Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy remains a challenging field in therapeutic endoscopy due to the complex anatomical reconstructions that limit access to t...Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy remains a challenging field in therapeutic endoscopy due to the complex anatomical reconstructions that limit access to the biliary tree.Over the past two decades,device-assisted enteroscopy(DAE),including singleballoon,double-balloon,and motorized spiral enteroscopy,has expanded the feasibility of ERCP in this population,with overall technical success rates generally reported between 70%and 90%.Nevertheless,these techniques are technically demanding,time-consuming,and frequently affected by limited reach and unstable positioning.More recently,interventional endoscopic ultrasound(EUS)-guided procedures have emerged as highly effective alternatives,significantly improving clinical outcomes in selected patients,particularly in those with long-limb Roux-en-Y reconstructions where conventional methods are less effective.Percutaneous transhepatic biliary drainage continues to represent a valuable salvage option when endoscopic approaches fail,though it is associated with a greater burden of reinterventions and adverse events.This minireview provides a comprehensive overview of the main endoscopic strategies for biliary drainage in altered anatomy,focusing on technical considerations,efficacy,and safety profiles of DAE-assisted ERCP,EUS-guided interventions,and motorized systems.The evolving landscape of biliary drainage in this setting highlights the need for tailored treatment strategies,multidisciplinary collaboration,referral to high-volume centers,and further prospective studies to refine patient selection and optimize clinical outcomes.展开更多
Altered rock,often encountered in major engineering projects,can seriously affect the stability of rocks and slopes surrounding deeply buried tunnels.This study addressed the alteration mechanism,alteration degree cla...Altered rock,often encountered in major engineering projects,can seriously affect the stability of rocks and slopes surrounding deeply buried tunnels.This study addressed the alteration mechanism,alteration degree classification,and mechanical parameters of altered rock in engineering project areas using field testing,thin slice identification,X-ray diffraction,and major element testing.Results showed that the altered rock types in the areas of the Pingjiang Pumped Storage Power Station,Hunan Province,and a diversion tunnel in northern Xinjiang Uygur Autonomous Region include biotite granodiorite,biotite monzogranite,and cataclastic granite,and that the main alteration mechanisms are chloritization of biotite and clayization of feldspar minerals.The altered rocks were classified as slightly,moderately,or strongly altered according to their apparent characteristics,rebound value,longitudinal wave velocity,metamorphic mineral content,and porosity.The bulk density,elastic modulus,cohesion,and internal friction angle(Poisson’s ratio)of the altered rocks decreased(increased)with increase in the degree of alteration.Numerical simulations showed that in altered rock slope areas,the zone of strong rock alteration and the moderate-strong alteration contact zone exhibit locally large deformations that represent a certain hazard to engineering projects.These results provide valuable guidance and support for major projects in altered rock areas.展开更多
BACKGROUND Performing endoscopic retrograde cholangiopancreatography(ERCP)in pati-ents with surgically altered gastrointestinal anatomy poses significant challenges.Double-balloon enteroscopy-assisted ERCP(DBE-ERCP)ha...BACKGROUND Performing endoscopic retrograde cholangiopancreatography(ERCP)in pati-ents with surgically altered gastrointestinal anatomy poses significant challenges.Double-balloon enteroscopy-assisted ERCP(DBE-ERCP)has emerged as a safe and effective approach in this patient population.This study aims to provide an updated systematic review and meta-analysis of the safety and efficacy of DBEERCP in patients with surgically altered anatomy(SAA),building on previously published evidence.AIM To evaluate the safety and efficacy of DBE-ERCP in patients with SAA through an updated systematic review and meta-analysis and to compare outcomes between short-and long-scope double-balloon enteroscopy(DBE).METHODS A comprehensive search of PubMed,EMBASE,and Web of Science was performed for studies published up to March 2025 investigating DBE-ERCP in patients with surgically altered gastrointestinal anatomy.A random-effects model was applied to conduct a meta-analysis of proportions.The risk of bias was evaluated using the Newcastle-Ottawa Scale and the Joanna Briggs Institute Scale.Heterogeneity was evaluated using the inconsistency statistic(I2).Publication bias was examined using funnel plots and Egger’s regression test.RESULTS A total of 40 studies were included,comprising 10 cohort studies and 30 case series,including 2689 patients who underwent 3478 procedures.The surgical procedures were primarily classified into three categories:Roux-en-Y reconstruction(including hepaticojejunostomy,gastric bypass,and choledochojejunostomy,etc.)in 1156 cases;pancreaticoduodenectomy(performed using either the Whipple or Child technique)in 549 cases;and Billroth II anastomosis in 265 cases.The combined success rate for reaching the papilla was 92%(95%CI:89%-95%).The overall enteroscopy success rate was 89%(95%CI:85%-92%).The pooled diagnostic success rate was 90%(95%CI:85%-95%),while the therapeutic success rate reached 92%(95%CI:89%-95%).Adverse events reported in 5.7%of patients(95%CI:4.1%-7.5%).Subgroup analysis comparing short-scope and long-scope demonstrated that the short DBE was superior in terms of papilla reached rate,enteroscopy success,and procedural success.No significant differences were observed between groups in diagnostic success or adverse events.CONCLUSION DBE-ERCP demonstrates both safety and efficacy in patients with SAA.Compared to long-scope DBE,short-scope DBE shows greater clinical promise;however,further randomized controlled trials are warranted to validate these findings.展开更多
This review summarizes studies of hydrothermal alteration minerals at the Qiucun gold deposit in southeastern China and focuses on characterization and mapping of the deposit using hyperspectral remote sensing.The dep...This review summarizes studies of hydrothermal alteration minerals at the Qiucun gold deposit in southeastern China and focuses on characterization and mapping of the deposit using hyperspectral remote sensing.The deposit exhibits multistage fluid-rock interaction,as evidenced by systematic alteration assemblages,including silicification,sericitization by white micas,the development of argillaceous clays,variable chloritization,and locally significant carbonate alteration.We describe the genetic importance of such mineral groups and emphasize their diagnostic Visible and Near-Infrared to Short-Wave Infrared(VNIR-SWIR)spectral signatures,especially Al-OH,Mg-OH/Fe-OH,and CO3 absorption bands,which make it possible to distinguish between minerals,not to mention the fact that,in some instances,compositional trends may be predicted.This review’s methodological advances are discussed beginning with data collection at satellite,airborne,and ground levels,proceeding to processing procedures,such as atmospheric and topographic correction,and culminating in spectral analysis,including continuum removal,spectral matching,and unmixing/classification techniques.An integrated study of hyperspectral findings reveals that alteration minerals develop spatially coherent zones that are strongly controlled by fault/fracture structures and host-rock reactivity,producing proximal silicification/sericitization cores and larger silicified/larcenies of argillaceous rocks owing to diverse apex coverings of carbonate.This should be combined with petrography and geochemistry to address overprinting,mixed pixels,and surface weathering,and to couple mineral maps with ore-forming processes.The review finds that hyperspectral remote sensing offers a solid modeling platform for the deposit-scale alteration at Qiucun and other hydrothermal gold systems,and outlines the directions for future research to integrate quantitatively and more threedimensional alteration characterization.展开更多
Epithermal deposits are characterized by complex low-temperature hydrothermal alterations, but the links between mineralization and superimposed alteration are obscure and require further elucidation. This study emplo...Epithermal deposits are characterized by complex low-temperature hydrothermal alterations, but the links between mineralization and superimposed alteration are obscure and require further elucidation. This study employs shortwave infrared(SWIR) spectral scalars for alteration mineral mapping and three-dimensional modeling of the Ulan Uzhur Ag polymetallic deposit, a newly discovered epithermal deposit in the Qimantagh. Alteration zoning transitions from illitemuscovite-carbonate-pyrite in the core(Zone Ⅰ), through muscovite ± illite-kaolinite-chlorite-carbonate(Zone Ⅱ), to muscovite-chlorite-biotite(Zone Ⅲ) at the periphery. The Zone Ⅰ with mineralization features long-wavelength white mica(wAlOH > 2207 nm) with a high Illite Crystallinity(IC)(mean > 2.0), suggesting a relatively high-temperature environment conducive to mineralization. Petrographic analyses with fluid inclusion and IC curve characteristics suggests that fluid boiling may be a pivotal mechanism for mineral precipitation. Furthermore, surface mapping and deep threedimensional modeling of spectral characteristics reveal a correlation between long-wavelength white mica, high IC and mineralization zones. These findings indicate that SWIR spectroscopy reveal the evolution of fluids and provide valuable guidance for future exploration efforts.展开更多
Load frequency control(LFC)is a critical function to balance the power consumption and generation.Thegrid frequency is a crucial indicator for maintaining balance.However,the widely used information and communication ...Load frequency control(LFC)is a critical function to balance the power consumption and generation.Thegrid frequency is a crucial indicator for maintaining balance.However,the widely used information and communication infrastructure for LFC increases the risk of being attacked by malicious actors.The dynamic load altering attack(DLAA)is a typical attack that can destabilize the power system,causing the grid frequency to deviate fromits nominal value.Therefore,in this paper,we mathematically analyze the impact of DLAA on the stability of the grid frequency and propose the network parameter regulation(NPR)to mitigate the impact.To begin with,the dynamic LFC model is constructed by highlighting the importance of the network parameter.Then,we model the DLAA and analyze its impact on LFC using the theory of second-order dynamic systems.Finally,we model the NPR and prove its effect in mitigating the DLAA.Besides,we construct a least-effort NPR considering its infrastructure cost and aim to reduce the operation cost.Finally,we carry out extensive simulations to demonstrate the impact of the DLAA and evaluate the mitigation performance of NPR.The proposed cost-benefit NPR approach can not only mitigate the impact of DLAA with 100%and also save 41.18$/MWh in terms of the operation cost.展开更多
Endoscopic retrograde cholangiopancreatography(ERCP) remains challenging in patients who have undergone surgical reconstruction of the intestine.Recently,many studies have reported that balloonenteroscope-assisted ERC...Endoscopic retrograde cholangiopancreatography(ERCP) remains challenging in patients who have undergone surgical reconstruction of the intestine.Recently,many studies have reported that balloonenteroscope-assisted ERCP(BEA-ERCP) is a safe and effective procedure.However,further improvements in outcomes and the development of simplified procedures are required.Percutaneous treatment,Laparoscopy-assisted ERCP,endoscopic ultrasoundguided anterograde intervention,and open surgery are effective treatments.However,treatment should be noninvasive,effective,and safe.We believe that these procedures should be performed only in difficult-to-treat patients because of many potential complications.BEA-ERCP still requires high expertiselevel techniques and is far from a routinely performed procedure.Various techniques have been proposed to facilitate scope insertion(insertion with percutaneous transhepatic biliary drainage(PTBD) rendezvous technique,Short type single-balloon enteroscopes with passive bending section,Intraluminal injection of indigo carmine,CO2 inflation guidance),cannulation(PTBD or percutaneous transgallbladder drainage rendezvous technique,Dilation using screw drill,Rendezvous technique combining DBE with a cholangioscope,endoscopic ultrasound-guided rendezvous technique),and treatment(overtube-assisted technique,Short type balloon enteroscopes) during BEA-ERCP.The use of these techniques may allow treatment to be performed by BEA-ERCP in many patients.A standard procedure for ERCP yet to be established for patients with a reconstructed intestine.At present,BEA-ERCP is considered the safest and most effective procedure and is therefore likely to be recommended as firstline treatment.In this article,we discuss the current status of BEA-ERCP in patients with surgically altered gastrointestinal anatomy.展开更多
Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy must be performed by a highly experienced endoscopist.The challenges are accessing the afferent limb in different types o...Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy must be performed by a highly experienced endoscopist.The challenges are accessing the afferent limb in different types of reconstruction,cannulating a papilla with a reverse orientation,and performing therapeutic interventions with uncommon endoscopic accessories.The development of endoscopic techniques has led to higher success rates in this group of patients.Device-assisted ERCP is the endoscopic procedure of choice for high success rates in short-limb reconstruction;however,these success rate is lower in long-limb reconstruction.ERCP assisted by endoscopic ultrasonography is now popular because it can be performed independent of the limb length;however,it must be performed by a highly experienced and skilled endoscopist.Stent deployment and small stone removal can be performed immediately after ERCP assisted by endoscopic ultrasonography,but the second session is needed for other difficult procedures such as cholangioscopy-guided electrohydraulic lithotripsy.Laparoscopic-assisted ERCP has an almost 100%success rate in longlimb reconstruction because of the use of a conventional side-view duodenoscope,which is compatible with standard accessories.This requires cooperation between the surgeon and endoscopist and is suitable in urgent situations requiring concomitant cholecystectomy.This review focuses on the advantages,disadvantages,and outcomes of various procedures that are suitable in different situations and reconstruction types.Emerging new techniques and their outcomes are also discussed.展开更多
Endoscopic retrograde cholangiopancreatography(ERCP) in patients with surgically altered anatomy is challenging. Several operative interventions of both the gastrointestinal tract and the biliary and/or pancreatic sys...Endoscopic retrograde cholangiopancreatography(ERCP) in patients with surgically altered anatomy is challenging. Several operative interventions of both the gastrointestinal tract and the biliary and/or pancreatic system lead to altered anatomy, rendering ERCP more difficult or even impossible with a conventional side-viewing duodenoscope. Adapted endoscopes are avail-able to reach the biliopancreatic system and to perform ERCP in patients with altered anatomy. However, both technical difficulties and complications determine the procedure's success. Different technical approaches have been described and are highly dependent on local expertise and endoscopic equipment. Standard-ized practical guidelines are currently unavailable. This review focuses on the challenges encountered during ERCP in patients with altered anatomy and how to deal with them. The first challenge is reaching the papilla or the bilioenteric/pancreatoenteric anastomosis in the patient with postoperative altered anatomy. The sec-ond challenge is the cannulation of the biliopancreatic system and performing all conventional ERCP interven-tions and the third challenge is the control of possible complications. The available literature data on this topicis reviewed and illustrated with clinical cases.展开更多
The easternmost part of Southwest Indian Ridge（SWIR） has special crustal structure, magmatic and tectonic processes. Abyssal peridotite from the easternmost part of Southwest Indian Ridge（63.5oE/28oS） is serpentin...The easternmost part of Southwest Indian Ridge（SWIR） has special crustal structure, magmatic and tectonic processes. Abyssal peridotite from the easternmost part of Southwest Indian Ridge（63.5oE/28oS） is serpentinized spinel lherzolite. The accessory spinel has zoned texture, which was studied by petrography, electron probe micro-analysis（EPMA）, and backscattered electron（BSE） imaging to reconstruct the petrotectonic and hydrothermal metamorphic history of the host abyssal peridotite. The fresh core is magmatic Al-spinel with low Cr~#. The average extent of melting of the abyssal peridotite is about 5.9%. The composition of fresh magmatic spinel core indicates the studied area to be an anomalously thin crust with a melt-poor system. Hydrothermal reaction modifies the chemical composition of magmatic spinel. Ferritchromit is the first product forming the inner rim during pre-serpentinization. The abyssal ferritchromit crystalized as micro- to nano-sized particle with no triple grain boundary, indicating they crystalized in a rapid cooling process during hydrothermal alteration. Chemical compositions of ferritchromit indicate a hydrothermal metamorphism in amphibolite facies. Magnetite in the outer rim was formed by replacement of ferritchromit during syn- or post-serpentinization. Authigenic chlorites crystallized in two events：（1） after formation of ferritchromit crystallized as vein in fracture-zone near the core of spinel and （2） after formation of magnetite crystallized at outermost rim. They are different in compositions, indicating their formation temperature was about 289 oC and declined to 214 oC. These results show that the abyssal peridotite had undergone amphibolite to lower-greenschist facies hydrothermal events during pre- to syn-serpentinization or post-serpentinization.展开更多
Hydrocarbon micro-seepage can cause oxidation reduction reactions and produce altered minerals in surface sediments and soft. The typical altered minerals mapping by their diagnostic spectral features on hyper-spectra...Hydrocarbon micro-seepage can cause oxidation reduction reactions and produce altered minerals in surface sediments and soft. The typical altered minerals mapping by their diagnostic spectral features on hyper-spectral images is an important tool for the petroleum exploration industry. In this study, the airborne hyper-spectral data were used to investigate the altered minerals induced by hydrocarbon micro-seepages by spectral feature fitting （SFF） in the loess coverage area of Xifeng Oflfield. The results re- veal that the distribution region of the altered minerals induced by hydrocarbon micro-seepage is larger than the known oilfield exploration area. The potential hydrocarbon micro-seepage region was also re- vealed by the distribution of altered minerals besides the known hydrocarbon area. A fast index was pro- posed by the absorption depths of clay and carbonate minerals for assessment of hydrocarbon micro- seepage. And it gave much clearer boundaries for the hydrocarbon micro-seepage in the loess coverage area than those by the altered mineral mapping. In addition, some field samples were analyzed by X-ray diffrac- tion （XRD） and atomic absorption spectrophotometer to validate the results. Within the extents of hydro- carbon micro-seepage, there are lower contents of ferric iron and higher contents of carbonate minerals in these samples. Therefore, it is satisfactory to have the airborne hyper-spectral data to outline the extents of hydrocarbon micro-seepage for further hydrocarbon exploration in the loess coverage area.展开更多
BACKGROUND Intravascular large B-cell lymphoma(IVLBCL)is a rare and aggressive subtype of non-Hodgkin lymphoma with a varied presentation and no pathognomonic findings.Early diagnosis is critical to altering the disea...BACKGROUND Intravascular large B-cell lymphoma(IVLBCL)is a rare and aggressive subtype of non-Hodgkin lymphoma with a varied presentation and no pathognomonic findings.Early diagnosis is critical to altering the disease course as early treatment with chemoimmunotherapy is required to prevent a rapidly fatal outcome.Strategies including improved awareness of this clinical entity through publication of cases with unique presentations are essential to prompt consideration of IVLBCL early in the disease workup.Here,we present a case of IVLBCL presenting with altered mental status and systemic organ dysfunction.CASE SUMMARY A 61-year-old male patient presented with flu-like symptoms and a high fever.He experienced rapid clinical deterioration with liver,kidney failure,and shock despite rapid antibiotic administration and supportive care.A broad infectious workup was negative.Intracranial imaging revealed nonspecific changes to the corpus callosum suspicious for vasculitis.Renal biopsy was non-diagnostic.After further progression of his symptoms,the family elected to withdraw care and the patient died shortly thereafter.Post-mortem analysis revealed clear multi-organ involvement by IVLBCL,prompting re-examination of the ante-mortem renal biopsy that also identified IVLBCL involvement.CONCLUSION IVLBCL is a rare disease.Communication with specialties and early biopsy is critical to establishing the diagnosis and initiating therapy.展开更多
The alteration types of the large-scale Tsagaan Suvarga Cu-Mo porphyry deposit mostly comprise stockwork silicification, argillization, quartz-sericite alteration, K-silicate alteration, and propylitization. The miner...The alteration types of the large-scale Tsagaan Suvarga Cu-Mo porphyry deposit mostly comprise stockwork silicification, argillization, quartz-sericite alteration, K-silicate alteration, and propylitization. The mineralized and altered zones from hydrothermal metallogenic center to the outside successively are Cu-bearing stockwork silicification zone, Cu-beating argillized zone, Cu-Mo-bearing quartz-sericite alteration zone, Cu-Mo-bearing K-silicate alteration zone, and pro- pylitization zone. The K-silicate alteration occurred in the early phase, quartz-sericite alteration in the medium phase, and argillization and carbonatization （calcite） in the later phase. Ore-bearing-altered rocks are significantly controlled by the structure and fissure zones of different scales, and NE- and NW-trending fissure zones could probably be the migration pathways of the porphyry hydrothermal system. Results in this study indicated that the less the concentrations of REE, LREE, and HREE and the more the extensive fractionation between LREE and HREE, the closer it is to the center circulatory hydrothermal ore-forming and the more extensive silicification. The exponential relationship between the fractionation of LREE and HREE and the intensity of silicification and K-silicate alteration was found in the Cu-Mo deposit studied. The negative Eu anomaly, normal Eu, positive Eu anomaly and obviously positive Eu anomaly are coincident with the enhancement of Na2O and K2O concentrations gradually, which indicated that Eu anomaly would be significantly controlled by the alkaline metasomatism of the circulatory hydrothermal ore-forming system. Therefore, such characteristics as the positive Eu anomaly, the obvious fractionation between LREE and HREE and their related special alteration lithofacies are suggested to be metallogenic prognostic and exploration indications for Tsagaan Suvarga-style porphyry Cu-Mo deposits in Mongolia and China.展开更多
BACKGROUND： Altered mental status （AMS） is a very common emergency case, but the exact etiology of many AMS patients is unknown. Patients often manifest vague symptoms, thus, AMS diagnosis and treatment are highly ...BACKGROUND： Altered mental status （AMS） is a very common emergency case, but the exact etiology of many AMS patients is unknown. Patients often manifest vague symptoms, thus, AMS diagnosis and treatment are highly challenging for emergency physicians. The aim of this study is to provide a framework for the assessment of AMS patients. This assessment should allow providers to better understand the etiology of mental status changes and therefore improve diagnostic skills and management.METHODS： This is a prospective cohort observational study. We recruited all adult patients with undifferentiated AMS at a single center tertiary care academic emergency department over 24 months （June 2009 to June 2011）. Demographic characteristics, clinical manifestations, assessment approaches, causative factors, emergency treatments and outcomes were collected prospectively.RESULTS： In 1934 patients with AMS recruited, accounting for 0.93% of all emergency department （ED） patients, 1 026 （53.1%） were male, and 908 （46.9%） female. Their average age was 51.95±15.71 years. Etiologic factors were neurological （n=641; 35.0%）, pharmacological and toxicological （n=421; 23.0%）, systemic and organic （n=266; 14.5%）, infectious （n=167; 9.1%）, endocrine/metabolic （n=145; 7.9%）, psychiatric （n=71; 3.9%）, traumatic （n=38; 2.1%）, and gynecologic and obstetric （n=35; 1.9%）. Total mortality rate was 8.1% （n=156）. The death rate was higher in elderly patients （≥60） than in younger patients （10.8% vs. 6.9%, P=-0.003）.CONCLUSION： Patients with AMS pose a challenge for ED physicians. The most frequently encountered diagnostic categories causing AMS were primary CNS disorders, intoxication, organ system dysfunction, and endocrine/metabolic diseases. AMS has a high fatality rate in the ED. AMS is an important warning signal for ED patients because of its potentially fatal and reversible effects. Prompt evaluation and treatment are essential to decreasing morbidity and mortality associated with AMS.展开更多
Petrography and geochemistry of the altered and unaltered host rocks surrounding the Koktokay No.3 pegmatite revealed that the unaltered amphibolite is mainly composed of hornblende, plagioclase, and ilmenite.Beyond t...Petrography and geochemistry of the altered and unaltered host rocks surrounding the Koktokay No.3 pegmatite revealed that the unaltered amphibolite is mainly composed of hornblende, plagioclase, and ilmenite.Beyond these primary components, the altered host rocks contain a few newly formed minerals, including biotite,tourmaline, chlorine, and muscovite. The alteration zone surrounding the Koktokay No.3 pegmatite is limited to 2.0 m, characterized by biotitization, tourmalization, and chloritization. In the altered host rocks, the contents of SiO2, MgO, MnO, Na2O, and TiO2 did not vary greatly.However, Al2O3 showed a weak decreasing trend with the increasing distance from the pegmatite contact zone, while Fe2O3 and CaO showed an increasing trend. The contents of Li, Rb, and Cs in the altered host rocks were much higher than those in the unaltered host rocks, decreasing with distance from the contact. The chondrite-normalized rare earth element（REE） pattern of the altered and unaltered host rock was right-inclined from La to Lu, but enriched in light REEs over heavy REEs after hydrothermal alteration. An isocon plot shows that some oxides migrated in with an order of P2O5〉K2O 〉TiO2〉Al2O3〉SiO2〉MnO≥MgO, while others migrated out with an order of Na2O 〉CaO 〉Fe2O3. For REEs, the migration ratios are positive values withCs 〉Rb 〉Li 〉Nb 〉Ta 〉Be, signifying that all REEs migrated from the exsolved magmatic fluid into the altered host rocks. It was concluded that diffusion was the only mechanism for migration of ore-forming elements in the alteration zone. The effective diffusion coefficients（Deff）of LiF, RbF, and CsF were estimated under a fluid temperature of 500–550℃. Using a function of concentration（C（x,t）） and distance（x）, the order of migration distance was determined to be LiF 〉CsF 〉RbF, with diffusion times of （3.39 ± 0.35）× 10^6,（3.19 ± 0.28） × 10^5 and（6.33 ± 0.05） × 10^5 years, respectively.展开更多
Background Palpitation is a common complaint in generalised anxiety disorder(GAD).Brain imaging studies have Investigated the neural mechanism of heartbeat perception in healthy volunteers.This study explored the neur...Background Palpitation is a common complaint in generalised anxiety disorder(GAD).Brain imaging studies have Investigated the neural mechanism of heartbeat perception in healthy volunteers.This study explored the neuroanatomical differences of altered heartbeat perception in patients with GAD using structural MRI.Aims Based on the strong somatic-interoceptive symptoms in GAD,we explored the regional structural brain abnormalities involved in heartbeat perception in patients with GAD.Methods This study was applied to the a priori regions using neuroanatomical theories of heartbeat perception,including the insula,anterior cingulate cortex,supplementary motor area and prefrontal cortex.A total of 19 patients with GAD and 19 healthy control subjects were enrolled.We used the FMRIB Software Library voxel-based morphometry software for estimating the grey matter volume of these regions of interest and analysed the correlation between heartbeat perception sensitivity and the volume of abnormal grey matter.Results Patients with GAD showed a significantly decreased volume of grey matter in their left medial prefrontal cortex,right orbital frontal cortex and anterior cingulate cortex.The grey matter volume of the left medial prefrontal cortex negatively correlated with heartbeat perception sensitivity in patients with GAD.Conclusions It should be the first study that shows heartbeat perception is associated with brain structure in GAD.Our findings suggest that the frontal region may play an important role in aberrant heartbeat perception processing in patients with GAD,and this may be an underlying mechanism resulting in the abnormal cardiovascular complaints in GAD.This is hypothesised as a'top-down'deficiency,especially in the medial prefrontal cortex.This will provide the foundation for a more targeted region for neuromodulation intervention in the future.展开更多
In recent years,the close relationship between uranium and Ti-Fe oxides in the sandstonetype uranium deposits has been extensively recognized.However,the altered characteristics of ilmenite and its relationship with u...In recent years,the close relationship between uranium and Ti-Fe oxides in the sandstonetype uranium deposits has been extensively recognized.However,the altered characteristics of ilmenite and its relationship with uranium enrichment still remain unclear.With this paper based on heavymineral sorting of uranium ore selected from the Tarangaole-Nalinggou deposit in the northeastern Ordos Basin,electron probe,backscattering image,energy spectrum and scanning electron microscopy were systematically performed.The ilmenite in the sandstone can be divided into four groups,including unaltered,weakly altered,moderately altered,and strongly altered ilmenite.The alteration of ilmenite in uranium ores is notably more intense than that of the surrounding rocks.In addition,weakly,moderately,and strongly altered ilmenite associated with uranium minerals in uranium ores demonstrate that the more intensity ilmenite altered,the closer its relationship with uranium minerals is.The ilmenite has likely been somewhat altered before mineralization,and the alteration intensifies by later exposure related to an oxygencontaining fluid.The alteration mechanism comprises a process of competitive diffusion between Fe^(2+)and O_(2)-ions.In the early stage,Fe ions was mainly diffused on the particle surface.Subsequently,diffusion of O ions into the particles began to be dominate.Most of the leached iron is stripped or carried away by fluid.In an alkaline and reductive environment,the remaining iron is reduced to form the surrounding pyrite,and TiO_(2)in a form of titanium sol recrystallizes(i.e.,anatase).Backscattering images show that uranium and altered ilmenite are close in space.Coffinite is often distributed along the edges of altered ilmenite as burrs in shape.Colloidal or knitted coffinite associated with anatase is formed in the voids of altered ilmenite.The chemical composition of altered ilmenite varies considerably from the core to edge,and the mineral assemblage sequence is from girdle with ilmenite,to leucosphenite,to anatase,and to coffinite.There is no brannerite that is symbiotic with altered ilmenite.It is considered to be a uranium-containing titanium mineral aggregate caused by the reduction and adsorption of uranium.As the altered product of ilmenite,TiO_(2)is an aggregation agent,increasing the concentration of uranium by adsorption.Together with Fe^(2+)and S_(2)-in secondary pyrite,this aggregate creates a uranium-rich environment in the microzone for the formation of coffinite.Therefore,the alteration of ilmenite plays a geochemical role in the processes of sedimentary,diagenesis and mineralization,in which Fe is removed,Ti is enriched,and U is adsorbed and reduced.展开更多
AIM: To investigate the clinical and pathological significance of altered retinoblastoma (Rb) encoding protein (pRb) in gastric carcinoma. METHODS: Expression of altered pRb was analyzed in 91 patients with gastric ad...AIM: To investigate the clinical and pathological significance of altered retinoblastoma (Rb) encoding protein (pRb) in gastric carcinoma. METHODS: Expression of altered pRb was analyzed in 91 patients with gastric adenocarcinoma by immunohistochemistry. RESULTS: Sixty-five percent (59/91) of the tumors were positively stained and the staining in tumor nuclei of gastric carcinoma ranged 0%-90%. Moreover, strong expression of altered pRb was found in 35% (6/17), 24% (5/21), 17% (8/46) and 0% (0/7) of T1, T2, T3 and T4 gastric carcinomas, respectively. altered pRb expression was inversely correlated with the depth of tumor invasion (P = 0.047). Degree of immunoreactivity had no significant correlation with tumor grade, node metastasis and distant metastasis. In terms of prognostic significance, univariate analysis showed that poor differentiation [41 (66.1%) vs 34 (42.5%) P = 0.051], advanced tumor stage (P < 0.001) and weakly altered pRb expression [17 (80.5%) vs 58 (49.6%) P = 0.044] were associated with worse prognosis in these patients. However, multivariate analysis revealed that advanced tumor stage was the only independent poor prognostic factor (P < 0.001). CONCLUSION: The mutation of Rb gene is frequent in gastric carcinoma. The expression of altered pRb inversely correlates with tumor invasion and is not an independent prognostic marker in gastric adenocarcinoma.展开更多
Dear Editor Despite remarkable advances in our understanding of brain functions,the neural substrates and correlates of consciousness remain unclear[1].It has been argued that classical physics is intrinsically incapa...Dear Editor Despite remarkable advances in our understanding of brain functions,the neural substrates and correlates of consciousness remain unclear[1].It has been argued that classical physics is intrinsically incapable of explaining the holistic aspects of consciousness.展开更多
文摘Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy remains a challenging field in therapeutic endoscopy due to the complex anatomical reconstructions that limit access to the biliary tree.Over the past two decades,device-assisted enteroscopy(DAE),including singleballoon,double-balloon,and motorized spiral enteroscopy,has expanded the feasibility of ERCP in this population,with overall technical success rates generally reported between 70%and 90%.Nevertheless,these techniques are technically demanding,time-consuming,and frequently affected by limited reach and unstable positioning.More recently,interventional endoscopic ultrasound(EUS)-guided procedures have emerged as highly effective alternatives,significantly improving clinical outcomes in selected patients,particularly in those with long-limb Roux-en-Y reconstructions where conventional methods are less effective.Percutaneous transhepatic biliary drainage continues to represent a valuable salvage option when endoscopic approaches fail,though it is associated with a greater burden of reinterventions and adverse events.This minireview provides a comprehensive overview of the main endoscopic strategies for biliary drainage in altered anatomy,focusing on technical considerations,efficacy,and safety profiles of DAE-assisted ERCP,EUS-guided interventions,and motorized systems.The evolving landscape of biliary drainage in this setting highlights the need for tailored treatment strategies,multidisciplinary collaboration,referral to high-volume centers,and further prospective studies to refine patient selection and optimize clinical outcomes.
基金the National Key Research and Development Project of China(No.2019YFC1509704)the National Natural Science Foundation of China(Nos.U1704243,41741019,41977249 and 42090052)+2 种基金the Henan Province Science and Technology Research Project(Nos.192102310006,232102320035)the Innovation Fund for Doctoral Students of North China University of Water Resources and Electric Power(No.NCWUBC202313)the Key Research Project Plan for Higher Education Institutions in Henan Province(No.24A410003).
文摘Altered rock,often encountered in major engineering projects,can seriously affect the stability of rocks and slopes surrounding deeply buried tunnels.This study addressed the alteration mechanism,alteration degree classification,and mechanical parameters of altered rock in engineering project areas using field testing,thin slice identification,X-ray diffraction,and major element testing.Results showed that the altered rock types in the areas of the Pingjiang Pumped Storage Power Station,Hunan Province,and a diversion tunnel in northern Xinjiang Uygur Autonomous Region include biotite granodiorite,biotite monzogranite,and cataclastic granite,and that the main alteration mechanisms are chloritization of biotite and clayization of feldspar minerals.The altered rocks were classified as slightly,moderately,or strongly altered according to their apparent characteristics,rebound value,longitudinal wave velocity,metamorphic mineral content,and porosity.The bulk density,elastic modulus,cohesion,and internal friction angle(Poisson’s ratio)of the altered rocks decreased(increased)with increase in the degree of alteration.Numerical simulations showed that in altered rock slope areas,the zone of strong rock alteration and the moderate-strong alteration contact zone exhibit locally large deformations that represent a certain hazard to engineering projects.These results provide valuable guidance and support for major projects in altered rock areas.
基金Supported by Department of Science and Technology of Liaoning Province,No.2024JH2/102600288 and No.2022JH2/101500013。
文摘BACKGROUND Performing endoscopic retrograde cholangiopancreatography(ERCP)in pati-ents with surgically altered gastrointestinal anatomy poses significant challenges.Double-balloon enteroscopy-assisted ERCP(DBE-ERCP)has emerged as a safe and effective approach in this patient population.This study aims to provide an updated systematic review and meta-analysis of the safety and efficacy of DBEERCP in patients with surgically altered anatomy(SAA),building on previously published evidence.AIM To evaluate the safety and efficacy of DBE-ERCP in patients with SAA through an updated systematic review and meta-analysis and to compare outcomes between short-and long-scope double-balloon enteroscopy(DBE).METHODS A comprehensive search of PubMed,EMBASE,and Web of Science was performed for studies published up to March 2025 investigating DBE-ERCP in patients with surgically altered gastrointestinal anatomy.A random-effects model was applied to conduct a meta-analysis of proportions.The risk of bias was evaluated using the Newcastle-Ottawa Scale and the Joanna Briggs Institute Scale.Heterogeneity was evaluated using the inconsistency statistic(I2).Publication bias was examined using funnel plots and Egger’s regression test.RESULTS A total of 40 studies were included,comprising 10 cohort studies and 30 case series,including 2689 patients who underwent 3478 procedures.The surgical procedures were primarily classified into three categories:Roux-en-Y reconstruction(including hepaticojejunostomy,gastric bypass,and choledochojejunostomy,etc.)in 1156 cases;pancreaticoduodenectomy(performed using either the Whipple or Child technique)in 549 cases;and Billroth II anastomosis in 265 cases.The combined success rate for reaching the papilla was 92%(95%CI:89%-95%).The overall enteroscopy success rate was 89%(95%CI:85%-92%).The pooled diagnostic success rate was 90%(95%CI:85%-95%),while the therapeutic success rate reached 92%(95%CI:89%-95%).Adverse events reported in 5.7%of patients(95%CI:4.1%-7.5%).Subgroup analysis comparing short-scope and long-scope demonstrated that the short DBE was superior in terms of papilla reached rate,enteroscopy success,and procedural success.No significant differences were observed between groups in diagnostic success or adverse events.CONCLUSION DBE-ERCP demonstrates both safety and efficacy in patients with SAA.Compared to long-scope DBE,short-scope DBE shows greater clinical promise;however,further randomized controlled trials are warranted to validate these findings.
基金supported by the Jiangsu Province Frontier Leading Technology Basic Research Special Project-Research on the New Optoelectronic Imaging and Information Processing Basic Theory and Method(No:BK20192003).
文摘This review summarizes studies of hydrothermal alteration minerals at the Qiucun gold deposit in southeastern China and focuses on characterization and mapping of the deposit using hyperspectral remote sensing.The deposit exhibits multistage fluid-rock interaction,as evidenced by systematic alteration assemblages,including silicification,sericitization by white micas,the development of argillaceous clays,variable chloritization,and locally significant carbonate alteration.We describe the genetic importance of such mineral groups and emphasize their diagnostic Visible and Near-Infrared to Short-Wave Infrared(VNIR-SWIR)spectral signatures,especially Al-OH,Mg-OH/Fe-OH,and CO3 absorption bands,which make it possible to distinguish between minerals,not to mention the fact that,in some instances,compositional trends may be predicted.This review’s methodological advances are discussed beginning with data collection at satellite,airborne,and ground levels,proceeding to processing procedures,such as atmospheric and topographic correction,and culminating in spectral analysis,including continuum removal,spectral matching,and unmixing/classification techniques.An integrated study of hyperspectral findings reveals that alteration minerals develop spatially coherent zones that are strongly controlled by fault/fracture structures and host-rock reactivity,producing proximal silicification/sericitization cores and larger silicified/larcenies of argillaceous rocks owing to diverse apex coverings of carbonate.This should be combined with petrography and geochemistry to address overprinting,mixed pixels,and surface weathering,and to couple mineral maps with ore-forming processes.The review finds that hyperspectral remote sensing offers a solid modeling platform for the deposit-scale alteration at Qiucun and other hydrothermal gold systems,and outlines the directions for future research to integrate quantitatively and more threedimensional alteration characterization.
基金supported by the Natural Science Foundation of China(Grant No.42372346,41802080,42030809,41873043).
文摘Epithermal deposits are characterized by complex low-temperature hydrothermal alterations, but the links between mineralization and superimposed alteration are obscure and require further elucidation. This study employs shortwave infrared(SWIR) spectral scalars for alteration mineral mapping and three-dimensional modeling of the Ulan Uzhur Ag polymetallic deposit, a newly discovered epithermal deposit in the Qimantagh. Alteration zoning transitions from illitemuscovite-carbonate-pyrite in the core(Zone Ⅰ), through muscovite ± illite-kaolinite-chlorite-carbonate(Zone Ⅱ), to muscovite-chlorite-biotite(Zone Ⅲ) at the periphery. The Zone Ⅰ with mineralization features long-wavelength white mica(wAlOH > 2207 nm) with a high Illite Crystallinity(IC)(mean > 2.0), suggesting a relatively high-temperature environment conducive to mineralization. Petrographic analyses with fluid inclusion and IC curve characteristics suggests that fluid boiling may be a pivotal mechanism for mineral precipitation. Furthermore, surface mapping and deep threedimensional modeling of spectral characteristics reveal a correlation between long-wavelength white mica, high IC and mineralization zones. These findings indicate that SWIR spectroscopy reveal the evolution of fluids and provide valuable guidance for future exploration efforts.
基金supported by the project Major Scientific and Technological Special Project of Guizhou Province([2024]014).
文摘Load frequency control(LFC)is a critical function to balance the power consumption and generation.Thegrid frequency is a crucial indicator for maintaining balance.However,the widely used information and communication infrastructure for LFC increases the risk of being attacked by malicious actors.The dynamic load altering attack(DLAA)is a typical attack that can destabilize the power system,causing the grid frequency to deviate fromits nominal value.Therefore,in this paper,we mathematically analyze the impact of DLAA on the stability of the grid frequency and propose the network parameter regulation(NPR)to mitigate the impact.To begin with,the dynamic LFC model is constructed by highlighting the importance of the network parameter.Then,we model the DLAA and analyze its impact on LFC using the theory of second-order dynamic systems.Finally,we model the NPR and prove its effect in mitigating the DLAA.Besides,we construct a least-effort NPR considering its infrastructure cost and aim to reduce the operation cost.Finally,we carry out extensive simulations to demonstrate the impact of the DLAA and evaluate the mitigation performance of NPR.The proposed cost-benefit NPR approach can not only mitigate the impact of DLAA with 100%and also save 41.18$/MWh in terms of the operation cost.
文摘Endoscopic retrograde cholangiopancreatography(ERCP) remains challenging in patients who have undergone surgical reconstruction of the intestine.Recently,many studies have reported that balloonenteroscope-assisted ERCP(BEA-ERCP) is a safe and effective procedure.However,further improvements in outcomes and the development of simplified procedures are required.Percutaneous treatment,Laparoscopy-assisted ERCP,endoscopic ultrasoundguided anterograde intervention,and open surgery are effective treatments.However,treatment should be noninvasive,effective,and safe.We believe that these procedures should be performed only in difficult-to-treat patients because of many potential complications.BEA-ERCP still requires high expertiselevel techniques and is far from a routinely performed procedure.Various techniques have been proposed to facilitate scope insertion(insertion with percutaneous transhepatic biliary drainage(PTBD) rendezvous technique,Short type single-balloon enteroscopes with passive bending section,Intraluminal injection of indigo carmine,CO2 inflation guidance),cannulation(PTBD or percutaneous transgallbladder drainage rendezvous technique,Dilation using screw drill,Rendezvous technique combining DBE with a cholangioscope,endoscopic ultrasound-guided rendezvous technique),and treatment(overtube-assisted technique,Short type balloon enteroscopes) during BEA-ERCP.The use of these techniques may allow treatment to be performed by BEA-ERCP in many patients.A standard procedure for ERCP yet to be established for patients with a reconstructed intestine.At present,BEA-ERCP is considered the safest and most effective procedure and is therefore likely to be recommended as firstline treatment.In this article,we discuss the current status of BEA-ERCP in patients with surgically altered gastrointestinal anatomy.
文摘Endoscopic retrograde cholangiopancreatography(ERCP)in patients with surgically altered anatomy must be performed by a highly experienced endoscopist.The challenges are accessing the afferent limb in different types of reconstruction,cannulating a papilla with a reverse orientation,and performing therapeutic interventions with uncommon endoscopic accessories.The development of endoscopic techniques has led to higher success rates in this group of patients.Device-assisted ERCP is the endoscopic procedure of choice for high success rates in short-limb reconstruction;however,these success rate is lower in long-limb reconstruction.ERCP assisted by endoscopic ultrasonography is now popular because it can be performed independent of the limb length;however,it must be performed by a highly experienced and skilled endoscopist.Stent deployment and small stone removal can be performed immediately after ERCP assisted by endoscopic ultrasonography,but the second session is needed for other difficult procedures such as cholangioscopy-guided electrohydraulic lithotripsy.Laparoscopic-assisted ERCP has an almost 100%success rate in longlimb reconstruction because of the use of a conventional side-view duodenoscope,which is compatible with standard accessories.This requires cooperation between the surgeon and endoscopist and is suitable in urgent situations requiring concomitant cholecystectomy.This review focuses on the advantages,disadvantages,and outcomes of various procedures that are suitable in different situations and reconstruction types.Emerging new techniques and their outcomes are also discussed.
文摘Endoscopic retrograde cholangiopancreatography(ERCP) in patients with surgically altered anatomy is challenging. Several operative interventions of both the gastrointestinal tract and the biliary and/or pancreatic system lead to altered anatomy, rendering ERCP more difficult or even impossible with a conventional side-viewing duodenoscope. Adapted endoscopes are avail-able to reach the biliopancreatic system and to perform ERCP in patients with altered anatomy. However, both technical difficulties and complications determine the procedure's success. Different technical approaches have been described and are highly dependent on local expertise and endoscopic equipment. Standard-ized practical guidelines are currently unavailable. This review focuses on the challenges encountered during ERCP in patients with altered anatomy and how to deal with them. The first challenge is reaching the papilla or the bilioenteric/pancreatoenteric anastomosis in the patient with postoperative altered anatomy. The sec-ond challenge is the cannulation of the biliopancreatic system and performing all conventional ERCP interven-tions and the third challenge is the control of possible complications. The available literature data on this topicis reviewed and illustrated with clinical cases.
基金supported by the National Natural Science Foundation of China (No. 41172050)the Special Fund for Basic Scientific Research of Central Universities, China University of Geosciences (Wuhan)the China Postdoctoral Science Foundation
文摘The easternmost part of Southwest Indian Ridge（SWIR） has special crustal structure, magmatic and tectonic processes. Abyssal peridotite from the easternmost part of Southwest Indian Ridge（63.5oE/28oS） is serpentinized spinel lherzolite. The accessory spinel has zoned texture, which was studied by petrography, electron probe micro-analysis（EPMA）, and backscattered electron（BSE） imaging to reconstruct the petrotectonic and hydrothermal metamorphic history of the host abyssal peridotite. The fresh core is magmatic Al-spinel with low Cr~#. The average extent of melting of the abyssal peridotite is about 5.9%. The composition of fresh magmatic spinel core indicates the studied area to be an anomalously thin crust with a melt-poor system. Hydrothermal reaction modifies the chemical composition of magmatic spinel. Ferritchromit is the first product forming the inner rim during pre-serpentinization. The abyssal ferritchromit crystalized as micro- to nano-sized particle with no triple grain boundary, indicating they crystalized in a rapid cooling process during hydrothermal alteration. Chemical compositions of ferritchromit indicate a hydrothermal metamorphism in amphibolite facies. Magnetite in the outer rim was formed by replacement of ferritchromit during syn- or post-serpentinization. Authigenic chlorites crystallized in two events：（1） after formation of ferritchromit crystallized as vein in fracture-zone near the core of spinel and （2） after formation of magnetite crystallized at outermost rim. They are different in compositions, indicating their formation temperature was about 289 oC and declined to 214 oC. These results show that the abyssal peridotite had undergone amphibolite to lower-greenschist facies hydrothermal events during pre- to syn-serpentinization or post-serpentinization.
基金supported by the National High Technology Research and Development Program of China(No.2012AA12A308)China Geological Surveys(No.1212011087112)
文摘Hydrocarbon micro-seepage can cause oxidation reduction reactions and produce altered minerals in surface sediments and soft. The typical altered minerals mapping by their diagnostic spectral features on hyper-spectral images is an important tool for the petroleum exploration industry. In this study, the airborne hyper-spectral data were used to investigate the altered minerals induced by hydrocarbon micro-seepages by spectral feature fitting （SFF） in the loess coverage area of Xifeng Oflfield. The results re- veal that the distribution region of the altered minerals induced by hydrocarbon micro-seepage is larger than the known oilfield exploration area. The potential hydrocarbon micro-seepage region was also re- vealed by the distribution of altered minerals besides the known hydrocarbon area. A fast index was pro- posed by the absorption depths of clay and carbonate minerals for assessment of hydrocarbon micro- seepage. And it gave much clearer boundaries for the hydrocarbon micro-seepage in the loess coverage area than those by the altered mineral mapping. In addition, some field samples were analyzed by X-ray diffrac- tion （XRD） and atomic absorption spectrophotometer to validate the results. Within the extents of hydro- carbon micro-seepage, there are lower contents of ferric iron and higher contents of carbonate minerals in these samples. Therefore, it is satisfactory to have the airborne hyper-spectral data to outline the extents of hydrocarbon micro-seepage for further hydrocarbon exploration in the loess coverage area.
文摘BACKGROUND Intravascular large B-cell lymphoma(IVLBCL)is a rare and aggressive subtype of non-Hodgkin lymphoma with a varied presentation and no pathognomonic findings.Early diagnosis is critical to altering the disease course as early treatment with chemoimmunotherapy is required to prevent a rapidly fatal outcome.Strategies including improved awareness of this clinical entity through publication of cases with unique presentations are essential to prompt consideration of IVLBCL early in the disease workup.Here,we present a case of IVLBCL presenting with altered mental status and systemic organ dysfunction.CASE SUMMARY A 61-year-old male patient presented with flu-like symptoms and a high fever.He experienced rapid clinical deterioration with liver,kidney failure,and shock despite rapid antibiotic administration and supportive care.A broad infectious workup was negative.Intracranial imaging revealed nonspecific changes to the corpus callosum suspicious for vasculitis.Renal biopsy was non-diagnostic.After further progression of his symptoms,the family elected to withdraw care and the patient died shortly thereafter.Post-mortem analysis revealed clear multi-organ involvement by IVLBCL,prompting re-examination of the ante-mortem renal biopsy that also identified IVLBCL involvement.CONCLUSION IVLBCL is a rare disease.Communication with specialties and early biopsy is critical to establishing the diagnosis and initiating therapy.
基金Project supported by Chinese State Key Project on Fundamental Research Planning (2007CB411304) Open Project of StateKey Laboratory of Deposit Geochemistry of Institute of Geochemistry, Chinese Academy of Sciences
文摘The alteration types of the large-scale Tsagaan Suvarga Cu-Mo porphyry deposit mostly comprise stockwork silicification, argillization, quartz-sericite alteration, K-silicate alteration, and propylitization. The mineralized and altered zones from hydrothermal metallogenic center to the outside successively are Cu-bearing stockwork silicification zone, Cu-beating argillized zone, Cu-Mo-bearing quartz-sericite alteration zone, Cu-Mo-bearing K-silicate alteration zone, and pro- pylitization zone. The K-silicate alteration occurred in the early phase, quartz-sericite alteration in the medium phase, and argillization and carbonatization （calcite） in the later phase. Ore-bearing-altered rocks are significantly controlled by the structure and fissure zones of different scales, and NE- and NW-trending fissure zones could probably be the migration pathways of the porphyry hydrothermal system. Results in this study indicated that the less the concentrations of REE, LREE, and HREE and the more the extensive fractionation between LREE and HREE, the closer it is to the center circulatory hydrothermal ore-forming and the more extensive silicification. The exponential relationship between the fractionation of LREE and HREE and the intensity of silicification and K-silicate alteration was found in the Cu-Mo deposit studied. The negative Eu anomaly, normal Eu, positive Eu anomaly and obviously positive Eu anomaly are coincident with the enhancement of Na2O and K2O concentrations gradually, which indicated that Eu anomaly would be significantly controlled by the alkaline metasomatism of the circulatory hydrothermal ore-forming system. Therefore, such characteristics as the positive Eu anomaly, the obvious fractionation between LREE and HREE and their related special alteration lithofacies are suggested to be metallogenic prognostic and exploration indications for Tsagaan Suvarga-style porphyry Cu-Mo deposits in Mongolia and China.
文摘BACKGROUND： Altered mental status （AMS） is a very common emergency case, but the exact etiology of many AMS patients is unknown. Patients often manifest vague symptoms, thus, AMS diagnosis and treatment are highly challenging for emergency physicians. The aim of this study is to provide a framework for the assessment of AMS patients. This assessment should allow providers to better understand the etiology of mental status changes and therefore improve diagnostic skills and management.METHODS： This is a prospective cohort observational study. We recruited all adult patients with undifferentiated AMS at a single center tertiary care academic emergency department over 24 months （June 2009 to June 2011）. Demographic characteristics, clinical manifestations, assessment approaches, causative factors, emergency treatments and outcomes were collected prospectively.RESULTS： In 1934 patients with AMS recruited, accounting for 0.93% of all emergency department （ED） patients, 1 026 （53.1%） were male, and 908 （46.9%） female. Their average age was 51.95±15.71 years. Etiologic factors were neurological （n=641; 35.0%）, pharmacological and toxicological （n=421; 23.0%）, systemic and organic （n=266; 14.5%）, infectious （n=167; 9.1%）, endocrine/metabolic （n=145; 7.9%）, psychiatric （n=71; 3.9%）, traumatic （n=38; 2.1%）, and gynecologic and obstetric （n=35; 1.9%）. Total mortality rate was 8.1% （n=156）. The death rate was higher in elderly patients （≥60） than in younger patients （10.8% vs. 6.9%, P=-0.003）.CONCLUSION： Patients with AMS pose a challenge for ED physicians. The most frequently encountered diagnostic categories causing AMS were primary CNS disorders, intoxication, organ system dysfunction, and endocrine/metabolic diseases. AMS has a high fatality rate in the ED. AMS is an important warning signal for ED patients because of its potentially fatal and reversible effects. Prompt evaluation and treatment are essential to decreasing morbidity and mortality associated with AMS.
基金supported jointly by the Natural Science Foundation of China (Grant No.41372104)Research Project of Xinjiang Nonferrous Metals Industry (Group) Co.,Ltd.(Grant No.YSKY2011-02)
文摘Petrography and geochemistry of the altered and unaltered host rocks surrounding the Koktokay No.3 pegmatite revealed that the unaltered amphibolite is mainly composed of hornblende, plagioclase, and ilmenite.Beyond these primary components, the altered host rocks contain a few newly formed minerals, including biotite,tourmaline, chlorine, and muscovite. The alteration zone surrounding the Koktokay No.3 pegmatite is limited to 2.0 m, characterized by biotitization, tourmalization, and chloritization. In the altered host rocks, the contents of SiO2, MgO, MnO, Na2O, and TiO2 did not vary greatly.However, Al2O3 showed a weak decreasing trend with the increasing distance from the pegmatite contact zone, while Fe2O3 and CaO showed an increasing trend. The contents of Li, Rb, and Cs in the altered host rocks were much higher than those in the unaltered host rocks, decreasing with distance from the contact. The chondrite-normalized rare earth element（REE） pattern of the altered and unaltered host rock was right-inclined from La to Lu, but enriched in light REEs over heavy REEs after hydrothermal alteration. An isocon plot shows that some oxides migrated in with an order of P2O5〉K2O 〉TiO2〉Al2O3〉SiO2〉MnO≥MgO, while others migrated out with an order of Na2O 〉CaO 〉Fe2O3. For REEs, the migration ratios are positive values withCs 〉Rb 〉Li 〉Nb 〉Ta 〉Be, signifying that all REEs migrated from the exsolved magmatic fluid into the altered host rocks. It was concluded that diffusion was the only mechanism for migration of ore-forming elements in the alteration zone. The effective diffusion coefficients（Deff）of LiF, RbF, and CsF were estimated under a fluid temperature of 500–550℃. Using a function of concentration（C（x,t）） and distance（x）, the order of migration distance was determined to be LiF 〉CsF 〉RbF, with diffusion times of （3.39 ± 0.35）× 10^6,（3.19 ± 0.28） × 10^5 and（6.33 ± 0.05） × 10^5 years, respectively.
基金supported by Shanghai Science and Technology Commission(16411965000,18411952400)Shanghai Jiao Tong University Foundation(YG2016MS37)+2 种基金National Key R&D Program of China(2018YFC2001605,2019YFA0706200)Natural Science Foundation of Shanghai(18ZR1432600,81071098)Shanghai Municipal Commission of Health and Family Planning Foundation(20164Y0215).
文摘Background Palpitation is a common complaint in generalised anxiety disorder(GAD).Brain imaging studies have Investigated the neural mechanism of heartbeat perception in healthy volunteers.This study explored the neuroanatomical differences of altered heartbeat perception in patients with GAD using structural MRI.Aims Based on the strong somatic-interoceptive symptoms in GAD,we explored the regional structural brain abnormalities involved in heartbeat perception in patients with GAD.Methods This study was applied to the a priori regions using neuroanatomical theories of heartbeat perception,including the insula,anterior cingulate cortex,supplementary motor area and prefrontal cortex.A total of 19 patients with GAD and 19 healthy control subjects were enrolled.We used the FMRIB Software Library voxel-based morphometry software for estimating the grey matter volume of these regions of interest and analysed the correlation between heartbeat perception sensitivity and the volume of abnormal grey matter.Results Patients with GAD showed a significantly decreased volume of grey matter in their left medial prefrontal cortex,right orbital frontal cortex and anterior cingulate cortex.The grey matter volume of the left medial prefrontal cortex negatively correlated with heartbeat perception sensitivity in patients with GAD.Conclusions It should be the first study that shows heartbeat perception is associated with brain structure in GAD.Our findings suggest that the frontal region may play an important role in aberrant heartbeat perception processing in patients with GAD,and this may be an underlying mechanism resulting in the abnormal cardiovascular complaints in GAD.This is hypothesised as a'top-down'deficiency,especially in the medial prefrontal cortex.This will provide the foundation for a more targeted region for neuromodulation intervention in the future.
基金financially supported by projects under the National Key Research and Development Program of China(No.2018YFC0604200)the Open Fund Project of State Key Laboratory of Nuclear Resources and Environment (No.2020NRE10)+3 种基金the National Key Infrastructure Development Plan (No.2015CB453006)the China Geological Survey (Nos.DD20190119,DD20221678)the International Geoscience Programme (No.IGCP-675)the National Nature Science Foundation of China (No.92162212)
文摘In recent years,the close relationship between uranium and Ti-Fe oxides in the sandstonetype uranium deposits has been extensively recognized.However,the altered characteristics of ilmenite and its relationship with uranium enrichment still remain unclear.With this paper based on heavymineral sorting of uranium ore selected from the Tarangaole-Nalinggou deposit in the northeastern Ordos Basin,electron probe,backscattering image,energy spectrum and scanning electron microscopy were systematically performed.The ilmenite in the sandstone can be divided into four groups,including unaltered,weakly altered,moderately altered,and strongly altered ilmenite.The alteration of ilmenite in uranium ores is notably more intense than that of the surrounding rocks.In addition,weakly,moderately,and strongly altered ilmenite associated with uranium minerals in uranium ores demonstrate that the more intensity ilmenite altered,the closer its relationship with uranium minerals is.The ilmenite has likely been somewhat altered before mineralization,and the alteration intensifies by later exposure related to an oxygencontaining fluid.The alteration mechanism comprises a process of competitive diffusion between Fe^(2+)and O_(2)-ions.In the early stage,Fe ions was mainly diffused on the particle surface.Subsequently,diffusion of O ions into the particles began to be dominate.Most of the leached iron is stripped or carried away by fluid.In an alkaline and reductive environment,the remaining iron is reduced to form the surrounding pyrite,and TiO_(2)in a form of titanium sol recrystallizes(i.e.,anatase).Backscattering images show that uranium and altered ilmenite are close in space.Coffinite is often distributed along the edges of altered ilmenite as burrs in shape.Colloidal or knitted coffinite associated with anatase is formed in the voids of altered ilmenite.The chemical composition of altered ilmenite varies considerably from the core to edge,and the mineral assemblage sequence is from girdle with ilmenite,to leucosphenite,to anatase,and to coffinite.There is no brannerite that is symbiotic with altered ilmenite.It is considered to be a uranium-containing titanium mineral aggregate caused by the reduction and adsorption of uranium.As the altered product of ilmenite,TiO_(2)is an aggregation agent,increasing the concentration of uranium by adsorption.Together with Fe^(2+)and S_(2)-in secondary pyrite,this aggregate creates a uranium-rich environment in the microzone for the formation of coffinite.Therefore,the alteration of ilmenite plays a geochemical role in the processes of sedimentary,diagenesis and mineralization,in which Fe is removed,Ti is enriched,and U is adsorbed and reduced.
文摘AIM: To investigate the clinical and pathological significance of altered retinoblastoma (Rb) encoding protein (pRb) in gastric carcinoma. METHODS: Expression of altered pRb was analyzed in 91 patients with gastric adenocarcinoma by immunohistochemistry. RESULTS: Sixty-five percent (59/91) of the tumors were positively stained and the staining in tumor nuclei of gastric carcinoma ranged 0%-90%. Moreover, strong expression of altered pRb was found in 35% (6/17), 24% (5/21), 17% (8/46) and 0% (0/7) of T1, T2, T3 and T4 gastric carcinomas, respectively. altered pRb expression was inversely correlated with the depth of tumor invasion (P = 0.047). Degree of immunoreactivity had no significant correlation with tumor grade, node metastasis and distant metastasis. In terms of prognostic significance, univariate analysis showed that poor differentiation [41 (66.1%) vs 34 (42.5%) P = 0.051], advanced tumor stage (P < 0.001) and weakly altered pRb expression [17 (80.5%) vs 58 (49.6%) P = 0.044] were associated with worse prognosis in these patients. However, multivariate analysis revealed that advanced tumor stage was the only independent poor prognostic factor (P < 0.001). CONCLUSION: The mutation of Rb gene is frequent in gastric carcinoma. The expression of altered pRb inversely correlates with tumor invasion and is not an independent prognostic marker in gastric adenocarcinoma.
基金supported by the National Natural Science Foundation of China (31640034)the Sci-Tech Support Plan of Hubei Province, China (2014BEC086)the Research Team Fund of the South-Central University for Nationalities, China (XTZ15014)
文摘Dear Editor Despite remarkable advances in our understanding of brain functions,the neural substrates and correlates of consciousness remain unclear[1].It has been argued that classical physics is intrinsically incapable of explaining the holistic aspects of consciousness.
