Waterborne polyurethane(WPU)is attracting widespread attention in the friction field,but pure WPU cannot meet the wear resistance requirements due to poor thermal and self-lubricating properties.Herein,a novel cellulo...Waterborne polyurethane(WPU)is attracting widespread attention in the friction field,but pure WPU cannot meet the wear resistance requirements due to poor thermal and self-lubricating properties.Herein,a novel cellulose/BNNSs-AgNPs aerogel(CBAg)composed of zero-dimensional silver nanoparticles(AgNPs),onedimensional cellulose and two-dimensional boron nitride nanosheets(BNNSs)was successfully fabricated.Specifically,AgNPs were loaded onto the surface of BNNSs,which could serve as bridges to connect adjacent BNNSs.Cellulose was used to construct a 3D skeleton structure for stabilizing better dispersion of inorganic fillers.Finally,the thermal and tribological properties of CBAg-WPU were improved compared to pure WPU,with a 69%increase in thermal conductivity and an 89%reduction in wear rate.This was attributed to the load-bearing capacity of cellulose and outstanding thermal and lubricant capability of BNNSs-AgNPs.In addition,BNNSs and AgNPs inside the aerogel were transferred to the sliding interface and participated in the formation of high-quality friction transfer film,further endowing CBAg-WPU composites prominent tribological performance.Therefore,the novel design of 3D hybrid aerogels provided a promising avenue to improve the tribological performance of WPU composites.展开更多
Ischemic heart disease(IHD)is associated with high morbidity and mortality rates.Reperfusion therapy is the best treatment option for this condition.However,reperfusion can aggravate myocardial damage through a phenom...Ischemic heart disease(IHD)is associated with high morbidity and mortality rates.Reperfusion therapy is the best treatment option for this condition.However,reperfusion can aggravate myocardial damage through a phenomenon known as myocardial ischemia/reperfusion(I/R)injury,which has recently gained the attention of researchers.Several studies have shown that Chinese herbal medicines and their natural monomeric components exert therapeutic effects against I/R injury.This review outlines the current knowledge on the pathological mechanisms through which mitochondria participate in I/R injury,focusing on the issues related to energy metabolism,mitochondrial quality control disorders,oxidative stress,and calcium.The mechanisms by which mitochondria mediate cell death have also been discussed.To develop a resource for the prevention and management of clinical myocardial I/R damage,we compiled the most recent research on the effects of Chinese herbal remedies and their monomer components.展开更多
Integrated-energy systems(IESs)are key to advancing renewable-energy utilization and addressing environmental challenges.Key components of IESs include low-carbon,economic dispatch and demand response,for maximizing r...Integrated-energy systems(IESs)are key to advancing renewable-energy utilization and addressing environmental challenges.Key components of IESs include low-carbon,economic dispatch and demand response,for maximizing renewable-energy consumption and supporting sustainable-energy systems.User participation is central to demand response;however,many users are not inclined to engage actively;therefore,the full potential of demand response remains unrealized.User satisfaction must be prioritized in demand-response assessments.This study proposed a two-stage,capacity-optimization configuration method for user-level energy systems con-sidering thermal inertia and user satisfaction.This method addresses load coordination and complementary issues within the IES and seeks to minimize the annual,total cost for determining equipment capacity configurations while introducing models for system thermal inertia and user satisfaction.Indoor heating is adjusted,for optimizing device output and load profiles,with a focus on typical,daily,economic,and environmental objectives.The studyfindings indicate that the system thermal inertia optimizes energy-system scheduling considering user satisfaction.This optimization mitigates environmental concerns and enhances clean-energy integration.展开更多
On-chip devices for generating pre-designed vectorial optical fields(VOFs)under surface wave(SW)excitations are highly desired in integrated photonics.However,conventional devices are usually of large footprints,low e...On-chip devices for generating pre-designed vectorial optical fields(VOFs)under surface wave(SW)excitations are highly desired in integrated photonics.However,conventional devices are usually of large footprints,low efficiencies,and limited wave-control capabilities.Here,we present a generic approach to design ultra-compact on-chip devices that can efficiently generate pre-designed VOFs under SW excitations,and experimentally verify the concept in terahertz(THz)regime.We first describe how to design SW-excitation metasurfaces for generating circularly polarized complex beams,and experimentally demonstrate two meta-devices to realize directional emission and focusing of THz waves with oppo-site circular polarizations,respectively.We then establish a systematic approach to construct an integrated device via merging two carefully designed metasurfaces,which,under SW excitations,can separately produce pre-designed far-field patterns with different circular polarizations and generate target VOF based on their interference.As a proof of con-cept,we demonstrate experimentally a meta-device that can generate a radially polarized Bessel beam under SW excita-tion at~0.4 THz.Experimental results agree well with full-wave simulations,collectively verifying the performance of our device.Our study paves the road to realizing highly integrated on-chip functional THz devices,which may find many ap-plications in biological sensing,communications,displays,image multiplexing,and beyond.展开更多
Objective:To understand the current situation of career planning awareness and readiness of freshman medical students with a background in digital medicine,and to provide references for optimizing the medical educatio...Objective:To understand the current situation of career planning awareness and readiness of freshman medical students with a background in digital medicine,and to provide references for optimizing the medical education system and career guidance.Methods:A cross-sectional study was conducted on freshman medical students at a university in Yunnan Province using questionnaire survey.Results:A total of 272 questionnaires were distributed and 264 valid questionnaires were returned,yielding an effective response rate of 97.10%.The average score of digital medical awareness of freshman medical students was(70.50±8.81),and 63.63%of the students had a high awareness(score≧70);The average score of career planning awareness and readiness of freshman medical students was(91.76±14.87),and 60.63%of students had high awareness and readiness(score≧90).Pearson correlation analysis showed that the total score of digital medical awareness was positively correlated with the total score of career planning awareness and readiness(r=0.13,P<0.05).Conclusion:Freshman medical students’career planning awareness and readiness are generally good,but their practical application of digital medical-related skills still needs improvement.It is suggested that schools strengthen the integration of interdisciplinary curriculum,introduce digital vocational training modules,and formulate differentiated guidance strategies for different majors to enhance students’professional competitiveness in the digital medical era.展开更多
With the widespread application of global navigation satellite system(GNSS),spoofing attacks pose a threat to the security and reliability of GNSS.It is of great significance to design effective GNSS spoofing detectio...With the widespread application of global navigation satellite system(GNSS),spoofing attacks pose a threat to the security and reliability of GNSS.It is of great significance to design effective GNSS spoofing detection technology to ensure the security and reliability of GNSS system applications for receiver users.Traditional spoofing detection techniques generally only determine whether a spoofing attack has occurred by monitoring the feature changes of one or two data information in the receiver.However,some spoofing modes can cleverly make the monitored data very close to the real data,thus avoiding these detection methods and easily making them ineffective.In this study,a GNSS spoofing jamming detection method based on hybrid kernel relevance vector machine(RVM)is proposed.The improved signal quality monitoring(SQM)movement variance,carrier noise ratio movement variance,pseudo range Doppler consistency,pseudorange residual,Doppler frequency,clock offset and clock drift are used as detection characteristics.This technology can detect GNSS spoofing signals,effectively improving the safety and reliability of GNSS systems.The experimental results show that this technology has high detection accuracy and anti-interference ability and can effectively respond to various forms of spoofing attacks.展开更多
The isotope effect on zonal flows(ZFs)and turbulence remains a key issue that is not completely solved in fusion plasmas.This paper presents the first experimental results of the ab initio prediction of causal relatio...The isotope effect on zonal flows(ZFs)and turbulence remains a key issue that is not completely solved in fusion plasmas.This paper presents the first experimental results of the ab initio prediction of causal relation between geodesic acoustic mode(GAM)and ambient turbulence at different isotope masses in the edge of HL-2A tokamak,where transfer entropy method based on information-theoretical approach is utilized as a quantified indicator of causality.Analysis shows that GAM is more pronounced in deuterium plasmas than in hydrogen,leading to a lower heat transport as well as more peaked profiles in the former situation.The causal impact of GAM on conductive heat flux component is stronger than on the convective component,which is resulted from a larger causal influence of zonal flow on temperature fluctuation.While a stronger GAM in deuterium plasmas has larger influence on all flux components,the relative change in temperature fluctuation and coefficient is more obvious when the ion mass varies.These findings not only offer an in-depth understanding of the real causality between zonal flow and turbulence in the present isotope experiments,but also provide useful ways for the physical understandings of transport and zonal flow dynamics in future deuterium-tritium fusion plasmas.展开更多
This study investigated the protective effect of the compatibility of hypaconitine （HA） and glycyrrhetinic acid （GA） on H9c2 cells under oxygen and glucose deprivation （OGD）-induced injury, and the possible mech...This study investigated the protective effect of the compatibility of hypaconitine （HA） and glycyrrhetinic acid （GA） on H9c2 cells under oxygen and glucose deprivation （OGD）-induced injury, and the possible mechanisms. We found that HA＋GA significantly improved pathology and morphology of the nucleus and ultrastructure of H9c2 cells under OGD as determined by Hoechst 33342 staining and transmission electron microscopy （TEM） tests. It also reduced the releases of lactate dehydrogenase （LDH）, creatine kinase-myocardial band isoenzyme （CK-MB）, and aspartate transaminase （AST） from the cultured supernatant of H9c2 cells, which were tested by enzyme-linked immune sorbent assay （ELISA） kits. In addition, it lessened the apoptotic rate as determined by a fluorescein isothiocyanate-annexin V/propidium iodide （FITC-AV/PI） double staining assay. It was also found that HA＋GA might regulate the protein expression associated with the phosphatidylinositol 3-kinase （PI3K）/Akt signaling pathway. Overall, the study demonstrated that HA＋GA protected H9c2 cells against OGD-induced injury, and the signaling mechanism might be related to the PI3K/Akt signaling pathway.展开更多
AIM：To investigate the changes in the expression of micro RNA-181a（mi R-181a）and Bim in a rat model of retinal ischemia-reperfusion（RIR）,to explore their target relationship in RIR and their involvement in regula...AIM：To investigate the changes in the expression of micro RNA-181a（mi R-181a）and Bim in a rat model of retinal ischemia-reperfusion（RIR）,to explore their target relationship in RIR and their involvement in regulating apoptosis of retinal ganglion cells（RGCs）.·M ETHODS：Target gene prediction for mi R-181a was performed with the aid of bioinformatics and Bim was identified as a potential target gene of mi R-181a.A rat model of RIR was created by increasing the intraocular pressure.RGCs in the flatmounted retinas were labeled with Brn3,a marker for alive RGCs,by immunofluorescent staining.The changes in the number of RGCs after RIR were recorded.Quantitative reverse transcription-polymerase chain reaction（q RT-PCR）was used to determine the expression level of mi R-181a in the retina.Bim/Brn3 double immunofluorescence was used to detect the localization of Bim.The expression of Bim in the retina was determined with the aids of Western blot and q RT-PCR.·R ESULTS：Compared with the negative control group,the density of RGCs was significantly lower in the ischemia/reperfusion（I/R）-24h and I/R-72h groups（〈0.001）.The expression level of mi R-181a started to decrease at 0h after RIR,and further decreased at 24h and 72h compared with the negative control group（〈0.001）.Bim was significantly upregulated at 12h after RIR（〈0.05）and reached peak at 24,72h compared with the negative control group（〈0.01）.Pearson correlation analysis showed that the expression level of Bim was negatively correlated with the expression level of mi R-181a and the density of RGCs.·CONCLUSION：Bim may be a potential target gene of mi R-181a.Both mi R-181a and Bim are involved in RGCs death in RIR.RIR may promote RGCs apoptosis in the retina downregulation of mi R-181a and its inhibition on Bim expression.展开更多
Development of adsorbent materials for highly efficient iodine capture is high demand from the perspective of ecological environment and human health. Herein, the two kinds of thiophene-based covalent organic framewor...Development of adsorbent materials for highly efficient iodine capture is high demand from the perspective of ecological environment and human health. Herein, the two kinds of thiophene-based covalent organic frameworks(COFs) with different morphologies were synthesized by solvothermal reaction using thieno[3,2-b]thiophene-2,5-dicarbaldehyde(TT) as the aldehyde monomer and tri(4-aminophenyl)benzene(PB) or tris(4-aminophenyl)amine(PA) as the amino monomer(denoted as PB-TT COF and PA-TT COF) and the as-prepared two heteroatoms-rich COFs possessed many excellent properties,including high thermal stability and abundant binding sites. Among them, PB-TT COF exhibited ultra-high iodine uptake up to 5.97 g/g in vapor, surpassing most of adsorbents previously reported, which was ascribed to its high specific surface(1305.3 m2/g). Interestingly, PA-TT COF with low specific surface(48.6m2/g) showed good adsorption ability for iodine in cyclohexane solution with uptake value of 750 mg/g,which was 2.38 times higher than that obtained with PB-TT COF due to its unique sheet-like morphology.Besides, the two COFs possessed good reusability, high selectivity and iodine retention ability. Based on experimental results, the adsorption mechanisms of both COFs were studied, revealing that iodine was captured by the physical-chemical adsorption. Furthermore, the both COFs showed excellent adsorption ability in real radioactive seawater treated safely, demonstrating their great potential in real environment.展开更多
Background context:Metastatic spinal cord compression(MSCC)seriously affects the survival rate.Objective:The therapeutic effects of two treatment strategies for MSCC:percutaneous vertebroplasty(PVP)combined with radio...Background context:Metastatic spinal cord compression(MSCC)seriously affects the survival rate.Objective:The therapeutic effects of two treatment strategies for MSCC:percutaneous vertebroplasty(PVP)combined with radiofrequency ablation(RFA)and PVP combined with^(125)I particle implantation,were compared.Study design:Retrospective study.Patient sample:40 patients with MSCC were divided into two groups:19 cases in the RFA group and 21 cases in the^(125)I group.Method:All patients were accessed to determine the differences in pain,which was evaluated using the visual analog scale(VAS)at 1 week,1 month,and 3 months after the operation,and spinal stenosis rates(SSRs),which were measured at 1 and 3 months after the operation,between the two groups.Results:The VAS scores and SSRs at baseline were comparable between the RFA group and the^(125)I group(7.19±2.07 vs 7.42±1.95,37.7%±11.2%vs 41.1%±11.4%).The VAS scores and SSRs at 1 month and 3 months after the operation were significantly reduced in both groups,compared with those at baseline.The VAS scores and SSRs in the^(125)I group were lower than those in the RFA group at 3 months after the operation(1.09±0.97 vs 1.75±1.06 p=0.048 and 12.3%±6.4%vs 18.1%±10.1%p=0.034),while the VAS scores at1 week after the operation in the RFA group were lower than those in the^(125)I group(4.39±1.34 vs 5.05±1.82 p=0.049).Conclusion:PVP combined with RFA has a slight advantage in relieving pain in the short term,while PVP combined with^(125)I particle implantation may have a better effect in the relieving pain and decreasing the SSRs at 3 months after the operation.展开更多
Background:Until January 18,2021,coronavirus disease-2019(COVID-19)has infected more than 93 million individuals and has caused a certain degree of panic.Viral pneumonia caused by common viruses such as respiratory sy...Background:Until January 18,2021,coronavirus disease-2019(COVID-19)has infected more than 93 million individuals and has caused a certain degree of panic.Viral pneumonia caused by common viruses such as respiratory syncytial virus,rhinovirus,human metapneumovirus,human bocavirus,and parainfluenza viruses have been more common in children.However,the incidence of COVID-19 in children was significantly lower than that in adults.The purpose of this study was to describe the clinical manifestations,treatment and outcomes of COVID-19 in children compared with those of other sources of viral pneumonia diagnosed during the COVID-19 outbreak.Methods:Children with COVID-19 and viral pneumonia admitted to 20 hospitals were enrolled in this retrospective multi-center cohort study.A total of 64 children with COVID-19 were defined as the COVID-19 cohort,of which 40 children who developed pneumonia were defined as the COVID-19 pneumonia cohort.Another 284 children with pneumonia caused by other viruses were defined as the viral pneumonia cohort.The epidemiologic,clinical,and laboratory findings were compared by Kolmogorov-Smirnov test,t-test,Mann-Whitney U test and Contingency table method.Drug usage,immunotherapy,blood transfusion,and need for oxygen support were collected as the treatment indexes.Mortality,intensive care needs and symptomatic duration were collected as the outcome indicators.Results:Compared with the viral pneumonia cohort,children in the COVID-19 cohort were mostly exposed to family members confirmed to have COVID-19(53/64 vs.23/284),were of older median age(6.3 years vs.3.2 years),and had a higher proportion of ground-glass opacity(GGO)on computed tomography(18/40 vs.0/38,P<0.001).Children in the COVID-19 pneumonia cohort had a lower proportion of severe cases(1/40 vs.38/284,P=0.048),and lower cases with high fever(3/40 vs.167/284,P<0.001),requiring intensive care(1/40 vs.32/284,P<0.047)and with shorter symptomatic duration(median 5d vs.8d,P<0.001).The proportion of cases with evaluated inflammatory indicators,biochemical indicators related to organ or tissue damage,D-dimer and secondary bacterial infection were lower in the COVID-19 pneumonia cohort than those in the viral pneumonia cohort(P<0.05).No statistical differences were found in the duration of positive PCR results from pharyngeal swabs in 25 children with COVID-19 who received antiviral drugs(lopinavir-ritonavir,ribavirin,and arbidol)as compared with duration in 39 children without antiviral therapy(median 10d vs.9d,P=0.885).Conclusions:The symptoms and severity of COVID-19 pneumonia in children were no more severe than those in children with other viral pneumonia.Lopinavir-ritonavir,ribavirin and arbidol do not shorten the duration of positive PCR results from pharyngeal swabs in children with COVID-19.During the COVID-19 outbreak,attention also must be given to children with infection by other pathogens infection.展开更多
Multi-stage Mesozoic thrust-nappe and extensional structures are distributed in the east segment of the Southeast Yangtze Block situated in the junction region of Zhejiang-Jiangxi-Anhui provinces. The features and gen...Multi-stage Mesozoic thrust-nappe and extensional structures are distributed in the east segment of the Southeast Yangtze Block situated in the junction region of Zhejiang-Jiangxi-Anhui provinces. The features and genetic mechanism of the deformations were analyzed after a detailed field observation of their distribution, geometry, and kinematics. In addition, the time sequences of the thrust and extensional structures were determined by combining the results of the comparative analysis with the chronological evidence of strata and magmatic rocks cut by a fault or formed after a fault according to field facts. This study identified three stages of the nappe structures and at least two stages of the extensional structures during the Mesozoic. The geotectonic setting of the nappe and extensional structures was considered to be related to the different geodynamics in the study area including the Early Mesozoic geological event, i.e., N-S compression, forming Lantian fault, etc.;the Late Mesozoic flat-slab subduction, forming Xiaoxi thrust fault and tectonic window;and the roll-back of the paleoPacific Plate, forming extensional structures like basin marginal fault;the last compression, forming Wucheng-Shenxian fault. These findings provide additional evidence for remodeling the tectonic and geodynamic evolution of Southeast China.展开更多
Ischemic stroke(IS)is a multifactorial and heterogeneous disease.Despite years of studies,effective strategies for the diagnosis,management and treatment of stroke are still lacking in clinical practice.Metabolomics i...Ischemic stroke(IS)is a multifactorial and heterogeneous disease.Despite years of studies,effective strategies for the diagnosis,management and treatment of stroke are still lacking in clinical practice.Metabolomics is a growing field in systems biology.It is starting to show promise in the identification of biomarkers and in the use of pharmacometabolomics to help patients with certain disorders choose their course of treatment.The development of metabolomics has enabled further and more biological applications.Particularly,metabolomics is increasingly being used to diagnose diseases,discover new drug targets,elucidate mechanisms,and monitor therapeutic outcomes and its potential effect on precision medicine.In this review,we reviewed some recent advances in the study of metabolomics as well as how metabolomics might be used to identify novel biomarkers and understand the mechanisms of IS.Then,the use of metabolomics approaches to investigate the molecular processes and active ingredients of Chinese herbal formulations with anti-IS capabilities is summarized.We finally summarized recent developments in single cell metabolomics for exploring the metabolic profiles of single cells.Although the field is relatively young,the development of single cell metabolomics promises to provide a powerful tool for unraveling the pathogenesis of IS.展开更多
OBJECTIVE:To explore the core herbs of two illustrious senior Traditional Chinese Medicine(TCM)Physicians for the treatment of liver cancer,and to further clarify the gene targets and pathway mechanisms of liver cance...OBJECTIVE:To explore the core herbs of two illustrious senior Traditional Chinese Medicine(TCM)Physicians for the treatment of liver cancer,and to further clarify the gene targets and pathway mechanisms of liver cancer that the core prescription(CP)may regulate.METHODS:We used the patient information of two illustrious senior TCM physicians from the Affiliated Hospital of Shandong University of Traditional Chinese Medicine and the Affiliated Hospital of Capital Medical University as the database.The CP was analyzed using the community network algorithm.The pathway mechanism was analyzed using network pharmacology method.And the prognostic survival genes were identified using Single factor cox regression analysis.Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine(TCMIP),Herb,Online Mendelian Inheritance in Man(OMIM),Genecards,Kyoto Encyclopedia of Genes and Genomes(KEGG),Genomic Data Commons(GDC),The Cancer Genome Atlas(TCGA),Gephi and R were used to mine CP,building a pathway network diagram.All the analyses were visualized.RESULTS:We found that the CP consistes of Huangqi(Radix Astragali Mongolici),Danshen(Radix Salviae Miltiorrhizae),Shuihonghuazi(Polygoni Orientalis Fructus),Baihuasheshecao(Herba Hedyotdis),Banzhilian(Herba Scutellariae Barbatae),and Ezhu(Rhizoma Curcumae Phaeocaulis),which were attributed to the two physicians respectively.The CP played an anticancer role through such pathways as signal transduction,energy metabolism,immune system and other pathways,covering a total of 112 pathways and 176 herb-diseaserelated genes.Fourteen genes have a significant impact on the prognosis and survival of liver cancer.CONCLUSION:Based on the liver cancer cases of two illustrious senior TCM physicians,we obtained the CP through data mining.The CP may mainly exert anticancer effects by inhibiting inflammatory response,angiogenesis,and enhancing the body’s immune response.We screened out 14 genes in the CP that may be related to the prognosis of liver cancer,and these genes may play an important regulatory role in the prognosis of liver cancer.展开更多
Accurate prediction ofmonthly oil and gas production is essential for oil enterprises tomake reasonable production plans,avoid blind investment and realize sustainable development.Traditional oil well production trend...Accurate prediction ofmonthly oil and gas production is essential for oil enterprises tomake reasonable production plans,avoid blind investment and realize sustainable development.Traditional oil well production trend prediction methods are based on years of oil field production experience and expertise,and the application conditions are very demanding.With the rapid development of artificial intelligence technology,big data analysis methods are gradually applied in various sub-fields of the oil and gas reservoir development.Based on the data-driven artificial intelligence algorithmGradient BoostingDecision Tree(GBDT),this paper predicts the initial single-layer production by considering geological data,fluid PVT data and well data.The results show that the GBDT algorithm prediction model has great accuracy,significantly improving efficiency and strong universal applicability.The GBDTmethod trained in this paper can predict production,which is helpful for well site optimization,perforation layer optimization and engineering parameter optimization and has guiding significance for oilfield development.展开更多
Kaposiform hemangioendothelioma （KHE） is a rare locally ag- gressive vascular tumor that mainly occurs in children and early adolescents. It is often associated with the Kasabach-Meritt phenomenon which is marked by...Kaposiform hemangioendothelioma （KHE） is a rare locally ag- gressive vascular tumor that mainly occurs in children and early adolescents. It is often associated with the Kasabach-Meritt phenomenon which is marked by severe thrombocytopenia and a variable degree of anemia. The tumor mostly is located in the superficial or deep soft tissue mass of the extremities. Herein, we report an unusual case of kaposiform hemangioendothelioma that,展开更多
BACKGROUND Hilar cholangiocarcinoma is the most common malignant tumor of the extrahepatic bile duct.Until now,radical resection has been the most effective method for the long-term survival of patients with the disea...BACKGROUND Hilar cholangiocarcinoma is the most common malignant tumor of the extrahepatic bile duct.Until now,radical resection has been the most effective method for the long-term survival of patients with the disease.However,many problems have emerged in the field of hepatobiliary surgery for a long time,including complex surgical procedures,low resection rate,and postoperative complications.We have adopted the“multiple Roux-en-Y hepaticojejunostomy reconstruction by formation of a bile duct lake”technique in the treatment of hilar cholangiocarcinoma since 2008,and obtained satisfactory short-and longterm results.AIM To examine the feasibility of the application of multiple Roux-en-Y hepaticojejunostomy reconstruction by formation of a bile duct lake in the operation of hilar cholangiocarcinoma METHODS A retrospective analysis was performed for the clinical data,surgical methods,and results of 76 patients with hilar cholangiocarcinoma who were treated with hilar bile duct lake-forming multiple Roux-en-Y hepaticojejunostomy reconstruction at Gansu Provincial Hospital.RESULTS In all 76 cases,the operation was successful and no operative death occurred.The mean(range)operation time was 215.4±53.5 min(124–678 min),and the amount of bleeding during the operation was 428.2±63.8 mL(240–2200 mL).The overall 1-year survival rate was 78.9%,and the 3-year survival rate was 32.8%.CONCLUSION The multiple Roux-en-Y hepaticojejunostomy reconstruction technique with formation of a bile duct lake is safe and effective for the surgical treatment of hilar cholangiocarcinoma.展开更多
基金supported by the Open Project of Basic Research of Shandong Laboratory of Advanced Materials and Green Manufacturing at Yantai(Grant No.AMGM2023F08)Open Fund Project of National United Engineering Laboratory for Advanced Bearing Tribology(No.202301).
文摘Waterborne polyurethane(WPU)is attracting widespread attention in the friction field,but pure WPU cannot meet the wear resistance requirements due to poor thermal and self-lubricating properties.Herein,a novel cellulose/BNNSs-AgNPs aerogel(CBAg)composed of zero-dimensional silver nanoparticles(AgNPs),onedimensional cellulose and two-dimensional boron nitride nanosheets(BNNSs)was successfully fabricated.Specifically,AgNPs were loaded onto the surface of BNNSs,which could serve as bridges to connect adjacent BNNSs.Cellulose was used to construct a 3D skeleton structure for stabilizing better dispersion of inorganic fillers.Finally,the thermal and tribological properties of CBAg-WPU were improved compared to pure WPU,with a 69%increase in thermal conductivity and an 89%reduction in wear rate.This was attributed to the load-bearing capacity of cellulose and outstanding thermal and lubricant capability of BNNSs-AgNPs.In addition,BNNSs and AgNPs inside the aerogel were transferred to the sliding interface and participated in the formation of high-quality friction transfer film,further endowing CBAg-WPU composites prominent tribological performance.Therefore,the novel design of 3D hybrid aerogels provided a promising avenue to improve the tribological performance of WPU composites.
基金supported by the National Natural Science Foundation of China(Grant No.:82074235)the Central Universities in China(Grant No.:2023-JYB-JBQN-041)。
文摘Ischemic heart disease(IHD)is associated with high morbidity and mortality rates.Reperfusion therapy is the best treatment option for this condition.However,reperfusion can aggravate myocardial damage through a phenomenon known as myocardial ischemia/reperfusion(I/R)injury,which has recently gained the attention of researchers.Several studies have shown that Chinese herbal medicines and their natural monomeric components exert therapeutic effects against I/R injury.This review outlines the current knowledge on the pathological mechanisms through which mitochondria participate in I/R injury,focusing on the issues related to energy metabolism,mitochondrial quality control disorders,oxidative stress,and calcium.The mechanisms by which mitochondria mediate cell death have also been discussed.To develop a resource for the prevention and management of clinical myocardial I/R damage,we compiled the most recent research on the effects of Chinese herbal remedies and their monomer components.
基金supported by the science and technology foundation of Guizhou province[2022]general 013the science and technology foundation of Guizhou province[2022]general 014+1 种基金the science and technology foundation of Guizhou province GCC[2022]016-1the educational technology foundation of Guizhou province[2022]043.
文摘Integrated-energy systems(IESs)are key to advancing renewable-energy utilization and addressing environmental challenges.Key components of IESs include low-carbon,economic dispatch and demand response,for maximizing renewable-energy consumption and supporting sustainable-energy systems.User participation is central to demand response;however,many users are not inclined to engage actively;therefore,the full potential of demand response remains unrealized.User satisfaction must be prioritized in demand-response assessments.This study proposed a two-stage,capacity-optimization configuration method for user-level energy systems con-sidering thermal inertia and user satisfaction.This method addresses load coordination and complementary issues within the IES and seeks to minimize the annual,total cost for determining equipment capacity configurations while introducing models for system thermal inertia and user satisfaction.Indoor heating is adjusted,for optimizing device output and load profiles,with a focus on typical,daily,economic,and environmental objectives.The studyfindings indicate that the system thermal inertia optimizes energy-system scheduling considering user satisfaction.This optimization mitigates environmental concerns and enhances clean-energy integration.
基金the financial support from National Natural Science Foundation of China (Nos. 62192771, 12374344, 12221004)National Key Research and Development Program of China (2022YFA1204700, 2020YFA0710100)+1 种基金Natural Science Foundation of Shanghai (Grant No. 23dz2260100)China Postdoctoral Science Foundation 2021TQ0077
文摘On-chip devices for generating pre-designed vectorial optical fields(VOFs)under surface wave(SW)excitations are highly desired in integrated photonics.However,conventional devices are usually of large footprints,low efficiencies,and limited wave-control capabilities.Here,we present a generic approach to design ultra-compact on-chip devices that can efficiently generate pre-designed VOFs under SW excitations,and experimentally verify the concept in terahertz(THz)regime.We first describe how to design SW-excitation metasurfaces for generating circularly polarized complex beams,and experimentally demonstrate two meta-devices to realize directional emission and focusing of THz waves with oppo-site circular polarizations,respectively.We then establish a systematic approach to construct an integrated device via merging two carefully designed metasurfaces,which,under SW excitations,can separately produce pre-designed far-field patterns with different circular polarizations and generate target VOF based on their interference.As a proof of con-cept,we demonstrate experimentally a meta-device that can generate a radially polarized Bessel beam under SW excita-tion at~0.4 THz.Experimental results agree well with full-wave simulations,collectively verifying the performance of our device.Our study paves the road to realizing highly integrated on-chip functional THz devices,which may find many ap-plications in biological sensing,communications,displays,image multiplexing,and beyond.
文摘Objective:To understand the current situation of career planning awareness and readiness of freshman medical students with a background in digital medicine,and to provide references for optimizing the medical education system and career guidance.Methods:A cross-sectional study was conducted on freshman medical students at a university in Yunnan Province using questionnaire survey.Results:A total of 272 questionnaires were distributed and 264 valid questionnaires were returned,yielding an effective response rate of 97.10%.The average score of digital medical awareness of freshman medical students was(70.50±8.81),and 63.63%of the students had a high awareness(score≧70);The average score of career planning awareness and readiness of freshman medical students was(91.76±14.87),and 60.63%of students had high awareness and readiness(score≧90).Pearson correlation analysis showed that the total score of digital medical awareness was positively correlated with the total score of career planning awareness and readiness(r=0.13,P<0.05).Conclusion:Freshman medical students’career planning awareness and readiness are generally good,but their practical application of digital medical-related skills still needs improvement.It is suggested that schools strengthen the integration of interdisciplinary curriculum,introduce digital vocational training modules,and formulate differentiated guidance strategies for different majors to enhance students’professional competitiveness in the digital medical era.
基金supported in part by the Key Science and Technology Research of Henan Province(252102210239,242102211029,242102211105)the Henan Provincial Key Laboratory of Smart Lighting Open Fund(2023KF06)+2 种基金Zhumadian Science and Technology Youth Innovation Special Fund(QNZX202407)the Computer Basic Education Teaching Research Project of the National Research Society for Computer Basic Education in Higher Education Institutions(2024-AFCEC-393)the Young Backbone Teacher Support Program of Huanghuai University.
文摘With the widespread application of global navigation satellite system(GNSS),spoofing attacks pose a threat to the security and reliability of GNSS.It is of great significance to design effective GNSS spoofing detection technology to ensure the security and reliability of GNSS system applications for receiver users.Traditional spoofing detection techniques generally only determine whether a spoofing attack has occurred by monitoring the feature changes of one or two data information in the receiver.However,some spoofing modes can cleverly make the monitored data very close to the real data,thus avoiding these detection methods and easily making them ineffective.In this study,a GNSS spoofing jamming detection method based on hybrid kernel relevance vector machine(RVM)is proposed.The improved signal quality monitoring(SQM)movement variance,carrier noise ratio movement variance,pseudo range Doppler consistency,pseudorange residual,Doppler frequency,clock offset and clock drift are used as detection characteristics.This technology can detect GNSS spoofing signals,effectively improving the safety and reliability of GNSS systems.The experimental results show that this technology has high detection accuracy and anti-interference ability and can effectively respond to various forms of spoofing attacks.
基金supported by the National MCF Energy Research and Development Program(Grant Nos.2024YFE03190001,2024YFE03190004,2022YFE03030001,and 2019YFE03030002)the National Natural Science Foundation of China(Grant Nos.12405257,12475215,and 12475219)+2 种基金the Natural Science Foundation of Sichuan Province,China(Grant Nos.2023NSFSC1289 and 2025ZNSFSC0066)the Nuclear Technology Research and Development Program(Grant No.HJSYF2024(02))the Innovation Program of Southwestern Institute of Physics(Grant No.202301XWCX001)。
文摘The isotope effect on zonal flows(ZFs)and turbulence remains a key issue that is not completely solved in fusion plasmas.This paper presents the first experimental results of the ab initio prediction of causal relation between geodesic acoustic mode(GAM)and ambient turbulence at different isotope masses in the edge of HL-2A tokamak,where transfer entropy method based on information-theoretical approach is utilized as a quantified indicator of causality.Analysis shows that GAM is more pronounced in deuterium plasmas than in hydrogen,leading to a lower heat transport as well as more peaked profiles in the former situation.The causal impact of GAM on conductive heat flux component is stronger than on the convective component,which is resulted from a larger causal influence of zonal flow on temperature fluctuation.While a stronger GAM in deuterium plasmas has larger influence on all flux components,the relative change in temperature fluctuation and coefficient is more obvious when the ion mass varies.These findings not only offer an in-depth understanding of the real causality between zonal flow and turbulence in the present isotope experiments,but also provide useful ways for the physical understandings of transport and zonal flow dynamics in future deuterium-tritium fusion plasmas.
基金Project supported by the National Natural Science Foundation of China(Nos.81473412,81573868,and 81630105)the Zhejiang Provincial Natural Science Foundation of China(No.LZ17H270001)the Zhejiang Provincial Program for the Cultivation of High-Level Innovative Health Talents,China
文摘This study investigated the protective effect of the compatibility of hypaconitine （HA） and glycyrrhetinic acid （GA） on H9c2 cells under oxygen and glucose deprivation （OGD）-induced injury, and the possible mechanisms. We found that HA＋GA significantly improved pathology and morphology of the nucleus and ultrastructure of H9c2 cells under OGD as determined by Hoechst 33342 staining and transmission electron microscopy （TEM） tests. It also reduced the releases of lactate dehydrogenase （LDH）, creatine kinase-myocardial band isoenzyme （CK-MB）, and aspartate transaminase （AST） from the cultured supernatant of H9c2 cells, which were tested by enzyme-linked immune sorbent assay （ELISA） kits. In addition, it lessened the apoptotic rate as determined by a fluorescein isothiocyanate-annexin V/propidium iodide （FITC-AV/PI） double staining assay. It was also found that HA＋GA might regulate the protein expression associated with the phosphatidylinositol 3-kinase （PI3K）/Akt signaling pathway. Overall, the study demonstrated that HA＋GA protected H9c2 cells against OGD-induced injury, and the signaling mechanism might be related to the PI3K/Akt signaling pathway.
基金Supported by the National Natural Science Foundation of China(No.81070742/H1205)the International Collaboration Foundation from the Department of Science and Technology of Sichuan Province,China(No.2010HH0030)
文摘AIM：To investigate the changes in the expression of micro RNA-181a（mi R-181a）and Bim in a rat model of retinal ischemia-reperfusion（RIR）,to explore their target relationship in RIR and their involvement in regulating apoptosis of retinal ganglion cells（RGCs）.·M ETHODS：Target gene prediction for mi R-181a was performed with the aid of bioinformatics and Bim was identified as a potential target gene of mi R-181a.A rat model of RIR was created by increasing the intraocular pressure.RGCs in the flatmounted retinas were labeled with Brn3,a marker for alive RGCs,by immunofluorescent staining.The changes in the number of RGCs after RIR were recorded.Quantitative reverse transcription-polymerase chain reaction（q RT-PCR）was used to determine the expression level of mi R-181a in the retina.Bim/Brn3 double immunofluorescence was used to detect the localization of Bim.The expression of Bim in the retina was determined with the aids of Western blot and q RT-PCR.·R ESULTS：Compared with the negative control group,the density of RGCs was significantly lower in the ischemia/reperfusion（I/R）-24h and I/R-72h groups（〈0.001）.The expression level of mi R-181a started to decrease at 0h after RIR,and further decreased at 24h and 72h compared with the negative control group（〈0.001）.Bim was significantly upregulated at 12h after RIR（〈0.05）and reached peak at 24,72h compared with the negative control group（〈0.01）.Pearson correlation analysis showed that the expression level of Bim was negatively correlated with the expression level of mi R-181a and the density of RGCs.·CONCLUSION：Bim may be a potential target gene of mi R-181a.Both mi R-181a and Bim are involved in RGCs death in RIR.RIR may promote RGCs apoptosis in the retina downregulation of mi R-181a and its inhibition on Bim expression.
基金supported by the Major Scientific and Technological Innovation Project of Shandong (No. 2021CXGC010705)National Natural Science Foundation of China (Nos. 91843301, 22036001 and 21974021)。
文摘Development of adsorbent materials for highly efficient iodine capture is high demand from the perspective of ecological environment and human health. Herein, the two kinds of thiophene-based covalent organic frameworks(COFs) with different morphologies were synthesized by solvothermal reaction using thieno[3,2-b]thiophene-2,5-dicarbaldehyde(TT) as the aldehyde monomer and tri(4-aminophenyl)benzene(PB) or tris(4-aminophenyl)amine(PA) as the amino monomer(denoted as PB-TT COF and PA-TT COF) and the as-prepared two heteroatoms-rich COFs possessed many excellent properties,including high thermal stability and abundant binding sites. Among them, PB-TT COF exhibited ultra-high iodine uptake up to 5.97 g/g in vapor, surpassing most of adsorbents previously reported, which was ascribed to its high specific surface(1305.3 m2/g). Interestingly, PA-TT COF with low specific surface(48.6m2/g) showed good adsorption ability for iodine in cyclohexane solution with uptake value of 750 mg/g,which was 2.38 times higher than that obtained with PB-TT COF due to its unique sheet-like morphology.Besides, the two COFs possessed good reusability, high selectivity and iodine retention ability. Based on experimental results, the adsorption mechanisms of both COFs were studied, revealing that iodine was captured by the physical-chemical adsorption. Furthermore, the both COFs showed excellent adsorption ability in real radioactive seawater treated safely, demonstrating their great potential in real environment.
文摘Background context:Metastatic spinal cord compression(MSCC)seriously affects the survival rate.Objective:The therapeutic effects of two treatment strategies for MSCC:percutaneous vertebroplasty(PVP)combined with radiofrequency ablation(RFA)and PVP combined with^(125)I particle implantation,were compared.Study design:Retrospective study.Patient sample:40 patients with MSCC were divided into two groups:19 cases in the RFA group and 21 cases in the^(125)I group.Method:All patients were accessed to determine the differences in pain,which was evaluated using the visual analog scale(VAS)at 1 week,1 month,and 3 months after the operation,and spinal stenosis rates(SSRs),which were measured at 1 and 3 months after the operation,between the two groups.Results:The VAS scores and SSRs at baseline were comparable between the RFA group and the^(125)I group(7.19±2.07 vs 7.42±1.95,37.7%±11.2%vs 41.1%±11.4%).The VAS scores and SSRs at 1 month and 3 months after the operation were significantly reduced in both groups,compared with those at baseline.The VAS scores and SSRs in the^(125)I group were lower than those in the RFA group at 3 months after the operation(1.09±0.97 vs 1.75±1.06 p=0.048 and 12.3%±6.4%vs 18.1%±10.1%p=0.034),while the VAS scores at1 week after the operation in the RFA group were lower than those in the^(125)I group(4.39±1.34 vs 5.05±1.82 p=0.049).Conclusion:PVP combined with RFA has a slight advantage in relieving pain in the short term,while PVP combined with^(125)I particle implantation may have a better effect in the relieving pain and decreasing the SSRs at 3 months after the operation.
基金Scientific Research Project of Military Logistics Department,Grant Award Number:CLB20J032。
文摘Background:Until January 18,2021,coronavirus disease-2019(COVID-19)has infected more than 93 million individuals and has caused a certain degree of panic.Viral pneumonia caused by common viruses such as respiratory syncytial virus,rhinovirus,human metapneumovirus,human bocavirus,and parainfluenza viruses have been more common in children.However,the incidence of COVID-19 in children was significantly lower than that in adults.The purpose of this study was to describe the clinical manifestations,treatment and outcomes of COVID-19 in children compared with those of other sources of viral pneumonia diagnosed during the COVID-19 outbreak.Methods:Children with COVID-19 and viral pneumonia admitted to 20 hospitals were enrolled in this retrospective multi-center cohort study.A total of 64 children with COVID-19 were defined as the COVID-19 cohort,of which 40 children who developed pneumonia were defined as the COVID-19 pneumonia cohort.Another 284 children with pneumonia caused by other viruses were defined as the viral pneumonia cohort.The epidemiologic,clinical,and laboratory findings were compared by Kolmogorov-Smirnov test,t-test,Mann-Whitney U test and Contingency table method.Drug usage,immunotherapy,blood transfusion,and need for oxygen support were collected as the treatment indexes.Mortality,intensive care needs and symptomatic duration were collected as the outcome indicators.Results:Compared with the viral pneumonia cohort,children in the COVID-19 cohort were mostly exposed to family members confirmed to have COVID-19(53/64 vs.23/284),were of older median age(6.3 years vs.3.2 years),and had a higher proportion of ground-glass opacity(GGO)on computed tomography(18/40 vs.0/38,P<0.001).Children in the COVID-19 pneumonia cohort had a lower proportion of severe cases(1/40 vs.38/284,P=0.048),and lower cases with high fever(3/40 vs.167/284,P<0.001),requiring intensive care(1/40 vs.32/284,P<0.047)and with shorter symptomatic duration(median 5d vs.8d,P<0.001).The proportion of cases with evaluated inflammatory indicators,biochemical indicators related to organ or tissue damage,D-dimer and secondary bacterial infection were lower in the COVID-19 pneumonia cohort than those in the viral pneumonia cohort(P<0.05).No statistical differences were found in the duration of positive PCR results from pharyngeal swabs in 25 children with COVID-19 who received antiviral drugs(lopinavir-ritonavir,ribavirin,and arbidol)as compared with duration in 39 children without antiviral therapy(median 10d vs.9d,P=0.885).Conclusions:The symptoms and severity of COVID-19 pneumonia in children were no more severe than those in children with other viral pneumonia.Lopinavir-ritonavir,ribavirin and arbidol do not shorten the duration of positive PCR results from pharyngeal swabs in children with COVID-19.During the COVID-19 outbreak,attention also must be given to children with infection by other pathogens infection.
文摘Multi-stage Mesozoic thrust-nappe and extensional structures are distributed in the east segment of the Southeast Yangtze Block situated in the junction region of Zhejiang-Jiangxi-Anhui provinces. The features and genetic mechanism of the deformations were analyzed after a detailed field observation of their distribution, geometry, and kinematics. In addition, the time sequences of the thrust and extensional structures were determined by combining the results of the comparative analysis with the chronological evidence of strata and magmatic rocks cut by a fault or formed after a fault according to field facts. This study identified three stages of the nappe structures and at least two stages of the extensional structures during the Mesozoic. The geotectonic setting of the nappe and extensional structures was considered to be related to the different geodynamics in the study area including the Early Mesozoic geological event, i.e., N-S compression, forming Lantian fault, etc.;the Late Mesozoic flat-slab subduction, forming Xiaoxi thrust fault and tectonic window;and the roll-back of the paleoPacific Plate, forming extensional structures like basin marginal fault;the last compression, forming Wucheng-Shenxian fault. These findings provide additional evidence for remodeling the tectonic and geodynamic evolution of Southeast China.
基金supported by the National Natural Science Foundation of China(Grant Nos.:81873226,and 81874366)the Zhejiang Provincial Science and Technology Innovation Leading Talent Project of“Ten Thousand Talents Plan”(2019).
文摘Ischemic stroke(IS)is a multifactorial and heterogeneous disease.Despite years of studies,effective strategies for the diagnosis,management and treatment of stroke are still lacking in clinical practice.Metabolomics is a growing field in systems biology.It is starting to show promise in the identification of biomarkers and in the use of pharmacometabolomics to help patients with certain disorders choose their course of treatment.The development of metabolomics has enabled further and more biological applications.Particularly,metabolomics is increasingly being used to diagnose diseases,discover new drug targets,elucidate mechanisms,and monitor therapeutic outcomes and its potential effect on precision medicine.In this review,we reviewed some recent advances in the study of metabolomics as well as how metabolomics might be used to identify novel biomarkers and understand the mechanisms of IS.Then,the use of metabolomics approaches to investigate the molecular processes and active ingredients of Chinese herbal formulations with anti-IS capabilities is summarized.We finally summarized recent developments in single cell metabolomics for exploring the metabolic profiles of single cells.Although the field is relatively young,the development of single cell metabolomics promises to provide a powerful tool for unraveling the pathogenesis of IS.
基金Supported by National Key R&D Program of China(Research on Inheritance and Innovation of Experience(Integration of Tao and Shu)of Illustrious Senior Traditional Chinese Medicine Practitioners by adopting Multiple Research Methods 2018YFC1704100 and Research on Methodology System and Paradigms for Mining and Inheriting Illustrious Senior Traditional Chinese Medicine Practitioners’Experience 2018YFC1704101)。
文摘OBJECTIVE:To explore the core herbs of two illustrious senior Traditional Chinese Medicine(TCM)Physicians for the treatment of liver cancer,and to further clarify the gene targets and pathway mechanisms of liver cancer that the core prescription(CP)may regulate.METHODS:We used the patient information of two illustrious senior TCM physicians from the Affiliated Hospital of Shandong University of Traditional Chinese Medicine and the Affiliated Hospital of Capital Medical University as the database.The CP was analyzed using the community network algorithm.The pathway mechanism was analyzed using network pharmacology method.And the prognostic survival genes were identified using Single factor cox regression analysis.Integrative Pharmacology-based Research Platform of Traditional Chinese Medicine(TCMIP),Herb,Online Mendelian Inheritance in Man(OMIM),Genecards,Kyoto Encyclopedia of Genes and Genomes(KEGG),Genomic Data Commons(GDC),The Cancer Genome Atlas(TCGA),Gephi and R were used to mine CP,building a pathway network diagram.All the analyses were visualized.RESULTS:We found that the CP consistes of Huangqi(Radix Astragali Mongolici),Danshen(Radix Salviae Miltiorrhizae),Shuihonghuazi(Polygoni Orientalis Fructus),Baihuasheshecao(Herba Hedyotdis),Banzhilian(Herba Scutellariae Barbatae),and Ezhu(Rhizoma Curcumae Phaeocaulis),which were attributed to the two physicians respectively.The CP played an anticancer role through such pathways as signal transduction,energy metabolism,immune system and other pathways,covering a total of 112 pathways and 176 herb-diseaserelated genes.Fourteen genes have a significant impact on the prognosis and survival of liver cancer.CONCLUSION:Based on the liver cancer cases of two illustrious senior TCM physicians,we obtained the CP through data mining.The CP may mainly exert anticancer effects by inhibiting inflammatory response,angiogenesis,and enhancing the body’s immune response.We screened out 14 genes in the CP that may be related to the prognosis of liver cancer,and these genes may play an important regulatory role in the prognosis of liver cancer.
文摘Accurate prediction ofmonthly oil and gas production is essential for oil enterprises tomake reasonable production plans,avoid blind investment and realize sustainable development.Traditional oil well production trend prediction methods are based on years of oil field production experience and expertise,and the application conditions are very demanding.With the rapid development of artificial intelligence technology,big data analysis methods are gradually applied in various sub-fields of the oil and gas reservoir development.Based on the data-driven artificial intelligence algorithmGradient BoostingDecision Tree(GBDT),this paper predicts the initial single-layer production by considering geological data,fluid PVT data and well data.The results show that the GBDT algorithm prediction model has great accuracy,significantly improving efficiency and strong universal applicability.The GBDTmethod trained in this paper can predict production,which is helpful for well site optimization,perforation layer optimization and engineering parameter optimization and has guiding significance for oilfield development.
文摘Kaposiform hemangioendothelioma （KHE） is a rare locally ag- gressive vascular tumor that mainly occurs in children and early adolescents. It is often associated with the Kasabach-Meritt phenomenon which is marked by severe thrombocytopenia and a variable degree of anemia. The tumor mostly is located in the superficial or deep soft tissue mass of the extremities. Herein, we report an unusual case of kaposiform hemangioendothelioma that,
基金Supported by National Natural Science Foundation of China,No.81260326 and No.81660398Natural Science Foundation of Gansu Province,No.17JR5RA034
文摘BACKGROUND Hilar cholangiocarcinoma is the most common malignant tumor of the extrahepatic bile duct.Until now,radical resection has been the most effective method for the long-term survival of patients with the disease.However,many problems have emerged in the field of hepatobiliary surgery for a long time,including complex surgical procedures,low resection rate,and postoperative complications.We have adopted the“multiple Roux-en-Y hepaticojejunostomy reconstruction by formation of a bile duct lake”technique in the treatment of hilar cholangiocarcinoma since 2008,and obtained satisfactory short-and longterm results.AIM To examine the feasibility of the application of multiple Roux-en-Y hepaticojejunostomy reconstruction by formation of a bile duct lake in the operation of hilar cholangiocarcinoma METHODS A retrospective analysis was performed for the clinical data,surgical methods,and results of 76 patients with hilar cholangiocarcinoma who were treated with hilar bile duct lake-forming multiple Roux-en-Y hepaticojejunostomy reconstruction at Gansu Provincial Hospital.RESULTS In all 76 cases,the operation was successful and no operative death occurred.The mean(range)operation time was 215.4±53.5 min(124–678 min),and the amount of bleeding during the operation was 428.2±63.8 mL(240–2200 mL).The overall 1-year survival rate was 78.9%,and the 3-year survival rate was 32.8%.CONCLUSION The multiple Roux-en-Y hepaticojejunostomy reconstruction technique with formation of a bile duct lake is safe and effective for the surgical treatment of hilar cholangiocarcinoma.
