BACKGROUND Understanding the type and extent of coronary artery involvement in patients with acute type A aortic dissection(ATAAD)is vital for surgical planning.The Neri classification has been proposed as a guide for...BACKGROUND Understanding the type and extent of coronary artery involvement in patients with acute type A aortic dissection(ATAAD)is vital for surgical planning.The Neri classification has been proposed as a guide for surgical strategies,however,its prognostic impact on postoperative mortality rates remains understudied in large-scale cohorts.METHODS We reviewed 600 ATAAD patients who underwent surgery and coronary computed tomography angiography from 2016 to 2020 at Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China.Patients were classified based on the Neri classification system:no coronary artery involvement,type A(ostial involvement),type B(dissection in coronary body),and type C(circumferential detachment or complete avulsion).The primary endpoint was 30-day mortality.RESULTS Overall,28.3%of the patients had coronary artery involvement,with Neri type A,Neri type B,and Neri type C accounting for 13.3%,11.2%,and 3.8%,respectively.The right coronary artery was more frequently involved(25.3%)than the left coronary artery(8.0%).In the unadjusted analysis,patients with coronary artery involvement exhibited a numerically higher 30-day mortality compared to those without(5.3%vs.2.3%)(OR=2.35,95%CI:0.94–5.88,P=0.07),though this difference did not reach statistical significance.However,multivariable adjustment revealed significant association(adjusted OR=3.71,95%CI:1.05–13.13,P=0.04).Interestingly,after additional adjustment for coronary artery bypass grafting,the impact of coronary artery involvement on 30-day mortality no longer remained statistically significant(adjusted OR=3.13,95%CI:0.85–11.58,P=0.09).The 1-year mortality was higher in those with coronary artery involvement,but this significant association disappeared after adjusting for potential confounding variables.Furthermore,no significant difference in 30-day and 1-year mortality were observed among patients with different Neri classifications.CONCLUSIONS In patients with ATAAD who undergo surgery,the presence of coronary artery involvement is significantly associated with an increased risk of 30-day mortality.Proactive coronary artery bypass grafting may potentially mitigate the adverse impact of coronary artery involvement on 30-day mortality.展开更多
This study pioneers the integrated fabrication of magnesium corrugated-core sandwich structures using wire-arc directed energy deposition(WA-DED).Two sandwich structures—V-type and X-type—were designed with optimize...This study pioneers the integrated fabrication of magnesium corrugated-core sandwich structures using wire-arc directed energy deposition(WA-DED).Two sandwich structures—V-type and X-type—were designed with optimized deposition paths to achieve comparable grain morphology while enhancing strength.The compression properties and failure modes of the two corrugated-core sandwich structures were examined through quasi-static compression tests.Results showed that the V-type structure exhibited a higher specific compressive strength(93 MPa∙cm^(3)/g)than the X-type structure(72 MPa∙cm^(3)/g).Both finite element analysis and experimental compression tests indicated that failure occurred at the midsection of the corrugated core.This work offers valuable insights for the efficient fabrication of high-strength corrugated-core sandwich structures.展开更多
BACKGROUND Intermittent fasting(IF),particularly time-restricted feeding(TRF),is increasingly popular has gained popularity for weight loss,yet management,but its effects impact on gut health remain unclear.Remains in...BACKGROUND Intermittent fasting(IF),particularly time-restricted feeding(TRF),is increasingly popular has gained popularity for weight loss,yet management,but its effects impact on gut health remain unclear.Remains inadequately understood.This study explores how investigated the effects of TRF effects on intestinal health and explored the underlying mechanisms.AIM To assess the effects of IF on intestinal health,elucidate the mechanisms involved.METHODS Mice were divided into two groups:Normal control(NC)and IF.The IF group underwent TRF,while the NC group had unrestricted access to food.Body weight,fecal characteristics,and intestinal morphology were analyzed.Colon tissue,serum,and fecal samples were collected for histological analysis,enzymelinked immunosorbent assay,flow cytometry,16S rRNA sequencing,and metabolomic profiling.RESULTS IF significantly affected body weight and intestinal morphology,compromised the intestinal barrier,increased pro-inflammatory cytokines,and heightened gut immune activation(P<0.05).It also disrupted the gut microbiota,promoting proinflammatory bacteria,reducing anti-inflammatory metabolites,and elevating pro-inflammatory metabolites(P<0.05).Indoleacrylic acid(IAA)supplementation notably alleviated intestinal inflammation and reversed immune dysfunction induced by IF(P<0.05).CONCLUSION Prolonged IF exacerbates intestinal inflammation by impairing gut barrier integrity and disrupting microbial homeostasis.However,IAA supplementation effectively mitigates fasting-induced intestinal inflammation and immune imbalance,suggesting its potential as a therapeutic agent.展开更多
With the rise of big data,the increasing volume of information has raised significant demands on data storage technologies,presenting various challenges to current information storage solutions.Consequently,finding mo...With the rise of big data,the increasing volume of information has raised significant demands on data storage technologies,presenting various challenges to current information storage solutions.Consequently,finding more efficient and higher-capacity methods for data storage has become crucial.In comparison to conventional semiconductor random access memory,magnetic random access memory(MRAM),which has been progressively developed in recent years,shows promise as a candidate for the next generation of information storage due to its notable advantages,including non-volatility,high density,stability,low power consumption,and resistance to radiation.Among the MRAM variants,spin–orbit torque magnetic random access memory(SOT-MRAM)exhibits considerable potential for advancement.Utilizing a vertical magnetized thin film structure made up of heavy metal and ferromagnetic metal,SOT-MRAM leverages the strong spin–orbit coupling effect of the heavy metal to convert the flow of charge into pure spin flow.This process also allows for the injection of spin accumulation from the interface into the adjacent magnetic layer through mechanisms such as the spin Hall effect and the Rashba effect,ultimately applying spin–orbit torque to manipulate the magnetic moment of the magnetic layer,facilitating its reversal.This paper primarily investigates the physical mechanisms underlying the motion of magnetic domain walls driven by current-induced spin–orbit moments in vertically magnetized heterostructures.Utilizing a magneto-optical Kerr microscope to observe the movement of the magnetic domain walls,the study analyzes and compares the velocity behaviors of the domain walls across different cobalt thicknesses.These investigations offer valuable design insights for applications involving track memory driven by spin–orbit moments.展开更多
To the Editor:Contemporary guidelines recommend primary percutaneous coronary intervention(PPCI)as the gold-standard reperfusion modality in patients with ST-segment elevation myocardial infarction(STEMI)within 12 h o...To the Editor:Contemporary guidelines recommend primary percutaneous coronary intervention(PPCI)as the gold-standard reperfusion modality in patients with ST-segment elevation myocardial infarction(STEMI)within 12 h of symptom onset.However,in realworld clinical practice,the implementation of PPCI faces substantial operational challenges,particularly in resource-limited settings,such as inadequate availability of specialized cardiac catheterization teams with requisite procedural expertise or the complete absence of coronary intervention capabilities in numerous rural healthcare facilities across China.Consequently,fibrinolytic therapy remains the predominant reperfusion strategy for STEMI management in county-level hospitals,with particularly high utilization rates observed in geographically remote regions.[3,4]Furthermore,our previous study revealed that 42.5%of STEMI patients fail to receive any form of evidence-based reperfusion therapy,representing a critical gap in optimal care delivery.To elucidate the prognostic implications of these treatment pathways within China’s unique healthcare system,this study aimed to compare the long-term outcomes among STEMI patients receiving PPCI,fibrinolysis,and no reperfusion therapy using data from the China Acute Myocardial Infarction Registry(CAMI Registry,clinicaltrials.gov,NCT01874691).展开更多
Background Diabetes is frequently associated with poor prognosis among acute myocardial infarction(AMI)patients.Patients with these comorbidities often have atypical symptoms and subsequent delay in treatment.Few stud...Background Diabetes is frequently associated with poor prognosis among acute myocardial infarction(AMI)patients.Patients with these comorbidities often have atypical symptoms and subsequent delay in treatment.Few studies have reported detailed AMI symptoms in patients with diabetes.This study compared AMI symptoms and presentation characteristics between diabetics and non-diabetics.Methods We included patients from the China AMI registry diagnosed with AMI between January 2013 and September 2014.Baseline characteristics,symptomology,and delay in treatment were compared between diabetics and non-diabetics.Multivariable logistic regression analysis was used to explore independent predictors of atypical symptoms.Results A total of 4450(20.2%)patients had diabetes.They were older,more often women,higher in body mass index,and more likely to have non-ST segment elevation myocardial infarction.Fewer diabetic patients presented with persistent precordial chest pain(63.1%vs.68%,P<0.0001),diaphoresis(60.1%vs.65.6%,P<0.0001),fatigue(16.7%vs.18.3%,P=0.0123),and incontinence(0.4%vs.0.7%,P=0.0093).Time to hospital presentation was longer among patients with diabetes than those without.In multivariable analysis,diabetes was identified as an independent predictor of atypical symptoms(OR:1.112,95%CI:1.034?1.196).Conclusions Our study is the first large-scale study providing evidence that diabetics are less likely to present with typical chest pain and more likely to experience treatment delay when suffering from an AMI.Our results may increase clinician awareness of recognizing AMI patients rapidly to reduce diagnosis and treatment delay,particularly in the context of diabetes.展开更多
The hot deformation characteristics of Rene88DT superalloy with directionally solidified micro- structure produced by electroslag remelting continuous directionally solidification （ESR-CDS） were studied in the tempe...The hot deformation characteristics of Rene88DT superalloy with directionally solidified micro- structure produced by electroslag remelting continuous directionally solidification （ESR-CDS） were studied in the temperature range of 1,040-1,140 ℃ and strain rate range of 0.001-1.000 s-1 by hot compression tests. Flow curves for Rene88DT alloy with initial directionally solidified （DS） microstructure exhibit pronounced peak stresses at the early stage of deformation followed by the occurrence of dynamic softening phenomenon. Rene88DT alloy with DS micro- structure shows higher flow peak stresses compared with HIPed P/M superalloy FGH4096, but the disparities in peak stresses between ESR-CDSed Rene88DT and HIPed P/M superalloy FGH4096 reduce as temperature increases. The improvement of hot workability of DS alloy with columnar grains avoiding the maximum shear stress comes true. A hot deformation constitutive equation as a function of strain that describes the dependence of flow stress on strain rate and temperature is established. Hot deformation apparent acti- vation energy （Q） varies not only with the strain rate and temperature but also with strain. The strain rate sensitivity exponent （m） map is established at the strain of 0.8, which reveals that global dynamic recrystallization （DRX） shows a relatively high m value in a large strain compression. Optimum parameters are predicted in two regions： T = 1,100-1,130 ℃, ε = 0.100-1.000 s-1 and T = 1,080- 1,100 ℃, ε = 0.010-100 s-1, which is based on pro- cessing maps and deformation microstructure observations.展开更多
OBJECTIVES To assess the correlation between triglyceride glucose(TyG)index and in-hospital mortality in patients with ST-segment elevation myocardial infarction(STEMI).METHODS A total of 2190 patients with STEMI who ...OBJECTIVES To assess the correlation between triglyceride glucose(TyG)index and in-hospital mortality in patients with ST-segment elevation myocardial infarction(STEMI).METHODS A total of 2190 patients with STEMI who underwent primary angiography within 12 h from symptom onset were selected from the prospective,nationwide,multicenter CAMI registry.TyG index was calculated with the formula:Ln[fasting triglycerides(mmol/L)×fasting glucose(mmol/L)/2].Patients were divided into three groups according to the tertiles of TyG index.The primary endpoint was in-hospital mortality.RESULTS Overall,46 patients died during hospitalization,in-hospital mortality was 1.5%,2.2%,2.6%for tertile 1,tertile 2,and tertile 3,respectively.However,TyG index was not significantly correlated with in-hospital mortality in single-variable logistic regression analysis.Nonetheless,after adjusting for age and sex,TyG index was significantly associated with higher mortality when regarded as a continuous variable(adjusted OR=1.75,95%CI:1.16-2.63)or categorical variable(tertile 3 vs.tertile 1:adjus-ted OR=2.50,95%CI:1.14-5.49).Furthermore,TyG index,either as a continuous variable(adjusted OR=2.54,95%CI:1.42-4.54)or categorical variable(tertile 3 vs.tertile 1:adjusted OR=3.57,95%CI:1.24-10.29),was an independent predictor of in-hospital mortality after adjusting for multiple confounders in multivariable logistic regression analysis.In subgroup analysis,the pro-gnostic effect of high TyG index was more significant in patients with body mass index<18.5 kg/m2(P interaction=0.006).CONCLUSIONS This study showed that TyG index was positively correlated with in-hospital mortality in STEMI patients who underwent primary angiography,especially in underweight patients.展开更多
In all the connexin-associated human diseases, deafness is one of the most important diseases with high frequency. The mu- tations of GJB2 （gap junction protein β2, also called connexin 26, Cx26） gene link with non...In all the connexin-associated human diseases, deafness is one of the most important diseases with high frequency. The mu- tations of GJB2 （gap junction protein β2, also called connexin 26, Cx26） gene link with nonsyndromic or syndromic senso- rineural hearing loss and were shown to account for a large proportion of congenital deaf cases in many studied populations （del Castillo and del Castillo, 2011）. For example, the 235de1C mutation in GJB2 shows the frequency of approximately 1% and is the most frequent mutation in East Asian population （Yan et al., 2003）. Many efforts have been put to study the function of Gjb2 gene in both mouse model and human. In mouse, extensive deletion of Gjb2 causes embryo lethal due to the decreased transplacental glucose uptake, which was not found in human （Takata and Hirano, 1997; Gabriel et al., 1998）. In human, GJB2 deficiency is not able to cause embryo lethal （D＇Andrea et al., 2002）. However, the study of GJB2-associated hearing loss is hampered by many difficulties, such as unobtainable human cochlea and acoustic nerve tissues, and therefore the GJB2-associated hearing loss are underlying mechanisms of still remaining unclear.展开更多
OBJECTIVES To evaluate the predictive value of fasting plasma glucose(FPG)for in-hospital mortality in patients with acute myocardial infarction(AMI)with different glucose metabolism status.METHODS We selected 5,308 p...OBJECTIVES To evaluate the predictive value of fasting plasma glucose(FPG)for in-hospital mortality in patients with acute myocardial infarction(AMI)with different glucose metabolism status.METHODS We selected 5,308 participants with AMI from the prospective,nationwide,multicenter CAMI registry,of which 2,081 were diabetic and 3,227 were nondiabetic.Patients were divided into high FPG and low FPG groups according to the optim-al cutoff values of FPG to predict in-hospital mortality for diabetic and nondiabetic cohorts,respectively.The primary endpoint was in-hospital mortality.RESULTS Overall,94 diabetic patients(4.5%)and 131 nondiabetic patients(4.1%)died during hospitalization,and the optimal FPG thresholds for predicting in-hospital death of the two cohorts were 13.2 mmol/L and 6.4 mmol/L,respectively.Compared with individuals who had low FPG,those with high FPG were significantly associated with higher in-hospital mortality in diabet-ic cohort(10.1%vs.2.8%;odds ratio[OR]=3.862,95%confidence interval[CI]:2.542-5.869)and nondiabetic cohort(7.4%vs.1.7%;HR=4.542,95%CI:3.041-6.782).After adjusting the potential confounders,this significant association was not changed.Further-more,FPG as a continuous variable was positively associated with in-hospital mortality in single-variable and multivariable models regardless of diabetic status.Adding FPG to the original model showed a significant improvement in C-statistic and net reclassification in diabetic and nondiabetic cohorts.CONCLUSIONS This large-scale registry indicated that there is a strong positive association between FPG and in-hospital mor-tality in AMI patients with and without diabetes.FPG might be useful to stratify patients with AMI.展开更多
Here we propose to employ wire-arc directed energy deposition(WA-DED) to tune the microstructure and the mechanical property of Mg-Al-Si alloys, on the basis of its sub-rapid solidification effect. According to finite...Here we propose to employ wire-arc directed energy deposition(WA-DED) to tune the microstructure and the mechanical property of Mg-Al-Si alloys, on the basis of its sub-rapid solidification effect. According to finite element analysis, WA-DED shows higher cooling rate than conventional casting, reaching 598.3 K/s for Mg-Al-Si alloy, and the lower heat input, the larger cooling rate of WA-DED. Significant microstructure refinement is thus achieved, with reduced grain size and Mg_(2)Si particle diameter. The transition from hypereutectic to fully eutectic microstructure is triggered by reducing the heat input. Compared with the as-cast alloy, WA-DED alloys demonstrate higher ultimate tensile strengths(UTS) at both room-and high-temperature(150℃) properties, increasing by 50.1% and 30.3%, respectively. The superior strength-ductility synergy for Mg-Al-Si alloys results from the microstructure tuning via sub-rapid solidification of WA-DED.展开更多
Hepatocellular carcinoma(HCC),a prevalent solid carcinoma of significant concern,is an aggressive and often fatal disease with increasing global incidence rates and poor therapeutic outcomes.The etiology and pathologi...Hepatocellular carcinoma(HCC),a prevalent solid carcinoma of significant concern,is an aggressive and often fatal disease with increasing global incidence rates and poor therapeutic outcomes.The etiology and pathological progression of non-alcoholic steatohepatitis(NASH)-related HCC is multifactorial and multistage.However,no single animal model can accurately mimic the full NASH-related HCC pathological progression,posing considerable challenges to transition and mechanistic studies.Herein,a novel conditional inducible wild-type human HRAS overexpressed mouse model(HRAS-HCC)was established,demonstrating 100%morbidity and mortality within approximately one month under normal dietary and lifestyle conditions.Advanced symptoms of HCC such as ascites,thrombus,internal hemorrhage,jaundice,and lung metastasis were successfully replicated in mice.In-depth pathological features of NASH-related HCC were demonstrated by pathological staining,biochemical analyses,and typical marker gene detections.Combined murine anti-PD-1 and sorafenib treatment effectively prolonged mouse survival,further confirming the accuracy and reliability of the model.Based on protein-protein interaction(PPI)network and RNA sequencing analyses,we speculated that overexpression of HRAS may initiate the THBS1-COL4A3 axis to induce NASH with severe fibrosis,with subsequent progression to HCC.Collectively,our study successfully duplicated natural sequential progression in a single murine model over a very short period,providing an accurate and reliable preclinical tool for therapeutic evaluations targeting the NASH to HCC continuum.展开更多
Immediately following the Ms7.0 Lushan earthquake on April 20, 2013, using high-pass and low- pass filtering on the digital seismic stations in the Shanxi Province, located about 870-1,452 km from the earthquake epice...Immediately following the Ms7.0 Lushan earthquake on April 20, 2013, using high-pass and low- pass filtering on the digital seismic stations in the Shanxi Province, located about 870-1,452 km from the earthquake epicenter, we detected some earthquakes at a time corre- sponding to the first arrival of surface waves in high-pass filtering waveform. The earthquakes were especially noticed at stations in Youyu （YUY）, Shanzizao （SZZ）, Shanghuangzhuang （SHZ）, and Zhenchuan （ZCH）, which are located in a volcanic region in the Shanxi Province,but they were not listed in the Shanxi seismic observation report. These earthquakes occurred 4-50 rain after the passage of the maximum amplitude Rayleigh wave, and the periods of the surface waves were mainly between 15 and 20 s following. The Coulomb stresses caused by the Ray- leigh waves that acted on the four stations was about 0.001 MPa, which is a little lower than the threshold value of dynamic triggering, therefore, we may conclude that the Datong volcanic region is more sensitive to the Coulomb stress change. To verify, if the similar phenomena are widespread, we used the same filtering to observecontrastively continuous waveform data before, and 5 h after, the Ms7.0 Lushan earthquake and Ms9.0 Tohoku earthquake in 2011. The results show that the similar phenomena occur before the earthquakes, but the seis- micity rates after the earthquakes are remarkably increased. Since these weak earthquakes are quite small, it is hard to get clear phase arrival time from three or more stations to locate them. In addition, the travel time differences between P waves and S waves （S-P） are all less than 4 s, that means the events should occur in 34 km around the stations in the volcanic region. The stress of initial dynamic triggering of the Ms9.0 Tohoku earthquake was about 0.09 MPa, which is much higher than the threshold value of dynamic triggering stress. The earthquakes after the Ms9.0 Tohoku earthquake are related to dynamic triggering stress, but the events before the earthquake cannot be linked to seismic events, but may be related to the back- ground seismicity or from other kinds of local sources, such as anthropogenic sources （i.e., explosions）. Using two teleseismic filtering, the small background earthquakes in the Datong volcanic region occur frequently, thus we postulate that previous catalog does not apply bandpass filter to pick out the weak earthquakes, and some of the observed weak events were not triggered by changes in the dynamic stress field.展开更多
Background Globally,populations afflicted by armed conflict are known to have high rates of mental health disorders.Aims This meta-analysis aims to estimate the prevalence of post-traumatic stress disorder(PTSD)and de...Background Globally,populations afflicted by armed conflict are known to have high rates of mental health disorders.Aims This meta-analysis aims to estimate the prevalence of post-traumatic stress disorder(PTSD)and depressive symptoms among civilians residing in armed conflictaffected regions.Methods This meta-analysis was conducted in accordance with the Preferred Reporting Items forSystematic Reviews and Meta-Analyses.A literature search employing MEDLINE(R),Embase Classic+Embase,APA PsyclNFO,Ovid Healthstar,Journal@Ovid Full Text,Cochrane,PTSDpubs and CINAHL was conducted from inception until 19 March 2024 to identify relevant studies.Quality assessment was performed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies,and a Comprehensive Meta-Analysiswas usedto conduct the statistical analysis.Results The search yielded 38595 articles,of which 57 were considered eligible for inclusion.The included studies comprised data from 64596 participants.We estimated a prevalence of 23.70%(95%CI 19.50%to28.40%)forPTSD symptomsand 25.60%(95%Cl 20.70%to 31.10%)for depressive features among war-afflicted civilians.The subgroup analysis based on time since the war and the country's economic status revealed the highest prevalence for both PTSD and depressive symptoms was present during the years of war and in low/middle-incomecountries.Conclusions The results of this study provide conclusive evidence of the detrimental impacts of armed conflict on mental health outcomes.Hence,it is crucial to emphasise the significance of both physical and mental health in the aftermath of war and take appropriate humanistic measures to overcome challenges in the management of psychiatric illnesses.展开更多
During the COVID-19 pandemic,the number of suspected cases,confirmed cases and those who passed away from the virus has been reported in major media and the internet,and has caused a high degree of tension.In addition...During the COVID-19 pandemic,the number of suspected cases,confirmed cases and those who passed away from the virus has been reported in major media and the internet,and has caused a high degree of tension.In addition,people's outdoor activities have been limited,making it more difficult to find outlets for releasing stress.Under this situation,some people began to experience emotions of anxiety and depression.This article reports a case of depression with fever caused by the stress tension of the pandemic.The patient was highly suspected to have contracted COVID-19.The reported patient,who had a history of depression and had been to Wuhan to attend an exam,showed obvious pre-exam anxiety under the epidemic situation,which gradually increased the patient's pressure and then caused some adverse symptoms,such as insomnia,anxiety,sweating and a reoccurrent fever.Local community authorities paid close attention to him and later sent him to a general hospital in Jingmen for quarantine and treatment,as he was suspected of having COVID-19.After being hospitalised for half a month,he was ruled out from having‘COVID-19'and was cured of depression and discharged from the hospital.From this case,we can realise that,under the situation of the epidemic,people are easily prone to insomnia,anxiety and even depression.As clinicians in general hospitals,especially when encountering large emergencies,we must carefully inquire about the patient's medical history while strengthening our understanding of psychiatric knowledge to improve the recognition rate for depression.展开更多
Catatonia is a state of high-degree psychomotor inhibition in which patients often maintain a constant fixed posture,and generally have unconscious obstacles and various reflex preservation.Patients suffering from sev...Catatonia is a state of high-degree psychomotor inhibition in which patients often maintain a constant fixed posture,and generally have unconscious obstacles and various reflex preservation.Patients suffering from severe catatonia will become stiff.Catatonia generally manifests unconsciousness while various reflexes are preserved.Patients show reticence,no food or drink intake,and immobility as signs of complete suppression of speech and movement,and even incontinence.Patients are often first diagnosed in non-psychiatric departments and are more likely to be misdiagnosed as having‘coma’or‘epilepsy,,thus delaying treatment.This article reports a case of a 19-year-old female patient who was misdiagnosed with'catatonia'.A month ago,she was admitted to a general hospital of our city because of"intermittent attacks of nausea,vomiting,stupor for 15 years,with one week of exacerbation".During her hospitalisation,she suddenly appeared was mute,had no food or drink intake,and showed immobility and incontinence,presenting a'coma state'.She was transferred to a general hospital in Wuhan to further investigate the cause of her"coma".After 7 days in the hospital,no abnormal examination results were found and the symptoms were not alleviated.Later,she was transferred to the mental health centre for hospitalisation in this city.The patient was diagnosed as having(1)‘epileptic psychosis’and(2)‘catatonic stupor*.After 3 days of treatment,the patient's recovered consciousness.She was clinically cured and discharged half a month later.We hereby report this case.展开更多
The most widely used method of identification of microbial morphology and structure is microscopy,but it can be difficult to distinguish between pathogens with a similar appearance.Existing fluorescent staining method...The most widely used method of identification of microbial morphology and structure is microscopy,but it can be difficult to distinguish between pathogens with a similar appearance.Existing fluorescent staining methods require a combination of a variety of fluorescent materials to meet this demand.In this study,unique concentration-dependent fluorescent carbon dots(CDs)were synthesized for the identification and quantification of pathogens.The emission wavelength of the CDs could be tuned spanning the full visible region by virtue of aggregation-induced narrowing of bandgaps.This tunable emission wavelength of the specific concentration response to diverse microbes can be used to distinguish microorganisms with a similar appearance,even in a same genus.A hyperspectral microscopy system was demonstrated to distinguish Aspergillus flavus and A.fumigatus based on the results above.The identification accuracy of the two similar-looking pathogens can be close to 100%,and the relative proportions and spatial distributions can also be profiled from the mixture of the pathogens.This technique can provide a solution to the fast detection of microorganisms and is potentially applicable to a wide range of problems in areas such as healthcare,food preparation,biotechnology,and health emergency.展开更多
Gene fusions and MET alterations are rare and difficult to detect in plasma samples.The clinical detection efficacy of molecular residual disease(MRD)based on circulating tumor DNA(ctDNA)in patients with non-small cel...Gene fusions and MET alterations are rare and difficult to detect in plasma samples.The clinical detection efficacy of molecular residual disease(MRD)based on circulating tumor DNA(ctDNA)in patients with non-small cell lung cancer(NSCLC)with these mutations remains unknown.This prospective,non-intervention study recruited 49 patients with operable NSCLC with actionable gene fusions(ALK,ROS1,RET,and FGFR1),MET exon 14 skipping or de novo MET amplification.We analyzed 43 tumor tissues and 111 serial perioperative plasma samples using 1021-and 338-gene panels,respectively.Detectable MRD correlated with a significantly higher recurrence rate(P<0.001),yielding positive predictive values of 100%and 90.9%,and negative predictive values of 82.4%and 86.4%at landmark and longitudinal time points,respectively.Patients with detectable MRD showed reduced disease-free survival(DFS)compared to those with undetectable MRD(P<0.001).Patients who harbored tissue-derived fusion/MET alterations in their MRD had reduced DFS compared to those who did not(P=0.05).To our knowledge,this is the first comprehensive study on ctDNA-MRD clinical detection efficacy in operable NSCLC patients with gene fusions and MET alterations.Patients with detectable tissue-derived fusion/MET alterations in postoperative MRD had worse clinical outcomes.展开更多
Herein,organophotoredox-catalyzed annulation of enamines with sulfoxonium ylides to construct pyrrole derivatives is developed under transition-metal-free and mild condition.A broad range of readily accessible substra...Herein,organophotoredox-catalyzed annulation of enamines with sulfoxonium ylides to construct pyrrole derivatives is developed under transition-metal-free and mild condition.A broad range of readily accessible substrates are suitable for this protocol,providing a convenient and efficient approach to preparing pyrrole derivatives with satisfying yields.Mechanistically,a photoredox-mediated radical chain mechanistic pathway is proposed for this reaction by a synergistic experimental and computational study.Two key radicals,α-imino andα-carbonyl C-radicals derived from enamines and sulfoxonium ylides,respectively,could be generated via two steps of single-electron transfer in a photoredox catalytic loop.Subsequently,the formedα-carbonyl C-radical may attack the alkenyl moiety of enamines.Next,the formed radical adduct could undergo H-atom transfer with sulfoxonium ylides to regenerate the keyα-carbonyl C-radical and thus fulfill the chain propagation process.The afforded adduct intermediate could undergo an intramolecular cyclization followed by dehydration to furnish the desired pyrrole derivatives.展开更多
基金supported by the National High Level Hospital Clinical Research Funding(No.2024-GSP-TJ-15&No.2023-GSP-QN-17)the Chinese Society of Cardiology’s Foundation(CSCF2023B03).
文摘BACKGROUND Understanding the type and extent of coronary artery involvement in patients with acute type A aortic dissection(ATAAD)is vital for surgical planning.The Neri classification has been proposed as a guide for surgical strategies,however,its prognostic impact on postoperative mortality rates remains understudied in large-scale cohorts.METHODS We reviewed 600 ATAAD patients who underwent surgery and coronary computed tomography angiography from 2016 to 2020 at Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China.Patients were classified based on the Neri classification system:no coronary artery involvement,type A(ostial involvement),type B(dissection in coronary body),and type C(circumferential detachment or complete avulsion).The primary endpoint was 30-day mortality.RESULTS Overall,28.3%of the patients had coronary artery involvement,with Neri type A,Neri type B,and Neri type C accounting for 13.3%,11.2%,and 3.8%,respectively.The right coronary artery was more frequently involved(25.3%)than the left coronary artery(8.0%).In the unadjusted analysis,patients with coronary artery involvement exhibited a numerically higher 30-day mortality compared to those without(5.3%vs.2.3%)(OR=2.35,95%CI:0.94–5.88,P=0.07),though this difference did not reach statistical significance.However,multivariable adjustment revealed significant association(adjusted OR=3.71,95%CI:1.05–13.13,P=0.04).Interestingly,after additional adjustment for coronary artery bypass grafting,the impact of coronary artery involvement on 30-day mortality no longer remained statistically significant(adjusted OR=3.13,95%CI:0.85–11.58,P=0.09).The 1-year mortality was higher in those with coronary artery involvement,but this significant association disappeared after adjusting for potential confounding variables.Furthermore,no significant difference in 30-day and 1-year mortality were observed among patients with different Neri classifications.CONCLUSIONS In patients with ATAAD who undergo surgery,the presence of coronary artery involvement is significantly associated with an increased risk of 30-day mortality.Proactive coronary artery bypass grafting may potentially mitigate the adverse impact of coronary artery involvement on 30-day mortality.
基金supported by JCKY Project(Grant No.JCKY2023602B012).
文摘This study pioneers the integrated fabrication of magnesium corrugated-core sandwich structures using wire-arc directed energy deposition(WA-DED).Two sandwich structures—V-type and X-type—were designed with optimized deposition paths to achieve comparable grain morphology while enhancing strength.The compression properties and failure modes of the two corrugated-core sandwich structures were examined through quasi-static compression tests.Results showed that the V-type structure exhibited a higher specific compressive strength(93 MPa∙cm^(3)/g)than the X-type structure(72 MPa∙cm^(3)/g).Both finite element analysis and experimental compression tests indicated that failure occurred at the midsection of the corrugated core.This work offers valuable insights for the efficient fabrication of high-strength corrugated-core sandwich structures.
基金Supported by the Anhui University Research Project,No.2022AH051171Natural Science Foundation Project of Anhui Province,No.2408085QH271+6 种基金Anhui Medical University Scientific Research Level Improvement Plan,No.2022xkjT028Health Research Project of Anhui Province,No.AHWJ2023A30047the Anhui Provincial Natural Science Foundation,No.2208085MH240the Scientific Research Project of Anhui Provincial Department of Education,No.2022AH051167the Anhui Quality Engineering Project,No.2023sx200,No.2023jyjxggyjY087 and No.2023zyxwjxalk046the Anhui Provincial Postgraduate Education Quality Project,No.2024cxcysj062and Anhui Medical University Graduate Research and Practice Innovation Project,No.YJS20240095.
文摘BACKGROUND Intermittent fasting(IF),particularly time-restricted feeding(TRF),is increasingly popular has gained popularity for weight loss,yet management,but its effects impact on gut health remain unclear.Remains inadequately understood.This study explores how investigated the effects of TRF effects on intestinal health and explored the underlying mechanisms.AIM To assess the effects of IF on intestinal health,elucidate the mechanisms involved.METHODS Mice were divided into two groups:Normal control(NC)and IF.The IF group underwent TRF,while the NC group had unrestricted access to food.Body weight,fecal characteristics,and intestinal morphology were analyzed.Colon tissue,serum,and fecal samples were collected for histological analysis,enzymelinked immunosorbent assay,flow cytometry,16S rRNA sequencing,and metabolomic profiling.RESULTS IF significantly affected body weight and intestinal morphology,compromised the intestinal barrier,increased pro-inflammatory cytokines,and heightened gut immune activation(P<0.05).It also disrupted the gut microbiota,promoting proinflammatory bacteria,reducing anti-inflammatory metabolites,and elevating pro-inflammatory metabolites(P<0.05).Indoleacrylic acid(IAA)supplementation notably alleviated intestinal inflammation and reversed immune dysfunction induced by IF(P<0.05).CONCLUSION Prolonged IF exacerbates intestinal inflammation by impairing gut barrier integrity and disrupting microbial homeostasis.However,IAA supplementation effectively mitigates fasting-induced intestinal inflammation and immune imbalance,suggesting its potential as a therapeutic agent.
基金supported by the Shenzhen Fundamental Research Fund(Grant No.JCYJ20210324120213037)the Basic and Applied Basic Research Foundation of Guangdong Province,China(Grant No.2021B1515120047)+2 种基金the Fund from the Shenzhen Peacock Group Plan(Grant No.KQTD20180413181702403)the National Natural Science Foundation of China(Grant Nos.12374123 and 12204396)the 2023 SZSTI stable support scheme。
文摘With the rise of big data,the increasing volume of information has raised significant demands on data storage technologies,presenting various challenges to current information storage solutions.Consequently,finding more efficient and higher-capacity methods for data storage has become crucial.In comparison to conventional semiconductor random access memory,magnetic random access memory(MRAM),which has been progressively developed in recent years,shows promise as a candidate for the next generation of information storage due to its notable advantages,including non-volatility,high density,stability,low power consumption,and resistance to radiation.Among the MRAM variants,spin–orbit torque magnetic random access memory(SOT-MRAM)exhibits considerable potential for advancement.Utilizing a vertical magnetized thin film structure made up of heavy metal and ferromagnetic metal,SOT-MRAM leverages the strong spin–orbit coupling effect of the heavy metal to convert the flow of charge into pure spin flow.This process also allows for the injection of spin accumulation from the interface into the adjacent magnetic layer through mechanisms such as the spin Hall effect and the Rashba effect,ultimately applying spin–orbit torque to manipulate the magnetic moment of the magnetic layer,facilitating its reversal.This paper primarily investigates the physical mechanisms underlying the motion of magnetic domain walls driven by current-induced spin–orbit moments in vertically magnetized heterostructures.Utilizing a magneto-optical Kerr microscope to observe the movement of the magnetic domain walls,the study analyzes and compares the velocity behaviors of the domain walls across different cobalt thicknesses.These investigations offer valuable design insights for applications involving track memory driven by spin–orbit moments.
基金supported by the Twelfth Five-Year Planning Project of the Scientific and Technological Department of China(No.2011BAI11B02)the CAMS Innovation Fund for Medical Sciences(CIFMS)(Nos.2020-I2M-C&T-B-050 and 2016-I2M-1-009).
文摘To the Editor:Contemporary guidelines recommend primary percutaneous coronary intervention(PPCI)as the gold-standard reperfusion modality in patients with ST-segment elevation myocardial infarction(STEMI)within 12 h of symptom onset.However,in realworld clinical practice,the implementation of PPCI faces substantial operational challenges,particularly in resource-limited settings,such as inadequate availability of specialized cardiac catheterization teams with requisite procedural expertise or the complete absence of coronary intervention capabilities in numerous rural healthcare facilities across China.Consequently,fibrinolytic therapy remains the predominant reperfusion strategy for STEMI management in county-level hospitals,with particularly high utilization rates observed in geographically remote regions.[3,4]Furthermore,our previous study revealed that 42.5%of STEMI patients fail to receive any form of evidence-based reperfusion therapy,representing a critical gap in optimal care delivery.To elucidate the prognostic implications of these treatment pathways within China’s unique healthcare system,this study aimed to compare the long-term outcomes among STEMI patients receiving PPCI,fibrinolysis,and no reperfusion therapy using data from the China Acute Myocardial Infarction Registry(CAMI Registry,clinicaltrials.gov,NCT01874691).
基金supported by CAMS Innovation Fund for Medical Sciences (CIFMS) (2016-I2M-1-009)the Twelfth Five-Year Planning Project of the Scientific and Technological Department of China (2011BAI11B02)2014 Special fund for scientific research in the public interest by National Health and Family Planning Commission of the People’s Republic of China (No. 201402001)
文摘Background Diabetes is frequently associated with poor prognosis among acute myocardial infarction(AMI)patients.Patients with these comorbidities often have atypical symptoms and subsequent delay in treatment.Few studies have reported detailed AMI symptoms in patients with diabetes.This study compared AMI symptoms and presentation characteristics between diabetics and non-diabetics.Methods We included patients from the China AMI registry diagnosed with AMI between January 2013 and September 2014.Baseline characteristics,symptomology,and delay in treatment were compared between diabetics and non-diabetics.Multivariable logistic regression analysis was used to explore independent predictors of atypical symptoms.Results A total of 4450(20.2%)patients had diabetes.They were older,more often women,higher in body mass index,and more likely to have non-ST segment elevation myocardial infarction.Fewer diabetic patients presented with persistent precordial chest pain(63.1%vs.68%,P<0.0001),diaphoresis(60.1%vs.65.6%,P<0.0001),fatigue(16.7%vs.18.3%,P=0.0123),and incontinence(0.4%vs.0.7%,P=0.0093).Time to hospital presentation was longer among patients with diabetes than those without.In multivariable analysis,diabetes was identified as an independent predictor of atypical symptoms(OR:1.112,95%CI:1.034?1.196).Conclusions Our study is the first large-scale study providing evidence that diabetics are less likely to present with typical chest pain and more likely to experience treatment delay when suffering from an AMI.Our results may increase clinician awareness of recognizing AMI patients rapidly to reduce diagnosis and treatment delay,particularly in the context of diabetes.
基金financially supported by the Military Supporting Project (No. JPPT125GJGG11)
文摘The hot deformation characteristics of Rene88DT superalloy with directionally solidified micro- structure produced by electroslag remelting continuous directionally solidification （ESR-CDS） were studied in the temperature range of 1,040-1,140 ℃ and strain rate range of 0.001-1.000 s-1 by hot compression tests. Flow curves for Rene88DT alloy with initial directionally solidified （DS） microstructure exhibit pronounced peak stresses at the early stage of deformation followed by the occurrence of dynamic softening phenomenon. Rene88DT alloy with DS micro- structure shows higher flow peak stresses compared with HIPed P/M superalloy FGH4096, but the disparities in peak stresses between ESR-CDSed Rene88DT and HIPed P/M superalloy FGH4096 reduce as temperature increases. The improvement of hot workability of DS alloy with columnar grains avoiding the maximum shear stress comes true. A hot deformation constitutive equation as a function of strain that describes the dependence of flow stress on strain rate and temperature is established. Hot deformation apparent acti- vation energy （Q） varies not only with the strain rate and temperature but also with strain. The strain rate sensitivity exponent （m） map is established at the strain of 0.8, which reveals that global dynamic recrystallization （DRX） shows a relatively high m value in a large strain compression. Optimum parameters are predicted in two regions： T = 1,100-1,130 ℃, ε = 0.100-1.000 s-1 and T = 1,080- 1,100 ℃, ε = 0.010-100 s-1, which is based on pro- cessing maps and deformation microstructure observations.
基金supported by CAMS Innovation Fund for Medical Sciences(CIFMS:2021-I2M-1-008)Beijing Municipal Health Commission-Capital Health Development Research Project(2020-1-4032)+1 种基金Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences(CIFMS:2020-I2M-C&TB-056)the Twelfth Five-Year Planning Project of the Scientific and Technological Department of China(2011BAI11B02).
文摘OBJECTIVES To assess the correlation between triglyceride glucose(TyG)index and in-hospital mortality in patients with ST-segment elevation myocardial infarction(STEMI).METHODS A total of 2190 patients with STEMI who underwent primary angiography within 12 h from symptom onset were selected from the prospective,nationwide,multicenter CAMI registry.TyG index was calculated with the formula:Ln[fasting triglycerides(mmol/L)×fasting glucose(mmol/L)/2].Patients were divided into three groups according to the tertiles of TyG index.The primary endpoint was in-hospital mortality.RESULTS Overall,46 patients died during hospitalization,in-hospital mortality was 1.5%,2.2%,2.6%for tertile 1,tertile 2,and tertile 3,respectively.However,TyG index was not significantly correlated with in-hospital mortality in single-variable logistic regression analysis.Nonetheless,after adjusting for age and sex,TyG index was significantly associated with higher mortality when regarded as a continuous variable(adjusted OR=1.75,95%CI:1.16-2.63)or categorical variable(tertile 3 vs.tertile 1:adjus-ted OR=2.50,95%CI:1.14-5.49).Furthermore,TyG index,either as a continuous variable(adjusted OR=2.54,95%CI:1.42-4.54)or categorical variable(tertile 3 vs.tertile 1:adjusted OR=3.57,95%CI:1.24-10.29),was an independent predictor of in-hospital mortality after adjusting for multiple confounders in multivariable logistic regression analysis.In subgroup analysis,the pro-gnostic effect of high TyG index was more significant in patients with body mass index<18.5 kg/m2(P interaction=0.006).CONCLUSIONS This study showed that TyG index was positively correlated with in-hospital mortality in STEMI patients who underwent primary angiography,especially in underweight patients.
基金supported by grants from the National Key Basic Research Programs of China (Nos. 2012CB966600 and 2012CB967900)the National Natural Science Foundation Project (No. 31371506)the 12th Five-Year National Key Technologies R&D Program (No. 2012BAI12B00)
文摘In all the connexin-associated human diseases, deafness is one of the most important diseases with high frequency. The mu- tations of GJB2 （gap junction protein β2, also called connexin 26, Cx26） gene link with nonsyndromic or syndromic senso- rineural hearing loss and were shown to account for a large proportion of congenital deaf cases in many studied populations （del Castillo and del Castillo, 2011）. For example, the 235de1C mutation in GJB2 shows the frequency of approximately 1% and is the most frequent mutation in East Asian population （Yan et al., 2003）. Many efforts have been put to study the function of Gjb2 gene in both mouse model and human. In mouse, extensive deletion of Gjb2 causes embryo lethal due to the decreased transplacental glucose uptake, which was not found in human （Takata and Hirano, 1997; Gabriel et al., 1998）. In human, GJB2 deficiency is not able to cause embryo lethal （D＇Andrea et al., 2002）. However, the study of GJB2-associated hearing loss is hampered by many difficulties, such as unobtainable human cochlea and acoustic nerve tissues, and therefore the GJB2-associated hearing loss are underlying mechanisms of still remaining unclear.
基金supported by CAMS Innovation Fund for Medical Sciences (CIFMS: 2021-I2M-1008)Beijing Municipal Health Commission-Capital Health Development Research Project (20201–4032)+1 种基金Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (CIFMS: 2020I2M-C&T-B-056)the Twelfth Five-Year Planning Project of the Scientific and Technological Department of China (2011BAI11B02)
文摘OBJECTIVES To evaluate the predictive value of fasting plasma glucose(FPG)for in-hospital mortality in patients with acute myocardial infarction(AMI)with different glucose metabolism status.METHODS We selected 5,308 participants with AMI from the prospective,nationwide,multicenter CAMI registry,of which 2,081 were diabetic and 3,227 were nondiabetic.Patients were divided into high FPG and low FPG groups according to the optim-al cutoff values of FPG to predict in-hospital mortality for diabetic and nondiabetic cohorts,respectively.The primary endpoint was in-hospital mortality.RESULTS Overall,94 diabetic patients(4.5%)and 131 nondiabetic patients(4.1%)died during hospitalization,and the optimal FPG thresholds for predicting in-hospital death of the two cohorts were 13.2 mmol/L and 6.4 mmol/L,respectively.Compared with individuals who had low FPG,those with high FPG were significantly associated with higher in-hospital mortality in diabet-ic cohort(10.1%vs.2.8%;odds ratio[OR]=3.862,95%confidence interval[CI]:2.542-5.869)and nondiabetic cohort(7.4%vs.1.7%;HR=4.542,95%CI:3.041-6.782).After adjusting the potential confounders,this significant association was not changed.Further-more,FPG as a continuous variable was positively associated with in-hospital mortality in single-variable and multivariable models regardless of diabetic status.Adding FPG to the original model showed a significant improvement in C-statistic and net reclassification in diabetic and nondiabetic cohorts.CONCLUSIONS This large-scale registry indicated that there is a strong positive association between FPG and in-hospital mor-tality in AMI patients with and without diabetes.FPG might be useful to stratify patients with AMI.
基金National Natural Science Foundation of China (52105319)。
文摘Here we propose to employ wire-arc directed energy deposition(WA-DED) to tune the microstructure and the mechanical property of Mg-Al-Si alloys, on the basis of its sub-rapid solidification effect. According to finite element analysis, WA-DED shows higher cooling rate than conventional casting, reaching 598.3 K/s for Mg-Al-Si alloy, and the lower heat input, the larger cooling rate of WA-DED. Significant microstructure refinement is thus achieved, with reduced grain size and Mg_(2)Si particle diameter. The transition from hypereutectic to fully eutectic microstructure is triggered by reducing the heat input. Compared with the as-cast alloy, WA-DED alloys demonstrate higher ultimate tensile strengths(UTS) at both room-and high-temperature(150℃) properties, increasing by 50.1% and 30.3%, respectively. The superior strength-ductility synergy for Mg-Al-Si alloys results from the microstructure tuning via sub-rapid solidification of WA-DED.
基金supported by the National Institutes for Food and Drug Control,State Key Laboratory of Drug Regulatory Science。
文摘Hepatocellular carcinoma(HCC),a prevalent solid carcinoma of significant concern,is an aggressive and often fatal disease with increasing global incidence rates and poor therapeutic outcomes.The etiology and pathological progression of non-alcoholic steatohepatitis(NASH)-related HCC is multifactorial and multistage.However,no single animal model can accurately mimic the full NASH-related HCC pathological progression,posing considerable challenges to transition and mechanistic studies.Herein,a novel conditional inducible wild-type human HRAS overexpressed mouse model(HRAS-HCC)was established,demonstrating 100%morbidity and mortality within approximately one month under normal dietary and lifestyle conditions.Advanced symptoms of HCC such as ascites,thrombus,internal hemorrhage,jaundice,and lung metastasis were successfully replicated in mice.In-depth pathological features of NASH-related HCC were demonstrated by pathological staining,biochemical analyses,and typical marker gene detections.Combined murine anti-PD-1 and sorafenib treatment effectively prolonged mouse survival,further confirming the accuracy and reliability of the model.Based on protein-protein interaction(PPI)network and RNA sequencing analyses,we speculated that overexpression of HRAS may initiate the THBS1-COL4A3 axis to induce NASH with severe fibrosis,with subsequent progression to HCC.Collectively,our study successfully duplicated natural sequential progression in a single murine model over a very short period,providing an accurate and reliable preclinical tool for therapeutic evaluations targeting the NASH to HCC continuum.
基金supported by Office of Science and Technology in Shanxi province based on research Projects(2012011029)National Natural Science Foundation(41174086)+1 种基金Scientific and Technological Research Project in Shanxi province(20100311129-2,20090311084)the China Earthquake Administration Spark Project(XH1005,XH13004)
文摘Immediately following the Ms7.0 Lushan earthquake on April 20, 2013, using high-pass and low- pass filtering on the digital seismic stations in the Shanxi Province, located about 870-1,452 km from the earthquake epicenter, we detected some earthquakes at a time corre- sponding to the first arrival of surface waves in high-pass filtering waveform. The earthquakes were especially noticed at stations in Youyu （YUY）, Shanzizao （SZZ）, Shanghuangzhuang （SHZ）, and Zhenchuan （ZCH）, which are located in a volcanic region in the Shanxi Province,but they were not listed in the Shanxi seismic observation report. These earthquakes occurred 4-50 rain after the passage of the maximum amplitude Rayleigh wave, and the periods of the surface waves were mainly between 15 and 20 s following. The Coulomb stresses caused by the Ray- leigh waves that acted on the four stations was about 0.001 MPa, which is a little lower than the threshold value of dynamic triggering, therefore, we may conclude that the Datong volcanic region is more sensitive to the Coulomb stress change. To verify, if the similar phenomena are widespread, we used the same filtering to observecontrastively continuous waveform data before, and 5 h after, the Ms7.0 Lushan earthquake and Ms9.0 Tohoku earthquake in 2011. The results show that the similar phenomena occur before the earthquakes, but the seis- micity rates after the earthquakes are remarkably increased. Since these weak earthquakes are quite small, it is hard to get clear phase arrival time from three or more stations to locate them. In addition, the travel time differences between P waves and S waves （S-P） are all less than 4 s, that means the events should occur in 34 km around the stations in the volcanic region. The stress of initial dynamic triggering of the Ms9.0 Tohoku earthquake was about 0.09 MPa, which is much higher than the threshold value of dynamic triggering stress. The earthquakes after the Ms9.0 Tohoku earthquake are related to dynamic triggering stress, but the events before the earthquake cannot be linked to seismic events, but may be related to the back- ground seismicity or from other kinds of local sources, such as anthropogenic sources （i.e., explosions）. Using two teleseismic filtering, the small background earthquakes in the Datong volcanic region occur frequently, thus we postulate that previous catalog does not apply bandpass filter to pick out the weak earthquakes, and some of the observed weak events were not triggered by changes in the dynamic stress field.
文摘Background Globally,populations afflicted by armed conflict are known to have high rates of mental health disorders.Aims This meta-analysis aims to estimate the prevalence of post-traumatic stress disorder(PTSD)and depressive symptoms among civilians residing in armed conflictaffected regions.Methods This meta-analysis was conducted in accordance with the Preferred Reporting Items forSystematic Reviews and Meta-Analyses.A literature search employing MEDLINE(R),Embase Classic+Embase,APA PsyclNFO,Ovid Healthstar,Journal@Ovid Full Text,Cochrane,PTSDpubs and CINAHL was conducted from inception until 19 March 2024 to identify relevant studies.Quality assessment was performed using the Joanna Briggs Institute Critical Appraisal Checklist for Prevalence Studies,and a Comprehensive Meta-Analysiswas usedto conduct the statistical analysis.Results The search yielded 38595 articles,of which 57 were considered eligible for inclusion.The included studies comprised data from 64596 participants.We estimated a prevalence of 23.70%(95%CI 19.50%to28.40%)forPTSD symptomsand 25.60%(95%Cl 20.70%to 31.10%)for depressive features among war-afflicted civilians.The subgroup analysis based on time since the war and the country's economic status revealed the highest prevalence for both PTSD and depressive symptoms was present during the years of war and in low/middle-incomecountries.Conclusions The results of this study provide conclusive evidence of the detrimental impacts of armed conflict on mental health outcomes.Hence,it is crucial to emphasise the significance of both physical and mental health in the aftermath of war and take appropriate humanistic measures to overcome challenges in the management of psychiatric illnesses.
文摘During the COVID-19 pandemic,the number of suspected cases,confirmed cases and those who passed away from the virus has been reported in major media and the internet,and has caused a high degree of tension.In addition,people's outdoor activities have been limited,making it more difficult to find outlets for releasing stress.Under this situation,some people began to experience emotions of anxiety and depression.This article reports a case of depression with fever caused by the stress tension of the pandemic.The patient was highly suspected to have contracted COVID-19.The reported patient,who had a history of depression and had been to Wuhan to attend an exam,showed obvious pre-exam anxiety under the epidemic situation,which gradually increased the patient's pressure and then caused some adverse symptoms,such as insomnia,anxiety,sweating and a reoccurrent fever.Local community authorities paid close attention to him and later sent him to a general hospital in Jingmen for quarantine and treatment,as he was suspected of having COVID-19.After being hospitalised for half a month,he was ruled out from having‘COVID-19'and was cured of depression and discharged from the hospital.From this case,we can realise that,under the situation of the epidemic,people are easily prone to insomnia,anxiety and even depression.As clinicians in general hospitals,especially when encountering large emergencies,we must carefully inquire about the patient's medical history while strengthening our understanding of psychiatric knowledge to improve the recognition rate for depression.
文摘Catatonia is a state of high-degree psychomotor inhibition in which patients often maintain a constant fixed posture,and generally have unconscious obstacles and various reflex preservation.Patients suffering from severe catatonia will become stiff.Catatonia generally manifests unconsciousness while various reflexes are preserved.Patients show reticence,no food or drink intake,and immobility as signs of complete suppression of speech and movement,and even incontinence.Patients are often first diagnosed in non-psychiatric departments and are more likely to be misdiagnosed as having‘coma’or‘epilepsy,,thus delaying treatment.This article reports a case of a 19-year-old female patient who was misdiagnosed with'catatonia'.A month ago,she was admitted to a general hospital of our city because of"intermittent attacks of nausea,vomiting,stupor for 15 years,with one week of exacerbation".During her hospitalisation,she suddenly appeared was mute,had no food or drink intake,and showed immobility and incontinence,presenting a'coma state'.She was transferred to a general hospital in Wuhan to further investigate the cause of her"coma".After 7 days in the hospital,no abnormal examination results were found and the symptoms were not alleviated.Later,she was transferred to the mental health centre for hospitalisation in this city.The patient was diagnosed as having(1)‘epileptic psychosis’and(2)‘catatonic stupor*.After 3 days of treatment,the patient's recovered consciousness.She was clinically cured and discharged half a month later.We hereby report this case.
基金supported by the National Natural Science Foundation of China(NSFC)(Nos.61935010,61975069,21905253,and 51973200)the China Postdoctoral Science Foundation(Nos.2018M640681 and 2019T120632)+5 种基金the Natural Science Foundation of Henan(No.202300410372)Key-Area Research and Development Program of Guangdong Province(No.2020B090922006)Guangdong Project of Science and Technology Grants(No.2018B030323017)Guangzhou science and technology project(Nos.201903010042 and 201904010294)Youth project of science and technology research program of Chongqing Education Commission of China(No.KJQN202001322)the Science and Technology Development Fund from Macao SAR(File Nos.0125/2018/A3 and 0071/2019/AMJ).
文摘The most widely used method of identification of microbial morphology and structure is microscopy,but it can be difficult to distinguish between pathogens with a similar appearance.Existing fluorescent staining methods require a combination of a variety of fluorescent materials to meet this demand.In this study,unique concentration-dependent fluorescent carbon dots(CDs)were synthesized for the identification and quantification of pathogens.The emission wavelength of the CDs could be tuned spanning the full visible region by virtue of aggregation-induced narrowing of bandgaps.This tunable emission wavelength of the specific concentration response to diverse microbes can be used to distinguish microorganisms with a similar appearance,even in a same genus.A hyperspectral microscopy system was demonstrated to distinguish Aspergillus flavus and A.fumigatus based on the results above.The identification accuracy of the two similar-looking pathogens can be close to 100%,and the relative proportions and spatial distributions can also be profiled from the mixture of the pathogens.This technique can provide a solution to the fast detection of microorganisms and is potentially applicable to a wide range of problems in areas such as healthcare,food preparation,biotechnology,and health emergency.
基金supported by funding from the National Natural Science Foundation of China Major Joint Project on Key Scientific Issues of Lung Cancer(No.82241235)the National Natural Science Foundation of China(No.81872510)+3 种基金Guangdong Provincial People’s Hospital Young Talent Project(No.GDPPHYTP201902)Guangdong Basic and Applied Basic Research Foundation(No.2019B1515130002)High-level Hospital Construction Project(No.DFJH201801)Guangdong Provincial Key Laboratory of Translational Medicine in Lung Cancer(No.2017B030314120).
文摘Gene fusions and MET alterations are rare and difficult to detect in plasma samples.The clinical detection efficacy of molecular residual disease(MRD)based on circulating tumor DNA(ctDNA)in patients with non-small cell lung cancer(NSCLC)with these mutations remains unknown.This prospective,non-intervention study recruited 49 patients with operable NSCLC with actionable gene fusions(ALK,ROS1,RET,and FGFR1),MET exon 14 skipping or de novo MET amplification.We analyzed 43 tumor tissues and 111 serial perioperative plasma samples using 1021-and 338-gene panels,respectively.Detectable MRD correlated with a significantly higher recurrence rate(P<0.001),yielding positive predictive values of 100%and 90.9%,and negative predictive values of 82.4%and 86.4%at landmark and longitudinal time points,respectively.Patients with detectable MRD showed reduced disease-free survival(DFS)compared to those with undetectable MRD(P<0.001).Patients who harbored tissue-derived fusion/MET alterations in their MRD had reduced DFS compared to those who did not(P=0.05).To our knowledge,this is the first comprehensive study on ctDNA-MRD clinical detection efficacy in operable NSCLC patients with gene fusions and MET alterations.Patients with detectable tissue-derived fusion/MET alterations in postoperative MRD had worse clinical outcomes.
基金the National Natural Science Foundation of China(22373073)the project of scientific and technologic infrastructure of Suzhou(SZS201708)the Priority Academic Program Development of Jiangsu Higher Education Institutions(PAPD)for financial support.
文摘Herein,organophotoredox-catalyzed annulation of enamines with sulfoxonium ylides to construct pyrrole derivatives is developed under transition-metal-free and mild condition.A broad range of readily accessible substrates are suitable for this protocol,providing a convenient and efficient approach to preparing pyrrole derivatives with satisfying yields.Mechanistically,a photoredox-mediated radical chain mechanistic pathway is proposed for this reaction by a synergistic experimental and computational study.Two key radicals,α-imino andα-carbonyl C-radicals derived from enamines and sulfoxonium ylides,respectively,could be generated via two steps of single-electron transfer in a photoredox catalytic loop.Subsequently,the formedα-carbonyl C-radical may attack the alkenyl moiety of enamines.Next,the formed radical adduct could undergo H-atom transfer with sulfoxonium ylides to regenerate the keyα-carbonyl C-radical and thus fulfill the chain propagation process.The afforded adduct intermediate could undergo an intramolecular cyclization followed by dehydration to furnish the desired pyrrole derivatives.
