The latitudinal diversity gradient(LDG)is one of the most notable biodiversity patterns in biogeography.The metabolic theory of ecology(MTE)explains ecological patterns,including the LDG.However,little is known about ...The latitudinal diversity gradient(LDG)is one of the most notable biodiversity patterns in biogeography.The metabolic theory of ecology(MTE)explains ecological patterns,including the LDG.However,little is known about whether the LDG remains stable over time as climate warming progresses and whether MTE remains applicable to clarify this pattern.In this study,forest data spanning temperate,subtropical,and tropical zones across China were used to analyze long-term changes in the LDG of tree species over 2005-2020.Based on the MTE framework,spatial scales were considered to assess temperature dependence of typical forest trees species.Our results show that species richness decreased with increasing latitude,and that temperature was the primary driver of this change.Although temperature in China has significantly increased over the past two decades,the LDG of tree species has remained stable.However,there was a decrease in species richness in tropical regions over time.With predictions of the MTE,the logarithm of typical forest tree species richness exhibited negative linear relationships with the inverse of ambient temperature,indicating temperature dependence of species richness.However,the relationship remained stable and was strongly influenced by spatial scale,intensifying as spatial scale increased.The findings emphasize the important role of temperature in shaping the LDG.The effects of spatial scale,in particular,should be considered when biodiversity management plans are developed for future climate change.展开更多
To address the high cost and limited electrochemical endurance of Pt-based electrocatalysts,the appropriate introduction of transition metal-based compounds as supports to disperse and anchor Pt species offers a promi...To address the high cost and limited electrochemical endurance of Pt-based electrocatalysts,the appropriate introduction of transition metal-based compounds as supports to disperse and anchor Pt species offers a promising approach for improving catalytic efficiency.In this study,sub-1 nm Pt nanoclusters were uniformly confined on NiO supports with a hierarchical nanotube/nanosheet structure(Pt/NiO/NF)through a combination of spatial domain confinement and annealing.The resulting catalyst exhibited excellent electrocatalytic activity and stability for hydrogen evolution(HER)and urea oxidation reactions(UOR)under alkaline conditions.Structural characterization and density functional theory calculations demonstrated that sub-1 nm Pt nanoclusters were immobilized on the NiO supports by Pt–O–Ni bonds at the interface.The strong metal-support interaction induced massive charge redistribution around the heterointerface,leading to the formation of multiple active sites.The Pt/NiO/NF catalyst only required an overpotential of 12 and 136 mV to actuate current densities of 10 and 100 mA cm^(-2) for the HER,respectively,and maintained a voltage retention of 96%for 260 h of continuous operation at a current density of 500 mA cm^(-2).Notably,in energy-efficient hydrogen production systems coupled with the HER and UOR,the catalyst required cell voltages of 1.37 and 1.53 V to drive current densities of 10 and 50 mA cm^(-2),respectively—approximately 300 mV lower than conventional water electrolysis systems.This study presents a novel pathway for designing highly efficient and robust sub-nanometer metal cluster catalysts.展开更多
Fetal skeletal dysplasia(FSD)encompasses diverse clinical features and complicates prenatal diagnosis and perinatal care.In this retrospective study,we integrate prenatal deep phenotyping with exome or genome sequenci...Fetal skeletal dysplasia(FSD)encompasses diverse clinical features and complicates prenatal diagnosis and perinatal care.In this retrospective study,we integrate prenatal deep phenotyping with exome or genome sequencing(ES/GS)to elucidate comprehensive genotype and phenotype landscapes,diagnostic outcomes,genotype-phenotype correlations,and postnatal follow-up findings and to refine genetic counseling and clinical decision-making.The study includes a cohort of 152 fetuses with FSD in China.All fetuses undergo prenatal deep phenotyping followed by ES/GS analysis.Prenatal deep phenotyping enables classification into isolated and non-isolated FSD groups and identifies previously unrecognized prenatal features associated with KBG syndrome and Segawa syndrome.Among skeletal anomalies,limb bone anomalies are the most common(72.4%).Genetic testing yields positive diagnoses in 88 fetuses(57.9%).Notably,fetuses with cranial and limb bone abnormalities demonstrate a higher diagnostic yield.Comparative analysis of prenatal and postnatal genotypes and phenotypes in individuals harboring pathogenic variants in four hotspot genes provides a deeper understanding of skeletal dysplasia phenotypes.Genetic findings from this cohort directly inform reproductive decisions in 16 subsequent pregnancies.Our findings significantly enhance genotype-phenotype correlations and contribute to improved prenatal counseling,informed clinical decision-making,and optimized perinatal care,and advance precision medicine strategies for FSD-affected families.展开更多
Immune thrombocytopenia(ITP)is a hemorrhagic autoimmune disease characterized by antibody-mediated platelet injury.ITP has complicated immunopathological mechanisms that need further elucidation.It is well known that ...Immune thrombocytopenia(ITP)is a hemorrhagic autoimmune disease characterized by antibody-mediated platelet injury.ITP has complicated immunopathological mechanisms that need further elucidation.It is well known that the costimulatory molecules OX40 ligand(OX40L)and OX40 play essential roles in the immunological mechanisms of autoimmune diseases.Previously,we discovered that the expression of OX40L and OX40 is significantly increased in the peripheral blood mononuclear cells(PBMCs)of ITP patients.In our present study,OX40L-induced follicular helper T(Tfh)cells exhibited an activated phenotype with elevated expression of inducible T-cell costimulator(ICOS),programmed cell death protein-1(PD-1),and cluster of differentiation 40 ligand(CD40L)in vitro.Moreover,aberrant OX40L-OX40 expression might promote the Tfh1-to-Tfh2 shift in vivo,inducing the generation of autoantibodies by enhancing the helper function of Tfh cells for B lymphocytes in a mouse model,which might accelerate the progression of ITP.Additionally,signal transduction through the OX40L-OX40 axis might be related to the activation of tumor necrosis factor receptor-associated factor(TRAF)-nuclear factor-κB(NF-κB)and Janus kinase(JAK)-signal transducer and activator of transcription(STAT)signaling pathways.Overall,OX40L-OX40 signaling is proposed as a potential novel therapeutic target for ITP.展开更多
Myofascial pain syndrome(MPS)is characterized by myofascial trigger points and fascial constrictions.At present,domestic and foreign scholars have not reached a consensus on the etiology and pathogenesis of MPS.Due to...Myofascial pain syndrome(MPS)is characterized by myofascial trigger points and fascial constrictions.At present,domestic and foreign scholars have not reached a consensus on the etiology and pathogenesis of MPS.Due to the lack of specific laboratory indicators and imaging evidence,there is no unified diagnostic criteria for MPS,making it easy to confuse with other diseases.The Chinese Association for the Study of Pain organized domestic experts to formulate this Chinese Pain Specialist Consensus on the diagnosis and treatment of MPS.This article reviews relevant domestic and foreign literature on the definition,epidemiology,pathogenesis,clinical manifestation,diagnostic criteria and treatments of MPS.The consensus is intended to normalize the diagnosis and treatment of MPS and be used by first-line doctors,including pain physicians to manage patients with MPS.展开更多
Emission factors （EFs） of parent polycyclic aromatic hydrocarbons （pPAHs）, nitrated PAHs （nPAHs）, and oxygenated PAHs （oPAHs） were measured for indoor corn straw burned in a brick cooking stove under different...Emission factors （EFs） of parent polycyclic aromatic hydrocarbons （pPAHs）, nitrated PAHs （nPAHs）, and oxygenated PAHs （oPAHs） were measured for indoor corn straw burned in a brick cooking stove under different burning conditions. The EFs of total 28 pPAHs, 6 nPAHs and 4 oPAHs were （7.9 ±3.4）, （6.5 ±1.6）×10^-3, and （6.1 ±1.4）×10^-1mg/kg, respectively. Fuel charge size had insignificant influence on the pollutant emissions. Measured EFs increased significantly in a fast burning due to the oxygen deficient atmosphere formed in the stove chamber. In both restricted and enhanced air supply conditions, the EFs of pPAHs, nPAHs and oPAHs were significantly higher than those measured in normal burning conditions. Though EFs varied among different burning conditions, the composition profiles and calculated isomer ratios were similar, without significant differences. The results from the stepwise regression model showed that fuel burning rate, air supply amount, and modified combustion efficiency were the three most significant influencing factors, explaining 72%-85% of the total variations.展开更多
Cervicogenic headache(CEH)has been recognized as a unique category of headache that can be difficult to diagnose and treat.In China,CEH patients are managed by many different specialties,and the treatment plans remain...Cervicogenic headache(CEH)has been recognized as a unique category of headache that can be difficult to diagnose and treat.In China,CEH patients are managed by many different specialties,and the treatment plans remain controversial.Therefore,there is a great need for comprehensive evidence-based Chinese experts’recommendations for the management of CEH.The Chinese Association for the Study of Pain asked an expert panel to develop recommendations for a series of questions that are essential for daily clinical management of patients with CEH.A group of multidisciplinary Chinese Association for the Study of Pain experts identified the clinically relevant topics in CEH.A systematic review of the literature was performed,and evidence supporting the benefits and harms for the management of CEH was summarized.Twenty-four recommendations were finally developed through expert consensus voting for evidence quality and recommendation strength.We hope this guideline provides direction for clinicians and patients making treatment decisions for the management of CEH.展开更多
Chronic pain lasting more than 3 mo,or even several years can lead to disability.Treating chronic pain safely and effectively is a critical challenge faced by clinicians.Because administration of analgesics through or...Chronic pain lasting more than 3 mo,or even several years can lead to disability.Treating chronic pain safely and effectively is a critical challenge faced by clinicians.Because administration of analgesics through oral,intravenous or intramuscular routes is not satisfactory,research toward percutaneous delivery has gained interest.The transdermal patch is one such percutaneous delivery system that can deliver drugs through the skin and capillaries at a certain rate to achieve a systemic or local therapeutic effect in the affected area.It has many advantages including ease of administration and hepatic first pass metabolism avoidance as well as controlling drug delivery,which reduces the dose frequency and side effects.If not required,then the patch can be removed from the skin immediately.The scopolamine patch was the first transdermal patch to be approved for the treatment of motion sickness by the Food and Drug Administration in 1979.From then on,the transdermal patch has been widely used to treat many diseases.To date,no guidelines or consensus are available on the use of analgesic drugs through transdermal delivery.The pain branch of the Chinese Medical Association,after meeting and discussing with experts and based on clinical evidence,developed a consensus for promoting and regulating standard use of transdermal patches containing analgesic drugs.展开更多
Helicobacter pylori (H. pylori) is one of the most common pathogenic bacterial infections and is found in the stomachs of approximately half of the world’s population. It is the primary known cause of gast...Helicobacter pylori (H. pylori) is one of the most common pathogenic bacterial infections and is found in the stomachs of approximately half of the world’s population. It is the primary known cause of gastritis, gastroduodenal ulcer disease and gastric cancer. However, combined drug therapy as the general treatment in the clinic, the rise of antibiotic-resistant bacteria, adverse reactions and poor patient compliance are major obstacles to the eradication of H. pylori. Oral site-specific drug delivery systems that could increase the longevity of the treatment agent at the target site might improve the therapeutic effect and avoid side effects. Gastroretentive drug delivery systems potentially prolong the gastric retention time and controlled/sustained release of a drug, thereby increasing the concentration of the drug at the application site, potentially improving its bioavailability and reducing the necessary dosage. Recommended gastroretentive drug delivery systems for enhancing local drug delivery include floating systems, bioadhesive systems and expandable systems. In this review, we summarize the important physiological parameters of the gastrointestinal tract that affect the gastric residence time. We then focus on various aspects useful in the development of gastroretentive drug delivery systems, including current trends and the progress of novel forms, especially with respect to their application for the treatment of H. pylori infections.展开更多
Objective To investigate whether the connection of p27 Kip1 to S-phase kinase-associated protein 2 (Skp2) plays an oncogenic role in intraductal proliferative lesions of the breast. Methods Here we investigated the me...Objective To investigate whether the connection of p27 Kip1 to S-phase kinase-associated protein 2 (Skp2) plays an oncogenic role in intraductal proliferative lesions of the breast. Methods Here we investigated the mechanism involved in association of Skp2's degradation of p27 Kip1 with the breast carcinogenesis by immunohistochemical method through detection of Skp2 and p27 Kip1 protein levels in 120 paraffin-embedded tissues of intraductal proliferative lesions including usual ductal hyperplasia (UDH, n=30), atypical ductal hyperplasia (n=30), flat epithelial atypia (FEA, n=30), and ductal carcinoma in situ (DCIS, n=30). Moreover, the expression status of Skp2 and p27 Kip1 in 30 cases of the normal breast paraffin-embedded tissues were explored. Results The DCIS group was with the highest Skp2 level and the lowest p27 Kip1 level, and the UDH group was with the lowest Skp2 level and the highest p27 Kip1 level. Both Skp2 and p27 Kip1 levels in the DCIS group were significantly different from those in the UDH group (all P<0.01). The levels of Skp2 and p27 Kip1 in the FEA group were significantly different from both the DCIS and UDH groups (all P<0.05). p27 Kip1 was negatively correlated with Skp2 in both the UDH group (r=-0.629, P=0.026) and DCIS group (r=-0.893, P=0.000). Conclusion Overexpression of Skp2 might be the mechanism underlying p27 Kip1 over degradation.展开更多
Chronic postsurgical pain is a common surgical complication that severely reduces a patient’s quality of life.Many perioperative interventions and management strategies have been developed for reducing and managing c...Chronic postsurgical pain is a common surgical complication that severely reduces a patient’s quality of life.Many perioperative interventions and management strategies have been developed for reducing and managing chronic postsurgical pain.Under the leadership of the Chinese Association for the Study of Pain,an editorial committee was formed for chronic postsurgical pain diagnosis and treatment by experts in relevant fields.The editorial committee composed the main content and framework of this consensus and established a working group.The working group conducted literature review(1989-2020)using key words such as“surgery”,“post-surgical”,“post-operative”,“pain”,“chronic”,and“persistent”in different databases including MEDLINE,EMBASE,PubMed,Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews.Only publications in the English language were included.The types of literature included systematic reviews,randomized controlled studies,cohort studies and case reports.This consensus was written based on clinical practice combined with literature evidence.The first draft of the consensus was rigorously reviewed and edited by all the editorial committee experts before being finalized.The level of evidence was assessed by methodological experts based on the Oxford Centre for Evidence-Based Medicine Levels of Evidence.The strength of recommendation was evaluated by all editorial committee experts,and the opinions of most experts were adopted as the final decision.The recommendation level“strong”generally refers to recommendations based on high-level evidence and consistency between clinical behavior and expected results.The recommendation level“weak”generally refers to the uncertainty between clinical behavior and expected results based on low-level evidence.展开更多
BACKGROUND Acute flaccid paralysis(AFP)and neurogenic respiratory failure rarely occur in children.At the end of 2018,some children with such symptoms were admitted to our hospital.In this study,we aimed to assess two...BACKGROUND Acute flaccid paralysis(AFP)and neurogenic respiratory failure rarely occur in children.At the end of 2018,some children with such symptoms were admitted to our hospital.In this study,we aimed to assess two children with AFP and neurogenic respiratory failure associated with enterovirus D68(EV-D68).CASE SUMMARY Two children admitted to our hospital presented with symptoms and imaging results different from those of acute disseminated encephalomyelitis and hand,foot,and mouth disease.Their main symptoms were AFP and neurogenic respiratory failure.Magnetic resonance imaging showed severe inflammatory injury mainly to the anterior horn cells of the spinal cord.Blood and cerebrospinal fluid samples were collected to assess for pathogens,including bacteria,tuberculosis,cryptococcus,herpes virus,and coxsackie virus,and the results were negative.At the beginning,the two cases were not assessed for EV-D68 in the nasopharyngeal,blood,and cerebrospinal fluid specimens.About 2 mo later,EVD68 was detected in the stool sample of one of the cases.The symptom of AFP was caused by injury to the anterior horn cells at levels C5-L5 of the spinal cord,while neurogenic respiratory failure was at levels C3-C5.CONCLUSION We should pay attention to the detection and diagnosis of EV-D68 and make efforts to develop antivirus drugs and vaccines.展开更多
BACKGROUND Cutaneous myiasis is frequently observed;however,eosinophilic pleural effusion induced by this condition is rare.CASE SUMMARY We report the case of a 65-year-old female Tibetan patient from Qinghai Province...BACKGROUND Cutaneous myiasis is frequently observed;however,eosinophilic pleural effusion induced by this condition is rare.CASE SUMMARY We report the case of a 65-year-old female Tibetan patient from Qinghai Province,who presented to West China Hospital of Sichuan University around mid-November 2011 with a chief complaint of recurrent cough,occasional hemoptysis,and right chest pain.There was no past medical and surgical history of note,except for occasional dietary habit of eating raw meat.Clinical examination revealed a left lung collapse and diminished breathing sounds in her left lung,with moist rales heard in both lungs.Chest X-rays demonstrated a left hydropneumothorax and a right lung infection.Chest computed tomography revealed a left hydropneumothorax with partial compressive atelectasis and patchy consolidation on the right lung.Laboratory data revealed peripheral blood eosinophilia of 37.2%,with a white blood cell count of 10.4×109/L.Serum immunoglobulin E levels were elevated(1650 unit/mL).Serum parasite antibodies were negative except for cysticercosis immunoglobulin G.Bone marrow aspirates were hypercellular,with a marked increase in the number of mature eosinophils and eosinophilic myelocytes.An ultrasound-guided left-sided thoracentesis produced a yellow-cloudy exudative fluid.Failure to respond to antibiotic treatment during hospitalization for her symptoms and persistent blood eosinophilia led the team to start oral albendazole(400 mg/d)for presumed parasitic infestation for three consecutive days after the ninth day of hospitalization.Intermittent migratory stabbing pain and swelling sensation on both her upper arms and shoulders were reported;tender nodules and worm-like live organisms were observed in the responding sites 1 wk later.After the removal of the live organisms,they were subsequently identified as first stage hypodermal larvae by the Sichuan Institute of Parasites.The patient’s symptoms were relieved soon afterwards.Telephonic follow-up 1 mo later indicated that the blood eosinophilia and pleural effusion were resolved.CONCLUSION Eosinophilic pleural fluid can be present in a wide array of disorders.Myiasis should be an important consideration for the differential diagnosis when eosinophilic pleural effusion with blood eosinophilia is observed.展开更多
BACKGROUND Diabetic foot ulcers(DFUs)are a common complication of diabetes,often leading to severe infections,amputations,and reduced quality of life.The current standard treatment protocols for DFUs have limitations ...BACKGROUND Diabetic foot ulcers(DFUs)are a common complication of diabetes,often leading to severe infections,amputations,and reduced quality of life.The current standard treatment protocols for DFUs have limitations in promoting efficient wound healing and preventing complications.A comprehensive treatment approach targeting multiple aspects of wound care may offer improved outcomes for patients with DFUs.The hypothesis of this study is that a comprehensive treatment protocol for DFUs will result in faster wound healing,reduced amputation rates,and improved overall patient outcomes compared to standard treatment protocols.AIM To compare the efficacy and safety of a comprehensive treatment protocol for DFUs with those of the standard treatment protocol.METHODS This retrospective study included 62 patients with DFUs,enrolled between January 2022 and January 2024,randomly assigned to the experimental(n=32)or control(n=30)group.The experimental group received a comprehensive treatment comprising blood circulation improvement,debridement,vacuum sealing drainage,recombinant human epidermal growth factor and anti-inflammatory dressing,and skin grafting.The control group received standard treatment,which included wound cleaning and dressing,antibiotics administration,and surgical debridement or amputation,if necessary.Time taken to reduce the white blood cell count,number of dressing changes,wound healing rate and time,and amputation rate were assessed.RESULTS The experimental group exhibited significantly better outcomes than those of the control group in terms of the wound healing rate,wound healing time,and amputation rate.Additionally,the comprehensive treatment protocol was safe and well tolerated by the patients.CONCLUSION Comprehensive treatment for DFUs is more effective than standard treatment,promoting granulation tissue growth,shortening hospitalization time,reducing pain and amputation rate,improving wound healing,and enhancing quality of life.展开更多
A new approach to model and control an unknown system using subjective uncertain rules is proposed. This method is established by combining the grey system theory and the qualitative simulation method. The proposed ap...A new approach to model and control an unknown system using subjective uncertain rules is proposed. This method is established by combining the grey system theory and the qualitative simulation method. The proposed approach mainly contains three steps. In the first step, subjective uncertain rules are accumulated gradually during cognizing the system; the mapping relations between the system inputs and outputs are built and represented using the grey qualitative matrix in the second step; in the third step,the generalized whitening function is defined to realize the transformation between qualitative and quantitative information. Besides the theoretical results, two sets of simulations based on a water level control system are conducted comparatively to demonstrate the effectiveness of the proposed method. The water level expectation is set to be constant in the first set, while it changes in the second set. The simulation results show that the proposed method tracks the water level expectation well. By combining the proposed method with proportional-integral-derivative(PID) or fuzzy logic controller(FLC), it can be concluded that the system can reach the stable state more quickly and the overshoot can also be reduced compared to using PID or FLC alone.展开更多
The reduction and recovery of P_(2)O_(5)in dephosphorization slag were examined to establish a new recycling process for dephosphorization slag.The dephosphorization slag is obtained from the dephosphorization furnace...The reduction and recovery of P_(2)O_(5)in dephosphorization slag were examined to establish a new recycling process for dephosphorization slag.The dephosphorization slag is obtained from the dephosphorization furnace in the duplex converter process,and the content of P_(2)O_(5) in the dephosphorization slag can reach 9 wt.%.The dephosphorization slag is considered to be a prospective resource of phosphorus due to its high content of P_(2)O_(5).To explore the effects of temperature and Fe2O3 content in slag on phosphorus recovery from dephosphorization slag,the experimental slag was reduced by carbon powder in a resistance furnace.The results show that the temperature and content of Fe2O3 in slag have a significant effect on the reduction in P_(2)O_(5),and the reduction and recovery ratios of P_(2)O_(5) in slags increase with the increase in the experimental temperature and content of Fe_(2)O_(3),reaching 94.41%and 83.09%,respectively.It has been indicated that phosphorus recovery from dephosphorization slag using carbothermic reduction has significant environmental and economic benefits.展开更多
Background:Several biomarkers have been studied as prognostic indicators among people with diabetes and coro-nary artery disease(CAD).The purpose of this study was to determine the prognostic value of neutrophil count...Background:Several biomarkers have been studied as prognostic indicators among people with diabetes and coro-nary artery disease(CAD).The purpose of this study was to determine the prognostic value of neutrophil counts and the Gensini score in patients with diabetes and ACS undergoing percutaneous coronary intervention(PCI).Methods:A total of 694 people with ACS and T2DM who simultaneously had elevated HBA1c received PCI.Spear-man rank correlation estimates were used for correlation evaluation.Multivariate Cox regression and Kaplan-Meier analysis were used to identify characteristics associated with major adverse cardiovascular and cerebrovascular events(MACCEs)and patient survival.The effects of single-and multi-factor indices on MACCEs were evaluated through receiver operating characteristic curve analysis.Results:The Gensini score and neutrophil count significantly differed between the MACCE and non-MACCE groups among patients receiving PCI who had concomitant ACS and T2DM with elevated HBA1c(P<0.001).The Gensini score and neutrophil count were strongly associated with MACCEs(log-rank,P<0.001).The Gensini score and neu-trophil count,alone or in combination,were predictors of MACCEs,according to multivariate Cox regression analysis(adjusted hazard ratio[HR],1.005;95%confidence interval[CI],1.002–1.008;P=0.002;adjusted HR,1.512;95%CI,1.005–2.274;P=0.047,respectively).The Gensini score was strongly associated with neutrophil count(variance inflation factor≥5).Area under the curve analysis revealed that the combination of multivariate factors predicted the occurrence of MACCEs better than any single variable.Conclusion:In patients with T2DM and ACS with elevated HBA1c who underwent PCI,both the Gensini score and neutrophil count were independent predictors of outcomes.The combination of both predictors has a higher predict-ability.展开更多
基金supported by the Key Program of National Science of China(Grant No.:42030509 and 42141005)。
文摘The latitudinal diversity gradient(LDG)is one of the most notable biodiversity patterns in biogeography.The metabolic theory of ecology(MTE)explains ecological patterns,including the LDG.However,little is known about whether the LDG remains stable over time as climate warming progresses and whether MTE remains applicable to clarify this pattern.In this study,forest data spanning temperate,subtropical,and tropical zones across China were used to analyze long-term changes in the LDG of tree species over 2005-2020.Based on the MTE framework,spatial scales were considered to assess temperature dependence of typical forest trees species.Our results show that species richness decreased with increasing latitude,and that temperature was the primary driver of this change.Although temperature in China has significantly increased over the past two decades,the LDG of tree species has remained stable.However,there was a decrease in species richness in tropical regions over time.With predictions of the MTE,the logarithm of typical forest tree species richness exhibited negative linear relationships with the inverse of ambient temperature,indicating temperature dependence of species richness.However,the relationship remained stable and was strongly influenced by spatial scale,intensifying as spatial scale increased.The findings emphasize the important role of temperature in shaping the LDG.The effects of spatial scale,in particular,should be considered when biodiversity management plans are developed for future climate change.
文摘To address the high cost and limited electrochemical endurance of Pt-based electrocatalysts,the appropriate introduction of transition metal-based compounds as supports to disperse and anchor Pt species offers a promising approach for improving catalytic efficiency.In this study,sub-1 nm Pt nanoclusters were uniformly confined on NiO supports with a hierarchical nanotube/nanosheet structure(Pt/NiO/NF)through a combination of spatial domain confinement and annealing.The resulting catalyst exhibited excellent electrocatalytic activity and stability for hydrogen evolution(HER)and urea oxidation reactions(UOR)under alkaline conditions.Structural characterization and density functional theory calculations demonstrated that sub-1 nm Pt nanoclusters were immobilized on the NiO supports by Pt–O–Ni bonds at the interface.The strong metal-support interaction induced massive charge redistribution around the heterointerface,leading to the formation of multiple active sites.The Pt/NiO/NF catalyst only required an overpotential of 12 and 136 mV to actuate current densities of 10 and 100 mA cm^(-2) for the HER,respectively,and maintained a voltage retention of 96%for 260 h of continuous operation at a current density of 500 mA cm^(-2).Notably,in energy-efficient hydrogen production systems coupled with the HER and UOR,the catalyst required cell voltages of 1.37 and 1.53 V to drive current densities of 10 and 50 mA cm^(-2),respectively—approximately 300 mV lower than conventional water electrolysis systems.This study presents a novel pathway for designing highly efficient and robust sub-nanometer metal cluster catalysts.
基金the National Key Research and Development Program of China(2022YFC2703100 to S.Z.,2024YFC2707100 for Q.Q.,2022YFC2703901 to Z.W.,2022YFC2703102 to N.W.)National Natural Science Foundation of China(82172525 to G.Q.,82172382 to J.Z.)+2 种基金CAMS Innovation Fund for Medical Sciences(CIFMS,2021-I2M-1-051 to J.Z.and N.W.,2021-I2M-1-052 and 2022-I2M-2-001 to Z.W.,2023-I2M-C&T-A-003 to J.Z.)National High Level Hospital Clinical Research Funding(2022-PUMCH-D-004 to J.Z.and N.W.,2022-PUMCH-C-033 to N.W.,2022-PUMCH-D-002 to Z.W.)Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(2019PT320025 to N.W.).
文摘Fetal skeletal dysplasia(FSD)encompasses diverse clinical features and complicates prenatal diagnosis and perinatal care.In this retrospective study,we integrate prenatal deep phenotyping with exome or genome sequencing(ES/GS)to elucidate comprehensive genotype and phenotype landscapes,diagnostic outcomes,genotype-phenotype correlations,and postnatal follow-up findings and to refine genetic counseling and clinical decision-making.The study includes a cohort of 152 fetuses with FSD in China.All fetuses undergo prenatal deep phenotyping followed by ES/GS analysis.Prenatal deep phenotyping enables classification into isolated and non-isolated FSD groups and identifies previously unrecognized prenatal features associated with KBG syndrome and Segawa syndrome.Among skeletal anomalies,limb bone anomalies are the most common(72.4%).Genetic testing yields positive diagnoses in 88 fetuses(57.9%).Notably,fetuses with cranial and limb bone abnormalities demonstrate a higher diagnostic yield.Comparative analysis of prenatal and postnatal genotypes and phenotypes in individuals harboring pathogenic variants in four hotspot genes provides a deeper understanding of skeletal dysplasia phenotypes.Genetic findings from this cohort directly inform reproductive decisions in 16 subsequent pregnancies.Our findings significantly enhance genotype-phenotype correlations and contribute to improved prenatal counseling,informed clinical decision-making,and optimized perinatal care,and advance precision medicine strategies for FSD-affected families.
基金supported by the National Natural Science Foundation of China(Nos.82172335,81971994,91846103,and 81871709)the Zhejiang Provincial Key Research and Development Program(No.2020C03032),China.
文摘Immune thrombocytopenia(ITP)is a hemorrhagic autoimmune disease characterized by antibody-mediated platelet injury.ITP has complicated immunopathological mechanisms that need further elucidation.It is well known that the costimulatory molecules OX40 ligand(OX40L)and OX40 play essential roles in the immunological mechanisms of autoimmune diseases.Previously,we discovered that the expression of OX40L and OX40 is significantly increased in the peripheral blood mononuclear cells(PBMCs)of ITP patients.In our present study,OX40L-induced follicular helper T(Tfh)cells exhibited an activated phenotype with elevated expression of inducible T-cell costimulator(ICOS),programmed cell death protein-1(PD-1),and cluster of differentiation 40 ligand(CD40L)in vitro.Moreover,aberrant OX40L-OX40 expression might promote the Tfh1-to-Tfh2 shift in vivo,inducing the generation of autoantibodies by enhancing the helper function of Tfh cells for B lymphocytes in a mouse model,which might accelerate the progression of ITP.Additionally,signal transduction through the OX40L-OX40 axis might be related to the activation of tumor necrosis factor receptor-associated factor(TRAF)-nuclear factor-κB(NF-κB)and Janus kinase(JAK)-signal transducer and activator of transcription(STAT)signaling pathways.Overall,OX40L-OX40 signaling is proposed as a potential novel therapeutic target for ITP.
文摘Myofascial pain syndrome(MPS)is characterized by myofascial trigger points and fascial constrictions.At present,domestic and foreign scholars have not reached a consensus on the etiology and pathogenesis of MPS.Due to the lack of specific laboratory indicators and imaging evidence,there is no unified diagnostic criteria for MPS,making it easy to confuse with other diseases.The Chinese Association for the Study of Pain organized domestic experts to formulate this Chinese Pain Specialist Consensus on the diagnosis and treatment of MPS.This article reviews relevant domestic and foreign literature on the definition,epidemiology,pathogenesis,clinical manifestation,diagnostic criteria and treatments of MPS.The consensus is intended to normalize the diagnosis and treatment of MPS and be used by first-line doctors,including pain physicians to manage patients with MPS.
基金supported by the National Natural Science Foundation of China (No.41130754,41001343)the Beijing Municipal Government (No.YB20101000101)+2 种基金Ministry of Environmental Protection (No.201209018)NIEHS (No.P42 ES016465)Guofeng Shen’s work in was supported by Jiangsu EPDProject (combined air pollution in Nanjing and surrounding area)
文摘Emission factors （EFs） of parent polycyclic aromatic hydrocarbons （pPAHs）, nitrated PAHs （nPAHs）, and oxygenated PAHs （oPAHs） were measured for indoor corn straw burned in a brick cooking stove under different burning conditions. The EFs of total 28 pPAHs, 6 nPAHs and 4 oPAHs were （7.9 ±3.4）, （6.5 ±1.6）×10^-3, and （6.1 ±1.4）×10^-1mg/kg, respectively. Fuel charge size had insignificant influence on the pollutant emissions. Measured EFs increased significantly in a fast burning due to the oxygen deficient atmosphere formed in the stove chamber. In both restricted and enhanced air supply conditions, the EFs of pPAHs, nPAHs and oPAHs were significantly higher than those measured in normal burning conditions. Though EFs varied among different burning conditions, the composition profiles and calculated isomer ratios were similar, without significant differences. The results from the stepwise regression model showed that fuel burning rate, air supply amount, and modified combustion efficiency were the three most significant influencing factors, explaining 72%-85% of the total variations.
文摘Cervicogenic headache(CEH)has been recognized as a unique category of headache that can be difficult to diagnose and treat.In China,CEH patients are managed by many different specialties,and the treatment plans remain controversial.Therefore,there is a great need for comprehensive evidence-based Chinese experts’recommendations for the management of CEH.The Chinese Association for the Study of Pain asked an expert panel to develop recommendations for a series of questions that are essential for daily clinical management of patients with CEH.A group of multidisciplinary Chinese Association for the Study of Pain experts identified the clinically relevant topics in CEH.A systematic review of the literature was performed,and evidence supporting the benefits and harms for the management of CEH was summarized.Twenty-four recommendations were finally developed through expert consensus voting for evidence quality and recommendation strength.We hope this guideline provides direction for clinicians and patients making treatment decisions for the management of CEH.
文摘Chronic pain lasting more than 3 mo,or even several years can lead to disability.Treating chronic pain safely and effectively is a critical challenge faced by clinicians.Because administration of analgesics through oral,intravenous or intramuscular routes is not satisfactory,research toward percutaneous delivery has gained interest.The transdermal patch is one such percutaneous delivery system that can deliver drugs through the skin and capillaries at a certain rate to achieve a systemic or local therapeutic effect in the affected area.It has many advantages including ease of administration and hepatic first pass metabolism avoidance as well as controlling drug delivery,which reduces the dose frequency and side effects.If not required,then the patch can be removed from the skin immediately.The scopolamine patch was the first transdermal patch to be approved for the treatment of motion sickness by the Food and Drug Administration in 1979.From then on,the transdermal patch has been widely used to treat many diseases.To date,no guidelines or consensus are available on the use of analgesic drugs through transdermal delivery.The pain branch of the Chinese Medical Association,after meeting and discussing with experts and based on clinical evidence,developed a consensus for promoting and regulating standard use of transdermal patches containing analgesic drugs.
文摘Helicobacter pylori (H. pylori) is one of the most common pathogenic bacterial infections and is found in the stomachs of approximately half of the world’s population. It is the primary known cause of gastritis, gastroduodenal ulcer disease and gastric cancer. However, combined drug therapy as the general treatment in the clinic, the rise of antibiotic-resistant bacteria, adverse reactions and poor patient compliance are major obstacles to the eradication of H. pylori. Oral site-specific drug delivery systems that could increase the longevity of the treatment agent at the target site might improve the therapeutic effect and avoid side effects. Gastroretentive drug delivery systems potentially prolong the gastric retention time and controlled/sustained release of a drug, thereby increasing the concentration of the drug at the application site, potentially improving its bioavailability and reducing the necessary dosage. Recommended gastroretentive drug delivery systems for enhancing local drug delivery include floating systems, bioadhesive systems and expandable systems. In this review, we summarize the important physiological parameters of the gastrointestinal tract that affect the gastric residence time. We then focus on various aspects useful in the development of gastroretentive drug delivery systems, including current trends and the progress of novel forms, especially with respect to their application for the treatment of H. pylori infections.
基金Supported by the National Natural Science Foundation of China(30471967)research funding of Tianjin Cancer Institute&Hospitalof Tianjin Medical University
文摘Objective To investigate whether the connection of p27 Kip1 to S-phase kinase-associated protein 2 (Skp2) plays an oncogenic role in intraductal proliferative lesions of the breast. Methods Here we investigated the mechanism involved in association of Skp2's degradation of p27 Kip1 with the breast carcinogenesis by immunohistochemical method through detection of Skp2 and p27 Kip1 protein levels in 120 paraffin-embedded tissues of intraductal proliferative lesions including usual ductal hyperplasia (UDH, n=30), atypical ductal hyperplasia (n=30), flat epithelial atypia (FEA, n=30), and ductal carcinoma in situ (DCIS, n=30). Moreover, the expression status of Skp2 and p27 Kip1 in 30 cases of the normal breast paraffin-embedded tissues were explored. Results The DCIS group was with the highest Skp2 level and the lowest p27 Kip1 level, and the UDH group was with the lowest Skp2 level and the highest p27 Kip1 level. Both Skp2 and p27 Kip1 levels in the DCIS group were significantly different from those in the UDH group (all P<0.01). The levels of Skp2 and p27 Kip1 in the FEA group were significantly different from both the DCIS and UDH groups (all P<0.05). p27 Kip1 was negatively correlated with Skp2 in both the UDH group (r=-0.629, P=0.026) and DCIS group (r=-0.893, P=0.000). Conclusion Overexpression of Skp2 might be the mechanism underlying p27 Kip1 over degradation.
文摘Chronic postsurgical pain is a common surgical complication that severely reduces a patient’s quality of life.Many perioperative interventions and management strategies have been developed for reducing and managing chronic postsurgical pain.Under the leadership of the Chinese Association for the Study of Pain,an editorial committee was formed for chronic postsurgical pain diagnosis and treatment by experts in relevant fields.The editorial committee composed the main content and framework of this consensus and established a working group.The working group conducted literature review(1989-2020)using key words such as“surgery”,“post-surgical”,“post-operative”,“pain”,“chronic”,and“persistent”in different databases including MEDLINE,EMBASE,PubMed,Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews.Only publications in the English language were included.The types of literature included systematic reviews,randomized controlled studies,cohort studies and case reports.This consensus was written based on clinical practice combined with literature evidence.The first draft of the consensus was rigorously reviewed and edited by all the editorial committee experts before being finalized.The level of evidence was assessed by methodological experts based on the Oxford Centre for Evidence-Based Medicine Levels of Evidence.The strength of recommendation was evaluated by all editorial committee experts,and the opinions of most experts were adopted as the final decision.The recommendation level“strong”generally refers to recommendations based on high-level evidence and consistency between clinical behavior and expected results.The recommendation level“weak”generally refers to the uncertainty between clinical behavior and expected results based on low-level evidence.
文摘BACKGROUND Acute flaccid paralysis(AFP)and neurogenic respiratory failure rarely occur in children.At the end of 2018,some children with such symptoms were admitted to our hospital.In this study,we aimed to assess two children with AFP and neurogenic respiratory failure associated with enterovirus D68(EV-D68).CASE SUMMARY Two children admitted to our hospital presented with symptoms and imaging results different from those of acute disseminated encephalomyelitis and hand,foot,and mouth disease.Their main symptoms were AFP and neurogenic respiratory failure.Magnetic resonance imaging showed severe inflammatory injury mainly to the anterior horn cells of the spinal cord.Blood and cerebrospinal fluid samples were collected to assess for pathogens,including bacteria,tuberculosis,cryptococcus,herpes virus,and coxsackie virus,and the results were negative.At the beginning,the two cases were not assessed for EV-D68 in the nasopharyngeal,blood,and cerebrospinal fluid specimens.About 2 mo later,EVD68 was detected in the stool sample of one of the cases.The symptom of AFP was caused by injury to the anterior horn cells at levels C5-L5 of the spinal cord,while neurogenic respiratory failure was at levels C3-C5.CONCLUSION We should pay attention to the detection and diagnosis of EV-D68 and make efforts to develop antivirus drugs and vaccines.
基金Supported by Key Project of Science and Technology Agency of Sichuan Province,China,No.2020YFS0149.
文摘BACKGROUND Cutaneous myiasis is frequently observed;however,eosinophilic pleural effusion induced by this condition is rare.CASE SUMMARY We report the case of a 65-year-old female Tibetan patient from Qinghai Province,who presented to West China Hospital of Sichuan University around mid-November 2011 with a chief complaint of recurrent cough,occasional hemoptysis,and right chest pain.There was no past medical and surgical history of note,except for occasional dietary habit of eating raw meat.Clinical examination revealed a left lung collapse and diminished breathing sounds in her left lung,with moist rales heard in both lungs.Chest X-rays demonstrated a left hydropneumothorax and a right lung infection.Chest computed tomography revealed a left hydropneumothorax with partial compressive atelectasis and patchy consolidation on the right lung.Laboratory data revealed peripheral blood eosinophilia of 37.2%,with a white blood cell count of 10.4×109/L.Serum immunoglobulin E levels were elevated(1650 unit/mL).Serum parasite antibodies were negative except for cysticercosis immunoglobulin G.Bone marrow aspirates were hypercellular,with a marked increase in the number of mature eosinophils and eosinophilic myelocytes.An ultrasound-guided left-sided thoracentesis produced a yellow-cloudy exudative fluid.Failure to respond to antibiotic treatment during hospitalization for her symptoms and persistent blood eosinophilia led the team to start oral albendazole(400 mg/d)for presumed parasitic infestation for three consecutive days after the ninth day of hospitalization.Intermittent migratory stabbing pain and swelling sensation on both her upper arms and shoulders were reported;tender nodules and worm-like live organisms were observed in the responding sites 1 wk later.After the removal of the live organisms,they were subsequently identified as first stage hypodermal larvae by the Sichuan Institute of Parasites.The patient’s symptoms were relieved soon afterwards.Telephonic follow-up 1 mo later indicated that the blood eosinophilia and pleural effusion were resolved.CONCLUSION Eosinophilic pleural fluid can be present in a wide array of disorders.Myiasis should be an important consideration for the differential diagnosis when eosinophilic pleural effusion with blood eosinophilia is observed.
基金Supported by General Medical Research Fund Project,No.TYYLKYJJ-2022-021.
文摘BACKGROUND Diabetic foot ulcers(DFUs)are a common complication of diabetes,often leading to severe infections,amputations,and reduced quality of life.The current standard treatment protocols for DFUs have limitations in promoting efficient wound healing and preventing complications.A comprehensive treatment approach targeting multiple aspects of wound care may offer improved outcomes for patients with DFUs.The hypothesis of this study is that a comprehensive treatment protocol for DFUs will result in faster wound healing,reduced amputation rates,and improved overall patient outcomes compared to standard treatment protocols.AIM To compare the efficacy and safety of a comprehensive treatment protocol for DFUs with those of the standard treatment protocol.METHODS This retrospective study included 62 patients with DFUs,enrolled between January 2022 and January 2024,randomly assigned to the experimental(n=32)or control(n=30)group.The experimental group received a comprehensive treatment comprising blood circulation improvement,debridement,vacuum sealing drainage,recombinant human epidermal growth factor and anti-inflammatory dressing,and skin grafting.The control group received standard treatment,which included wound cleaning and dressing,antibiotics administration,and surgical debridement or amputation,if necessary.Time taken to reduce the white blood cell count,number of dressing changes,wound healing rate and time,and amputation rate were assessed.RESULTS The experimental group exhibited significantly better outcomes than those of the control group in terms of the wound healing rate,wound healing time,and amputation rate.Additionally,the comprehensive treatment protocol was safe and well tolerated by the patients.CONCLUSION Comprehensive treatment for DFUs is more effective than standard treatment,promoting granulation tissue growth,shortening hospitalization time,reducing pain and amputation rate,improving wound healing,and enhancing quality of life.
基金supported by National Natural Science Foundation of China(No.61075073 and 61375079)
文摘A new approach to model and control an unknown system using subjective uncertain rules is proposed. This method is established by combining the grey system theory and the qualitative simulation method. The proposed approach mainly contains three steps. In the first step, subjective uncertain rules are accumulated gradually during cognizing the system; the mapping relations between the system inputs and outputs are built and represented using the grey qualitative matrix in the second step; in the third step,the generalized whitening function is defined to realize the transformation between qualitative and quantitative information. Besides the theoretical results, two sets of simulations based on a water level control system are conducted comparatively to demonstrate the effectiveness of the proposed method. The water level expectation is set to be constant in the first set, while it changes in the second set. The simulation results show that the proposed method tracks the water level expectation well. By combining the proposed method with proportional-integral-derivative(PID) or fuzzy logic controller(FLC), it can be concluded that the system can reach the stable state more quickly and the overshoot can also be reduced compared to using PID or FLC alone.
基金the National Natural Science Foundation of China(Grant Nos.51704080,51874102 and 52074093)the National Key Research and Development Program of China(Grant No.2019YFC1905200).
文摘The reduction and recovery of P_(2)O_(5)in dephosphorization slag were examined to establish a new recycling process for dephosphorization slag.The dephosphorization slag is obtained from the dephosphorization furnace in the duplex converter process,and the content of P_(2)O_(5) in the dephosphorization slag can reach 9 wt.%.The dephosphorization slag is considered to be a prospective resource of phosphorus due to its high content of P_(2)O_(5).To explore the effects of temperature and Fe2O3 content in slag on phosphorus recovery from dephosphorization slag,the experimental slag was reduced by carbon powder in a resistance furnace.The results show that the temperature and content of Fe2O3 in slag have a significant effect on the reduction in P_(2)O_(5),and the reduction and recovery ratios of P_(2)O_(5) in slags increase with the increase in the experimental temperature and content of Fe_(2)O_(3),reaching 94.41%and 83.09%,respectively.It has been indicated that phosphorus recovery from dephosphorization slag using carbothermic reduction has significant environmental and economic benefits.
基金The National Natural Science Foundation of China(Nos.2222007,82170281,and U2004203)the Henan Thousand Talents Program(No.ZYQR201912131)+1 种基金the Excellent Youth Science Foundation of Henan Province(No.202300410362)the Central Plains Youth Top Talent and Advanced Funds(No.2021-CCA-ACCESS-125)funded this research.
文摘Background:Several biomarkers have been studied as prognostic indicators among people with diabetes and coro-nary artery disease(CAD).The purpose of this study was to determine the prognostic value of neutrophil counts and the Gensini score in patients with diabetes and ACS undergoing percutaneous coronary intervention(PCI).Methods:A total of 694 people with ACS and T2DM who simultaneously had elevated HBA1c received PCI.Spear-man rank correlation estimates were used for correlation evaluation.Multivariate Cox regression and Kaplan-Meier analysis were used to identify characteristics associated with major adverse cardiovascular and cerebrovascular events(MACCEs)and patient survival.The effects of single-and multi-factor indices on MACCEs were evaluated through receiver operating characteristic curve analysis.Results:The Gensini score and neutrophil count significantly differed between the MACCE and non-MACCE groups among patients receiving PCI who had concomitant ACS and T2DM with elevated HBA1c(P<0.001).The Gensini score and neutrophil count were strongly associated with MACCEs(log-rank,P<0.001).The Gensini score and neu-trophil count,alone or in combination,were predictors of MACCEs,according to multivariate Cox regression analysis(adjusted hazard ratio[HR],1.005;95%confidence interval[CI],1.002–1.008;P=0.002;adjusted HR,1.512;95%CI,1.005–2.274;P=0.047,respectively).The Gensini score was strongly associated with neutrophil count(variance inflation factor≥5).Area under the curve analysis revealed that the combination of multivariate factors predicted the occurrence of MACCEs better than any single variable.Conclusion:In patients with T2DM and ACS with elevated HBA1c who underwent PCI,both the Gensini score and neutrophil count were independent predictors of outcomes.The combination of both predictors has a higher predict-ability.
