Acute lung injury(ALI)is a significant complication of sepsis,characterized by high morbidity,mortality,and poor prognosis.Neutrophils,as critical intrinsic immune cells in the lung,play a fundamental role in the deve...Acute lung injury(ALI)is a significant complication of sepsis,characterized by high morbidity,mortality,and poor prognosis.Neutrophils,as critical intrinsic immune cells in the lung,play a fundamental role in the development and progression of ALI.During ALI,neutrophils generate neutrophil extracellular traps(NETs),and excessive NETs can intensify inflammatory injury.Research indicates that Taohe Chengqi decoction(THCQD)can ameliorate sepsis-induced lung inflammation and modulate immune function.This study aimed to investigate the mechanisms by which THCQD improves ALI and its relationship with NETs in sepsis patients,seeking to provide novel perspectives and interventions for clinical treatment.The findings demonstrate that THCQD enhanced survival rates and reduced lung injury in the cecum ligation and puncture(CLP)-induced ALI mouse model.Furthermore,THCQD diminished neutrophil and macrophage infiltration,inflammatory responses,and the production of pro-inflammatory cytokines,including interleukin-1β(IL-1β),IL-6,and tumor necrosis factorα(TNF-α).Notably,subsequent experiments confirmed that THCQD inhibits NET formation both in vivo and in vitro.Moreover,THCQD significantly decreased the expression of peptidyl arginine deiminase 4(PAD4)protein,and molecular docking predicted that certain active compounds in THCQD could bind tightly to PAD4.PAD4 overexpression partially reversed THCQD’s inhibitory effects on PAD4.These findings strongly indicate that THCQD mitigates CLP-induced ALI by inhibiting PAD4-mediated NETs.展开更多
Human action recognition(HAR)is crucial for the development of efficient computer vision,where bioinspired neuromorphic perception visual systems have emerged as a vital solution to address transmission bottlenecks ac...Human action recognition(HAR)is crucial for the development of efficient computer vision,where bioinspired neuromorphic perception visual systems have emerged as a vital solution to address transmission bottlenecks across sensor-processor interfaces.However,the absence of interactions among versatile biomimicking functionalities within a single device,which was developed for specific vision tasks,restricts the computational capacity,practicality,and scalability of in-sensor vision computing.Here,we propose a bioinspired vision sensor composed of a Ga N/Al N-based ultrathin quantum-disks-in-nanowires(QD-NWs)array to mimic not only Parvo cells for high-contrast vision and Magno cells for dynamic vision in the human retina but also the synergistic activity between the two cells for in-sensor vision computing.By simply tuning the applied bias voltage on each QD-NW-array-based pixel,we achieve two biosimilar photoresponse characteristics with slow and fast reactions to light stimuli that enhance the in-sensor image quality and HAR efficiency,respectively.Strikingly,the interplay and synergistic interaction of the two photoresponse modes within a single device markedly increased the HAR recognition accuracy from 51.4%to 81.4%owing to the integrated artificial vision system.The demonstration of an intelligent vision sensor offers a promising device platform for the development of highly efficient HAR systems and future smart optoelectronics.展开更多
Fine-grained nuclear graphite is a key material in high-temperature gas-cooled reactors(HTGRs).During air ingress accidents,core graphite components undergo severe oxidation,threatening structural integrity.Therefore,...Fine-grained nuclear graphite is a key material in high-temperature gas-cooled reactors(HTGRs).During air ingress accidents,core graphite components undergo severe oxidation,threatening structural integrity.Therefore,understanding the oxidation behavior of nuclear graphite is essential for reactor safety.The influence of oxidation involves multiple factors,including temperature,sample size,oxidant,impurities,filler type and size,etc.The size of the filler particles plays a crucial role in this study.Five ultrafine-and superfine-grained nuclear graphite samples(5.9-34.4μm)are manufactured using identical raw materials and manufacturing processes.Isothermal oxidation tests conducted at 650℃-750℃ are used to study the oxidation behavior.Additionally,comprehensive characterization is performed to analyze the crystal structure,surface morphology,and nanoscale to microscale pore structure of the samples.Results indicate that oxidation behavior cannot be predicted solely based on filler grain size.Reactive site concentration,characterized by active surface area,dominates the chemical reaction kinetics,whereas pore tortuosity,quantified by the structural parameterΨ,plays a key role in regulating oxidant diffusion.These findings clarify the dual role of microstructure in oxidation mechanisms and establish a theoretical and experimental basis for the design of high-performance nuclear graphite capable of long-term service in high-temperature gas-cooled reactors.展开更多
The introduction of two-dimensional(2D)perovskite layers on top of three-dimensional(3D)perovskite films enhances the performance and stability of perovskite solar cells(PSCs).However,the electronic effect of the spac...The introduction of two-dimensional(2D)perovskite layers on top of three-dimensional(3D)perovskite films enhances the performance and stability of perovskite solar cells(PSCs).However,the electronic effect of the spacer cation and the quality of the 2D capping layer are critical factors in achieving the required results.In this study,we compared two fluorinated salts:4-(trifluoromethyl)benzamidine hydrochloride(4TF-BA·HCl)and 4-fluorobenzamidine hydrochloride(4F-BA·HCl)to engineer the 3D/2D perovskite films.Surprisingly,4F-BA formed a high-performance 3D/2D heterojunction,while4TF-BA produced an amorphous layer on the perovskite films.Our findings indicate that the balanced intramolecular charge polarization,which leads to effective hydrogen bonding,is more favorable in 4F-BA than in 4TF-BA,promoting the formation of a crystalline 2D perovskite.Nevertheless,4TF-BA managed to improve efficiency to 24%,surpassing the control device,primarily due to the natural passivation capabilities of benzamidine.Interestingly,the devices based on 4F-BA demonstrated an efficiency exceeding 25%with greater longevity under various storage conditions compared to 4TF-BA-based and the control devices.展开更多
Investigating structural and hydroxyl group effects in electrooxidation of alcohols to value-added products by solid-acid electrocatalysts is essential for upgrading biomass alcohols.Herein,we report efficient electro...Investigating structural and hydroxyl group effects in electrooxidation of alcohols to value-added products by solid-acid electrocatalysts is essential for upgrading biomass alcohols.Herein,we report efficient electrocatalytic oxidations of saturated alcohols(C_(1)-C_(6))to selectively form formate using Ni Co hydroxide(Ni Co-OH)derived Ni Co_(2)O_(4)solid-acid electrocatalysts with balanced Lewis acid(LASs)and Brønsted acid sites(BASs).Thermal treatment transforms BASs-rich(89.6%)Ni Co-OH into Ni Co_(2)O_(4)with nearly equal distribution of LASs(53.1%)and BASs(46.9%)which synergistically promote adsorption and activation of OH-and alcohol molecules for enhanced oxidation activity.In contrast,BASs-enriched Ni Co-OH facilitates formation of higher valence metal sites,beneficial for water oxidation.The combined experimental studies and theoretical calculation imply the oxidation ability of C1-C6alcohols increases as increased number of hydroxyl groups and decreased HOMO-LUMO gaps:methanol(C_(1))<ethylene glycol(C_(2))<glycerol(C3)<meso-erythritol(C4)<xylitol(C5)<sorbitol(C6),while the formate selectivity shows the opposite trend from 100 to 80%.This study unveils synergistic roles of LASs and BASs,as well as hydroxyl group effect in electro-upgrading of alcohols using solid-acid electrocatalysts.展开更多
Photodetectors can convert light energy into electrical signals,so are widely used in photovoltaics,photon counting,monitoring,and imaging.Photodetectors are easy to prepare high-resolution photochips because of their...Photodetectors can convert light energy into electrical signals,so are widely used in photovoltaics,photon counting,monitoring,and imaging.Photodetectors are easy to prepare high-resolution photochips because of their small size unit integration.However,these photodetector units often exhibit poor photoelectric performance due to material defects and inadequate structures,which greatly limit the functions of devices.Designing modification strategies and micro-/nanostructures can compensate for defects,adjust the bandgap,and develop novel quantum structures,which consequently optimize photovoltaic units and revolutionize optoelectronic devices.Here,this paper aims to comprehensively elaborate on the surface/interface engineering scheme of micro-/nano-photodetectors.It starts from the fundamentals of photodetectors,such as principles,types,and parameters,and describes the influence of material selection,manufacturing techniques,and post-processing.Then,we analyse in detail the great influence of surface/interface engineering on the performance of photovoltaic devices,including surface/interface modification and micro-/nanostructural design.Finally,the applications and prospects of optoelectronic devices in various fields such as miniaturization of electronic devices,robotics,and human–computer interaction are shown.展开更多
Besides leaves, non-foliar green organs such as stem and spike are also considered photosynthetic organs. To assess the photosynthetic contributions of these organs, the correlations between these photosynthetic areas...Besides leaves, non-foliar green organs such as stem and spike are also considered photosynthetic organs. To assess the photosynthetic contributions of these organs, the correlations between these photosynthetic areas and single-spike weight were investigated in a winter wheat(Triticum aestivum L.) under four nitrogen and mulching treatments: N120,N150, N195, and N195 + M. Two-year repeated field experiments were conducted on the Loess Plateau of China. Non-foliar photosynthetic area, grain-filling ratio and duration,grain yield, and in particular, single-spike weight, were measured, recorded and analyzed.Under the N195 + M treatment, plants showed the largest area of photosynthetic organs(flag leaf and non-foliar organs) and the highest grain yield and single spike weight. Singlespike weight was positively correlated with the areas of all examined non-foliar photosynthetic organs, in particular with the area above the flag leaf node(R^2= 0.761*)and the area above the exposed part of the peduncle(EXP)(R^2= 0.800**). In addition, singlespike weight was highly correlated with average grain-filling ratio(R^2= 0.993**), whereas it was less highly correlated with grain-filling duration(R^2= 0.533). The morphological traits of non-foliar photosynthetic organs were also more highly correlated with average grainfilling ratio than with average grain-filling duration. The significant correlation between each of the morphological traits(area, length and width) of EXP and single-spike weight indicates that morphological traits of EXP are important in determining spike weight in the Loess Plateau environment.展开更多
BACKGROUND Adverse events during endoscopic submucosal dissection(ESD)of superficial esophageal neoplasms,such as perforation and bleeding,have been welldocumented.However,the Mallory-Weiss Tear(MWT)during esophageal ...BACKGROUND Adverse events during endoscopic submucosal dissection(ESD)of superficial esophageal neoplasms,such as perforation and bleeding,have been welldocumented.However,the Mallory-Weiss Tear(MWT)during esophageal ESD remains under investigation.AIM To investigate the incidence and risk factors of the MWT during esophageal ESD.METHODS From June 2014 to July 2017,patients with superficial esophageal neoplasms who received ESD in our institution were retrospectively analyzed.The clinicopathological characteristics of the patients were collected.Patients were divided into an MWT group and non-MWT group based on whether MWT occurred during ESD.The incidence of MWTs was determined,and the risk factors for MWT were then further explored.RESULTS A total of 337 patients with 373 lesions treated by ESD were analyzed.Twenty patients developed MWTs during ESD(5.4%).Multivariate analysis identified that female sex(OR=5.36,95%CI:1.47-19.50,P=0.011)and procedure time longer than 88.5 min(OR=3.953,95%CI:1.497-10.417,P=0.005)were independent risk factors for an MWT during ESD.The cutoff value of the procedure time for an MWT was 88.5 min(sensitivity,65.0%;specificity,70.8%).Seven of the MWT patients received endoscopic hemostasis.All patients recovered satisfactorily without surgery for the laceration.CONCLUSION The incidence of MWTs during esophageal ESD was much higher than expected.Although most cases have a benign course,fatal conditions may occur.We recommend inspection of the stomach during and after the ESD procedure for timely management in cases of bleeding MWTs or even perforation outside of the procedure region.展开更多
Chengting Thomas WANG, a Christian went on to be an important Chinese Diplomat. Then after his diplomatic career had ended he focused on his religious beliefs. In the course of this process, he transformed from a nati...Chengting Thomas WANG, a Christian went on to be an important Chinese Diplomat. Then after his diplomatic career had ended he focused on his religious beliefs. In the course of this process, he transformed from a nationalist to an internationalist. As a nationalist he represented the interests of China, opposing Western Powers unequal treaties on China. As an internationalist his response to the Peace advocates in Western countries during the two world wars initiated in him taking the route of international cooperation to combat the rise of communism in China. Chengting Thomas WANG changed to an international activists, from nationalists, had very little benefit for his own country.展开更多
It has been reported that the PI3K/AKT signaling pathway plays a key role in the pathogenesis of ischemic stroke.As a result,the development of drugs targeting the PI3K/AKT signaling pathway has attracted increasing a...It has been reported that the PI3K/AKT signaling pathway plays a key role in the pathogenesis of ischemic stroke.As a result,the development of drugs targeting the PI3K/AKT signaling pathway has attracted increasing attention from researchers.This article reviews the pathological mechanisms and advancements in research related to the signaling pathways in ischemic stroke,with a focus on the PI3K/AKT signaling pathway.The key findings include the following:(1)The complex pathological mechanisms of ischemic stroke can be categorized into five major types:excitatory amino acid toxicity,Ca^(2+)overload,inflammatory response,oxidative stress,and apoptosis.(2)The PI3K/AKT-mediated signaling pathway is closely associated with the occurrence and progression of ischemic stroke,which primarily involves the NF-κB,NRF2,BCL-2,mTOR,and endothelial NOS signaling pathways.(3)Natural products,including flavonoids,quinones,alkaloids,phenylpropanoids,phenols,terpenoids,and iridoids,show great potential as candidate substances for the development of innovative anti-stroke medications.(4)Recently,novel therapeutic techniques,such as electroacupuncture and mesenchymal stem cell therapy,have demonstrated the potential to improve stroke outcomes by activating the PI3K/AKT signaling pathway,providing new possibilities for the treatment and rehabilitation of patients with ischemic stroke.Future investigations should focus on the direct regulatory mechanisms of drugs targeting the PI3K/AKT signaling pathway and their clinical translation to develop innovative treatment strategies for ischemic stroke.展开更多
基金supporteded by the National Natural ScienceFoundation of China(Nos.82374183,82405092,82204991,82274246,and 82374341)the Planned Science TechnologyProjectofGuangzhouCity(Nos.2023A03J0419and2023A03J0420)+3 种基金the General Project of Natural Science Foundationof Guangdong Province(No.2023A1515011090)Hong KongScholars Program 2024(No.XJ2024005)the Basic and AppliedBasic Research Foundation of Guangdong Province(No.2021A151510809)the Project of Administration of TraditionalChinese Medicine of Guangdong Province of China(No.20223013).
文摘Acute lung injury(ALI)is a significant complication of sepsis,characterized by high morbidity,mortality,and poor prognosis.Neutrophils,as critical intrinsic immune cells in the lung,play a fundamental role in the development and progression of ALI.During ALI,neutrophils generate neutrophil extracellular traps(NETs),and excessive NETs can intensify inflammatory injury.Research indicates that Taohe Chengqi decoction(THCQD)can ameliorate sepsis-induced lung inflammation and modulate immune function.This study aimed to investigate the mechanisms by which THCQD improves ALI and its relationship with NETs in sepsis patients,seeking to provide novel perspectives and interventions for clinical treatment.The findings demonstrate that THCQD enhanced survival rates and reduced lung injury in the cecum ligation and puncture(CLP)-induced ALI mouse model.Furthermore,THCQD diminished neutrophil and macrophage infiltration,inflammatory responses,and the production of pro-inflammatory cytokines,including interleukin-1β(IL-1β),IL-6,and tumor necrosis factorα(TNF-α).Notably,subsequent experiments confirmed that THCQD inhibits NET formation both in vivo and in vitro.Moreover,THCQD significantly decreased the expression of peptidyl arginine deiminase 4(PAD4)protein,and molecular docking predicted that certain active compounds in THCQD could bind tightly to PAD4.PAD4 overexpression partially reversed THCQD’s inhibitory effects on PAD4.These findings strongly indicate that THCQD mitigates CLP-induced ALI by inhibiting PAD4-mediated NETs.
基金funded by the National Natural Science Foundation of China(Grant Nos.62322410,52272168,624B2135,61804047)the Fundamental Research Funds for the Central Universities(No.WK2030000103)。
文摘Human action recognition(HAR)is crucial for the development of efficient computer vision,where bioinspired neuromorphic perception visual systems have emerged as a vital solution to address transmission bottlenecks across sensor-processor interfaces.However,the absence of interactions among versatile biomimicking functionalities within a single device,which was developed for specific vision tasks,restricts the computational capacity,practicality,and scalability of in-sensor vision computing.Here,we propose a bioinspired vision sensor composed of a Ga N/Al N-based ultrathin quantum-disks-in-nanowires(QD-NWs)array to mimic not only Parvo cells for high-contrast vision and Magno cells for dynamic vision in the human retina but also the synergistic activity between the two cells for in-sensor vision computing.By simply tuning the applied bias voltage on each QD-NW-array-based pixel,we achieve two biosimilar photoresponse characteristics with slow and fast reactions to light stimuli that enhance the in-sensor image quality and HAR efficiency,respectively.Strikingly,the interplay and synergistic interaction of the two photoresponse modes within a single device markedly increased the HAR recognition accuracy from 51.4%to 81.4%owing to the integrated artificial vision system.The demonstration of an intelligent vision sensor offers a promising device platform for the development of highly efficient HAR systems and future smart optoelectronics.
基金supported by the National Key Research and Development Program of China(2024YFA1612900)the National Natural Science Foundation of China(Grant No.52103365 and No.12375270)the Guangdong Innovative and Entrepreneurial Research Team Program,China(Grant No.2021ZT09L227).
文摘Fine-grained nuclear graphite is a key material in high-temperature gas-cooled reactors(HTGRs).During air ingress accidents,core graphite components undergo severe oxidation,threatening structural integrity.Therefore,understanding the oxidation behavior of nuclear graphite is essential for reactor safety.The influence of oxidation involves multiple factors,including temperature,sample size,oxidant,impurities,filler type and size,etc.The size of the filler particles plays a crucial role in this study.Five ultrafine-and superfine-grained nuclear graphite samples(5.9-34.4μm)are manufactured using identical raw materials and manufacturing processes.Isothermal oxidation tests conducted at 650℃-750℃ are used to study the oxidation behavior.Additionally,comprehensive characterization is performed to analyze the crystal structure,surface morphology,and nanoscale to microscale pore structure of the samples.Results indicate that oxidation behavior cannot be predicted solely based on filler grain size.Reactive site concentration,characterized by active surface area,dominates the chemical reaction kinetics,whereas pore tortuosity,quantified by the structural parameterΨ,plays a key role in regulating oxidant diffusion.These findings clarify the dual role of microstructure in oxidation mechanisms and establish a theoretical and experimental basis for the design of high-performance nuclear graphite capable of long-term service in high-temperature gas-cooled reactors.
基金supported by the National Key Research and Development Programs-Intergovernmental International Cooperation in Science and Technology Innovation Project(Grant No.2022YFE0118400)the Natural Science Foundation of Hunan Province(2023JJ50132)+1 种基金Shenzhen Science and Technology Innovation Committee(Grants Nos.JCYJ20220818100211025,and KCXST20221021111616039)Shenzhen Science and Technology Program(No.20231128110928003)。
文摘The introduction of two-dimensional(2D)perovskite layers on top of three-dimensional(3D)perovskite films enhances the performance and stability of perovskite solar cells(PSCs).However,the electronic effect of the spacer cation and the quality of the 2D capping layer are critical factors in achieving the required results.In this study,we compared two fluorinated salts:4-(trifluoromethyl)benzamidine hydrochloride(4TF-BA·HCl)and 4-fluorobenzamidine hydrochloride(4F-BA·HCl)to engineer the 3D/2D perovskite films.Surprisingly,4F-BA formed a high-performance 3D/2D heterojunction,while4TF-BA produced an amorphous layer on the perovskite films.Our findings indicate that the balanced intramolecular charge polarization,which leads to effective hydrogen bonding,is more favorable in 4F-BA than in 4TF-BA,promoting the formation of a crystalline 2D perovskite.Nevertheless,4TF-BA managed to improve efficiency to 24%,surpassing the control device,primarily due to the natural passivation capabilities of benzamidine.Interestingly,the devices based on 4F-BA demonstrated an efficiency exceeding 25%with greater longevity under various storage conditions compared to 4TF-BA-based and the control devices.
基金the financial support from the National Natural Science Foundation of China(52172110,52472231,52311530113)Shanghai"Science and Technology Innovation Action Plan"intergovernmental international science and technology cooperation project(23520710600)+1 种基金Science and Technology Commission of Shanghai Municipality(22DZ1205600)the Central Guidance on Science and Technology Development Fund of Zhejiang Province(2024ZY01011)。
文摘Investigating structural and hydroxyl group effects in electrooxidation of alcohols to value-added products by solid-acid electrocatalysts is essential for upgrading biomass alcohols.Herein,we report efficient electrocatalytic oxidations of saturated alcohols(C_(1)-C_(6))to selectively form formate using Ni Co hydroxide(Ni Co-OH)derived Ni Co_(2)O_(4)solid-acid electrocatalysts with balanced Lewis acid(LASs)and Brønsted acid sites(BASs).Thermal treatment transforms BASs-rich(89.6%)Ni Co-OH into Ni Co_(2)O_(4)with nearly equal distribution of LASs(53.1%)and BASs(46.9%)which synergistically promote adsorption and activation of OH-and alcohol molecules for enhanced oxidation activity.In contrast,BASs-enriched Ni Co-OH facilitates formation of higher valence metal sites,beneficial for water oxidation.The combined experimental studies and theoretical calculation imply the oxidation ability of C1-C6alcohols increases as increased number of hydroxyl groups and decreased HOMO-LUMO gaps:methanol(C_(1))<ethylene glycol(C_(2))<glycerol(C3)<meso-erythritol(C4)<xylitol(C5)<sorbitol(C6),while the formate selectivity shows the opposite trend from 100 to 80%.This study unveils synergistic roles of LASs and BASs,as well as hydroxyl group effect in electro-upgrading of alcohols using solid-acid electrocatalysts.
文摘Photodetectors can convert light energy into electrical signals,so are widely used in photovoltaics,photon counting,monitoring,and imaging.Photodetectors are easy to prepare high-resolution photochips because of their small size unit integration.However,these photodetector units often exhibit poor photoelectric performance due to material defects and inadequate structures,which greatly limit the functions of devices.Designing modification strategies and micro-/nanostructures can compensate for defects,adjust the bandgap,and develop novel quantum structures,which consequently optimize photovoltaic units and revolutionize optoelectronic devices.Here,this paper aims to comprehensively elaborate on the surface/interface engineering scheme of micro-/nano-photodetectors.It starts from the fundamentals of photodetectors,such as principles,types,and parameters,and describes the influence of material selection,manufacturing techniques,and post-processing.Then,we analyse in detail the great influence of surface/interface engineering on the performance of photovoltaic devices,including surface/interface modification and micro-/nanostructural design.Finally,the applications and prospects of optoelectronic devices in various fields such as miniaturization of electronic devices,robotics,and human–computer interaction are shown.
基金the financial support of the National Basic Research Program of China (2015CB150402)National Natural Science Foundation of China (51479189)+1 种基金Open Foundation of State Key Laboratory, Institute of Water and Soil Conservation, Chinese Academy of Sciences, Ministry of Water Resources (A314021402-1610)Key Research Foundation of Baoji University of Arts and Sciences (ZK16066)
文摘Besides leaves, non-foliar green organs such as stem and spike are also considered photosynthetic organs. To assess the photosynthetic contributions of these organs, the correlations between these photosynthetic areas and single-spike weight were investigated in a winter wheat(Triticum aestivum L.) under four nitrogen and mulching treatments: N120,N150, N195, and N195 + M. Two-year repeated field experiments were conducted on the Loess Plateau of China. Non-foliar photosynthetic area, grain-filling ratio and duration,grain yield, and in particular, single-spike weight, were measured, recorded and analyzed.Under the N195 + M treatment, plants showed the largest area of photosynthetic organs(flag leaf and non-foliar organs) and the highest grain yield and single spike weight. Singlespike weight was positively correlated with the areas of all examined non-foliar photosynthetic organs, in particular with the area above the flag leaf node(R^2= 0.761*)and the area above the exposed part of the peduncle(EXP)(R^2= 0.800**). In addition, singlespike weight was highly correlated with average grain-filling ratio(R^2= 0.993**), whereas it was less highly correlated with grain-filling duration(R^2= 0.533). The morphological traits of non-foliar photosynthetic organs were also more highly correlated with average grainfilling ratio than with average grain-filling duration. The significant correlation between each of the morphological traits(area, length and width) of EXP and single-spike weight indicates that morphological traits of EXP are important in determining spike weight in the Loess Plateau environment.
文摘BACKGROUND Adverse events during endoscopic submucosal dissection(ESD)of superficial esophageal neoplasms,such as perforation and bleeding,have been welldocumented.However,the Mallory-Weiss Tear(MWT)during esophageal ESD remains under investigation.AIM To investigate the incidence and risk factors of the MWT during esophageal ESD.METHODS From June 2014 to July 2017,patients with superficial esophageal neoplasms who received ESD in our institution were retrospectively analyzed.The clinicopathological characteristics of the patients were collected.Patients were divided into an MWT group and non-MWT group based on whether MWT occurred during ESD.The incidence of MWTs was determined,and the risk factors for MWT were then further explored.RESULTS A total of 337 patients with 373 lesions treated by ESD were analyzed.Twenty patients developed MWTs during ESD(5.4%).Multivariate analysis identified that female sex(OR=5.36,95%CI:1.47-19.50,P=0.011)and procedure time longer than 88.5 min(OR=3.953,95%CI:1.497-10.417,P=0.005)were independent risk factors for an MWT during ESD.The cutoff value of the procedure time for an MWT was 88.5 min(sensitivity,65.0%;specificity,70.8%).Seven of the MWT patients received endoscopic hemostasis.All patients recovered satisfactorily without surgery for the laceration.CONCLUSION The incidence of MWTs during esophageal ESD was much higher than expected.Although most cases have a benign course,fatal conditions may occur.We recommend inspection of the stomach during and after the ESD procedure for timely management in cases of bleeding MWTs or even perforation outside of the procedure region.
文摘Chengting Thomas WANG, a Christian went on to be an important Chinese Diplomat. Then after his diplomatic career had ended he focused on his religious beliefs. In the course of this process, he transformed from a nationalist to an internationalist. As a nationalist he represented the interests of China, opposing Western Powers unequal treaties on China. As an internationalist his response to the Peace advocates in Western countries during the two world wars initiated in him taking the route of international cooperation to combat the rise of communism in China. Chengting Thomas WANG changed to an international activists, from nationalists, had very little benefit for his own country.
基金supported by the National Natural Science Foundation of China,Nos.82274313(to YD),82204746(to ML),82003982(to TL).
文摘It has been reported that the PI3K/AKT signaling pathway plays a key role in the pathogenesis of ischemic stroke.As a result,the development of drugs targeting the PI3K/AKT signaling pathway has attracted increasing attention from researchers.This article reviews the pathological mechanisms and advancements in research related to the signaling pathways in ischemic stroke,with a focus on the PI3K/AKT signaling pathway.The key findings include the following:(1)The complex pathological mechanisms of ischemic stroke can be categorized into five major types:excitatory amino acid toxicity,Ca^(2+)overload,inflammatory response,oxidative stress,and apoptosis.(2)The PI3K/AKT-mediated signaling pathway is closely associated with the occurrence and progression of ischemic stroke,which primarily involves the NF-κB,NRF2,BCL-2,mTOR,and endothelial NOS signaling pathways.(3)Natural products,including flavonoids,quinones,alkaloids,phenylpropanoids,phenols,terpenoids,and iridoids,show great potential as candidate substances for the development of innovative anti-stroke medications.(4)Recently,novel therapeutic techniques,such as electroacupuncture and mesenchymal stem cell therapy,have demonstrated the potential to improve stroke outcomes by activating the PI3K/AKT signaling pathway,providing new possibilities for the treatment and rehabilitation of patients with ischemic stroke.Future investigations should focus on the direct regulatory mechanisms of drugs targeting the PI3K/AKT signaling pathway and their clinical translation to develop innovative treatment strategies for ischemic stroke.
