BACKGROUND Laparoscopic liver resection(LLR)can be challenging due to the difficulty of establishing a retrohepatic tunnel under laparoscopy.Dissecting the third hepatic hilum before parenchymal transection often lead...BACKGROUND Laparoscopic liver resection(LLR)can be challenging due to the difficulty of establishing a retrohepatic tunnel under laparoscopy.Dissecting the third hepatic hilum before parenchymal transection often leads to significant liver mobilization,tumor compression,and bleeding from the short hepatic veins(SHVs).This study introduces a novel technique utilizing the ventral avascular area of the inferior vena cava(IVC),allowing SHVs to be addressed after parenchymal transection,thereby reducing surgical complexity and improving outcomes in in situ LLR.AIM To introduce and evaluate a novel LLR technique using the ventral avascular area of the IVC and compare its short-term outcomes with conventional methods.METHODS The clinical cohort data of patients with pathologically confirmed hepatocellular carcinoma or intrahepatic cholangiocarcinoma who underwent conventional LLR and novel LLR between July 2021 and July 2023 at the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed.In novel LLR,we initially separated the caudate lobe from the IVC using dissecting forceps along the ventral avascular area of the IVC.Then,we transected the parenchyma of the left and right caudate lobes from the caudal side to the cephalic side using the avascular area as a marker.Subsequently,we addressed the SHVs and finally dissected the root of the right hepatic vein or left hepatic vein.The short-term postoperative outcomes and oncological results of the two approaches were evaluated and compared.RESULTS A total of 256 patients were included,with 150(58.59%)undergoing conventional LLR and 106(41.41%)undergoing novel LLR.The novel technique resulted in significantly larger tumor resections(6.47±2.96 cm vs 4.01±2.33 cm,P<0.001),shorter operative times(199.57±60.37 minutes vs 262.33±83.90 minutes,P<0.001),less intraoperative blood loss(206.92±37.09 mL vs 363.34±131.27 mL,P<0.001),and greater resection volume(345.11±31.40 mL vs 264.38±31.98 mL,P<0.001)compared to conventional LLR.CONCLUSION This novel technique enhances liver resection outcomes by reducing intraoperative complications such as bleeding and tumor compression.It facilitates a safer,in situ removal of complex liver tumors,even in challenging anatomical locations.Compared to conventional methods,this technique offers significant advantages,including reduced operative time,blood loss,and improved overall surgical efficiency.展开更多
The MIG welding of in-situ generated nano-Al_(2)O_(3)powder metallurgy 7A52(PM 7A52)aluminum alloy was investigated.The microstructure was characterized using EBSD and TEM,while macrotexture and internal residual stre...The MIG welding of in-situ generated nano-Al_(2)O_(3)powder metallurgy 7A52(PM 7A52)aluminum alloy was investigated.The microstructure was characterized using EBSD and TEM,while macrotexture and internal residual stresses were analyzed with a self-developed SWXRD technique.The results revealed that PM 7A52 aluminum alloy effectively reduced the grain size,dislocation density,and texture strength in the post-weld microstructure.Furthermore,the residual stress in the weld zone(WZ)of PM 7A52 aluminum alloy was reduced by 38 MPa compared to that of the conventional melt-cast 7A52(CM 7A52)aluminum alloy.Notably,the tensile strength and elongation of welded joints in PM 7A52 aluminum alloy were increased by approximately 15%and 26%,respectively.The improvement in joint tensile strength was primarily attributed to grain boundary strengthening and dispersion strengthening caused byγ-Al_(2)O_(3)particles entering the WZ.展开更多
Potassium hydroxide(KOH)was introduced into the molybdenite roasting process to convert molybdenum(Mo)and sulfur(S)into water-soluble potassium molybdate(K_(2)MoO_(4))and potassium sulfate(K_(2)SO_(4)).Roasting with a...Potassium hydroxide(KOH)was introduced into the molybdenite roasting process to convert molybdenum(Mo)and sulfur(S)into water-soluble potassium molybdate(K_(2)MoO_(4))and potassium sulfate(K_(2)SO_(4)).Roasting with a 1.8-fold excess of KOH at 400℃ for 3 h enabled the leaching of over 99%of Mo from the molybdenum calcine using water.A precipitation method involving potassium–magnesium(K-Mg)salts was proposed for impurity removal.Under the conditions of pH 11,30℃,excess coefficient of 1.7 for Mg salts,and a duration of 1 h,98.37%of phosphorus(P)was removed from the K_(2)MoO_(4) solution.With post-purification,over 99%of Mo crystallized upon adjustment of pH to 1.Subsequently,S and K were recovered as K_(2)SO_(4) fertilizer from the crystalline mother liquor.An environmentally sustainable approach was proposed to conduct molybdenite production and ensure the efficient recovery of both Mo and S.展开更多
Hepatocellular carcinoma is one of the leading causes of cancer-related deaths globally,and effective treatments are urgently needed.The present study aimed to investigate the inhibitory effect of Calculus Bovis(CB)on...Hepatocellular carcinoma is one of the leading causes of cancer-related deaths globally,and effective treatments are urgently needed.The present study aimed to investigate the inhibitory effect of Calculus Bovis(CB)on liver cancer and the underlying mechanisms.CB inhibited M2 tumor-associated macrophage polarization and modulated the Wnt/β-catenin signaling pathway,thereby suppressing the proliferation of liver cancer cells.The inhibitory effect on liver cancer growth was confirmed by both in vivo and in vitro experiments(detailed by Huang et al).The present study provides a theoretical basis for the application of CB for the treatment of liver cancer,providing new avenues for liver cancer treatment.展开更多
BACKGROUND Steroid-induced avascular necrosis of the femoral head(SANFH)involves bone metabolism imbalance and lacks effective therapies.Mesenchymal stem cells(MSCs),particularly human umbilical cord MSCs(hUCMSCs),off...BACKGROUND Steroid-induced avascular necrosis of the femoral head(SANFH)involves bone metabolism imbalance and lacks effective therapies.Mesenchymal stem cells(MSCs),particularly human umbilical cord MSCs(hUCMSCs),offer promise due to their osteogenic and immunomodulatory potential.Sclerostin(SOST)inhibits bone formation,so we developed a multi-target gene silencing strategy against SOST using RNA interference.We created hUCMSCs with SOST-silenced(sh-hUCMSCs)and compared their therapeutic efficacy with unmodified hUCMSCs in SANFH mice.This study explores a novel approach to enhance osteogenesis and mitigate SANFH progression.AIM To assess the effects of sh-hUCMSCs on bone metabolism in SANFH.METHODS hUCMSCs were isolated from placental tissue and transfected with SOST-targeting short hairpin RNA plasmids.A SANFH mouse model was established through intraperitoneal injection of lipopolysaccharide(20μg/kg)followed by intramuscular methylprednisolone administration(40 mg/kg).Mice were randomized into four experimental groups(n=10/group):Sham control,SANFH(untreated),hUCMSCs-treated,and sh-hUCMSCs-treated.Micro-computed tomography was used to measure bone volume(BV),bone surface area,bone surface/BV ratio,tra-becular number,trabecular thickness,and trabecular separation.Quantification of adipocyte area by hematoxylin and eosin staining.Collagen fiber volume was assessed by Masson’s trichrome staining.Serum levels of osteopro-tegerin(OPG),receptor activator of nuclear factor kappa B(RANK),RANK ligand(RANKL),tartrate-resistant acid phosphatase,and the OPG/RANKL ratio were measured by enzyme-linked immunosorbent assay.The expression levels of alkaline phosphatase,OPG,SOST,β-catenin,peroxisome proliferator-activated receptor gamma,and CCAAT/enhancer-binding protein in bone tissue were determined by western blot analysis.RESULTS hUCMSCs and sh-hUCMSCs exhibited typical fibroblast-like morphology and high expression of MSC surface markers(CD90,CD73,CD105>98%).These cells demonstrated tri-lineage differentiation potential,confirmed by positive Alizarin Red S,Oil Red O,and Alcian Blue staining,and upregulation of lineage-specific genes.After SOST-RNA interference modification,sh-hUCMSCs showed enhanced inhibition of adipogenesis and improved bone formation in a rat model of SANFH.Histological analysis revealed reduced lipid infiltration and empty lacunae in the femoral head of the sh-hUCMSC group.Western blot showed decreased CCAAT/enhancer-binding protein and peroxisome proliferator-activated receptor gamma expression(P<0.05).Masson staining and micro-computed tomography analysis confirmed significantly increased BV,trabecular number,trabecular thickness,and reduced trabecular separation in the sh-hUCMSC group compared to unmodified MSCs and SANFH groups(P<0.05).Serum enzyme-linked immunosorbent assay showed higher OPG and lower RANK,RANKL,and tartrate-resistant acid phosphatase levels in the sh-hUCMSCs group.Western blot further confirmed upregulated alkaline phosphatase,OPG,β-catenin,and downregulated SOST expression in sh-hUCMSCs compared to controls(P<0.05).These results suggest that SOST inhibition enhances the osteogenic potential and therapeutic efficacy of hUCMSCs in SANFH.CONCLUSION sh-hUCMSCs alleviate SANFH by activating the Wnt/β-catenin signaling pathway,thereby promoting osteogenic differentiation and suppressing adipogenesis to restore bone metabolic balance.展开更多
BACKGROUND Inflammatory bowel disease(IBD)comprises a group of chronic inflammatory gastrointestinal disorders,including Crohn's disease(CD)and ulcerative colitis,with uncertain etiologies.The natural course of IB...BACKGROUND Inflammatory bowel disease(IBD)comprises a group of chronic inflammatory gastrointestinal disorders,including Crohn's disease(CD)and ulcerative colitis,with uncertain etiologies.The natural course of IBD can be accompanied by extraintestinal manifestations involving the skin,mucous membranes,musculo-skeletal structures,eyes,cardiovascular system and nervous system.Guillain-Barrésyndrome(GBS)is a type of peripheral neuropathy.However,the etiology and pathogenesis of IBD combined with GBS are unclear,and only a few clinical cases have been reported.Here,we report a case of refractory CD complicated by GBS and review the previous literature to improve the understanding of these diseases.A 34-year-old man had a 9-year history of refractory CD.He became unres-ponsive to multiple drugs and experienced recurrent intestinal fistulas.After several abdominal surgeries and treatment with ustekinumab,he achieved clinical remission.Unfortunately,he developed GBS during maintenance treatment with ustekinumab.According to previous reports,in some patients with IBD combined with GBS,GBS may be a comorbidity,an extraintestinal manifestation of IBD,or an adverse reaction to IBD therapeutic drugs.After a comprehensive evaluation,we suspected that GBS might have been a comorbidity in this patient.To avoid fatal disease relapse after medication discontinuation,we concluded that ustekinumab should not be withdrawn.On the basis of a joint decision between doctors and the patient,we decided to continue maintenance treatment with ustekinumab along with intravenous immunoglobulin,dexamethasone and traditional Chinese medicine acupuncture,which resulted in a steady improvement in his GBS symptoms and sustained remission of CD.CONCLUSION When IBD is complicated by a neurological disease,it is first necessary to analyze the patient's condition and then choose the corresponding treatment strategy.If the neurological disease is a specific comorbidity,treatment of both IBD and the comorbid disease should be considered.For IBD patients with extraintestinal manifestations involving the nervous system,neurological manifestations tend to resolve when the active IBD is controlled.When an adverse drug reaction is suspected,the medication should be discontinued,and symptomatic treatment should be administered.展开更多
The distribution and competitive behaviors of phosphotungstic acid and ferric chloride in the TBP-HCl-H_(2)O system were investigated by controlling the extractant concentration and the solution environment.The result...The distribution and competitive behaviors of phosphotungstic acid and ferric chloride in the TBP-HCl-H_(2)O system were investigated by controlling the extractant concentration and the solution environment.The results revealed that phosphotungstic acid exhibited a strong affinity for TBP with decreasing TBP concentration.Higher acidity significantly improved the W extraction efficiency with TBP,and the lower Cl^(-)concentration reduced the extraction efficiency of Fe.As the organic phase approached saturation point,phosphotungstic acid competitively displaced Fe to combine with TBP.The hydrogen bond structure(P=O·HO-P-W-O)between phosphotungstic acid and TBP was characterized by FT-IR,and the salting-out effect induced by FeCl_(3) was elucidated.In summary,high acidity is beneficial for exhaustive extraction of W,and an effective W/Fe separation can be achieved by reducing the concentrations of TBP and Cl^(-).展开更多
BACKGROUND T/histiocyte-rich large B-cell lymphoma(T/HRBCL)is a highly aggressive subtype of diffuse large B-cell lymphoma characterized histologically by the presence of a few neoplastic large B cells amidst an abund...BACKGROUND T/histiocyte-rich large B-cell lymphoma(T/HRBCL)is a highly aggressive subtype of diffuse large B-cell lymphoma characterized histologically by the presence of a few neoplastic large B cells amidst an abundant background of reactive T lymphocytes and/or histiocytes.T/HRBCL commonly affects the lymph nodes,followed by extranodal sites,such as the spleen,liver,and bone marrow,with rare occurrences in the gastrointestinal tract.Primary gastrointestinal T/HRBCL lacks specific clinical and endoscopic manifestations,and it is difficult to differentiate from inflammatory diseases,nodular lymphocyte predominant Hodgkin lymphoma,and other diseases on a histological basis,thereby hindering early diagnosis.CASE SUMMARY A 63-year-old man was hospitalized with a one-month history of jaundice and weight loss of approximately 3 kg.Laboratory tests revealed increased hepatic parameters in a cholestatic pattern and elevated carbohydrate antigen 19-9 levels.An abdominal computed tomography scan revealed a low-density mass within the descending duodenum and dilation of the bile and pancreatic ducts.He was clinically diagnosed with a duodenal tumor.During surgery,a 7.0 cm×8.0 cm mass was identified within the descending duodenum,so pancreaticoduodenectomy and cholecystectomy were performed.Following operative biopsy,the tumor was diagnosed as primary duodenal T/HRBCL.The patient refused postoperative chemotherapy and died four months after surgery.CONCLUSION Primary duodenal T/HRBCL is an extremely rare and highly aggressive malignancy.The initial treatment strategies should be based on the original site of the tumor,the disease stage,and the patient's physical condition.Chemotherapy-based comprehensive treatment is still the main treatment method for primary gastrointestinal T/HRBCL.展开更多
Modern hydrometallurgy has been developing for more than 100 years and the related articles keep piling up.Based on a bibliometric analysis of the articles in Hydrometallurgy,the most authoritative journal in the fiel...Modern hydrometallurgy has been developing for more than 100 years and the related articles keep piling up.Based on a bibliometric analysis of the articles in Hydrometallurgy,the most authoritative journal in the field of hydrometallurgy,we try to catch the research and development trends from a global perspective.Firstly,keywords burstness shows that rare earth,recycling,lithium,ionic liquid,and thorium are the hotspots in recent years,and the economic and technological reasons behind them were discussed in depth.Secondly,the proportion of biohydrometallurgy grows fast from 5%to 13%and the related articles are almost all about bioleaching.There are some new directions such as direct preparation of materials in hydrometallurgical processes and ion-imprinted techniques.Thirdly,the advanced instrument analysis methods such as XAFS(X-ray absorption fine structure),gene sequencing,and micro-CT promote the deep understanding of hydrometallurgy mechanism.Finally,the cooperation network and contribution of the main institutes were mapped.展开更多
Considering the different geochemical enrichment behaviors of W and Mo,Fe?Mn binary oxide(FMBO),ferric hydroxide(Fe(OH)3)and manganese dioxide(MnO2)were studied to separate W from molybdate solution,respectively.The e...Considering the different geochemical enrichment behaviors of W and Mo,Fe?Mn binary oxide(FMBO),ferric hydroxide(Fe(OH)3)and manganese dioxide(MnO2)were studied to separate W from molybdate solution,respectively.The experimental results demonstrated that Fe?Mn binary oxide(FMBO)was the most suitable adsorbent for the separation.Under a wide pH(6.9?11.3)region,more than80%W removal efficiency and less than3%Mo loss could be obtained.In addition,the Fe?Mn binary oxide adsorbent can be regenerated by treating with3mol/L NaOH,and the W adsorption efficiency was retained after five adsorption?desorption?regeneration cycles.All these indicate that the Fe?Mn binary oxides have the potential for the separation of W from molybdate solution.展开更多
Nonalcoholic fatty liver disease(NAFLD),which has been renamed metabolic dysfunction-associated fatty liver disease,is a growing global medical problem.The incidence of NAFLD and its associated end-stage liver disease...Nonalcoholic fatty liver disease(NAFLD),which has been renamed metabolic dysfunction-associated fatty liver disease,is a growing global medical problem.The incidence of NAFLD and its associated end-stage liver disease is increasing each year,and many research advancements have been achieved to date.This review focuses on the current knowledge of the sex differences in NAFLD and does not elaborate on areas without differences.Studies have revealed significant sex differences in the prevalence,influencing factors,pathophysiology,complications and therapies of NAFLD.Men have a higher incidence than women.Compared with women,men exhibit increased visceral fat deposition,are more susceptible to leptin resistance,lack estrogen receptors,and tend to synthesize fatty acids into fat storage.Male patients will experience more severe hepatic fibrosis and a higher incidence of liver cancer.However,once NAFLD occurs,women show a faster progression of liver fibrosis,higher levels of liver cell damage and inflammation and are less likely to undergo liver transplantation than men.In general,men have more risk factors and more severe pathophysiological reactions than women,whereas the development of NAFLD is faster in women,and the treatments for women are more limited than those for men.Thus,whether sex differences should be considered in the individualized prevention and treatment of NAFLD in the future is worth considering.展开更多
Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rat...Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rate of CNLBP in young and middle-aged people who are demanded rapidly recovery and social contribution is rising.Recent guidelines indicate a reduced role for medicines in the management of CNLBP.Objective The present study investigates the short-term effects of cupping and scraping therapy using a medicated balm,compared to nonsteroidal anti-inflammatory drug(NSAID)with a capsaicin plaster,in the treatment of CNLBP.Design,setting,participants and interventions We designed a prospective multicenter randomized clinical trial enrolling patients from January 1,2022 to December 31,2022.A total of 156 patients with CNLBP were randomized into two parallel groups.Diclofenac sodium-sustained release tablets were administered orally to participants in the control group for one week while a capsaicin plaster was applied externally.Patients in the test group were treated with cupping and scraping using a medical device and medicated balm.Main outcome measures Primary outcome was pain recorded using the visual analogue scale(VAS).Two secondary outcomes were recorded using the Japanese Orthopedic Association low-back pain scale(JOA)and the traditional Chinese medicine(TCM)syndrome integral scale(TCMS)as assessment tools.Results Between baseline and postintervention,all changes in outcome metric scales were statistically significant(P<0.001).Compared to the control group,patients in the test group had a significantly greater treatment effect in all outcome variables,as indicated by lower VAS and TCMS scores and higher JOA scores,after the one-week intervention period(P<0.001).Further,according to the findings of multivariate linear regression analysis,the participants’pain(VAS score)was related to their marital status,age,smoking habits and body mass index.No adverse reactions were reported for any participants in this trial.Conclusion The effectiveness of TCM combined with the new physiotherapy tool is superior to that of NSAID combined with topical plasters,regarding to pain intensity,TCM symptoms and quality of life.The TCM plus physiotherapy also showed more stable and long-lasting therapeutic effects.展开更多
BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is a major chronic liver disorder worldwide,and there is no established treatment for this disease.We conducted a network meta-analysis(NMA)to compare existing treatme...BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is a major chronic liver disorder worldwide,and there is no established treatment for this disease.We conducted a network meta-analysis(NMA)to compare existing treatments,which include four classes of antidiabetic drugs,and examined the optimum treatments for NAFLD.AIM To compare the effectiveness of different treatments for NAFLD.METHODS An NMA was conducted using Stata 14.0(Corporation LLC,College Station,United States)and R(X643.6.3 version)in this study.Eligible randomized controlled trials(RCTs)were searched in the PubMed,Cochrane Library,Embase,Medline and Web of Science databases from database inception to April 2021.Two researchers independently screened the available studies in strict accordance with inclusion and exclusion criteria.The Cochrane Risk of Bias tool was used to evaluate the risk of bias of the included studies.The variables with and without dimensional differences were calculated as the standardized mean difference and weighted mean difference,respectively.An inconsistency model and“nodesplitting”technique were used to test for inconsistency.Funnel plots were used to evaluate publication bias.RESULTS Twenty-two eligible RCTs involving 1377 participants were eventually included in our analysis.Data were pooled using a random-effects model.Our NMA results revealed that glucagon-like peptide-1 receptor agonists(GLP-1RAs)were the most effective treatment,yielding improvements in hepatic fat content(HFC),alanine aminotransferase(ALT),aspartate aminotransferase(AST),serumγ-glutamyl transferase(GGT)and body weight[surface under the cumulative ranking curve(SUCRA)=99.6%,92.6%,82.8%,92.3%and 99.6%,respectively],while thiazolidinediones(TZDs)were the best intervention for reducing the NAFLD activity score(NAS;SUCRA=98.9%).In addition,moderate performance was observed for the sodium glucose cotransporter-2 inhibitors groups(SUCRA=25.1%,66.2%,63.5%,58.2%and 71.9%for HFC,ALT,AST,GGT and body weight,respectively).However,metformin performed poorly according to most indicators(SUCRA=54.5%,0.3%,19.5%,33.7%,57.7%and 44.3%for HFC,NAS,ALT,AST,GGT and body weight,respectively).CONCLUSION GLP-1RAs may be the optimum choice for most patients with NAFLD.However,TZDs are considered the most effective therapies in NAFLD patients with histological disease activity.展开更多
BACKGROUND Maturity-onset diabetes of the young(MODY)is a monogenic genetic disease often clinically misdiagnosed as type 1 or type 2 diabetes.MODY type 9(MODY9)is a rare subtype caused by mutations in the PAX4 gene.C...BACKGROUND Maturity-onset diabetes of the young(MODY)is a monogenic genetic disease often clinically misdiagnosed as type 1 or type 2 diabetes.MODY type 9(MODY9)is a rare subtype caused by mutations in the PAX4 gene.Currently,there are limited reports on PAX4-MODY,and its clinical characteristics and treatments are still unclear.In this report,we described a Chinese patient with high autoimmune antibodies,hyperglycemia and a site mutation in the PAX4 gene.CASE SUMMARY A 42-year-old obese woman suffered diabetes ketoacidosis after consuming substantial amounts of beverages.She had never had diabetes before,and no one in her family had it.However,her autoantibody tested positive,and she managed her blood glucose within the normal range for 6 mo through lifestyle interventions.Later,her blood glucose gradually increased.Next-generation sequencing and Sanger sequencing were performed on her family.The results revealed that she and her mother had a heterozygous mutation in the PAX4 gene(c.314G>A,p.R105H),but her daughter did not.The patient is currently taking liraglutide(1.8 mg/d),and her blood glucose levels are under control.Previous cases were retrieved from PubMed to investigate the relationship between PAX4 gene mutations and diabetes.CONCLUSION We reported the first case of a PAX4 gene heterozygous mutation site(c.314G>A,p.R105H),which does not appear pathogenic to MODY9 but may facilitate the progression of latent autoimmune diabetes in adults.展开更多
High mobility quasi two-dimensional electron gas(2DEG)found at the CaZrO_(3)/SrTiO_(3) nonpolar heterointerface is attractive and provides a platform for the development of functional devices and nanoelectronics.Here ...High mobility quasi two-dimensional electron gas(2DEG)found at the CaZrO_(3)/SrTiO_(3) nonpolar heterointerface is attractive and provides a platform for the development of functional devices and nanoelectronics.Here we report that the carrier density and mobility at low temperature can be tuned by gate voltage at the CaZrO_(3)/SrTiO_(3) interface.Furthermore,the magnitude of Rashba spin-orbit interaction can be modulated and increases with the gate voltage.Remarkably,the diffusion constant and the spin-orbit relaxation time can be strongly tuned by gate voltage.The diffusion constant increases by a factor of~19.98 and the relaxation time is reduced by a factor of over three orders of magnitude while the gate voltage is swept from-50 V to 100 V.These findings not only lay a foundation for further understanding the underlying mechanism of Rashba spin-orbit coupling,but also have great significance in developing various oxide functional devices.展开更多
基金Supported by the General Project of the Natural Science Foundation of Chongqing,No.cstc2021jcyj-msxmX0604.
文摘BACKGROUND Laparoscopic liver resection(LLR)can be challenging due to the difficulty of establishing a retrohepatic tunnel under laparoscopy.Dissecting the third hepatic hilum before parenchymal transection often leads to significant liver mobilization,tumor compression,and bleeding from the short hepatic veins(SHVs).This study introduces a novel technique utilizing the ventral avascular area of the inferior vena cava(IVC),allowing SHVs to be addressed after parenchymal transection,thereby reducing surgical complexity and improving outcomes in in situ LLR.AIM To introduce and evaluate a novel LLR technique using the ventral avascular area of the IVC and compare its short-term outcomes with conventional methods.METHODS The clinical cohort data of patients with pathologically confirmed hepatocellular carcinoma or intrahepatic cholangiocarcinoma who underwent conventional LLR and novel LLR between July 2021 and July 2023 at the First Affiliated Hospital of Chongqing Medical University were retrospectively analyzed.In novel LLR,we initially separated the caudate lobe from the IVC using dissecting forceps along the ventral avascular area of the IVC.Then,we transected the parenchyma of the left and right caudate lobes from the caudal side to the cephalic side using the avascular area as a marker.Subsequently,we addressed the SHVs and finally dissected the root of the right hepatic vein or left hepatic vein.The short-term postoperative outcomes and oncological results of the two approaches were evaluated and compared.RESULTS A total of 256 patients were included,with 150(58.59%)undergoing conventional LLR and 106(41.41%)undergoing novel LLR.The novel technique resulted in significantly larger tumor resections(6.47±2.96 cm vs 4.01±2.33 cm,P<0.001),shorter operative times(199.57±60.37 minutes vs 262.33±83.90 minutes,P<0.001),less intraoperative blood loss(206.92±37.09 mL vs 363.34±131.27 mL,P<0.001),and greater resection volume(345.11±31.40 mL vs 264.38±31.98 mL,P<0.001)compared to conventional LLR.CONCLUSION This novel technique enhances liver resection outcomes by reducing intraoperative complications such as bleeding and tumor compression.It facilitates a safer,in situ removal of complex liver tumors,even in challenging anatomical locations.Compared to conventional methods,this technique offers significant advantages,including reduced operative time,blood loss,and improved overall surgical efficiency.
基金supported by the National Key Research and Development Program of China(No.SQ2021YFF0600011)。
文摘The MIG welding of in-situ generated nano-Al_(2)O_(3)powder metallurgy 7A52(PM 7A52)aluminum alloy was investigated.The microstructure was characterized using EBSD and TEM,while macrotexture and internal residual stresses were analyzed with a self-developed SWXRD technique.The results revealed that PM 7A52 aluminum alloy effectively reduced the grain size,dislocation density,and texture strength in the post-weld microstructure.Furthermore,the residual stress in the weld zone(WZ)of PM 7A52 aluminum alloy was reduced by 38 MPa compared to that of the conventional melt-cast 7A52(CM 7A52)aluminum alloy.Notably,the tensile strength and elongation of welded joints in PM 7A52 aluminum alloy were increased by approximately 15%and 26%,respectively.The improvement in joint tensile strength was primarily attributed to grain boundary strengthening and dispersion strengthening caused byγ-Al_(2)O_(3)particles entering the WZ.
基金financially supported by the National Natural Science Foundation of China(No.52174340)the National Key Research and Development Project of China(No.2022YFC2904505)the Hunan FURONG Scholars Project and the Basic Science Centre of the National Natural Science Foundation of China(No.72088101)。
文摘Potassium hydroxide(KOH)was introduced into the molybdenite roasting process to convert molybdenum(Mo)and sulfur(S)into water-soluble potassium molybdate(K_(2)MoO_(4))and potassium sulfate(K_(2)SO_(4)).Roasting with a 1.8-fold excess of KOH at 400℃ for 3 h enabled the leaching of over 99%of Mo from the molybdenum calcine using water.A precipitation method involving potassium–magnesium(K-Mg)salts was proposed for impurity removal.Under the conditions of pH 11,30℃,excess coefficient of 1.7 for Mg salts,and a duration of 1 h,98.37%of phosphorus(P)was removed from the K_(2)MoO_(4) solution.With post-purification,over 99%of Mo crystallized upon adjustment of pH to 1.Subsequently,S and K were recovered as K_(2)SO_(4) fertilizer from the crystalline mother liquor.An environmentally sustainable approach was proposed to conduct molybdenite production and ensure the efficient recovery of both Mo and S.
文摘Hepatocellular carcinoma is one of the leading causes of cancer-related deaths globally,and effective treatments are urgently needed.The present study aimed to investigate the inhibitory effect of Calculus Bovis(CB)on liver cancer and the underlying mechanisms.CB inhibited M2 tumor-associated macrophage polarization and modulated the Wnt/β-catenin signaling pathway,thereby suppressing the proliferation of liver cancer cells.The inhibitory effect on liver cancer growth was confirmed by both in vivo and in vitro experiments(detailed by Huang et al).The present study provides a theoretical basis for the application of CB for the treatment of liver cancer,providing new avenues for liver cancer treatment.
基金Supported by the National Natural Science Foundation of China,No.82260944the Key Research and Development Programs of Guangxi,No.2021AB09011。
文摘BACKGROUND Steroid-induced avascular necrosis of the femoral head(SANFH)involves bone metabolism imbalance and lacks effective therapies.Mesenchymal stem cells(MSCs),particularly human umbilical cord MSCs(hUCMSCs),offer promise due to their osteogenic and immunomodulatory potential.Sclerostin(SOST)inhibits bone formation,so we developed a multi-target gene silencing strategy against SOST using RNA interference.We created hUCMSCs with SOST-silenced(sh-hUCMSCs)and compared their therapeutic efficacy with unmodified hUCMSCs in SANFH mice.This study explores a novel approach to enhance osteogenesis and mitigate SANFH progression.AIM To assess the effects of sh-hUCMSCs on bone metabolism in SANFH.METHODS hUCMSCs were isolated from placental tissue and transfected with SOST-targeting short hairpin RNA plasmids.A SANFH mouse model was established through intraperitoneal injection of lipopolysaccharide(20μg/kg)followed by intramuscular methylprednisolone administration(40 mg/kg).Mice were randomized into four experimental groups(n=10/group):Sham control,SANFH(untreated),hUCMSCs-treated,and sh-hUCMSCs-treated.Micro-computed tomography was used to measure bone volume(BV),bone surface area,bone surface/BV ratio,tra-becular number,trabecular thickness,and trabecular separation.Quantification of adipocyte area by hematoxylin and eosin staining.Collagen fiber volume was assessed by Masson’s trichrome staining.Serum levels of osteopro-tegerin(OPG),receptor activator of nuclear factor kappa B(RANK),RANK ligand(RANKL),tartrate-resistant acid phosphatase,and the OPG/RANKL ratio were measured by enzyme-linked immunosorbent assay.The expression levels of alkaline phosphatase,OPG,SOST,β-catenin,peroxisome proliferator-activated receptor gamma,and CCAAT/enhancer-binding protein in bone tissue were determined by western blot analysis.RESULTS hUCMSCs and sh-hUCMSCs exhibited typical fibroblast-like morphology and high expression of MSC surface markers(CD90,CD73,CD105>98%).These cells demonstrated tri-lineage differentiation potential,confirmed by positive Alizarin Red S,Oil Red O,and Alcian Blue staining,and upregulation of lineage-specific genes.After SOST-RNA interference modification,sh-hUCMSCs showed enhanced inhibition of adipogenesis and improved bone formation in a rat model of SANFH.Histological analysis revealed reduced lipid infiltration and empty lacunae in the femoral head of the sh-hUCMSC group.Western blot showed decreased CCAAT/enhancer-binding protein and peroxisome proliferator-activated receptor gamma expression(P<0.05).Masson staining and micro-computed tomography analysis confirmed significantly increased BV,trabecular number,trabecular thickness,and reduced trabecular separation in the sh-hUCMSC group compared to unmodified MSCs and SANFH groups(P<0.05).Serum enzyme-linked immunosorbent assay showed higher OPG and lower RANK,RANKL,and tartrate-resistant acid phosphatase levels in the sh-hUCMSCs group.Western blot further confirmed upregulated alkaline phosphatase,OPG,β-catenin,and downregulated SOST expression in sh-hUCMSCs compared to controls(P<0.05).These results suggest that SOST inhibition enhances the osteogenic potential and therapeutic efficacy of hUCMSCs in SANFH.CONCLUSION sh-hUCMSCs alleviate SANFH by activating the Wnt/β-catenin signaling pathway,thereby promoting osteogenic differentiation and suppressing adipogenesis to restore bone metabolic balance.
文摘BACKGROUND Inflammatory bowel disease(IBD)comprises a group of chronic inflammatory gastrointestinal disorders,including Crohn's disease(CD)and ulcerative colitis,with uncertain etiologies.The natural course of IBD can be accompanied by extraintestinal manifestations involving the skin,mucous membranes,musculo-skeletal structures,eyes,cardiovascular system and nervous system.Guillain-Barrésyndrome(GBS)is a type of peripheral neuropathy.However,the etiology and pathogenesis of IBD combined with GBS are unclear,and only a few clinical cases have been reported.Here,we report a case of refractory CD complicated by GBS and review the previous literature to improve the understanding of these diseases.A 34-year-old man had a 9-year history of refractory CD.He became unres-ponsive to multiple drugs and experienced recurrent intestinal fistulas.After several abdominal surgeries and treatment with ustekinumab,he achieved clinical remission.Unfortunately,he developed GBS during maintenance treatment with ustekinumab.According to previous reports,in some patients with IBD combined with GBS,GBS may be a comorbidity,an extraintestinal manifestation of IBD,or an adverse reaction to IBD therapeutic drugs.After a comprehensive evaluation,we suspected that GBS might have been a comorbidity in this patient.To avoid fatal disease relapse after medication discontinuation,we concluded that ustekinumab should not be withdrawn.On the basis of a joint decision between doctors and the patient,we decided to continue maintenance treatment with ustekinumab along with intravenous immunoglobulin,dexamethasone and traditional Chinese medicine acupuncture,which resulted in a steady improvement in his GBS symptoms and sustained remission of CD.CONCLUSION When IBD is complicated by a neurological disease,it is first necessary to analyze the patient's condition and then choose the corresponding treatment strategy.If the neurological disease is a specific comorbidity,treatment of both IBD and the comorbid disease should be considered.For IBD patients with extraintestinal manifestations involving the nervous system,neurological manifestations tend to resolve when the active IBD is controlled.When an adverse drug reaction is suspected,the medication should be discontinued,and symptomatic treatment should be administered.
基金supported by the National key R&D Program of China(No.2022YFC2905105)the National Natural Science Foundation of China(No.72088101)。
文摘The distribution and competitive behaviors of phosphotungstic acid and ferric chloride in the TBP-HCl-H_(2)O system were investigated by controlling the extractant concentration and the solution environment.The results revealed that phosphotungstic acid exhibited a strong affinity for TBP with decreasing TBP concentration.Higher acidity significantly improved the W extraction efficiency with TBP,and the lower Cl^(-)concentration reduced the extraction efficiency of Fe.As the organic phase approached saturation point,phosphotungstic acid competitively displaced Fe to combine with TBP.The hydrogen bond structure(P=O·HO-P-W-O)between phosphotungstic acid and TBP was characterized by FT-IR,and the salting-out effect induced by FeCl_(3) was elucidated.In summary,high acidity is beneficial for exhaustive extraction of W,and an effective W/Fe separation can be achieved by reducing the concentrations of TBP and Cl^(-).
文摘BACKGROUND T/histiocyte-rich large B-cell lymphoma(T/HRBCL)is a highly aggressive subtype of diffuse large B-cell lymphoma characterized histologically by the presence of a few neoplastic large B cells amidst an abundant background of reactive T lymphocytes and/or histiocytes.T/HRBCL commonly affects the lymph nodes,followed by extranodal sites,such as the spleen,liver,and bone marrow,with rare occurrences in the gastrointestinal tract.Primary gastrointestinal T/HRBCL lacks specific clinical and endoscopic manifestations,and it is difficult to differentiate from inflammatory diseases,nodular lymphocyte predominant Hodgkin lymphoma,and other diseases on a histological basis,thereby hindering early diagnosis.CASE SUMMARY A 63-year-old man was hospitalized with a one-month history of jaundice and weight loss of approximately 3 kg.Laboratory tests revealed increased hepatic parameters in a cholestatic pattern and elevated carbohydrate antigen 19-9 levels.An abdominal computed tomography scan revealed a low-density mass within the descending duodenum and dilation of the bile and pancreatic ducts.He was clinically diagnosed with a duodenal tumor.During surgery,a 7.0 cm×8.0 cm mass was identified within the descending duodenum,so pancreaticoduodenectomy and cholecystectomy were performed.Following operative biopsy,the tumor was diagnosed as primary duodenal T/HRBCL.The patient refused postoperative chemotherapy and died four months after surgery.CONCLUSION Primary duodenal T/HRBCL is an extremely rare and highly aggressive malignancy.The initial treatment strategies should be based on the original site of the tumor,the disease stage,and the patient's physical condition.Chemotherapy-based comprehensive treatment is still the main treatment method for primary gastrointestinal T/HRBCL.
基金Project(2019JJ40377)supported by the Natural Science Foundation of Hunan Province,ChinaProject(2020CX026)supported by the Innovation-Driven Project of Central South University,ChinaProject(51934010)supported by the Major Program of National Natural Science Foundation of China。
文摘Modern hydrometallurgy has been developing for more than 100 years and the related articles keep piling up.Based on a bibliometric analysis of the articles in Hydrometallurgy,the most authoritative journal in the field of hydrometallurgy,we try to catch the research and development trends from a global perspective.Firstly,keywords burstness shows that rare earth,recycling,lithium,ionic liquid,and thorium are the hotspots in recent years,and the economic and technological reasons behind them were discussed in depth.Secondly,the proportion of biohydrometallurgy grows fast from 5%to 13%and the related articles are almost all about bioleaching.There are some new directions such as direct preparation of materials in hydrometallurgical processes and ion-imprinted techniques.Thirdly,the advanced instrument analysis methods such as XAFS(X-ray absorption fine structure),gene sequencing,and micro-CT promote the deep understanding of hydrometallurgy mechanism.Finally,the cooperation network and contribution of the main institutes were mapped.
基金financially supported by the National Natural Science Foundation of China (Nos. 52174340, 51704338)the Basic Science Center of the National Natural Science Foundation of China (No. 72088101)the National Key Research and Development Project of China (No. 2022YFC2904505)。
基金Projects(51334008,51304243,51604160)supported by the National Natural Science Foundation of ChinaProject(2016zzts037)supported by the Fundamental Research Funds for the Central Universities,China
文摘Considering the different geochemical enrichment behaviors of W and Mo,Fe?Mn binary oxide(FMBO),ferric hydroxide(Fe(OH)3)and manganese dioxide(MnO2)were studied to separate W from molybdate solution,respectively.The experimental results demonstrated that Fe?Mn binary oxide(FMBO)was the most suitable adsorbent for the separation.Under a wide pH(6.9?11.3)region,more than80%W removal efficiency and less than3%Mo loss could be obtained.In addition,the Fe?Mn binary oxide adsorbent can be regenerated by treating with3mol/L NaOH,and the W adsorption efficiency was retained after five adsorption?desorption?regeneration cycles.All these indicate that the Fe?Mn binary oxides have the potential for the separation of W from molybdate solution.
文摘Nonalcoholic fatty liver disease(NAFLD),which has been renamed metabolic dysfunction-associated fatty liver disease,is a growing global medical problem.The incidence of NAFLD and its associated end-stage liver disease is increasing each year,and many research advancements have been achieved to date.This review focuses on the current knowledge of the sex differences in NAFLD and does not elaborate on areas without differences.Studies have revealed significant sex differences in the prevalence,influencing factors,pathophysiology,complications and therapies of NAFLD.Men have a higher incidence than women.Compared with women,men exhibit increased visceral fat deposition,are more susceptible to leptin resistance,lack estrogen receptors,and tend to synthesize fatty acids into fat storage.Male patients will experience more severe hepatic fibrosis and a higher incidence of liver cancer.However,once NAFLD occurs,women show a faster progression of liver fibrosis,higher levels of liver cell damage and inflammation and are less likely to undergo liver transplantation than men.In general,men have more risk factors and more severe pathophysiological reactions than women,whereas the development of NAFLD is faster in women,and the treatments for women are more limited than those for men.Thus,whether sex differences should be considered in the individualized prevention and treatment of NAFLD in the future is worth considering.
基金supported by the 13th Five-Year Army Key Discipline Construction Project(No.2020SZ06-17).
文摘Background As one of the most common musculoskeletal ailments,chronic nonspecific low-back pain(CNLBP)causes persistent disability and substantial medical expenses.Epidemiological evidence shows that the incidence rate of CNLBP in young and middle-aged people who are demanded rapidly recovery and social contribution is rising.Recent guidelines indicate a reduced role for medicines in the management of CNLBP.Objective The present study investigates the short-term effects of cupping and scraping therapy using a medicated balm,compared to nonsteroidal anti-inflammatory drug(NSAID)with a capsaicin plaster,in the treatment of CNLBP.Design,setting,participants and interventions We designed a prospective multicenter randomized clinical trial enrolling patients from January 1,2022 to December 31,2022.A total of 156 patients with CNLBP were randomized into two parallel groups.Diclofenac sodium-sustained release tablets were administered orally to participants in the control group for one week while a capsaicin plaster was applied externally.Patients in the test group were treated with cupping and scraping using a medical device and medicated balm.Main outcome measures Primary outcome was pain recorded using the visual analogue scale(VAS).Two secondary outcomes were recorded using the Japanese Orthopedic Association low-back pain scale(JOA)and the traditional Chinese medicine(TCM)syndrome integral scale(TCMS)as assessment tools.Results Between baseline and postintervention,all changes in outcome metric scales were statistically significant(P<0.001).Compared to the control group,patients in the test group had a significantly greater treatment effect in all outcome variables,as indicated by lower VAS and TCMS scores and higher JOA scores,after the one-week intervention period(P<0.001).Further,according to the findings of multivariate linear regression analysis,the participants’pain(VAS score)was related to their marital status,age,smoking habits and body mass index.No adverse reactions were reported for any participants in this trial.Conclusion The effectiveness of TCM combined with the new physiotherapy tool is superior to that of NSAID combined with topical plasters,regarding to pain intensity,TCM symptoms and quality of life.The TCM plus physiotherapy also showed more stable and long-lasting therapeutic effects.
基金Supported by National Natural Science Foundation of China,No.81300702Natural Science Foundation Project of Chongqing CSTC,No.cstc2018jcyjAXO210.
文摘BACKGROUND Nonalcoholic fatty liver disease(NAFLD)is a major chronic liver disorder worldwide,and there is no established treatment for this disease.We conducted a network meta-analysis(NMA)to compare existing treatments,which include four classes of antidiabetic drugs,and examined the optimum treatments for NAFLD.AIM To compare the effectiveness of different treatments for NAFLD.METHODS An NMA was conducted using Stata 14.0(Corporation LLC,College Station,United States)and R(X643.6.3 version)in this study.Eligible randomized controlled trials(RCTs)were searched in the PubMed,Cochrane Library,Embase,Medline and Web of Science databases from database inception to April 2021.Two researchers independently screened the available studies in strict accordance with inclusion and exclusion criteria.The Cochrane Risk of Bias tool was used to evaluate the risk of bias of the included studies.The variables with and without dimensional differences were calculated as the standardized mean difference and weighted mean difference,respectively.An inconsistency model and“nodesplitting”technique were used to test for inconsistency.Funnel plots were used to evaluate publication bias.RESULTS Twenty-two eligible RCTs involving 1377 participants were eventually included in our analysis.Data were pooled using a random-effects model.Our NMA results revealed that glucagon-like peptide-1 receptor agonists(GLP-1RAs)were the most effective treatment,yielding improvements in hepatic fat content(HFC),alanine aminotransferase(ALT),aspartate aminotransferase(AST),serumγ-glutamyl transferase(GGT)and body weight[surface under the cumulative ranking curve(SUCRA)=99.6%,92.6%,82.8%,92.3%and 99.6%,respectively],while thiazolidinediones(TZDs)were the best intervention for reducing the NAFLD activity score(NAS;SUCRA=98.9%).In addition,moderate performance was observed for the sodium glucose cotransporter-2 inhibitors groups(SUCRA=25.1%,66.2%,63.5%,58.2%and 71.9%for HFC,ALT,AST,GGT and body weight,respectively).However,metformin performed poorly according to most indicators(SUCRA=54.5%,0.3%,19.5%,33.7%,57.7%and 44.3%for HFC,NAS,ALT,AST,GGT and body weight,respectively).CONCLUSION GLP-1RAs may be the optimum choice for most patients with NAFLD.However,TZDs are considered the most effective therapies in NAFLD patients with histological disease activity.
基金Supported by the National Natural Science Foundation of China,No.81300702the Natural Science Foundation Project of Chongqing CSTC,No.cstc2018jcyjAXO210.
文摘BACKGROUND Maturity-onset diabetes of the young(MODY)is a monogenic genetic disease often clinically misdiagnosed as type 1 or type 2 diabetes.MODY type 9(MODY9)is a rare subtype caused by mutations in the PAX4 gene.Currently,there are limited reports on PAX4-MODY,and its clinical characteristics and treatments are still unclear.In this report,we described a Chinese patient with high autoimmune antibodies,hyperglycemia and a site mutation in the PAX4 gene.CASE SUMMARY A 42-year-old obese woman suffered diabetes ketoacidosis after consuming substantial amounts of beverages.She had never had diabetes before,and no one in her family had it.However,her autoantibody tested positive,and she managed her blood glucose within the normal range for 6 mo through lifestyle interventions.Later,her blood glucose gradually increased.Next-generation sequencing and Sanger sequencing were performed on her family.The results revealed that she and her mother had a heterozygous mutation in the PAX4 gene(c.314G>A,p.R105H),but her daughter did not.The patient is currently taking liraglutide(1.8 mg/d),and her blood glucose levels are under control.Previous cases were retrieved from PubMed to investigate the relationship between PAX4 gene mutations and diabetes.CONCLUSION We reported the first case of a PAX4 gene heterozygous mutation site(c.314G>A,p.R105H),which does not appear pathogenic to MODY9 but may facilitate the progression of latent autoimmune diabetes in adults.
基金supported by the National Natural Science Foundation of China(Grants Nos.92065110,11974048,and 12074334)。
文摘High mobility quasi two-dimensional electron gas(2DEG)found at the CaZrO_(3)/SrTiO_(3) nonpolar heterointerface is attractive and provides a platform for the development of functional devices and nanoelectronics.Here we report that the carrier density and mobility at low temperature can be tuned by gate voltage at the CaZrO_(3)/SrTiO_(3) interface.Furthermore,the magnitude of Rashba spin-orbit interaction can be modulated and increases with the gate voltage.Remarkably,the diffusion constant and the spin-orbit relaxation time can be strongly tuned by gate voltage.The diffusion constant increases by a factor of~19.98 and the relaxation time is reduced by a factor of over three orders of magnitude while the gate voltage is swept from-50 V to 100 V.These findings not only lay a foundation for further understanding the underlying mechanism of Rashba spin-orbit coupling,but also have great significance in developing various oxide functional devices.
