BACKGROUND Acute myocardial infarction(AMI)is a major cause of mortality worldwide.The stress hyperglycemia ratio(SHR),which integrates glucose and glycated hemoglobin A1c levels,better reflects acute metabolic stress...BACKGROUND Acute myocardial infarction(AMI)is a major cause of mortality worldwide.The stress hyperglycemia ratio(SHR),which integrates glucose and glycated hemoglobin A1c levels,better reflects acute metabolic stress.This study assessed the SHR and longterm prognosis of patients with AMI.METHODS This study was a post-hoc analysis based on the prospective,multicenter OPTIMAL registry(http://www.clinicaltrials.gov,NCT number:NCT03084991).A total of 3384 consecutive patients who underwent percutaneous coronary intervention(PCI)at Department of Cardiology,The 2nd Affiliated Hospital of Harbin Medical University,Harbin,China were included in the present analysis after exclusions.Patients were stratified into quartiles according to the SHR.The primary endpoint was cardiovascular death,with all-cause death and major adverse cardiovascular events as secondary endpoints.The median follow-up duration was 24.1 months,with a completion rate of 99.5%.RESULTS Kaplan-Meier survival curves showed progressively worse survival across SHR quartiles(log-rank P<0.001),with patients in Q4(SHR≥1.34)experiencing the highest risk.Multivariate Cox regression analysis confirmed that the SHR was an independent predictor of cardiovascular death[hazard ratio(HR)=1.56],all-cause death(HR=1.48),and major adverse cardiovascular events(HR=1.34)for Q4(SHR≥1.34)versus Q2(SHR:0.93–1.11).Restricted cubic spline analysis revealed a J-shaped association between SHR and outcomes,with the lowest risk observed at an SHR of approximately 1.0.CONCLUSIONS The SHR is an independent predictor of long-term adverse outcomes in patients with AMI undergoing PCI,supporting its use for early risk stratification and glycemic management.展开更多
Image-based computational models have been used for vulnerable plaque progression and rupture predictions,and good results have been reported.However,mechanisms and predictions for plaque erosion are underinvestigated...Image-based computational models have been used for vulnerable plaque progression and rupture predictions,and good results have been reported.However,mechanisms and predictions for plaque erosion are underinvestigated.Patient-specific fluid-structure interaction(FSI)models based on optical coherence tomography(OCT)follow-up data from patients with plaque erosion and who received conservative antithrombotic treatment(using medication,no stenting)to identify risk factors that could be used to predict the treatment outcome.OCT and angiography datawere obtained from10 patientswho received conservative antithrombotic treatment.Five participants had worse outcomes(WOG,stenosis severity≥70%at one-year follow-up),while the other five had better outcomes(BOG,stenosis severity<70%at one-year follow-up).Patient-specific 3D FSI models were constructed to obtain morphological and biomechanical risk factor values(a total of nine risk factors)for comparison and prediction.A logistic regressionmodel was used to identify optimal predictors with the best treatment outcome prediction accuracies.Our results indicated that the combination of wall shear stress(WSS),lipid percent,and thrombus burden was the best group predictor according to the mean area under the curve(AUC)of 0.96(90%confidence interval=(0.85,1.00)).WSS was the best single predictor withmean AUC=0.70(90%confidence interval=(0.20,1.00)).Thrombus burden was the only risk factor showing statistically significant group difference,suggesting its crucial role in the outcomes of conservative anti-thrombotic therapy.This pilot study indicated that integratingmorphological and biomechanical risk factors could improve treatment outcome prediction accuracy in patients with plaque erosion compared to predictions using single predictors.Large-scale patient studies are needed to further validate our findings.展开更多
Track reconstruction algorithms are critical for polarization measurements.Convolutional neural networks(CNNs)are a promising alternative to traditional moment-based track reconstruction approaches.However,the hexagon...Track reconstruction algorithms are critical for polarization measurements.Convolutional neural networks(CNNs)are a promising alternative to traditional moment-based track reconstruction approaches.However,the hexagonal grid track images obtained using gas pixel detectors(GPDs)for better anisotropy do not match the classical rectangle-based CNN,and converting the track images from hexagonal to square results in a loss of information.We developed a new hexagonal CNN algorithm for track reconstruction and polarization estimation in X-ray polarimeters,which was used to extract the emission angles and absorption points from photoelectron track images and predict the uncer-tainty of the predicted emission angles.The simulated data from the PolarLight test were used to train and test the hexagonal CNN models.For individual energies,the hexagonal CNN algorithm produced 15%-30%improvements in the modulation factor compared to the moment analysis method for 100%polarized data,and its performance was comparable to that of the rectangle-based CNN algorithm that was recently developed by the Imaging X-ray Polarimetry Explorer team,but at a lower computational and storage cost for preprocessing.展开更多
随着电力市场和碳市场的发展,将需求响应和碳交易机制引入综合能源系统运行调度中,有助于引导用户和系统运营商优化用电和调度计划。通过分时电价和需求响应激励补贴等综合型激励措施引导用户参与需求响应,并基于IGDT(information gap d...随着电力市场和碳市场的发展,将需求响应和碳交易机制引入综合能源系统运行调度中,有助于引导用户和系统运营商优化用电和调度计划。通过分时电价和需求响应激励补贴等综合型激励措施引导用户参与需求响应,并基于IGDT(information gap decision theory)理论构建了考虑阶梯式碳交易机制以及需求响应的综合能源系统双层随机优化调度模型,并通过KKT条件和大M法将双层模型转化为单层模型进行求解。结果表明,引入需求响应和阶梯式碳交易机制之后能够实现综合能源系统的低碳环保运行。展开更多
Objective To investigate the indigenous lactobacilli from the vagina of pregnant women and to screen the isolates with antagonistic potential against pathogenic microorganisms. Methods The strains were isolated from p...Objective To investigate the indigenous lactobacilli from the vagina of pregnant women and to screen the isolates with antagonistic potential against pathogenic microorganisms. Methods The strains were isolated from pregnant women＇s vagina and identified using the API50CH system. The ability of the isolates to produce hydrogen peroxide was analyzed semi-quantitatively using the TMB-HRP-MRS agar. The antagonistic effects of the isolates on pathogenic microorganisms were determined with a double layer agar plate. Results One hundred and three lactobacilli strains were isolated from 60 samples of vaginal secretion from healthy pregnant women. Among them, 78 strains could produce hydrogen peroxide, in which 68%, 80%, 80%, and 88% had antagonistic effects against Candida albicans CMCC98001, Staphylococcus aureus CMCC26003, Escherichia coli CMCC44113, and Pseudomonas aeruginosa CMCC10110, respectively. Conclusion The recovery of hydrogen peroxide-producing lactobacilli decreases with the increasing pregnant age and time. The most commonly isolated species from vagina of Chinese pregnant women are Lactobacillus acidophilus and Lactobacillus crispatus. Most of L. acidophilus and L. crispatus produce a high H2O2 level.展开更多
Intrinsic radiation of materials is one of the major backgrounds for many rare-event search experiments.Thus,the production of pure materials in an underground laboratory is a promising approach for eliminating cosmog...Intrinsic radiation of materials is one of the major backgrounds for many rare-event search experiments.Thus,the production of pure materials in an underground laboratory is a promising approach for eliminating cosmogenic radionuclides.In this paper,we demonstrate a procedure to evaluate the yields of cosmogenic radionuclides in copper and germanium in the second phase of the China Jinping Underground Laboratory.Our results show that for copper and germanium materials,the largest cosmogenic background comes from 3 H and57,58,60Co,and 3 H and 68Ge,respectively,which all have yields on the order of 10-7 kg-1 day-1.The corresponding radioactivities after 90 days pf exposure underground are estimated to be lower than 10-6μBq kg-1.展开更多
Based on the monthly precipitation and air temperature from 1960 to 1989 in the Luanhe River Basin, the standardized precipitation evapotranspiration index （SPEI） and standardized precipitation index （SPI） at thre...Based on the monthly precipitation and air temperature from 1960 to 1989 in the Luanhe River Basin, the standardized precipitation evapotranspiration index （SPEI） and standardized precipitation index （SPI） at three- and six-month time scales and the self-calibrating Palmer drought severity index （sc-PDSI） were calculated to evaluate droughts in the study area. Temporal variations of the drought severity from 1960 to 1989 were analyzed and compared based on the results of different drought indices, and some typical drought events were identified. Spatial distributions of the drought severity according to the indices were also plotted and investigated. The results reveal the following： the performances of different drought indices are closely associated with the drought duration and the dominant factors of droughts; the SPEI is more accurate than the SPI when both evaporation and precipitation play important roles in drought events; the drought severity shown by the sc-PDSI is generally milder than the actual drought severity from 1960 to 1989; and the evolution of the droughts is usually delayed according to the scPDSI. This study provides valuable references for building drought early warning and mitigation systems in the Luanhe River Basin.展开更多
Objective:To investigate the effects of mirror neuron theory-based visual feedback therapy(VFT)on restoration of upper limb function of stroke patients and motor-related cortical function using functional magnetic res...Objective:To investigate the effects of mirror neuron theory-based visual feedback therapy(VFT)on restoration of upper limb function of stroke patients and motor-related cortical function using functional magnetic resonance imaging(fMRI).Methods:Hemiplegic stroke patients were randomly divided into two groups:a VFT group and a control(CTL)group.Sixteen patients in the VFT group received conventional rehabilitation(CR)and VFT for 8 weeks,while 15 patients in the CTL group received only CR.The Barthel Index(BI)was used to assess the activities of daily living at baseline and the 8th week of the recovery training period.The Fugl-Meyer assessment(FMA)scale,somatosensory evoked potential(SEP),and fMRI were used to evaluate the recovery effect of the training therapies.The latencies and amplitudes of N9 and N20 were measured.Before recovery training,fMRI was performed for all patients in the VFT and CTL groups.In addition,17 patients(9 in the VFT group and 8 in the CTL group)underwent fMRI for follow-up 2 months after treatment.Qualitative data were analyzed using the x2 test.The independent sample t-test was used to compare normally distributed data among different groups,the paired sample t-test was used to compare data between groups,and the non-parametric test was used to comparing data without normal distribution among groups.Results:There were no significant differences between the VFT and CTL group in all indexes.However,after 8 weeks of recovery training,these indexes were all significantly improved(P<0.05).As compared with the CTL group,the FMA scores,BI,and N9/N20 latencies and amplitudes of SEP in the VFT group were significantly improved(P<0.05).Two months after recovery training,fMRI showed that the degree of activation of the bilateral central anterior gyrus.parietal lobe,and auxiliary motor areas was significantly higher in the VFT group than the CTL group(P<0.05).Conclusions:VFT based on mirror neuron theory is an effective approach to improve upper extremity motor function and daily activity performance of stroke patients.The therapeutic mechanism promotes motor relearning by activating the mirror neuron system and motor cortex.SEP amplitudes increased only for patients who participated in visual feedback.VFT promotes sensory-motor plasticity and behavioral changes in both the motor and sensory domains.展开更多
Interference with quorum sensing(QS)represents an antivirulence strategy with a significant promise for the treatment of bacterial infections and a new approach to restoring antibiotic tolerance.Over the past two deca...Interference with quorum sensing(QS)represents an antivirulence strategy with a significant promise for the treatment of bacterial infections and a new approach to restoring antibiotic tolerance.Over the past two decades,a novel series of studies have reported that quorum quenching approaches and the discovery of quorum sensing inhibitors(QSIs)have a strong impact on the discovery of anti-infective drugs against various types of bacteria.The discovery of QSI was demonstrated to be an appropriate strategy to expand the anti-infective therapeutic approaches to complement classical antibiotics and antimicrobial agents.For the discovery of QSIs,diverse approaches exist and develop in-step with the scale of screening as well as specific QS systems.This review highlights the latest findings in strategies and methodologies for QSI screening,involving activity-based screening with bioassays,chemical methods to seek bacterial QS pathways for QSI discovery,virtual screening for QSI screening,and other potential tools for interpreting QS signaling,which are innovative routes for future efforts to discover additional QSIs to combat bacterial infections.展开更多
Gamma-Ray Integrated Detectors(GRID)mis-sion is a student project designed to use multiple gamma-ray detectors carried by nanosatellites(CubeSats),forming a full-time all-sky gamma-ray detection network that monitors ...Gamma-Ray Integrated Detectors(GRID)mis-sion is a student project designed to use multiple gamma-ray detectors carried by nanosatellites(CubeSats),forming a full-time all-sky gamma-ray detection network that monitors the transient gamma-ray sky in the multi-mes-senger astronomy era.A compact CubeSat gamma-ray detector,including its hardware and firmware,was designed and implemented for the mission.The detector employs four Gd 2 Al 2 Ga 3 O 12:Ce(GAGG:Ce)scintillators coupled with four silicon photomultiplier(SiPM)arrays to achieve a high gamma-ray detection efficiency between 10 keV and 2 MeV with low power and small dimensions.The first detector designed by the undergraduate student team onboard a commercial CubeSat was launched into a Sun-synchronous orbit on October 29,2018.The detector was in a normal observation state and accumulated data for approximately one month after on-orbit functional and performance tests,which were conducted in 2019.展开更多
Objective:To evaluate the effects of action observation therapy,which is based on mirror neuron theory,on upper limb function and activities of daily living in patients with stroke.Methods:Sixty-one patients with stro...Objective:To evaluate the effects of action observation therapy,which is based on mirror neuron theory,on upper limb function and activities of daily living in patients with stroke.Methods:Sixty-one patients with stroke were randomly divided into two groups;those in the control group received routine rehabilitation treatment and nursing,whereas those in the experimental group additionally received eight weeks of action observation therapy for 30 min,six times per week.Patients receiving action observation therapy watched videos depicting a model performing specific motor actions typically performed in daily life before enacting the same actions themselves.All patients were assessed using the FugleMeyer assessment,Barthel index and the modified Ashworth scale at baseline and at eight weeks,after treatment.Results:After the eight weeks of treatment,both groups of patients exhibited significant improvement in all the measurements(all p<0.05).Furthermore,the FugleMeyer assessment,Barthel index and modified Ashworth scale scores were significantly higher in the experimental group compared to the control group(all p<0.05).Conclusion:Action observation therapy significantly improves upper extremity motor function and performance of activities of daily living,and alleviates upper limb spasticity in patients with stroke.展开更多
The broad-energy germanium(BEGe)detector,with the ability of background discrimination using pulse shape discrimination,is a competitive candidate for neutrinoless double beta decay(ovββ)experiments.In this paper,we...The broad-energy germanium(BEGe)detector,with the ability of background discrimination using pulse shape discrimination,is a competitive candidate for neutrinoless double beta decay(ovββ)experiments.In this paper,we report our measurements of key parameters for detector modeling in a commercial p-type BEGe detector.Point-like sources are used to investigate energy resolution and linearity of the detector.A cylindrical volume source is used for efficiency calibration.With an assembled device for source positioning and a collimated ^(133)Ba source,the detector is scanned to check its active volume.Using an^(241)Am point-like source,the dead layer thicknesses is measured at about 0.17 mm on the front and 1.18 mm on the side.The detector characterization is of importance for BEGe detectors to be used in the ovββ experiments at China JinPing underground Laboratory(CJPL).展开更多
Last December 2019,a cluster of viral pneumonia cases identified as coronavirus disease 2019(COVID-19)was reported in Wuhan,China.We aimed to explore the frequencies of nasal symptoms in patients with COVID-19,includi...Last December 2019,a cluster of viral pneumonia cases identified as coronavirus disease 2019(COVID-19)was reported in Wuhan,China.We aimed to explore the frequencies of nasal symptoms in patients with COVID-19,including loss of smell and taste,as well as their presentation as the first symptom of the disease and their association with the severity of COVID-19.In this retrospective study,1206 laboratory-confirmed COVID-19 patients were included and followed up by telephone one month after discharged from Tongji Hospital,Wuhan.Demographic data,laboratory values,comorbidities,symptoms,and numerical rating scale scores(0–10)of nasal symptoms were extracted from the hospital medical records,and confirmed or reevaluated by the telephone follow-up.From patients(n=1172)completing follow-up,199(17%)subjects had severe COVID-19 and 342(29.2%)reported nasal symptoms.20.6%COVID-19 patients had loss of taste(median score=6),while 11.4%had loss of smell(median score=5).Loss of taste scores,but not loss of smell scores,were significantly increased in severe vs.nonsevere COVID-19 patients.Interleukin(IL)-6 and lactose dehydrogenase(LDH)serum levels were positively correlated with loss of taste scores.About 80%of COVID-19 patients recovered from smell and taste dysfunction in 2 weeks.In this cohort,only 1 out of 10 hospital admitted patients had loss of smell while 1 out of 5 reported loss of taste which was associated to severity of COVID-19.Most patients recovered smell and taste dysfunctions in 2 weeks.展开更多
Currently,with the advent of high-repetition-rate laser-plasma experiments,the demand for online diagnosis for the X-ray spectrum is increasing because the laser-plasma-generated X-ray spectrum is very important for c...Currently,with the advent of high-repetition-rate laser-plasma experiments,the demand for online diagnosis for the X-ray spectrum is increasing because the laser-plasma-generated X-ray spectrum is very important for characterizing electron dynamics and applications.In this study,scintillators and silicon PIN(P-type–intrinsic-N-type semiconductor)diodes were used to construct a wideband online filter stack spectrometer.The X-ray sensor and filter arrangement was optimized using a genetic algorithm to minimize the condition number of the response matrix.Consequently,the unfolding error was significantly reduced based on numerical experiments.The detector responses were quantitatively calibrated by irradiating the scintillator and PIN diode with various nuclides and comparing the measuredγ-ray peaks.A prototype 15-channel spectrometer was developed by integrating an X-ray detector with front-and back-end electronics.The prototype spectrometer could record X-ray pulse signals at a repetition rate of 1 kHz.Furthermore,an optimized spectrometer was employed to record the real-time spectra of laser-driven bremsstrahlung sources.This optimized spectrometer offers a compact solution for spectrum diagnostics of ultrashort X-ray pulses,exhibiting improved accuracy in terms of spectrum measurements and repetition rates,and could be widely used in next-generation high-repetition-rate high-power laser facilities.展开更多
In a multi-energy collaboration system, cooling, heating, electricity, and other energy components are coupled to complement each other. Through multi-energy coordination and cooperation, they can significantly improv...In a multi-energy collaboration system, cooling, heating, electricity, and other energy components are coupled to complement each other. Through multi-energy coordination and cooperation, they can significantly improve their individual operating efficiency and overall economic benefits. Demand response, as a multi-energy supply and demand balance method, can further improve system flexibility and economy. Therefore, a multi-energy cooperative system optimization model has been proposed, which is driven by price-based demand response to determine the impact of power-demand response on the optimal operating mode of a multi-energy cooperative system. The main components of the multi-energy collaborative system have been analyzed. The multi-energy coupling characteristics have been identified based on the energy hub model. Using market elasticity as a basis, a price-based demand response model has been built. The model has been optimized to minimize daily operating cost of the multi-energy collaborative system. Using data from an actual situation, the model has been verified, and we have shown that the adoption of price-based demand response measures can significantly improve the economy of multi-energy collaborative systems.展开更多
BACKGROUND The effectiveness of Platelet-Rich Plasma(PRP)in the treatment of patients with Achilles tendon rupture(ATR)and Achilles tendinopathy(AT)has been controversial.AIM To assess PRP injections’effectiveness in...BACKGROUND The effectiveness of Platelet-Rich Plasma(PRP)in the treatment of patients with Achilles tendon rupture(ATR)and Achilles tendinopathy(AT)has been controversial.AIM To assess PRP injections’effectiveness in treating ATR and AT.METHODS A comprehensive review of relevant literature was conducted utilizing multiple databases such as Cochrane Library,PubMed,Web of Science,Chinese Science and Technology Journal,EMBASE,and China Biomedical CD-ROM.The present investigation integrated randomized controlled trials that assessed the effectiveness of platelet-rich plasma injections in managing individuals with Achilles tendon rupture and tendinopathy.The eligibility criteria for the trials encompassed publications that were published within the timeframe of January 1,1966 to December 2022.The statistical analysis was performed utilizing the Review Manager 5.4.1,the visual analogue scale(VAS),Victorian Institute Ankle Function Scale(VISA-A),and Achilles Tendon Thickness were used to assess outcomes.RESULTS This meta-analysis included 13 randomized controlled trials,8 of which were randomized controlled trials of PRP for AT and 5 of which were randomized controlled trials of PRP for ATR.PRP for AT at 6 wk[weighted mean difference(WMD)=1.92,95%CI:-0.54 to 4.38,I2=34%],at 3 mo[WMD=0.20,95%CI:-2.65 to 3.05,I2=60%],and 6 mo[WMD=2.75,95%CI:-2.76 to 8.26,I2=87%)after which there was no significant difference in VISA-A scores between the PRP and control groups.There was no significant difference in VAS scores between the PRP group and the control group after 6 wk[WMD=6.75,95%CI:-6.12 to 19.62,I2=69%]and 6 mo[WMD=10.46,95%CI:-2.44 to 23.37,I2=69%]of treatment,and at mid-treatment at 3 mo[WMD=11.30,95%CI:7.33 to 15.27,I2=0%]after mid-treatment,the PRP group demonstrated better outcomes than the control group.Post-treatment patient satisfaction[WMD=1.07,95%CI:0.84 to 1.35,I2=0%],Achilles tendon thickness[WMD=0.34,95%CI:-0.04 to 0.71,I2=61%]and return to sport[WMD=1.11,95%CI:0.87 to 1.42,I2=0%]were not significantly different between the PRP and control groups.The study did not find any statistically significant distinction between the groups that received PRP treatment and those that did not,regarding the Victorian Institute of Sport Assessment-Achilles scores at 3 mo[WMD=-1.49,95%CI:-5.24 to 2.25,I2=0%],6 mo[WMD=-0.24,95%CI:-3.80 to 3.32,I2=0%],and 12 mo[WMD=-2.02,95%CI:-5.34 to 1.29,I2=87%]for ATR patients.Additionally,no significant difference was observed between the PRP and the control groups in improving Heel lift height respectively at 6 mo[WMD=-3.96,95%CI:-8.61 to 0.69,I2=0%]and 12 mo[WMD=-1.66,95%CI:-11.15 to 7.83,I2=0%]for ATR patients.There was no significant difference in calf circumference between the PRP group and the control group after 6 mo[WMD=1.01,95%CI:-0.78 to 2.80,I2=54%]and 12 mo[WMD=-0.55,95%CI:-2.2 to 1.09,I2=0%]of treatment.There was no significant difference in ankle mobility between the PRP and control groups at 6 mo of treatment[WMD=-0.38,95%CI:-2.34 to 1.58,I2=82%]and after 12 mo of treatment[WMD=-0.98,95%CI:-1.41 to-0.56,I2=10%]there was a significant improvement in ankle mobility between the PRP and control groups.There was no significant difference in the rate of return to exercise after treatment[WMD=1.20,95%CI:0.77 to 1.87,I2=0%]and the rate of adverse events[WMD=0.85,95%CI:0.50 to 1.45,I2=0%]between the PRP group and the control group.CONCLUSION The use of PRP for AT improved the patient’s immediate VAS scores but not VISA-A scores,changes in Achilles tendon thickness,patient satisfaction,or return to sport.Treatment of ATR with PRP injections alone improved long-term ankle mobility but had no significant effect on VISA-A scores,single heel lift height,calf circumference or return to sport.Additional research employing more extensive sampling sizes,more strict experimental methods,and standard methodologies may be necessary to yield more dependable and precise findings.展开更多
AIM:To evaluate impact of radiation therapy dose escalation through intensity modulated radiation therapy with simultaneous integrated boost(IMRT-SIB).METHODS:We retrospectively reviewed the patients who underwent fou...AIM:To evaluate impact of radiation therapy dose escalation through intensity modulated radiation therapy with simultaneous integrated boost(IMRT-SIB).METHODS:We retrospectively reviewed the patients who underwent four-dimensional-based IMRT-SIBbased neoadjuvant chemoradiation protocol.During the concurrent chemoradiation therapy,radiation therapy was through IMRT-SIB delivered in 28 consecutive daily fractions with total radiation doses of 56 Gy to tumor and 5040 Gy dose-painted to clinical tumor volume,with a regimen at the discretion of the treating medical oncologist.This was followed by surgical tumor resection.We analyzed pathological completion response(p CR)rates its relationship with overall survival and event-freesurvival.RESULTS:Seventeen patients underwent dose escalation with the IMRT-SIB protocol between 2007 and 2014 and their records were available for analysis.Among the IMRT-SIB-treated patients,the toxicity appeared mild,the most common side effects were grade 1-3 esophagitis(46%)and pneumonitis(11.7%).There were no cardiac events.The Ro resection rate was 94%(n=16),the p CR rate was 47%(n=8),and the postoperative morbidity was zero.There was one mediastinal failure found,one patient had local failure at the anastomosis site,and the majority of failures were distant in the lung or bone.The 3-year diseasefree survival and overall survival rates were 41%(n=7)and 53%(n=9),respectively.CONCLUSION:The dose escalation through IMRT-SIB in the chemoradiation regimen seems responsible for down-staging the distal esophageal with well-tolerated complications.展开更多
基金supported by the National Natural Science Foundation of China(No.62135002)the Key Research and Development Program of Heilongjiang Province(No.2022ZX01A28).
文摘BACKGROUND Acute myocardial infarction(AMI)is a major cause of mortality worldwide.The stress hyperglycemia ratio(SHR),which integrates glucose and glycated hemoglobin A1c levels,better reflects acute metabolic stress.This study assessed the SHR and longterm prognosis of patients with AMI.METHODS This study was a post-hoc analysis based on the prospective,multicenter OPTIMAL registry(http://www.clinicaltrials.gov,NCT number:NCT03084991).A total of 3384 consecutive patients who underwent percutaneous coronary intervention(PCI)at Department of Cardiology,The 2nd Affiliated Hospital of Harbin Medical University,Harbin,China were included in the present analysis after exclusions.Patients were stratified into quartiles according to the SHR.The primary endpoint was cardiovascular death,with all-cause death and major adverse cardiovascular events as secondary endpoints.The median follow-up duration was 24.1 months,with a completion rate of 99.5%.RESULTS Kaplan-Meier survival curves showed progressively worse survival across SHR quartiles(log-rank P<0.001),with patients in Q4(SHR≥1.34)experiencing the highest risk.Multivariate Cox regression analysis confirmed that the SHR was an independent predictor of cardiovascular death[hazard ratio(HR)=1.56],all-cause death(HR=1.48),and major adverse cardiovascular events(HR=1.34)for Q4(SHR≥1.34)versus Q2(SHR:0.93–1.11).Restricted cubic spline analysis revealed a J-shaped association between SHR and outcomes,with the lowest risk observed at an SHR of approximately 1.0.CONCLUSIONS The SHR is an independent predictor of long-term adverse outcomes in patients with AMI undergoing PCI,supporting its use for early risk stratification and glycemic management.
基金supported in part by National Sciences Foundation of China grants 11972117a Jiangsu Province Science and Technology Agency under grant number BE2016785+4 种基金support from Natural Science Foundation of China(81827806 and 62135002)support from Natural Science Foundation of China(81722025)Key R&D Project of Heilongjiang Province grant 2022ZX06C07support from the Natural Science Foundation of Shandong Province under grant number ZR2024QA110Shandong Province Medical Health Science and Technology Project(Nos.202425020256,and 202403010254).
文摘Image-based computational models have been used for vulnerable plaque progression and rupture predictions,and good results have been reported.However,mechanisms and predictions for plaque erosion are underinvestigated.Patient-specific fluid-structure interaction(FSI)models based on optical coherence tomography(OCT)follow-up data from patients with plaque erosion and who received conservative antithrombotic treatment(using medication,no stenting)to identify risk factors that could be used to predict the treatment outcome.OCT and angiography datawere obtained from10 patientswho received conservative antithrombotic treatment.Five participants had worse outcomes(WOG,stenosis severity≥70%at one-year follow-up),while the other five had better outcomes(BOG,stenosis severity<70%at one-year follow-up).Patient-specific 3D FSI models were constructed to obtain morphological and biomechanical risk factor values(a total of nine risk factors)for comparison and prediction.A logistic regressionmodel was used to identify optimal predictors with the best treatment outcome prediction accuracies.Our results indicated that the combination of wall shear stress(WSS),lipid percent,and thrombus burden was the best group predictor according to the mean area under the curve(AUC)of 0.96(90%confidence interval=(0.85,1.00)).WSS was the best single predictor withmean AUC=0.70(90%confidence interval=(0.20,1.00)).Thrombus burden was the only risk factor showing statistically significant group difference,suggesting its crucial role in the outcomes of conservative anti-thrombotic therapy.This pilot study indicated that integratingmorphological and biomechanical risk factors could improve treatment outcome prediction accuracy in patients with plaque erosion compared to predictions using single predictors.Large-scale patient studies are needed to further validate our findings.
基金supported by the National Natural Science Foundation of China(No.12025301)the Tsinghua University Initiative Scientific Research Program.
文摘Track reconstruction algorithms are critical for polarization measurements.Convolutional neural networks(CNNs)are a promising alternative to traditional moment-based track reconstruction approaches.However,the hexagonal grid track images obtained using gas pixel detectors(GPDs)for better anisotropy do not match the classical rectangle-based CNN,and converting the track images from hexagonal to square results in a loss of information.We developed a new hexagonal CNN algorithm for track reconstruction and polarization estimation in X-ray polarimeters,which was used to extract the emission angles and absorption points from photoelectron track images and predict the uncer-tainty of the predicted emission angles.The simulated data from the PolarLight test were used to train and test the hexagonal CNN models.For individual energies,the hexagonal CNN algorithm produced 15%-30%improvements in the modulation factor compared to the moment analysis method for 100%polarized data,and its performance was comparable to that of the rectangle-based CNN algorithm that was recently developed by the Imaging X-ray Polarimetry Explorer team,but at a lower computational and storage cost for preprocessing.
文摘随着电力市场和碳市场的发展,将需求响应和碳交易机制引入综合能源系统运行调度中,有助于引导用户和系统运营商优化用电和调度计划。通过分时电价和需求响应激励补贴等综合型激励措施引导用户参与需求响应,并基于IGDT(information gap decision theory)理论构建了考虑阶梯式碳交易机制以及需求响应的综合能源系统双层随机优化调度模型,并通过KKT条件和大M法将双层模型转化为单层模型进行求解。结果表明,引入需求响应和阶梯式碳交易机制之后能够实现综合能源系统的低碳环保运行。
基金China Scholarship Council (2003836007)863 Program of China (2008AA10Z337)973 Program of China (2005DKA21202-1)
文摘Objective To investigate the indigenous lactobacilli from the vagina of pregnant women and to screen the isolates with antagonistic potential against pathogenic microorganisms. Methods The strains were isolated from pregnant women＇s vagina and identified using the API50CH system. The ability of the isolates to produce hydrogen peroxide was analyzed semi-quantitatively using the TMB-HRP-MRS agar. The antagonistic effects of the isolates on pathogenic microorganisms were determined with a double layer agar plate. Results One hundred and three lactobacilli strains were isolated from 60 samples of vaginal secretion from healthy pregnant women. Among them, 78 strains could produce hydrogen peroxide, in which 68%, 80%, 80%, and 88% had antagonistic effects against Candida albicans CMCC98001, Staphylococcus aureus CMCC26003, Escherichia coli CMCC44113, and Pseudomonas aeruginosa CMCC10110, respectively. Conclusion The recovery of hydrogen peroxide-producing lactobacilli decreases with the increasing pregnant age and time. The most commonly isolated species from vagina of Chinese pregnant women are Lactobacillus acidophilus and Lactobacillus crispatus. Most of L. acidophilus and L. crispatus produce a high H2O2 level.
基金supported by the National Natural Science Foundation of China(No.U1865205).
文摘Intrinsic radiation of materials is one of the major backgrounds for many rare-event search experiments.Thus,the production of pure materials in an underground laboratory is a promising approach for eliminating cosmogenic radionuclides.In this paper,we demonstrate a procedure to evaluate the yields of cosmogenic radionuclides in copper and germanium in the second phase of the China Jinping Underground Laboratory.Our results show that for copper and germanium materials,the largest cosmogenic background comes from 3 H and57,58,60Co,and 3 H and 68Ge,respectively,which all have yields on the order of 10-7 kg-1 day-1.The corresponding radioactivities after 90 days pf exposure underground are estimated to be lower than 10-6μBq kg-1.
基金supported by the National Natural Science Foundation of China(Grant No.41171220)the Program for Changjiang Scholars and Innovative Research Team in University of the Ministry of Education of China(Grant No.IRT13062)+2 种基金the Programme of Introducing Talents of Discipline to Universities(the 111 Project,Grant No.B08048)the Jiangsu Provincial Collaborative Innovation Center for World Water Valley and Water Ecological Civilizationthe National Cooperative Innovation Center for Water Safety and Hydro-Science
文摘Based on the monthly precipitation and air temperature from 1960 to 1989 in the Luanhe River Basin, the standardized precipitation evapotranspiration index （SPEI） and standardized precipitation index （SPI） at three- and six-month time scales and the self-calibrating Palmer drought severity index （sc-PDSI） were calculated to evaluate droughts in the study area. Temporal variations of the drought severity from 1960 to 1989 were analyzed and compared based on the results of different drought indices, and some typical drought events were identified. Spatial distributions of the drought severity according to the indices were also plotted and investigated. The results reveal the following： the performances of different drought indices are closely associated with the drought duration and the dominant factors of droughts; the SPEI is more accurate than the SPI when both evaporation and precipitation play important roles in drought events; the drought severity shown by the sc-PDSI is generally milder than the actual drought severity from 1960 to 1989; and the evolution of the droughts is usually delayed according to the scPDSI. This study provides valuable references for building drought early warning and mitigation systems in the Luanhe River Basin.
基金This study was supported in part by grants from Zhejiang province medical and health technology achievement Funding project(2018ZH044)Zhejiang province medical and health science and technology project.(2020KY317)+1 种基金Zhejiang province natural science foundation(LQ19H170001)2019-2021 period key discipline construction plan funded project of traditional Chinese medicine in Jiaxing city(2019 XK-A07).
文摘Objective:To investigate the effects of mirror neuron theory-based visual feedback therapy(VFT)on restoration of upper limb function of stroke patients and motor-related cortical function using functional magnetic resonance imaging(fMRI).Methods:Hemiplegic stroke patients were randomly divided into two groups:a VFT group and a control(CTL)group.Sixteen patients in the VFT group received conventional rehabilitation(CR)and VFT for 8 weeks,while 15 patients in the CTL group received only CR.The Barthel Index(BI)was used to assess the activities of daily living at baseline and the 8th week of the recovery training period.The Fugl-Meyer assessment(FMA)scale,somatosensory evoked potential(SEP),and fMRI were used to evaluate the recovery effect of the training therapies.The latencies and amplitudes of N9 and N20 were measured.Before recovery training,fMRI was performed for all patients in the VFT and CTL groups.In addition,17 patients(9 in the VFT group and 8 in the CTL group)underwent fMRI for follow-up 2 months after treatment.Qualitative data were analyzed using the x2 test.The independent sample t-test was used to compare normally distributed data among different groups,the paired sample t-test was used to compare data between groups,and the non-parametric test was used to comparing data without normal distribution among groups.Results:There were no significant differences between the VFT and CTL group in all indexes.However,after 8 weeks of recovery training,these indexes were all significantly improved(P<0.05).As compared with the CTL group,the FMA scores,BI,and N9/N20 latencies and amplitudes of SEP in the VFT group were significantly improved(P<0.05).Two months after recovery training,fMRI showed that the degree of activation of the bilateral central anterior gyrus.parietal lobe,and auxiliary motor areas was significantly higher in the VFT group than the CTL group(P<0.05).Conclusions:VFT based on mirror neuron theory is an effective approach to improve upper extremity motor function and daily activity performance of stroke patients.The therapeutic mechanism promotes motor relearning by activating the mirror neuron system and motor cortex.SEP amplitudes increased only for patients who participated in visual feedback.VFT promotes sensory-motor plasticity and behavioral changes in both the motor and sensory domains.
基金funded by the National Natural Science Foundation of China (Grant No.: 81803812)
文摘Interference with quorum sensing(QS)represents an antivirulence strategy with a significant promise for the treatment of bacterial infections and a new approach to restoring antibiotic tolerance.Over the past two decades,a novel series of studies have reported that quorum quenching approaches and the discovery of quorum sensing inhibitors(QSIs)have a strong impact on the discovery of anti-infective drugs against various types of bacteria.The discovery of QSI was demonstrated to be an appropriate strategy to expand the anti-infective therapeutic approaches to complement classical antibiotics and antimicrobial agents.For the discovery of QSIs,diverse approaches exist and develop in-step with the scale of screening as well as specific QS systems.This review highlights the latest findings in strategies and methodologies for QSI screening,involving activity-based screening with bioassays,chemical methods to seek bacterial QS pathways for QSI discovery,virtual screening for QSI screening,and other potential tools for interpreting QS signaling,which are innovative routes for future efforts to discover additional QSIs to combat bacterial infections.
基金supported by the Tsinghua University Initiative Scientific Research Program,the National Natural Science Foundation of China(Nos.11633003,12025301,and 11821303)the National Key R&D Program of China(Nos.2018YFA0404502 and 2016YFA040080X).
文摘Gamma-Ray Integrated Detectors(GRID)mis-sion is a student project designed to use multiple gamma-ray detectors carried by nanosatellites(CubeSats),forming a full-time all-sky gamma-ray detection network that monitors the transient gamma-ray sky in the multi-mes-senger astronomy era.A compact CubeSat gamma-ray detector,including its hardware and firmware,was designed and implemented for the mission.The detector employs four Gd 2 Al 2 Ga 3 O 12:Ce(GAGG:Ce)scintillators coupled with four silicon photomultiplier(SiPM)arrays to achieve a high gamma-ray detection efficiency between 10 keV and 2 MeV with low power and small dimensions.The first detector designed by the undergraduate student team onboard a commercial CubeSat was launched into a Sun-synchronous orbit on October 29,2018.The detector was in a normal observation state and accumulated data for approximately one month after on-orbit functional and performance tests,which were conducted in 2019.
基金supported by funds from the Jaxing City Science and Technology Plan Project of Zhejiang province(2014AY21031-9)Zhejiang Provincial National Science Foundation of China(LY12H17004)the National Natural Science Foundation of China(81201504).
文摘Objective:To evaluate the effects of action observation therapy,which is based on mirror neuron theory,on upper limb function and activities of daily living in patients with stroke.Methods:Sixty-one patients with stroke were randomly divided into two groups;those in the control group received routine rehabilitation treatment and nursing,whereas those in the experimental group additionally received eight weeks of action observation therapy for 30 min,six times per week.Patients receiving action observation therapy watched videos depicting a model performing specific motor actions typically performed in daily life before enacting the same actions themselves.All patients were assessed using the FugleMeyer assessment,Barthel index and the modified Ashworth scale at baseline and at eight weeks,after treatment.Results:After the eight weeks of treatment,both groups of patients exhibited significant improvement in all the measurements(all p<0.05).Furthermore,the FugleMeyer assessment,Barthel index and modified Ashworth scale scores were significantly higher in the experimental group compared to the control group(all p<0.05).Conclusion:Action observation therapy significantly improves upper extremity motor function and performance of activities of daily living,and alleviates upper limb spasticity in patients with stroke.
基金supported by National Natural Science Foundation of China(Nos.11175099&11355001)Tsinghua University Initiative Scientific Research Program(Nos.20151080354&2014Z21016)
文摘The broad-energy germanium(BEGe)detector,with the ability of background discrimination using pulse shape discrimination,is a competitive candidate for neutrinoless double beta decay(ovββ)experiments.In this paper,we report our measurements of key parameters for detector modeling in a commercial p-type BEGe detector.Point-like sources are used to investigate energy resolution and linearity of the detector.A cylindrical volume source is used for efficiency calibration.With an assembled device for source positioning and a collimated ^(133)Ba source,the detector is scanned to check its active volume.Using an^(241)Am point-like source,the dead layer thicknesses is measured at about 0.17 mm on the front and 1.18 mm on the side.The detector characterization is of importance for BEGe detectors to be used in the ovββ experiments at China JinPing underground Laboratory(CJPL).
基金the Natural Science Foundation of Hubei Province of China(No.2018CFB602)National Key R&D Program of China(No.2018YFC0116800)National Natural Science Foundation of China(Nos:81630024,81920108011,and 81900925)。
文摘Last December 2019,a cluster of viral pneumonia cases identified as coronavirus disease 2019(COVID-19)was reported in Wuhan,China.We aimed to explore the frequencies of nasal symptoms in patients with COVID-19,including loss of smell and taste,as well as their presentation as the first symptom of the disease and their association with the severity of COVID-19.In this retrospective study,1206 laboratory-confirmed COVID-19 patients were included and followed up by telephone one month after discharged from Tongji Hospital,Wuhan.Demographic data,laboratory values,comorbidities,symptoms,and numerical rating scale scores(0–10)of nasal symptoms were extracted from the hospital medical records,and confirmed or reevaluated by the telephone follow-up.From patients(n=1172)completing follow-up,199(17%)subjects had severe COVID-19 and 342(29.2%)reported nasal symptoms.20.6%COVID-19 patients had loss of taste(median score=6),while 11.4%had loss of smell(median score=5).Loss of taste scores,but not loss of smell scores,were significantly increased in severe vs.nonsevere COVID-19 patients.Interleukin(IL)-6 and lactose dehydrogenase(LDH)serum levels were positively correlated with loss of taste scores.About 80%of COVID-19 patients recovered from smell and taste dysfunction in 2 weeks.In this cohort,only 1 out of 10 hospital admitted patients had loss of smell while 1 out of 5 reported loss of taste which was associated to severity of COVID-19.Most patients recovered smell and taste dysfunctions in 2 weeks.
基金partially supported by the Natural Science Foundation of China(Nos.12004353,11975214,11991071,11905202,12175212,and 12120101005)the Key Laboratory Foundation of the Science and Technology on Plasma Physics Laboratory(Nos.6142A04200103 and 6142A0421010).
文摘Currently,with the advent of high-repetition-rate laser-plasma experiments,the demand for online diagnosis for the X-ray spectrum is increasing because the laser-plasma-generated X-ray spectrum is very important for characterizing electron dynamics and applications.In this study,scintillators and silicon PIN(P-type–intrinsic-N-type semiconductor)diodes were used to construct a wideband online filter stack spectrometer.The X-ray sensor and filter arrangement was optimized using a genetic algorithm to minimize the condition number of the response matrix.Consequently,the unfolding error was significantly reduced based on numerical experiments.The detector responses were quantitatively calibrated by irradiating the scintillator and PIN diode with various nuclides and comparing the measuredγ-ray peaks.A prototype 15-channel spectrometer was developed by integrating an X-ray detector with front-and back-end electronics.The prototype spectrometer could record X-ray pulse signals at a repetition rate of 1 kHz.Furthermore,an optimized spectrometer was employed to record the real-time spectra of laser-driven bremsstrahlung sources.This optimized spectrometer offers a compact solution for spectrum diagnostics of ultrashort X-ray pulses,exhibiting improved accuracy in terms of spectrum measurements and repetition rates,and could be widely used in next-generation high-repetition-rate high-power laser facilities.
基金supported by State Grid Corporation Technology Project (5400-201956447A-0-0-00)。
文摘In a multi-energy collaboration system, cooling, heating, electricity, and other energy components are coupled to complement each other. Through multi-energy coordination and cooperation, they can significantly improve their individual operating efficiency and overall economic benefits. Demand response, as a multi-energy supply and demand balance method, can further improve system flexibility and economy. Therefore, a multi-energy cooperative system optimization model has been proposed, which is driven by price-based demand response to determine the impact of power-demand response on the optimal operating mode of a multi-energy cooperative system. The main components of the multi-energy collaborative system have been analyzed. The multi-energy coupling characteristics have been identified based on the energy hub model. Using market elasticity as a basis, a price-based demand response model has been built. The model has been optimized to minimize daily operating cost of the multi-energy collaborative system. Using data from an actual situation, the model has been verified, and we have shown that the adoption of price-based demand response measures can significantly improve the economy of multi-energy collaborative systems.
基金Supported by Scientific Research Project of Hunan Education Department,No.21B0031 and No.21B0042
文摘BACKGROUND The effectiveness of Platelet-Rich Plasma(PRP)in the treatment of patients with Achilles tendon rupture(ATR)and Achilles tendinopathy(AT)has been controversial.AIM To assess PRP injections’effectiveness in treating ATR and AT.METHODS A comprehensive review of relevant literature was conducted utilizing multiple databases such as Cochrane Library,PubMed,Web of Science,Chinese Science and Technology Journal,EMBASE,and China Biomedical CD-ROM.The present investigation integrated randomized controlled trials that assessed the effectiveness of platelet-rich plasma injections in managing individuals with Achilles tendon rupture and tendinopathy.The eligibility criteria for the trials encompassed publications that were published within the timeframe of January 1,1966 to December 2022.The statistical analysis was performed utilizing the Review Manager 5.4.1,the visual analogue scale(VAS),Victorian Institute Ankle Function Scale(VISA-A),and Achilles Tendon Thickness were used to assess outcomes.RESULTS This meta-analysis included 13 randomized controlled trials,8 of which were randomized controlled trials of PRP for AT and 5 of which were randomized controlled trials of PRP for ATR.PRP for AT at 6 wk[weighted mean difference(WMD)=1.92,95%CI:-0.54 to 4.38,I2=34%],at 3 mo[WMD=0.20,95%CI:-2.65 to 3.05,I2=60%],and 6 mo[WMD=2.75,95%CI:-2.76 to 8.26,I2=87%)after which there was no significant difference in VISA-A scores between the PRP and control groups.There was no significant difference in VAS scores between the PRP group and the control group after 6 wk[WMD=6.75,95%CI:-6.12 to 19.62,I2=69%]and 6 mo[WMD=10.46,95%CI:-2.44 to 23.37,I2=69%]of treatment,and at mid-treatment at 3 mo[WMD=11.30,95%CI:7.33 to 15.27,I2=0%]after mid-treatment,the PRP group demonstrated better outcomes than the control group.Post-treatment patient satisfaction[WMD=1.07,95%CI:0.84 to 1.35,I2=0%],Achilles tendon thickness[WMD=0.34,95%CI:-0.04 to 0.71,I2=61%]and return to sport[WMD=1.11,95%CI:0.87 to 1.42,I2=0%]were not significantly different between the PRP and control groups.The study did not find any statistically significant distinction between the groups that received PRP treatment and those that did not,regarding the Victorian Institute of Sport Assessment-Achilles scores at 3 mo[WMD=-1.49,95%CI:-5.24 to 2.25,I2=0%],6 mo[WMD=-0.24,95%CI:-3.80 to 3.32,I2=0%],and 12 mo[WMD=-2.02,95%CI:-5.34 to 1.29,I2=87%]for ATR patients.Additionally,no significant difference was observed between the PRP and the control groups in improving Heel lift height respectively at 6 mo[WMD=-3.96,95%CI:-8.61 to 0.69,I2=0%]and 12 mo[WMD=-1.66,95%CI:-11.15 to 7.83,I2=0%]for ATR patients.There was no significant difference in calf circumference between the PRP group and the control group after 6 mo[WMD=1.01,95%CI:-0.78 to 2.80,I2=54%]and 12 mo[WMD=-0.55,95%CI:-2.2 to 1.09,I2=0%]of treatment.There was no significant difference in ankle mobility between the PRP and control groups at 6 mo of treatment[WMD=-0.38,95%CI:-2.34 to 1.58,I2=82%]and after 12 mo of treatment[WMD=-0.98,95%CI:-1.41 to-0.56,I2=10%]there was a significant improvement in ankle mobility between the PRP and control groups.There was no significant difference in the rate of return to exercise after treatment[WMD=1.20,95%CI:0.77 to 1.87,I2=0%]and the rate of adverse events[WMD=0.85,95%CI:0.50 to 1.45,I2=0%]between the PRP group and the control group.CONCLUSION The use of PRP for AT improved the patient’s immediate VAS scores but not VISA-A scores,changes in Achilles tendon thickness,patient satisfaction,or return to sport.Treatment of ATR with PRP injections alone improved long-term ankle mobility but had no significant effect on VISA-A scores,single heel lift height,calf circumference or return to sport.Additional research employing more extensive sampling sizes,more strict experimental methods,and standard methodologies may be necessary to yield more dependable and precise findings.
文摘AIM:To evaluate impact of radiation therapy dose escalation through intensity modulated radiation therapy with simultaneous integrated boost(IMRT-SIB).METHODS:We retrospectively reviewed the patients who underwent four-dimensional-based IMRT-SIBbased neoadjuvant chemoradiation protocol.During the concurrent chemoradiation therapy,radiation therapy was through IMRT-SIB delivered in 28 consecutive daily fractions with total radiation doses of 56 Gy to tumor and 5040 Gy dose-painted to clinical tumor volume,with a regimen at the discretion of the treating medical oncologist.This was followed by surgical tumor resection.We analyzed pathological completion response(p CR)rates its relationship with overall survival and event-freesurvival.RESULTS:Seventeen patients underwent dose escalation with the IMRT-SIB protocol between 2007 and 2014 and their records were available for analysis.Among the IMRT-SIB-treated patients,the toxicity appeared mild,the most common side effects were grade 1-3 esophagitis(46%)and pneumonitis(11.7%).There were no cardiac events.The Ro resection rate was 94%(n=16),the p CR rate was 47%(n=8),and the postoperative morbidity was zero.There was one mediastinal failure found,one patient had local failure at the anastomosis site,and the majority of failures were distant in the lung or bone.The 3-year diseasefree survival and overall survival rates were 41%(n=7)and 53%(n=9),respectively.CONCLUSION:The dose escalation through IMRT-SIB in the chemoradiation regimen seems responsible for down-staging the distal esophageal with well-tolerated complications.
