atmospheric carbon.Algal Cu uptake is controlled by natural dissolved organic Cu(DOCu)speciation(i.e.,complexed with the dissolved organic matter)that conventionally could be tested by model prediction or molecular-level characterizations in the lab,while DOCu uptake are hardly directly assessed.Thus,the new chemistrybiology insight into the mechanisms of the Cu uptake process in algae is urgent.The DOCu speciation transformation(organic DOCu to free Cu(II)ions),enzymatic reduction-induced valence change(reduction of free Cu(II)to Cu(I)ions),and algal Cu uptake at the algae-water interface are imitated.Herein,an intelligent system with DOCu colorimetric sensor is developed for real-time monitoring of newly generated Cu(I)ions.Deep learning with whole sample image-based characterization and powerful feature extraction capabilities facilitates colorimetric measurement.In this context,the Cu bioavailability with 7 kinds of organic ligands(e.g.,amino acids,organic acids,carbohydrates)can be predicted by the mimetic intelligent biosensor within 15.0min,i.e.,the DOCu uptake and speciation is successfully predicted and streamlined by the biomimetic approach.展开更多
Manganese dioxide(MnO_(2))electrode material possesses the advantages of high energy density,structural diversity and high modification potential.This allows it become one of the important cathodes for aqueous zinc io...Manganese dioxide(MnO_(2))electrode material possesses the advantages of high energy density,structural diversity and high modification potential.This allows it become one of the important cathodes for aqueous zinc ion battery.However,the applications are limited by the poor electrical conductivity,narrow layer spacing and the ease of dissolution.Herein,we prepare MnO_(2)-PVP@0.03GO composites by the co-modification of polyvinylpyrrolidone(PVP)pre-insertion layer and graphene oxide(GO)self-assembly layer.The Zn//MnO_(2)-PVP@0.03GO cells deliver a discharge specific capacity of 442 mAh/g at a current density of 0.2 A/g.It also maintains 100%capacity for 1000 times cycling at 1 A/g.The assembled soft package batteries demonstrate superior flexibility and adaptability under different bending conditions.展开更多
Long-term excessive nitrogen(N)application neither increases nor enhances grain yield and N use efficiency(NUE)of maize,yet the mechanisms involving root morphological and physiological characteristics remain unclear....Long-term excessive nitrogen(N)application neither increases nor enhances grain yield and N use efficiency(NUE)of maize,yet the mechanisms involving root morphological and physiological characteristics remain unclear.This study aimed to elucidate the mechanisms underlying stagnant grain yield under excessive N application by examining root morphological and physiological characteristics.A 10-year N fertilizer trial was conducted in Jilin Province,Northeast China,cultivating maize at three N fertilizer levels(zero N,N0;recommended N,N2;and high N level,N4)from 2019 to 2021.Two widely cultivated maize genotypes,‘Xianyu 335’(XY335)and‘Zhengdan 958’(ZD958),were evaluated.Grain yield,N content,root morphology,and physiological characteristics were analyzed to assess the relationships between N uptake,N utilization,plant growth,and root systems under different N treatments.Compared to N0,root biomass,post-silking N uptake,and grain yield improved significantly with increased N input,while no significant differences emerged between recommended N and high N.High N application enhanced root length and root surface area but decreased root activity(measured by TTC(2,3,5-triphenyltetrazolium chloride)method),nitrate reductase activity,and root activity absorbing area across genotypes.Root length and root to shoot ratio negatively affected N uptake(by-1.2 and-24.6%),while root surface area,root activity,nitrate reductase activity,and root activity absorbing area contributed positively.The interaction between cultivar and N application significantly influenced NUE.XY335 achieved the highest NUE(11.6%)and N recovery efficiency(18.4%)through superior root surface area(23.6%),root activity(12.5%),nitrate reductase activity(8.3%),and root activity absorbing area(6.9%)compared to other treatments.Recommended N application enhanced Post N uptake,NUE,and grain yield through improved root characteristics,while high N application failed to increase or decreased NUE by reducing these parameters.This study demonstrates that root surface area,root activity,nitrate reductase activity,and root activity absorbing area limit NUE increase under high N application.展开更多
With the advantage of fast charge transfer,heterojunction engineering is identified as a viable method to reinforce the anodes'sodium storage performance.Also,vacancies can effectively strengthen the Na+adsorption...With the advantage of fast charge transfer,heterojunction engineering is identified as a viable method to reinforce the anodes'sodium storage performance.Also,vacancies can effectively strengthen the Na+adsorption ability and provide extra active sites for Na+adsorption.However,their synchronous engineering is rarely reported.Herein,a hybrid of Co_(0.85)Se/WSe_(2) heterostructure with Se vacancies and N-doped carbon polyhedron(CoWSe/NCP)has been fabricated for the first time via a hydrothermal and subsequent selenization strategy.Spherical aberration-corrected transmission electron microscopy confirms the phase interface of the Co_(0.85)Se/WSe_(2) heterostructure and the existence of Se vacancies.Density functional theory simulations reveal the accelerated charge transfer and enhanced Na+adsorption ability,which are contributed by the Co_(0.85)Se/WSe_(2) heterostructure and Se vacancies,respectively.As expected,the CoWSe/NCP anode in sodium-ion battery achieves outstanding rate capability(339.6 mAh g^(−1) at 20 A g^(−1)),outperforming almost all Co/W-based selenides.展开更多
Objective Brain microvascular endothelial cells (BMECs) were found to shift from their usually inactive state to an active state in ischemic stroke (IS) and cause neuronal damage. Ginsenoside Rb1 (GRb1),a component de...Objective Brain microvascular endothelial cells (BMECs) were found to shift from their usually inactive state to an active state in ischemic stroke (IS) and cause neuronal damage. Ginsenoside Rb1 (GRb1),a component derived from medicinal plants,is known for its pharmacological benefits in IS,but its protective effects on BMECs have yet to be explored. This study aimed to investigate the potential protective effects of GRb1 on BMECs. Methods An in vitro oxygen-glucose deprivation/reperfusion (OGD/R) model was established to mimic ischemia-reperfusion (I/R) injury. Bulk RNA-sequencing data were analyzed by using the Human Autophagy Database and various bioinformatic tools,including gene set enrichment analysis (GSEA),Gene Ontology (GO) classification and enrichment analysis,Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis,protein-protein interaction network analysis,and molecular docking. Experimental validation was also performed to ensure the reliability of our findings. Results Rb1 had a protective effect on BMECs subjected to OGD/R injury. Specifically,GRb1 was found to modulate the interplay between oxidative stress,apoptosis,and autophagy in BMECs. Key targets such as sequestosome 1 (SQSTM1/p62),autophagy related 5 (ATG5),and hypoxia-inducible factor 1-alpha (HIF-1α) were identified,highlighting their potential roles in mediating the protective effects of GRb1 against IS-induced damage. Conclusion GRbl protects BMECs against OGD/R injury by influencing oxidative stress,apoptosis,and autophagy. The identification of SQSTM1/p62,ATG5,and HIF-1α as promising targets further supports the potential of GRb1 as a therapeutic agent for IS,providing a foundation for future research into its mechanisms and applications in IS treatment.展开更多
In response to the rapid increase in world population and subsequent demands for food,edible insects represent an alternative food source for humans that is rich in proteins,amino acids and minerals.Entomophagy is a t...In response to the rapid increase in world population and subsequent demands for food,edible insects represent an alternative food source for humans that is rich in proteins,amino acids and minerals.Entomophagy is a tradition in many countries including China and Thailand,and edible insects have attracted a lot of attention in Western World due to their suitable nutrient composition,high mineral content(e.g.,Fe,Zn,Ca,Mg)and potential use as a supplement in human diet.In this study,we surveyed mineral content in seven insect orders and 67 species of mass produced and wild-harvested edible insects.The total content of essential elements in edible insects was very high in Tenebrio molitor,Bombyx mori,and Zonocerus variegatus.The heavy metal content(summarized for eight species)was below the maximum limit allowed for safe consumption.Sustainable supply of minerals derived from insect biomass is complicated due to the high variations of mineral content in insects and the potential of its change due to processing.展开更多
BACKGROUND Ventricular arrhythmia is a common type of arrhythmia observed in clinical practice.It is primarily characterized by premature ventricular contractions,ventricular tachycardia,and ventricular fibrillation.A...BACKGROUND Ventricular arrhythmia is a common type of arrhythmia observed in clinical practice.It is primarily characterized by premature ventricular contractions,ventricular tachycardia,and ventricular fibrillation.Abnormal formation or transmission of cardiac electrical impulses in patients affects cardiac ejection function.It may present with symptoms such as palpitations,dyspnea,chest discomfort,and reduced exercise tolerance.In severe cases,ventricular arrhy-thmia can even lead to death.Therefore,prompt treatment is very much essential upon diagnosis.The symptoms did not improve after previous conventional drugs and electrical defibrillation treatment,but the ventricular arrhythmia was prevented after the addition of nicorandil.CASE SUMMARY A 75-year-old female patient was admitted to the hospital because of intermittent chest tightness,shortness of breath for 10 days,and fainting once for 7 days.Combined with laboratory tests and auxiliary examination,the patient was tentatively diagnosed with coronary heart disease or arrhythmia-atrial fibrillation.After admission,the patient had intermittent ventricular arrhythmia,which was uncontrolled with lidocaine,defibrillation,and amiodarone.However,when she was treated with nicorandil,the ventricular arrhythmia stopped.Nicorandil mitigates the action potential duration by facilitating the opening of potassium ion channels,thereby regulating the likelihood of premature and delayed depolar-ization in two distinct phases and subsequently averting the onset of malignant ventricular arrhythmia.Nicorandil may inhibit ventricular arrhythmia by dilating coronary arteries,improving coronary microcirculation and reducing myocardial fibrosis.CONCLUSION option for inhibiting ventricular arrhythmias.展开更多
The anticancer potential of quassinoids has attracted a great deal of attention for decades,and scientific data revealing their possible applications in cancer management are continuously increasing in the literature....The anticancer potential of quassinoids has attracted a great deal of attention for decades,and scientific data revealing their possible applications in cancer management are continuously increasing in the literature.Aside from the potent cytotoxic and antitumor properties of these degraded triterpenes,several quassinoids have exhibited synergistic effects with anticancer drugs.This article provides an overview of the potential anticancer properties of quassinoids,including their cytotoxic and antitumor activities,mechanisms of action,safety evaluation,and potential benefits in combination with anticancer drugs.展开更多
Terahertz polarization conversion devices have significant potential applications in various fields such as terahertzimaging and spectroscopy.In this paper,we utilize genetic algorithms to topologically optimize the m...Terahertz polarization conversion devices have significant potential applications in various fields such as terahertzimaging and spectroscopy.In this paper,we utilize genetic algorithms to topologically optimize the metasurface unit cellsand design a reflective linear polarization conversion metasurface with ultra-broadband and wide-angle characteristics.By partitioning the metallic pattern layer into quadrants,the encoding length is effectively reduced,resulting in a shorteroptimization time.The research results indicate that the converter possesses a polarization conversion efficiency ratio higherthan 90%and a relative bandwidth ratio of 125%in a range of 0.231-0.995 THz.Meanwhile,it can maintain excellentpolarization conversion properties when the incident angle of terahertz waves is less than 45°and the polarization angle isless than 15°,demonstrating excellent practicality.New insights are provided for the design of terahertz wide-angle ultrawidebandpolarization conversion devices,and the proposed metasurfce has potential applications in terahertz polarizationimaging,spectroscopy and communication fields.展开更多
The total internal reflection(TIR)behavior of interface shear waves is crucial for ensuring the reliability of dielectric elastomer(DE)devices.However,due to the complex force-electric coupling and large deformation o...The total internal reflection(TIR)behavior of interface shear waves is crucial for ensuring the reliability of dielectric elastomer(DE)devices.However,due to the complex force-electric coupling and large deformation of DEs,the TIR behavior of shear waves in heterogeneous force-electric interface models is still unclear.This study modeled an elastic/DE bi-material interface to analyze the trajectory of out-of-plane shear waves.Employing Dorfmann and Ogden’s nonlinear electroelastic framework and the related linear small incremental motion theory,a method has been developed to control the TIR behavior of interface shear waves.It has been found that the TIR behavior is significantly influenced by the strain-stiffening effect induced by biasing fields.Consequently,a biasing field principle involving preset electric displacement and pre-stretch has been proposed for TIR occurrence.By controlling the pre-stretch and preset electric displacement,active regulation of TIR behavior can be achieved.These results suggest a potential method for achieving autonomous energy shielding to improve the reliability of DE devices.展开更多
Background:Transcatheter closure(TCC)has emerged as the preferred treatment for selected congenital heart disease(CHD).While TCC offers benefits for patients with postoperative residual shunts,understanding its mid-an...Background:Transcatheter closure(TCC)has emerged as the preferred treatment for selected congenital heart disease(CHD).While TCC offers benefits for patients with postoperative residual shunts,understanding its mid-and long-term efficacy and safety remains crucial.Objective:This study aims to assess the mid-and long-term safety and efficacy of TCC for patients with residual atrial or ventricular septal shunts following CHD correction.Methods:In this consecutive retrospective study,we enrolled 35 patients with residual shunt who underwent TCC or surgical repair of CHD between June 2011 to October 2022.TCC candidacy was determined based on established criteria.Echocardiography and electrocardiogram were conducted during the perioperative period and continued as part of long-term follow-up.Results:Among the patients,5(14.3%)exhibited interatrial shunt-ing,while 30(85.7%)had interventricular shunting.TCC was successfully implemented in 33 of 35 patients,with exceptions in two cases of post-ventricular septal defect repair due to anatomical challenges involving the shape and aortic angulation.This resulted in a TCC success rate of 94.3%.Trace residual shunt was detected in two interventricular shunting cases and a mild residual shunt in one interventricular shunting case;all resolved by the three-month follow-up after TCC.Minor complications included one hematoma at the puncture site and one transient junctional rhythm during the perioperative period.During a median follow-up of 73 months,there were no instances of residual shunt,device embolization,occluder displacement,valve insufficiency,malignant arrhythmia,infective endocarditis,death,or other serious complications.Conclusion:TCC is an effective and safe therapy for patients with residual atrial or ventricular septal shunts following CHD correction.Thesefindings support the consideration of TCC as the preferred treatment option for appropriate patient populations.展开更多
Objective: To investigate the application and feasibility of PDCA circulation method in the treatment of patients with severe neurological diseases in Internet + smart first aid, with a view to promoting the sustainab...Objective: To investigate the application and feasibility of PDCA circulation method in the treatment of patients with severe neurological diseases in Internet + smart first aid, with a view to promoting the sustainable construction of smart first aid. Methods: A total of 105 patients with severe neurological diseases in Zhuji people’s Hospital and cooperative units were selected, and 52 cases in the research group and 53 cases in the control group were divided according to the single and double number visiting time: In this paper, through reading the literature, the development of Internet + wisdom first aid treatment of patients with severe neurological diseases was investigated, and the common problems were analyzed and summarized, and the research group used the PDCA circulation method to sort out the existing problems, analyze the causes of the problems and improve them. The difference in treatment time between the two groups was compared, and the patient’s satisfaction was evaluated for the time of being transferred to the hospital emergency room by 120 ambulances, the time from emergency admission to surgery (Cath lab), and the satisfaction of the patient. Results: The time from emergency treatment to the operation room (catheter room) in the study group was significantly shortened, and patient satisfaction was significantly improved compared with that in the control group, with a statistically significant difference (P Conclusion: Through the application of PDCA circulation method in the Internet + smart emergency treatment of neurologically severe preoperative patients, the Internet + smart emergency mode can be continuously improved, the treatment process can be significantly optimized, the first aid time can be shortened, and the treatment efficiency of neurocritical ill patients can be improved. Therefore, it has been expected to improve the success rate of treatment and improve the success rate of neurological patients.展开更多
<strong>Objective:</strong> To retrospectively analyze the clinical utility of quantitative nursing measures of 10 cases of lower cranial nerves injury after cerebellopontine angle tumors surgery to provid...<strong>Objective:</strong> To retrospectively analyze the clinical utility of quantitative nursing measures of 10 cases of lower cranial nerves injury after cerebellopontine angle tumors surgery to provide the experience for improving the recovery rate and living quality of these patients. <strong>Methods:</strong> The clinical data of 10 cases of lower cranial nerves injury after cerebellopontine angle tumors surgery was analyzed. For problems such as dysphagia and dyspnea of these patients, the nursing care focused on strict monitoring, timely oxygen inhalation nursing, posture nursing, ventilator nursing, swallowing function training, etc. <strong>Results:</strong> After received quantitative care, 10 patients with lower cranial nerves injury after cerebellopontine angle tumors surgery were recovered well, and their symptoms such as dysphagia and dyspnea were gradually improved and safely discharged. <strong>Conclusion:</strong> Lower cranial nerves injury is one of the serious complications after removal of cerebellopontine angle tumors, which impacts the life and health of patients. Caregivers should accurately understand and analyze the symptoms, and quantitative and targeted nursing measures for posterior cranial nerves injury are helpful in the postoperative rehabilitation of patients and improve their living quality.展开更多
文摘目的:评估超声内镜引导下细针穿刺(endoscopic ultrasound-guided fine needle aspiration,EUS-FNA)在胆管病变中的诊断效能和安全性,并探讨影响其准确性的因素。方法:回顾性分析2021年1月到2023年12月成都市第三人民医院因疑似胆管恶性狭窄/占位而接受EUS-FNA的41例患者临床资料,其中男性22例,女性19例,平均年龄为65.9(35.0~89.0)岁。评估其诊断效能(敏感性、特异性、阳性预测值、阴性预测值和准确性)及影响因素。结果:EUS-FNA对于胆管病变的总体灵敏性为85%,特异性为100%,阳性预测值为100%,阴性预测值为33%,准确性为86%;25G穿刺针和是否存在实性占位是影响EUS-FNA诊断胆管病变准确性的重要因素,而穿刺部位并未对诊断效能产生影响,参与分析的41例患者在随访期间未发现与EUS-FNA相关不良事件。结论:EUS-FNA在诊断胆管病变时具有较高的准确性和安全性,特别是使用25G穿刺针及存在胆管实性占位时,EUSFNA的诊断准确性更高。
基金supported by Liaoning Xingliao Talent Project (Grant No. XLYC2007020)。
文摘Hemoptysis is a severe complication of pulmonary hypertension (PH) with a low in- cidence of 6%-11%.^([1-4])Although occurring in all forms of PH,it is more commonly seen in pulmonary arterial hypertension (PAH),associated with congenital heart disease (PAH-CHD).^([5,6])Since enlarged bronchial arteries are a frequent source of pulmonary bleeding,the primary treatment focuses on bronchial artery embolization (BAE),especially for chronic thromboembolic pulmonary hypertension (CTEPH) patients^([7,8]).However,there is disagreement regarding medical therapy,which has received little attention in the recently published PH guidelines.^([5,6])
基金Supported by Technology Development of Jilin Province,No:20190701069GHNatural Science Foundation of Inner Mongolia Autonomous Region,No:2018MS08036,No:2017MS(LH)0824.
文摘BACKGROUND The clinical application of doxorubicin(DOX)is limited by its potential to cause cardiac cardiotoxicity.AIM To investigate the correlation between calumenin(CALU)and mitochondrial kinetic-related proteins in rats with DOX cardiomyopathy.METHODS A rat model of DOX-induced cardiomyopathy was used to evaluate the effects of DOX.We observed the effect of DOX on electrical conduction in cardiomyocytes using the electromapping technique.Masson staining was performed to evaluate myocardium fibrosis.Electron microscopy was used to observe the changes in pathological ultrastructure of the myocardium.Western blotting and ELISAs were performed to detect protein levels and intracellular free Ca^(2+)concentration.RESULTS DOX slowed conduction and increased conduction dispersion in cardiomyocytes.The myocardial pathology in rats treated with DOX exhibited a significant deterioration,as demonstrated by an increase in mitochondrial Ca^(2+)concentration and a decrease in the expression of CALU,optic atrophy-1,and Bcl-2.Additionally,there was an increase in the expression of connexin 43(Cx43)and the mitochondrial mitotic proteins dynamin-related protein 1,CHOP,Cytochrome C,and Bax in DOX rats.Decreased expression of CALU in cardiomyocytes triggered an increase in cytoplasmic free calcium concentration,which would normally be taken up by mitochondria,but decreased expression of mitochondrial outer membrane fusion proteins triggered a decrease in mitochondrial Ca^(2+)uptake,and the increase in cytoplasmic free calcium concentration triggered cell apoptosis.CONCLUSION Increased cytoplasmic free calcium ion concentration induces calcium overload in ventricular myocytes,leading to decreased Cx43 protein,slowed conduction in myocytes,and increased conduction dispersion,resulting in arrhythmias.
基金supported in part by the Science and Technology Major Special Project Fund of Changsha(No.kh2401010)in part by the High-Performance Computing Center of Central South University+3 种基金supported by the National Natural Science Foundation of China(Grants Nos.82022024,31970572)The Science and Technology Innovation Program of Hunan Province(2021RC4018,2021RC5027)Innovation-Driven Project of Central South University(Grant No.2020CX003)NIH grants U01 MH122591,1U01MH116489,1R01MH110920,R01MH126459.
文摘Detecting Alzheimer’s disease is essential for patient care,as an accurate diagnosis influences treatment options.Classifying dementia from non-dementia in brain MRIs is challenging due to features such as hippocampal atrophy,while manual diagnosis is susceptible to error.Optimal computer-aided diagnosis(CAD)systems are essential for improving accuracy and reducing misclassification risks.This study proposes an optimized ensemble method(CEOE-Net)that initiates with the selection of pre-trained models,including DenseNet121,ResNet50V2,and ResNet152V2 for unique feature extraction.Each selected model is enhanced with the inclusion of a channel attention(CA)block to improve the feature extraction process.In addition,this study employs the Short Time Fourier transform(STFT)technique with each individual model for hierarchical feature extraction before making final predictions in classifying MRI images of dementia and non-demented individuals,considering them as backbone models for building the ensemble method.STFT highlights subtle differences in brain structure and activity,particularly when combined with CA mechanisms that emphasize relevant features by converting spatial data into the frequency domain.The predictions generated from these models are then processed by the Chaotic Evolution Optimization(CEO)algorithm,which determines the optimal weightage set for each backbone model to maximize their contribution.The CEO optimizer explores weight distribution to ensure the most effective combination of model predictions for enhancing classification accuracy,thus significantly improving overall ensemble performance.This study utilized three datasets for validation:two private clinical brain MRI datasets(OSASIS and ADNI)to test the proposed model’s effectiveness.Image augmentation techniques were also employed to enhance dataset diversity and improve classification performance.The proposed CEOE-Net outperforms conventional baseline models and existing methods by showing its effectiveness as a clinical tool for the accurate classification of dementia and non-dementia MRI brain images,as well as autistic and non-autistic facial features.It achieved consistent accuracies of 93.44%on OSASIS and 81.94%on ADNI.
基金Project supported by the National Key Research and Development Program of China(2024YFE0206100)the National Natural Science Foundation of China(T2325015,U21A2068,12174151)。
文摘Achieving high-efficiency photoluminescence in trivalent lanthanides(Ln^(3+))requires precise crystalfield perturbation to overcome parity-forbidden 4f-transitions and suppress nonradiative decay.However,realizing such control remains challenging,even in well-optimized Ln^(3+) -doped nanocrystals.Here,by exploiting the atomically precise structure of metal nanoclusters,we demonstrate symmetry engineering in the Eu_(2)Ti_(4) nanoclusters through stepwise ligand substitution(BA/Phen→FBA/Phen→FBA/Bpy.BA:benzoicacid;Phen:1,10-phenanthroline;FBA:p-fluorobenzoicacid;Bpy:2,2'-bipyridine).The incorporation of FBA effectively suppresses nonradiative relaxation,while the flexible Bpy ligand induces symmetry reduction from D_(2d) to C_(2v) through coordination modulation,yielding a high photoluminescence quantum yield(PLQY)of 91.2%in the Ln^(3+) cluster systems.The transient-absorption,Judd-Ofelt theory,crystal-field analysis,and temperature-dependent photophysical studies elucidated the underlying modulation mechanisms.Furthermore,these clusters exhibit promising potential for optoelectronic applications,offering a new design strategy for high-performance luminescent materials.
基金This work was supported by the National Key R&D Program of China(Grant No.2022YFE0207000)the National Natural Science Foundation of China(Grant Nos.12372289,11972250,and 12102298)+1 种基金the China Postdoctoral Science Foundation(Grant No.2021M702443)Tianjin Natural Science Foundation(Grant No.22JCZDJC00910).
文摘At low-Reynolds-number,the performance of airfoil is known to be greatly affected by the formation and burst of a laminar separation bubble(LSB),which requires a more precise simulation of the delicate flow structures.A framework based on the interior penalty discontinuous Galerkin method and large eddy simulation approach was adopted in the present study.The performances of various subgrid models,including the Smagorinsky(SM)model,the dynamic Smagorinsky(DSM)model,the wall-adapting local-eddy-viscosity(WALE)model,and the VREMAN model,have been analyzed through flow simulations of the SD7003 airfoil at a Reynolds number of 60000.It turns out that the SM model fails to predict the emergence of LSB,even modified by the Van-Driest damping function.On the contrary,the best agreement is generally achieved by the WALE model in terms of flow separation,reattachment,and transition locations,together with the aerodynamic loads.Furthermore,the influence of numerical dissipation has also been discussed through the comparison of skin friction and resolved Reynolds stresses.As numerical dissipation decreases,the prediction accuracy of the WALE model degrades.Meanwhile,nonlinear variation could be observed from the performances of the DSM model,which could be attributed to the interaction between the numerical dissipation and the subgrid model.
基金supported by the National Key R&D Program of China(2024YFB4607600)National Natural Science Foundation of China(NSFC,Grant No.52303359)+1 种基金Basic and Applied Basic Research Foundation of Guangdong Province(2023A1515011511,2022A1515110848,2023B1515040027,Young Top Talents Program 2021QN02C174)Open program of State Key Laboratory of Optoelectronic Materials and Technologies(OEMT-2024-KF-06).
文摘Harnessing solar energy to enhance the rechargeable zinc-air batteries(RZABs)performance is a promising avenue toward sustainable energy storage and conversion.Simultaneously enhancing light-absorption capacity and carrier separation efficiency in nanomaterials,as well as improving electrical conductivity and configuration for electrocatalysis,presents a formidable challenge due to inherent trade-offs and interdependencies.Here,we have developed a Janus dual-atom catalyst(JDAC)with bifunctional centers for efficient charge separation and electrocatalytic performance through a bipolar doping strategy.The in situ X-ray absorption near-edge structure and Raman spectroscopy analyses demonstrated that the Ni and Fe centers in JDAC not only function as effective sites for oxygen evolution reaction and oxygen reduction reaction,respectively,but also serve as efficient hole and electron enrichment sites,effectively suppressing photoelectron recombination while enhancing photocurrent generation.As a result,the assembled JDAC-based lightassisted RZABs exhibited extraordinary stability at large current densities.This work delivers pivotal insight to design Janus dual-atom catalysts that efficiently convert solar energy into electric and chemical energy.
基金supported by the National Natural Science Foundation of China(No.22074058,S.Li).
文摘Algal copper uptake(i.e.,Cu bioavailability)in the euphotic zone plays a vital role in algal photosynthesis and respiration,affecting the primary productivity and the source and sink of atmospheric carbon.Algal Cu uptake is controlled by natural dissolved organic Cu(DOCu)speciation(i.e.,complexed with the dissolved organic matter)that conventionally could be tested by model prediction or molecular-level characterizations in the lab,while DOCu uptake are hardly directly assessed.Thus,the new chemistrybiology insight into the mechanisms of the Cu uptake process in algae is urgent.The DOCu speciation transformation(organic DOCu to free Cu(II)ions),enzymatic reduction-induced valence change(reduction of free Cu(II)to Cu(I)ions),and algal Cu uptake at the algae-water interface are imitated.Herein,an intelligent system with DOCu colorimetric sensor is developed for real-time monitoring of newly generated Cu(I)ions.Deep learning with whole sample image-based characterization and powerful feature extraction capabilities facilitates colorimetric measurement.In this context,the Cu bioavailability with 7 kinds of organic ligands(e.g.,amino acids,organic acids,carbohydrates)can be predicted by the mimetic intelligent biosensor within 15.0min,i.e.,the DOCu uptake and speciation is successfully predicted and streamlined by the biomimetic approach.
基金supported by National Natural Science Foundation of China(No.52172218).
文摘Manganese dioxide(MnO_(2))electrode material possesses the advantages of high energy density,structural diversity and high modification potential.This allows it become one of the important cathodes for aqueous zinc ion battery.However,the applications are limited by the poor electrical conductivity,narrow layer spacing and the ease of dissolution.Herein,we prepare MnO_(2)-PVP@0.03GO composites by the co-modification of polyvinylpyrrolidone(PVP)pre-insertion layer and graphene oxide(GO)self-assembly layer.The Zn//MnO_(2)-PVP@0.03GO cells deliver a discharge specific capacity of 442 mAh/g at a current density of 0.2 A/g.It also maintains 100%capacity for 1000 times cycling at 1 A/g.The assembled soft package batteries demonstrate superior flexibility and adaptability under different bending conditions.
基金supported by the National Key Research and Development Program of China(2023YFD2301702)the earmarked Fund for China Agriculture Research System(CARS-02)the National Natural Science Foundation of China(31971852).
文摘Long-term excessive nitrogen(N)application neither increases nor enhances grain yield and N use efficiency(NUE)of maize,yet the mechanisms involving root morphological and physiological characteristics remain unclear.This study aimed to elucidate the mechanisms underlying stagnant grain yield under excessive N application by examining root morphological and physiological characteristics.A 10-year N fertilizer trial was conducted in Jilin Province,Northeast China,cultivating maize at three N fertilizer levels(zero N,N0;recommended N,N2;and high N level,N4)from 2019 to 2021.Two widely cultivated maize genotypes,‘Xianyu 335’(XY335)and‘Zhengdan 958’(ZD958),were evaluated.Grain yield,N content,root morphology,and physiological characteristics were analyzed to assess the relationships between N uptake,N utilization,plant growth,and root systems under different N treatments.Compared to N0,root biomass,post-silking N uptake,and grain yield improved significantly with increased N input,while no significant differences emerged between recommended N and high N.High N application enhanced root length and root surface area but decreased root activity(measured by TTC(2,3,5-triphenyltetrazolium chloride)method),nitrate reductase activity,and root activity absorbing area across genotypes.Root length and root to shoot ratio negatively affected N uptake(by-1.2 and-24.6%),while root surface area,root activity,nitrate reductase activity,and root activity absorbing area contributed positively.The interaction between cultivar and N application significantly influenced NUE.XY335 achieved the highest NUE(11.6%)and N recovery efficiency(18.4%)through superior root surface area(23.6%),root activity(12.5%),nitrate reductase activity(8.3%),and root activity absorbing area(6.9%)compared to other treatments.Recommended N application enhanced Post N uptake,NUE,and grain yield through improved root characteristics,while high N application failed to increase or decreased NUE by reducing these parameters.This study demonstrates that root surface area,root activity,nitrate reductase activity,and root activity absorbing area limit NUE increase under high N application.
基金support from the Natural Science Foundation of Jilin Province(Grant No.20200201073JC)the National Natural Science Foundation of China(Grant No.52130101)+1 种基金Interdisciplinary Integration and Innovation Project of JLU(Grant No.JLUXKJC2021ZY01)the Fundamental Research Funds for the Central Universities.
文摘With the advantage of fast charge transfer,heterojunction engineering is identified as a viable method to reinforce the anodes'sodium storage performance.Also,vacancies can effectively strengthen the Na+adsorption ability and provide extra active sites for Na+adsorption.However,their synchronous engineering is rarely reported.Herein,a hybrid of Co_(0.85)Se/WSe_(2) heterostructure with Se vacancies and N-doped carbon polyhedron(CoWSe/NCP)has been fabricated for the first time via a hydrothermal and subsequent selenization strategy.Spherical aberration-corrected transmission electron microscopy confirms the phase interface of the Co_(0.85)Se/WSe_(2) heterostructure and the existence of Se vacancies.Density functional theory simulations reveal the accelerated charge transfer and enhanced Na+adsorption ability,which are contributed by the Co_(0.85)Se/WSe_(2) heterostructure and Se vacancies,respectively.As expected,the CoWSe/NCP anode in sodium-ion battery achieves outstanding rate capability(339.6 mAh g^(−1) at 20 A g^(−1)),outperforming almost all Co/W-based selenides.
基金funded by the Science and Technology Innovation Project of the China Academy of Chinese Medical Sciences(Nos.CI2021A04618 and CI2021A01401).
文摘Objective Brain microvascular endothelial cells (BMECs) were found to shift from their usually inactive state to an active state in ischemic stroke (IS) and cause neuronal damage. Ginsenoside Rb1 (GRb1),a component derived from medicinal plants,is known for its pharmacological benefits in IS,but its protective effects on BMECs have yet to be explored. This study aimed to investigate the potential protective effects of GRb1 on BMECs. Methods An in vitro oxygen-glucose deprivation/reperfusion (OGD/R) model was established to mimic ischemia-reperfusion (I/R) injury. Bulk RNA-sequencing data were analyzed by using the Human Autophagy Database and various bioinformatic tools,including gene set enrichment analysis (GSEA),Gene Ontology (GO) classification and enrichment analysis,Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis,protein-protein interaction network analysis,and molecular docking. Experimental validation was also performed to ensure the reliability of our findings. Results Rb1 had a protective effect on BMECs subjected to OGD/R injury. Specifically,GRb1 was found to modulate the interplay between oxidative stress,apoptosis,and autophagy in BMECs. Key targets such as sequestosome 1 (SQSTM1/p62),autophagy related 5 (ATG5),and hypoxia-inducible factor 1-alpha (HIF-1α) were identified,highlighting their potential roles in mediating the protective effects of GRb1 against IS-induced damage. Conclusion GRbl protects BMECs against OGD/R injury by influencing oxidative stress,apoptosis,and autophagy. The identification of SQSTM1/p62,ATG5,and HIF-1α as promising targets further supports the potential of GRb1 as a therapeutic agent for IS,providing a foundation for future research into its mechanisms and applications in IS treatment.
基金founded by Jiangsu Agricultural Science and Technology Innovation Fund(CX(20)3179)Dongminghuanghetan Ecological Agriculture Co.,Ltd(204032897)+1 种基金partially funded funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no.861976,project SUSINCHAINthe German Federal Ministry of Education and Research(BMBF),in the frame of FACCE-SURPLUS/FACCE-JPI project UpWaste,grant number 031B0934A。
文摘In response to the rapid increase in world population and subsequent demands for food,edible insects represent an alternative food source for humans that is rich in proteins,amino acids and minerals.Entomophagy is a tradition in many countries including China and Thailand,and edible insects have attracted a lot of attention in Western World due to their suitable nutrient composition,high mineral content(e.g.,Fe,Zn,Ca,Mg)and potential use as a supplement in human diet.In this study,we surveyed mineral content in seven insect orders and 67 species of mass produced and wild-harvested edible insects.The total content of essential elements in edible insects was very high in Tenebrio molitor,Bombyx mori,and Zonocerus variegatus.The heavy metal content(summarized for eight species)was below the maximum limit allowed for safe consumption.Sustainable supply of minerals derived from insect biomass is complicated due to the high variations of mineral content in insects and the potential of its change due to processing.
文摘BACKGROUND Ventricular arrhythmia is a common type of arrhythmia observed in clinical practice.It is primarily characterized by premature ventricular contractions,ventricular tachycardia,and ventricular fibrillation.Abnormal formation or transmission of cardiac electrical impulses in patients affects cardiac ejection function.It may present with symptoms such as palpitations,dyspnea,chest discomfort,and reduced exercise tolerance.In severe cases,ventricular arrhy-thmia can even lead to death.Therefore,prompt treatment is very much essential upon diagnosis.The symptoms did not improve after previous conventional drugs and electrical defibrillation treatment,but the ventricular arrhythmia was prevented after the addition of nicorandil.CASE SUMMARY A 75-year-old female patient was admitted to the hospital because of intermittent chest tightness,shortness of breath for 10 days,and fainting once for 7 days.Combined with laboratory tests and auxiliary examination,the patient was tentatively diagnosed with coronary heart disease or arrhythmia-atrial fibrillation.After admission,the patient had intermittent ventricular arrhythmia,which was uncontrolled with lidocaine,defibrillation,and amiodarone.However,when she was treated with nicorandil,the ventricular arrhythmia stopped.Nicorandil mitigates the action potential duration by facilitating the opening of potassium ion channels,thereby regulating the likelihood of premature and delayed depolar-ization in two distinct phases and subsequently averting the onset of malignant ventricular arrhythmia.Nicorandil may inhibit ventricular arrhythmia by dilating coronary arteries,improving coronary microcirculation and reducing myocardial fibrosis.CONCLUSION option for inhibiting ventricular arrhythmias.
基金supported by the National Natural Science Foundation of China(82274085)the Natural Science Foundation of Jiangsu Province(BK20220478)the Natural Science Foundation of Jiangsu Higher Education institutions of China(22KJB360010).
文摘The anticancer potential of quassinoids has attracted a great deal of attention for decades,and scientific data revealing their possible applications in cancer management are continuously increasing in the literature.Aside from the potent cytotoxic and antitumor properties of these degraded triterpenes,several quassinoids have exhibited synergistic effects with anticancer drugs.This article provides an overview of the potential anticancer properties of quassinoids,including their cytotoxic and antitumor activities,mechanisms of action,safety evaluation,and potential benefits in combination with anticancer drugs.
基金supported by the National Natural Science Foundation of China and the Open Project Program of Wuhan National Laboratory for Optoelectronics(Grant No.2022WNLOKF012).
文摘Terahertz polarization conversion devices have significant potential applications in various fields such as terahertzimaging and spectroscopy.In this paper,we utilize genetic algorithms to topologically optimize the metasurface unit cellsand design a reflective linear polarization conversion metasurface with ultra-broadband and wide-angle characteristics.By partitioning the metallic pattern layer into quadrants,the encoding length is effectively reduced,resulting in a shorteroptimization time.The research results indicate that the converter possesses a polarization conversion efficiency ratio higherthan 90%and a relative bandwidth ratio of 125%in a range of 0.231-0.995 THz.Meanwhile,it can maintain excellentpolarization conversion properties when the incident angle of terahertz waves is less than 45°and the polarization angle isless than 15°,demonstrating excellent practicality.New insights are provided for the design of terahertz wide-angle ultrawidebandpolarization conversion devices,and the proposed metasurfce has potential applications in terahertz polarizationimaging,spectroscopy and communication fields.
基金supported by the National Natural Science Foundation of China(Grant No.12372154)National Science and Technology Major Project(Grant No.J2019-III-0010-0054).
文摘The total internal reflection(TIR)behavior of interface shear waves is crucial for ensuring the reliability of dielectric elastomer(DE)devices.However,due to the complex force-electric coupling and large deformation of DEs,the TIR behavior of shear waves in heterogeneous force-electric interface models is still unclear.This study modeled an elastic/DE bi-material interface to analyze the trajectory of out-of-plane shear waves.Employing Dorfmann and Ogden’s nonlinear electroelastic framework and the related linear small incremental motion theory,a method has been developed to control the TIR behavior of interface shear waves.It has been found that the TIR behavior is significantly influenced by the strain-stiffening effect induced by biasing fields.Consequently,a biasing field principle involving preset electric displacement and pre-stretch has been proposed for TIR occurrence.By controlling the pre-stretch and preset electric displacement,active regulation of TIR behavior can be achieved.These results suggest a potential method for achieving autonomous energy shielding to improve the reliability of DE devices.
文摘Background:Transcatheter closure(TCC)has emerged as the preferred treatment for selected congenital heart disease(CHD).While TCC offers benefits for patients with postoperative residual shunts,understanding its mid-and long-term efficacy and safety remains crucial.Objective:This study aims to assess the mid-and long-term safety and efficacy of TCC for patients with residual atrial or ventricular septal shunts following CHD correction.Methods:In this consecutive retrospective study,we enrolled 35 patients with residual shunt who underwent TCC or surgical repair of CHD between June 2011 to October 2022.TCC candidacy was determined based on established criteria.Echocardiography and electrocardiogram were conducted during the perioperative period and continued as part of long-term follow-up.Results:Among the patients,5(14.3%)exhibited interatrial shunt-ing,while 30(85.7%)had interventricular shunting.TCC was successfully implemented in 33 of 35 patients,with exceptions in two cases of post-ventricular septal defect repair due to anatomical challenges involving the shape and aortic angulation.This resulted in a TCC success rate of 94.3%.Trace residual shunt was detected in two interventricular shunting cases and a mild residual shunt in one interventricular shunting case;all resolved by the three-month follow-up after TCC.Minor complications included one hematoma at the puncture site and one transient junctional rhythm during the perioperative period.During a median follow-up of 73 months,there were no instances of residual shunt,device embolization,occluder displacement,valve insufficiency,malignant arrhythmia,infective endocarditis,death,or other serious complications.Conclusion:TCC is an effective and safe therapy for patients with residual atrial or ventricular septal shunts following CHD correction.Thesefindings support the consideration of TCC as the preferred treatment option for appropriate patient populations.
文摘Objective: To investigate the application and feasibility of PDCA circulation method in the treatment of patients with severe neurological diseases in Internet + smart first aid, with a view to promoting the sustainable construction of smart first aid. Methods: A total of 105 patients with severe neurological diseases in Zhuji people’s Hospital and cooperative units were selected, and 52 cases in the research group and 53 cases in the control group were divided according to the single and double number visiting time: In this paper, through reading the literature, the development of Internet + wisdom first aid treatment of patients with severe neurological diseases was investigated, and the common problems were analyzed and summarized, and the research group used the PDCA circulation method to sort out the existing problems, analyze the causes of the problems and improve them. The difference in treatment time between the two groups was compared, and the patient’s satisfaction was evaluated for the time of being transferred to the hospital emergency room by 120 ambulances, the time from emergency admission to surgery (Cath lab), and the satisfaction of the patient. Results: The time from emergency treatment to the operation room (catheter room) in the study group was significantly shortened, and patient satisfaction was significantly improved compared with that in the control group, with a statistically significant difference (P Conclusion: Through the application of PDCA circulation method in the Internet + smart emergency treatment of neurologically severe preoperative patients, the Internet + smart emergency mode can be continuously improved, the treatment process can be significantly optimized, the first aid time can be shortened, and the treatment efficiency of neurocritical ill patients can be improved. Therefore, it has been expected to improve the success rate of treatment and improve the success rate of neurological patients.
文摘<strong>Objective:</strong> To retrospectively analyze the clinical utility of quantitative nursing measures of 10 cases of lower cranial nerves injury after cerebellopontine angle tumors surgery to provide the experience for improving the recovery rate and living quality of these patients. <strong>Methods:</strong> The clinical data of 10 cases of lower cranial nerves injury after cerebellopontine angle tumors surgery was analyzed. For problems such as dysphagia and dyspnea of these patients, the nursing care focused on strict monitoring, timely oxygen inhalation nursing, posture nursing, ventilator nursing, swallowing function training, etc. <strong>Results:</strong> After received quantitative care, 10 patients with lower cranial nerves injury after cerebellopontine angle tumors surgery were recovered well, and their symptoms such as dysphagia and dyspnea were gradually improved and safely discharged. <strong>Conclusion:</strong> Lower cranial nerves injury is one of the serious complications after removal of cerebellopontine angle tumors, which impacts the life and health of patients. Caregivers should accurately understand and analyze the symptoms, and quantitative and targeted nursing measures for posterior cranial nerves injury are helpful in the postoperative rehabilitation of patients and improve their living quality.
