It is challenging to diagnose isolated hyperbilirubinemia with rare and complex etiologies under the constraints of traditional testing conditions.Herein,we present a rare case of coexisting Gilbert syndrome(GS)and er...It is challenging to diagnose isolated hyperbilirubinemia with rare and complex etiologies under the constraints of traditional testing conditions.Herein,we present a rare case of coexisting Gilbert syndrome(GS)and erythropoietic protoporphyria(EPP),which has not been previously documented.CASE SUMMARY We present a rare case of coexisting GS and EPP in a 23-year-old Chinese male with a long history of jaundice and recently found splenomegaly.Serial nonspecific hemolysis screening tests yielded inconsistent results,and investigations for common hemolytic etiologies were negative.However,Levitt’s carbon monoxide breath test,which measures erythrocyte lifespan(the gold-standard marker of hemolysis),demonstrated significant hemolysis,revealing a markedly shortened erythrocyte lifespan of 11 days(normal average 120 days).Genetic testing subsequently confirmed EPP with a homozygous ferrochelatase gene mutation and GS with a heterozygous uridine diphosphate glucuronosyl trans-ferase 1A1 gene mutation.CONCLUSION The rapid,non-invasive Levitt’s carbon monoxide breath test resolved the diagnostic challenge posed by a rare and complex cause of hyperbilirubinemia.展开更多
AIM To investigate the prognostic value of preoperative fbri-nogen concentration （FIB） and D-dimer-fibrinogen ratio （DFR） in gastrointestinal stromal tumors （GISTs）.METHODS The purpose of this study was to retro...AIM To investigate the prognostic value of preoperative fbri-nogen concentration （FIB） and D-dimer-fibrinogen ratio （DFR） in gastrointestinal stromal tumors （GISTs）.METHODS The purpose of this study was to retrospectively ana-lyze 170 patients with GISTs who were admitted to our hospital from January 2010 to December 2015. The op-timal cutoff values of related parameters were estimated by receiver operating characteristic （ROC） curve analysis. The recurrence free survival （RFS） rate was evaluated using Kaplan-Meier curves. Univariate analysis and multivariate Cox regression models were used to analyze the prognostic factors of GISTs. The relationship between the FIB, D-dimer, DFR, platelet count （PLT）, and the clinicopathological features of GISTs was described by the chi-square test or nonparametric rank sum test （Mann-Whitney test）.RESULTS In ROC analysis, the optimal cutoff values of FIB, D-dimer, DFR, and PLT were 3.24 g/L, 1.24 mg/L, 0.354, and 197.5 （× 109/L）, respectively. Univariate analysis and the Kaplan-Meier survival curve showed that FIB, D-dimer, DFR, PLT,National Institutes of Health （NIH） risk category, tumor size, tumor location, and mitotic index were signifcantly relevant to the 3-year and 5-year survival rate of patients （ P 〈 0.05）. Cox multivariate regression analysis illustrated that FIB （RR： 0.108, 95%CI： 0.031-0.373）, DFR （RR： 0.319, 95%CI： 0.131-0.777）, and NIH risk category （ RR： 0.166, 95%CI： 0.047-0.589） were independent prognostic factors of the RFS rate （ P 〈 0. 05）. Moreover, FIB, D-dimer, DFR, and PLT were correlated with the clinical features of GISTs.CONCLUSIONFIB, D-dimer, DFR, and PLT are all related to the prognosis of GISTs. Moreover, FIB and DFR may be independent risk factors for predicting the prognosis of resectable GISTs.展开更多
BACKGROUND Type 2 diabetes mellitus(T2DM)often leads to vascular complications,such as albuminuria.The role of insulin autoantibodies(IAA)and their interaction with D-dimer in this context remains unclear.AIM To inves...BACKGROUND Type 2 diabetes mellitus(T2DM)often leads to vascular complications,such as albuminuria.The role of insulin autoantibodies(IAA)and their interaction with D-dimer in this context remains unclear.AIM To investigate the characteristics of IAA and its effect on albuminuria in T2DM patients.METHODS We retrospectively analyzed clinical data from 115 T2DM patients with positive IAA induced by exogenous insulin,and 115 age-and sex-matched IAA-negative T2DM patients as controls.Propensity scores were calculated using multivariate logistic regression.Key variables were selected using the least absolute shrinkage and selection operator(LASSO)algorithm.We constructed a prediction model and analyzed the association between IAA and albuminuria based on demographic and laboratory parameters.RESULTS The IAA-positive group had significantly higher D-dimer levels[0.30(0.19-0.55)mg/L vs 0.21(0.19-0.33)mg/L,P=0.008]and plasma insulin levels[39.1(12.0-102.7)μU/mL vs 9.8(5.5-17.6)μU/mL,P<0.001]compared to the IAA-negative group.Increases in the insulin dose per weight ratio,diabetes duration,and urinary albumin-to-creatinine ratio(UACR)were observed but did not reach statistical significance.The LASSO model identified plasma insulin and D-dimer as key factors with larger coefficients.D-dimer was significantly associated with UACR in the total and IAA-positive groups but not in the IAA-negative group.The odds ratio for D-dimer elevation(>0.5 g/L)was 2.88(95%confidence interval:1.17-7.07)in the IAA-positive group(P interaction<0.05).CONCLUSION D-dimer elevation is an independent risk factor for abnormal albuminuria and interacts with IAA in the development of abnormal albuminuria in T2DM patients.展开更多
NOx sensors, as a core component of diesel engine exhaust treatment system, play an important role in exhaust emission control, which can accurately and quickly detect the NOx and O2 concentration. It has become a nec...NOx sensors, as a core component of diesel engine exhaust treatment system, play an important role in exhaust emission control, which can accurately and quickly detect the NOx and O2 concentration. It has become a necessary option for the detection of existing exhaust emission standards. At present, there is limited and scattered information on knowledge and test methods of NOx sensors, the research of NOx sensors has become a challenging research topic at home and abroad. Based on these requirements, the article systematically integrates the knowledge of principle and testing methods. First of all, through introducing functional description of NOx sensors and the basic principle of NOx sensors, the relevant scholars can have an overall understanding of the product and master the operation mode of products. Secondly, the current status of performance test bench and methods of NOx sensors were described, which can contribute to having a clear understanding of the development process. After that, a new structure of NOx sensors test bench was purposed, which contains six major units including standard gas source, gas mixing unit, analyzer measurement unit, sensor measurement unit, data processing and display unit, exhaust gas treatment unit. And the test bench was validated. The experimental results show that the test bench has the advantages of high-repeatability, high reliability and low cost. And it can realize automatic detection of multiple target values, which is worthy further promotion. Thereby, the article can contribute to the development of its technology indirectly.展开更多
Objective: to analyze the application effect of D-dimer combined with four coagulation tests in the prenatal examination of pregnant women. Methods: 103 pregnant women in our hospital were selected as the observation ...Objective: to analyze the application effect of D-dimer combined with four coagulation tests in the prenatal examination of pregnant women. Methods: 103 pregnant women in our hospital were selected as the observation group (including 51 cases in observation group A, abnormal;52 cases in observation group B, normal), from January 2020 to February 2022, and 41 non-pregnant healthy women during the same period were selected as the observation group. The control group and the three groups were all tested by D-dimer combined with coagulation, and the test results were analyzed. Results: there were significant differences in the four indexes of D-dimer and blood coagulation among the three groups (P<0.05);the safety of observation group A was higher (P<0.05). Conclusion: the D-dimer combined with coagulation test has obvious effect in the prenatal examination of pregnant women.展开更多
Advances in the identification of molecular biomarkers and the development of targeted therapies have enhanced the prognosis of patients with advanced gastric cancer.Several established biomarkers have been widely int...Advances in the identification of molecular biomarkers and the development of targeted therapies have enhanced the prognosis of patients with advanced gastric cancer.Several established biomarkers have been widely integrated into routine clinical diagnostics of gastric cancer to guide personalized treatment.Human epidermal growth factor receptor 2(HER2)was the first molecular biomarker to be used in gastric cancer with trastuzumab being the first approved targeted therapy for HER2-positive gastric cancer.Programmed death-ligand 1 positivity and microsatellite instability can guide the use of immunotherapies,such as pembrolizumab and nivolumab.More recently,zolbetuximab has been approved for patients with claudin 18.2-positive diseases in some countries.More targeted therapies,including savolitinib for MET-positive patients,are currently under clinical investigation.However,the clinical application of these diagnostic approaches could be hampered by many existing challenges,including invasive and costly sampling methods,variability in immunohistochemistry interpretation,high costs and long turnaround times for next-generation sequencing,the absence of standardized and clinically validated diagnostic cut-off values for some biomarkers,and tumor heterogeneity.Novel testing and analysis techniques,such as artificial intelligence-assisted image analysis and multiplex immunohistochemistry,and emerging therapeutic strategies,including combination therapies that integrate immune checkpoint inhibitors with targeted therapies,offer potential solutions to some of these challenges.This article reviews recent progress in gastric cancer testing,outlines current challenges,and explores future directions for biomarker testing and targeted therapy for gastric cancer.展开更多
The rapid progress in the construction of heavy-haul and high-speed railways has led to a surge in rail defects and unforeseen failures.Addressing this issue necessitates the implementation of more sophisticated rail ...The rapid progress in the construction of heavy-haul and high-speed railways has led to a surge in rail defects and unforeseen failures.Addressing this issue necessitates the implementation of more sophisticated rail inspection methods,specifically involving real-time,precise detection,and assessment of rail defects.Current applications fail to address the evolving requirements,prompting the need for advancements.This paper provides a summary of various types of rail defects and outlines both traditional and innovative non-destructive inspection techniques,examining their fundamental features,benefits,drawbacks,and practical suitability for railway track inspection.It also explores potential enhancements to equipment and software.The comprehensive review draws upon pertinent international research and review papers.Furthermore,the paper introduces a fusion of inspection methods aimed at enhancing the overall reliability of defect detection.展开更多
The purpose of this study is to analyze the application of ultrasonic non-destructive testing technology in bridge engineering.During the research phase,based on literature collection and reading,as well as the analys...The purpose of this study is to analyze the application of ultrasonic non-destructive testing technology in bridge engineering.During the research phase,based on literature collection and reading,as well as the analysis of bridge inspection materials,the principle of ultrasonic non-destructive testing technology and its adaptability to bridge engineering are elaborated.Subsequently,starting from the preparation work before inspection until damage assessment,the entire process of ultrasonic non-destructive testing is studied,and finally,a technical system of ultrasonic non-destructive testing for bridge engineering that runs through the entire process is formed.It is hoped that this article can provide technical reference value for relevant units in China,and promote the high-quality development of China’s bridge engineering from a macro perspective.展开更多
The mechanical behavior of cohesive soil is sensitized to drying-wetting cycles under confinements.However,the hydromechanical coupling effect has not been considered in current constitutive models.A macro-micro analy...The mechanical behavior of cohesive soil is sensitized to drying-wetting cycles under confinements.However,the hydromechanical coupling effect has not been considered in current constitutive models.A macro-micro analysis scheme is proposed in this paper to investigate the soil deformation behavior under the coupling of stress and drying-wetting cycles.A new device is developed based on CT(computerized tomography)workstation to apply certain normal and shear stresses on a soil specimen during drying-wetting cycles.A series of tests are conducted on a type of loess with various coupling of stress paths and drying-wetting cycles.At macroscopic level,stress sensor and laser sensor are used to acquire stress and strain,respectively.The shear and volumetric strain increase during the first few drying-wetting cycles and then become stable.The increase of the shear stress level or confining pressure would cause higher increase rate and the value of shear strain in the process of drying-wetting cycles.At microscopic level,the grayscale value(GSV)of CT scanning image is characterized as the proportion of soil particles to voids.A fabric state parameter is proposed to characterize soil microstructures under the influence of stress and drying-wetting cycle.Test results indicate that the macroand micro-responses show high consistence and relevance.The stress and drying-wetting cycles would both induce collapse of the soil microstructure,which dominants degradation of the soil mechanical properties.The evolution of the macro-mechanical property of soil exhibits a positive linear relationship with the micro-evolution of the fabric state parameter.展开更多
With the depletion of fossil fuels and increasing environmental concerns,the development of renewable energy,such as wave energy,has become a critical component of global energy strategies.However,challenges persist i...With the depletion of fossil fuels and increasing environmental concerns,the development of renewable energy,such as wave energy,has become a critical component of global energy strategies.However,challenges persist in the field testing methodologies for wave energy converters(WECs).In this paper,a numerical wave field of the Dawanshan Island Sea Area in Zhuhai City is constructed based on the MIKE21 SW wave model and by using an NCEP wind field driving model.In conjunction with the IEC-62600-100 standard,by taking site testing of the“Wanshan”wave energy converter on which a sea trial has been conducted in Dawanshan Island of Zhuhai city as an example,research on-site testing method for a wave energy converter has been carried out.The wave measurement position for the“Wanshan”converter was determined by combining statistically analyzed field data with a validated numerical wave model.By comparing a valid wave height at the position where a wave rider is located with a valid wave height at the position where the“Wanshan”wave energy converter is situated,the correlation coefficient between simulation and observed data reached 0.90,with a root-mean-square error of 0.19.The representativeness of wave measurement data during site testing is verified and can be used as a basis for calculating the input energy of the“Wanshan”wave energy converter.展开更多
Subgrade engineering is a fundamental aspect of infrastructure construction in China.As the primary structural element responsible for bearing and distributing traffic loads,the subgrade must not only withstand the su...Subgrade engineering is a fundamental aspect of infrastructure construction in China.As the primary structural element responsible for bearing and distributing traffic loads,the subgrade must not only withstand the substantial pressures exerted by vehicles,trains,and other forms of transportation,but also efficiently transfer these loads to the underlying foundation,ensuring the stability and longevity of the roadway.In recent years,advancements in subgrade engineering technology have propelled the industry towards smarter,greener,and more sustainable practices,particularly in the areas of intelligent monitoring,disaster management,and innovative construction methods.This paper reviews the application and methodologies of intelligent testing equipment,including cone penetration testing(CPT)devices,soil resistivity testers,and intelligent rebound testers,in subgrade engineering.It examines the operating principles,advantages,limitations,and application ranges of these tools in subgrade testing.Additionally,the paper evaluates the practical use of advanced equipment from both domestic and international perspectives,addressing the challenges encountered by various instruments in realworld applications.These devices enable precise,comprehensive testing and evaluation of subgrade conditions at different stages,providing real-time data analysis and intelligent early warnings.This supports effective subgrade health management and maintenance.As intelligent technologies continue to evolve and integrate,these tools will increasingly enhance the accuracy,efficiency,and sustainability of subgrade monitoring.展开更多
BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for...BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for assessing this risk.In Gabon,early implementation of anticoagulation therapy and D-dimer testing has been crucial in managing COVID-19.This study hypothesizes that elevated Ddimer levels are linked to increased COVID-19 severity.AIM To determine the impact of D-dimer levels on COVID-19 severity and their role in guiding clinical decisions.METHODS This retrospective study analyzed COVID-19 patients admitted to two hospitals in Gabon between March 2020 and December 2023.The study included patients with confirmed COVID-19 diagnoses and available D-dimer measurements at admission.Data on demographics,clinical outcomes,D-dimer levels,and healthcare costs were collected.COVID-19 severity was classified as non-severe(outpatients)or severe(inpatients).A multivariable logistic regression model was used to assess the relationship between D-dimer levels and disease severity,with adjusted odds ratios(OR)and 95%CI.RESULTS A total of 3004 patients were included,with a mean age of 50.17 years,and the majority were female(53.43%).Elevated D-dimer levels were found in 65.81%of patients,and 57.21%of these experienced severe COVID-19.Univariate analysis showed that patients with elevated D-dimer levels had 3.33 times higher odds of severe COVID-19(OR=3.33,95%CI:2.84-3.92,P<0.001),and this association remained significant in the multivariable analysis,adjusted for age,sex,and year of collection.The financial analysis revealed a substantial burden,particularly for uninsured patients.CONCLUSION D-dimer predicts COVID-19 severity and guides treatment,but the high cost of anticoagulant therapy highlights the need for policies ensuring affordable access in resource-limited settings like Gabon.展开更多
BACKGROUND Small intestinal bacterial overgrowth(SIBO)is suspected and excluded frequently in functional gastrointestinal(GI)disorders.Children presenting with various esophago-gastro-duodenal(upper GI)symptoms are ra...BACKGROUND Small intestinal bacterial overgrowth(SIBO)is suspected and excluded frequently in functional gastrointestinal(GI)disorders.Children presenting with various esophago-gastro-duodenal(upper GI)symptoms are rarely subjected to investig-ations for SIBO.AIM To estimate the frequency of SIBO in children having functional upper GI sym-ptoms(as cases)and to compare the result of the SIBO status to that of the con-trols.METHODS Children aged 6 to 18 who presented with upper GI symptoms were selected for the study.All children were subjected to upper GI endoscopy before being advised of any proton pump inhibitors(PPIs).Children with normal endoscopy were assigned as cases,and children having any endoscopic lesion were design-ated as controls.Both groups were subjected to a glucose-hydrogen breath test by Bedfont Gastrolyser.RESULTS A total of 129 consecutive children who were naive to PPIs and had normal ba-seline investigations were included in the study.Among them,67 patients had endoscopic lesions and served as the control group,with six cases being excluded due to the presence of Helicobacter pylori in gastric biopsies.Sixty-two children with normal endoscopy results formed the case group.In the case group,35 children(59%)tested positive for hydrogen breath tests,compared to 13 children(21%)in the control group.The calculated odds ratio was 5.38(95%confidence interval:2.41-12.0),which was statistically significant.Further analysis of symptoms revealed that nausea,halitosis,foul-smelling eructation,and epigastric fullness were positive predictors of SIBO.CONCLUSION It is worthwhile to investigate and treat SIBO in all children presenting with upper GI symptoms that are not explained by endoscopy findings.展开更多
Shotcrete is one of the common solutions for shallow sliding.It works by forming a protective layer with high strength and cementing the loose soil particles on the slope surface to prevent shallow sliding.However,the...Shotcrete is one of the common solutions for shallow sliding.It works by forming a protective layer with high strength and cementing the loose soil particles on the slope surface to prevent shallow sliding.However,the solidification time of conventional cement paste is long when shotcrete is used to treat cohesionless soil landslide.The idea of reinforcing slope with polyurethane solidified soil(i.e.,mixture of polyurethane and sand)was proposed.Model tests and finite element analysis were carried out to study the effectiveness of the proposed new method on the emergency treatment of cohesionless soil landslide.Surcharge loading on the crest of the slope was applied step by step until landslide was triggered so as to test and compare the stability and bearing capacity of slope models with different conditions.The simulated slope displacements were relatively close to the measured results,and the simulated slope deformation characteristics were in good agreement with the observed phenomena,which verifies the accuracy of the numerical method.Under the condition of surcharge loading on the crest of the slope,the unreinforced slope slid when the surcharge loading exceeded 30 k Pa,which presented a failure mode of local instability and collapse at the shallow layer of slope top.The reinforced slope remained stable even when the surcharge loading reached 48 k Pa.The displacement of the reinforced slope was reduced by more than 95%.Overall,this study verifies the effectiveness of polyurethane in the emergency treatment of cohesionless soil landslide and should have broad application prospects in the field of geological disasters concerning the safety of people's live.展开更多
Bedding parallel stepped rock slopes exist widely in nature and are used in slope engineering.They are characterized by complex topography and geological structure and are vulnerable to shattering under strong earthqu...Bedding parallel stepped rock slopes exist widely in nature and are used in slope engineering.They are characterized by complex topography and geological structure and are vulnerable to shattering under strong earthquakes.However,no previous studies have assessed the mechanisms underlying seismic failure in rock slopes.In this study,large-scale shaking table tests and numerical simulations were conducted to delineate the seismic failure mechanism in terms of acceleration,displacement,and earth pressure responses combined with shattering failure phenomena.The results reveal that acceleration response mutations usually occur within weak interlayers owing to their inferior performance,and these mutations may transform into potential sliding surfaces,thereby intensifying the nonlinear seismic response characteristics.Cumulative permanent displacements at the internal corners of the berms can induce quasi-rigid displacements at the external corners,leading to greater permanent displacements at the internal corners.Therefore,the internal corners are identified as the most susceptible parts of the slope.In addition,the concept of baseline offset was utilized to explain the mechanism of earth pressure responses,and the result indicates that residual earth pressures at the internal corners play a dominant role in causing deformation or shattering damage.Four evolutionary deformation phases characterize the processes of seismic responses and shattering failure of the bedding parallel stepped rock slope,i.e.the formation of tensile cracks at the internal corners of the berm,expansion of tensile cracks and bedding surface dislocation,development of vertical tensile cracks at the rear edge,and rock mass slipping leading to slope instability.Overall,this study provides a scientific basis for the seismic design of engineering slopes and offers valuable insights for further studies on preventing seismic disasters in bedding parallel stepped rock slopes.展开更多
Point-of-care testing(POCT)refers to a category of diagnostic tests that are performed at or near to the site of the patients(also called bedside testing)and is capable of obtaining accurate results in a short time by...Point-of-care testing(POCT)refers to a category of diagnostic tests that are performed at or near to the site of the patients(also called bedside testing)and is capable of obtaining accurate results in a short time by using portable diagnostic devices,avoiding sending samples to the medical laboratories.It has been extensively explored for diagnosing and monitoring patients’diseases and health conditions with the assistance of development in biochemistry and microfluidics.Microfluidic paper-based analytical devices(μPADs)have gained dramatic popularity in POCT because of their simplicity,user-friendly,fast and accurate result reading and low cost.SeveralμPADs have been successfully commercialized and received excellent feedback during the past several decades.This review briefly discusses the main types ofμPADs,preparation methods and their detection principles,followed by a few representative examples.The future perspectives of the development inμPADs are also provided.展开更多
文摘It is challenging to diagnose isolated hyperbilirubinemia with rare and complex etiologies under the constraints of traditional testing conditions.Herein,we present a rare case of coexisting Gilbert syndrome(GS)and erythropoietic protoporphyria(EPP),which has not been previously documented.CASE SUMMARY We present a rare case of coexisting GS and EPP in a 23-year-old Chinese male with a long history of jaundice and recently found splenomegaly.Serial nonspecific hemolysis screening tests yielded inconsistent results,and investigations for common hemolytic etiologies were negative.However,Levitt’s carbon monoxide breath test,which measures erythrocyte lifespan(the gold-standard marker of hemolysis),demonstrated significant hemolysis,revealing a markedly shortened erythrocyte lifespan of 11 days(normal average 120 days).Genetic testing subsequently confirmed EPP with a homozygous ferrochelatase gene mutation and GS with a heterozygous uridine diphosphate glucuronosyl trans-ferase 1A1 gene mutation.CONCLUSION The rapid,non-invasive Levitt’s carbon monoxide breath test resolved the diagnostic challenge posed by a rare and complex cause of hyperbilirubinemia.
文摘AIM To investigate the prognostic value of preoperative fbri-nogen concentration （FIB） and D-dimer-fibrinogen ratio （DFR） in gastrointestinal stromal tumors （GISTs）.METHODS The purpose of this study was to retrospectively ana-lyze 170 patients with GISTs who were admitted to our hospital from January 2010 to December 2015. The op-timal cutoff values of related parameters were estimated by receiver operating characteristic （ROC） curve analysis. The recurrence free survival （RFS） rate was evaluated using Kaplan-Meier curves. Univariate analysis and multivariate Cox regression models were used to analyze the prognostic factors of GISTs. The relationship between the FIB, D-dimer, DFR, platelet count （PLT）, and the clinicopathological features of GISTs was described by the chi-square test or nonparametric rank sum test （Mann-Whitney test）.RESULTS In ROC analysis, the optimal cutoff values of FIB, D-dimer, DFR, and PLT were 3.24 g/L, 1.24 mg/L, 0.354, and 197.5 （× 109/L）, respectively. Univariate analysis and the Kaplan-Meier survival curve showed that FIB, D-dimer, DFR, PLT,National Institutes of Health （NIH） risk category, tumor size, tumor location, and mitotic index were signifcantly relevant to the 3-year and 5-year survival rate of patients （ P 〈 0.05）. Cox multivariate regression analysis illustrated that FIB （RR： 0.108, 95%CI： 0.031-0.373）, DFR （RR： 0.319, 95%CI： 0.131-0.777）, and NIH risk category （ RR： 0.166, 95%CI： 0.047-0.589） were independent prognostic factors of the RFS rate （ P 〈 0. 05）. Moreover, FIB, D-dimer, DFR, and PLT were correlated with the clinical features of GISTs.CONCLUSIONFIB, D-dimer, DFR, and PLT are all related to the prognosis of GISTs. Moreover, FIB and DFR may be independent risk factors for predicting the prognosis of resectable GISTs.
文摘BACKGROUND Type 2 diabetes mellitus(T2DM)often leads to vascular complications,such as albuminuria.The role of insulin autoantibodies(IAA)and their interaction with D-dimer in this context remains unclear.AIM To investigate the characteristics of IAA and its effect on albuminuria in T2DM patients.METHODS We retrospectively analyzed clinical data from 115 T2DM patients with positive IAA induced by exogenous insulin,and 115 age-and sex-matched IAA-negative T2DM patients as controls.Propensity scores were calculated using multivariate logistic regression.Key variables were selected using the least absolute shrinkage and selection operator(LASSO)algorithm.We constructed a prediction model and analyzed the association between IAA and albuminuria based on demographic and laboratory parameters.RESULTS The IAA-positive group had significantly higher D-dimer levels[0.30(0.19-0.55)mg/L vs 0.21(0.19-0.33)mg/L,P=0.008]and plasma insulin levels[39.1(12.0-102.7)μU/mL vs 9.8(5.5-17.6)μU/mL,P<0.001]compared to the IAA-negative group.Increases in the insulin dose per weight ratio,diabetes duration,and urinary albumin-to-creatinine ratio(UACR)were observed but did not reach statistical significance.The LASSO model identified plasma insulin and D-dimer as key factors with larger coefficients.D-dimer was significantly associated with UACR in the total and IAA-positive groups but not in the IAA-negative group.The odds ratio for D-dimer elevation(>0.5 g/L)was 2.88(95%confidence interval:1.17-7.07)in the IAA-positive group(P interaction<0.05).CONCLUSION D-dimer elevation is an independent risk factor for abnormal albuminuria and interacts with IAA in the development of abnormal albuminuria in T2DM patients.
文摘NOx sensors, as a core component of diesel engine exhaust treatment system, play an important role in exhaust emission control, which can accurately and quickly detect the NOx and O2 concentration. It has become a necessary option for the detection of existing exhaust emission standards. At present, there is limited and scattered information on knowledge and test methods of NOx sensors, the research of NOx sensors has become a challenging research topic at home and abroad. Based on these requirements, the article systematically integrates the knowledge of principle and testing methods. First of all, through introducing functional description of NOx sensors and the basic principle of NOx sensors, the relevant scholars can have an overall understanding of the product and master the operation mode of products. Secondly, the current status of performance test bench and methods of NOx sensors were described, which can contribute to having a clear understanding of the development process. After that, a new structure of NOx sensors test bench was purposed, which contains six major units including standard gas source, gas mixing unit, analyzer measurement unit, sensor measurement unit, data processing and display unit, exhaust gas treatment unit. And the test bench was validated. The experimental results show that the test bench has the advantages of high-repeatability, high reliability and low cost. And it can realize automatic detection of multiple target values, which is worthy further promotion. Thereby, the article can contribute to the development of its technology indirectly.
文摘Objective: to analyze the application effect of D-dimer combined with four coagulation tests in the prenatal examination of pregnant women. Methods: 103 pregnant women in our hospital were selected as the observation group (including 51 cases in observation group A, abnormal;52 cases in observation group B, normal), from January 2020 to February 2022, and 41 non-pregnant healthy women during the same period were selected as the observation group. The control group and the three groups were all tested by D-dimer combined with coagulation, and the test results were analyzed. Results: there were significant differences in the four indexes of D-dimer and blood coagulation among the three groups (P<0.05);the safety of observation group A was higher (P<0.05). Conclusion: the D-dimer combined with coagulation test has obvious effect in the prenatal examination of pregnant women.
基金support by grants from Capital’s Funds for Health Improvement and Research(Grant No.2024-2-1024)Beijing Natural Science Foundation(Grant No.7232018).
文摘Advances in the identification of molecular biomarkers and the development of targeted therapies have enhanced the prognosis of patients with advanced gastric cancer.Several established biomarkers have been widely integrated into routine clinical diagnostics of gastric cancer to guide personalized treatment.Human epidermal growth factor receptor 2(HER2)was the first molecular biomarker to be used in gastric cancer with trastuzumab being the first approved targeted therapy for HER2-positive gastric cancer.Programmed death-ligand 1 positivity and microsatellite instability can guide the use of immunotherapies,such as pembrolizumab and nivolumab.More recently,zolbetuximab has been approved for patients with claudin 18.2-positive diseases in some countries.More targeted therapies,including savolitinib for MET-positive patients,are currently under clinical investigation.However,the clinical application of these diagnostic approaches could be hampered by many existing challenges,including invasive and costly sampling methods,variability in immunohistochemistry interpretation,high costs and long turnaround times for next-generation sequencing,the absence of standardized and clinically validated diagnostic cut-off values for some biomarkers,and tumor heterogeneity.Novel testing and analysis techniques,such as artificial intelligence-assisted image analysis and multiplex immunohistochemistry,and emerging therapeutic strategies,including combination therapies that integrate immune checkpoint inhibitors with targeted therapies,offer potential solutions to some of these challenges.This article reviews recent progress in gastric cancer testing,outlines current challenges,and explores future directions for biomarker testing and targeted therapy for gastric cancer.
文摘The rapid progress in the construction of heavy-haul and high-speed railways has led to a surge in rail defects and unforeseen failures.Addressing this issue necessitates the implementation of more sophisticated rail inspection methods,specifically involving real-time,precise detection,and assessment of rail defects.Current applications fail to address the evolving requirements,prompting the need for advancements.This paper provides a summary of various types of rail defects and outlines both traditional and innovative non-destructive inspection techniques,examining their fundamental features,benefits,drawbacks,and practical suitability for railway track inspection.It also explores potential enhancements to equipment and software.The comprehensive review draws upon pertinent international research and review papers.Furthermore,the paper introduces a fusion of inspection methods aimed at enhancing the overall reliability of defect detection.
文摘The purpose of this study is to analyze the application of ultrasonic non-destructive testing technology in bridge engineering.During the research phase,based on literature collection and reading,as well as the analysis of bridge inspection materials,the principle of ultrasonic non-destructive testing technology and its adaptability to bridge engineering are elaborated.Subsequently,starting from the preparation work before inspection until damage assessment,the entire process of ultrasonic non-destructive testing is studied,and finally,a technical system of ultrasonic non-destructive testing for bridge engineering that runs through the entire process is formed.It is hoped that this article can provide technical reference value for relevant units in China,and promote the high-quality development of China’s bridge engineering from a macro perspective.
基金funded by National Key R&D Program of China(Grant No.2023YFC3007001)Beijing Natural Science Foundation(Grant No.8244053)China Postdoctoral Science Foundation(Grant No.2024M754065).
文摘The mechanical behavior of cohesive soil is sensitized to drying-wetting cycles under confinements.However,the hydromechanical coupling effect has not been considered in current constitutive models.A macro-micro analysis scheme is proposed in this paper to investigate the soil deformation behavior under the coupling of stress and drying-wetting cycles.A new device is developed based on CT(computerized tomography)workstation to apply certain normal and shear stresses on a soil specimen during drying-wetting cycles.A series of tests are conducted on a type of loess with various coupling of stress paths and drying-wetting cycles.At macroscopic level,stress sensor and laser sensor are used to acquire stress and strain,respectively.The shear and volumetric strain increase during the first few drying-wetting cycles and then become stable.The increase of the shear stress level or confining pressure would cause higher increase rate and the value of shear strain in the process of drying-wetting cycles.At microscopic level,the grayscale value(GSV)of CT scanning image is characterized as the proportion of soil particles to voids.A fabric state parameter is proposed to characterize soil microstructures under the influence of stress and drying-wetting cycle.Test results indicate that the macroand micro-responses show high consistence and relevance.The stress and drying-wetting cycles would both induce collapse of the soil microstructure,which dominants degradation of the soil mechanical properties.The evolution of the macro-mechanical property of soil exhibits a positive linear relationship with the micro-evolution of the fabric state parameter.
基金supported by the“National Ocean Technology Center Innovation Fund”under Project No.N3220Z002,led by Ning Jia.The official website of the National Ocean Technology Center is accessible at:http://www.notcsoa.org.cn/.
文摘With the depletion of fossil fuels and increasing environmental concerns,the development of renewable energy,such as wave energy,has become a critical component of global energy strategies.However,challenges persist in the field testing methodologies for wave energy converters(WECs).In this paper,a numerical wave field of the Dawanshan Island Sea Area in Zhuhai City is constructed based on the MIKE21 SW wave model and by using an NCEP wind field driving model.In conjunction with the IEC-62600-100 standard,by taking site testing of the“Wanshan”wave energy converter on which a sea trial has been conducted in Dawanshan Island of Zhuhai city as an example,research on-site testing method for a wave energy converter has been carried out.The wave measurement position for the“Wanshan”converter was determined by combining statistically analyzed field data with a validated numerical wave model.By comparing a valid wave height at the position where a wave rider is located with a valid wave height at the position where the“Wanshan”wave energy converter is situated,the correlation coefficient between simulation and observed data reached 0.90,with a root-mean-square error of 0.19.The representativeness of wave measurement data during site testing is verified and can be used as a basis for calculating the input energy of the“Wanshan”wave energy converter.
基金supported by the National Natural Science Foundation of China for Distinguished Young Scholars(Grant No.42225206)National Natural Science Foundation of China(42207180,42477209,42302320).
文摘Subgrade engineering is a fundamental aspect of infrastructure construction in China.As the primary structural element responsible for bearing and distributing traffic loads,the subgrade must not only withstand the substantial pressures exerted by vehicles,trains,and other forms of transportation,but also efficiently transfer these loads to the underlying foundation,ensuring the stability and longevity of the roadway.In recent years,advancements in subgrade engineering technology have propelled the industry towards smarter,greener,and more sustainable practices,particularly in the areas of intelligent monitoring,disaster management,and innovative construction methods.This paper reviews the application and methodologies of intelligent testing equipment,including cone penetration testing(CPT)devices,soil resistivity testers,and intelligent rebound testers,in subgrade engineering.It examines the operating principles,advantages,limitations,and application ranges of these tools in subgrade testing.Additionally,the paper evaluates the practical use of advanced equipment from both domestic and international perspectives,addressing the challenges encountered by various instruments in realworld applications.These devices enable precise,comprehensive testing and evaluation of subgrade conditions at different stages,providing real-time data analysis and intelligent early warnings.This supports effective subgrade health management and maintenance.As intelligent technologies continue to evolve and integrate,these tools will increasingly enhance the accuracy,efficiency,and sustainability of subgrade monitoring.
文摘BACKGROUND Coronavirus disease 2019(COVID-19)is strongly associated with an increased risk of thrombotic events,including severe outcomes such as pulmonary embolism.Elevated D-dimer levels are a critical biomarker for assessing this risk.In Gabon,early implementation of anticoagulation therapy and D-dimer testing has been crucial in managing COVID-19.This study hypothesizes that elevated Ddimer levels are linked to increased COVID-19 severity.AIM To determine the impact of D-dimer levels on COVID-19 severity and their role in guiding clinical decisions.METHODS This retrospective study analyzed COVID-19 patients admitted to two hospitals in Gabon between March 2020 and December 2023.The study included patients with confirmed COVID-19 diagnoses and available D-dimer measurements at admission.Data on demographics,clinical outcomes,D-dimer levels,and healthcare costs were collected.COVID-19 severity was classified as non-severe(outpatients)or severe(inpatients).A multivariable logistic regression model was used to assess the relationship between D-dimer levels and disease severity,with adjusted odds ratios(OR)and 95%CI.RESULTS A total of 3004 patients were included,with a mean age of 50.17 years,and the majority were female(53.43%).Elevated D-dimer levels were found in 65.81%of patients,and 57.21%of these experienced severe COVID-19.Univariate analysis showed that patients with elevated D-dimer levels had 3.33 times higher odds of severe COVID-19(OR=3.33,95%CI:2.84-3.92,P<0.001),and this association remained significant in the multivariable analysis,adjusted for age,sex,and year of collection.The financial analysis revealed a substantial burden,particularly for uninsured patients.CONCLUSION D-dimer predicts COVID-19 severity and guides treatment,but the high cost of anticoagulant therapy highlights the need for policies ensuring affordable access in resource-limited settings like Gabon.
文摘BACKGROUND Small intestinal bacterial overgrowth(SIBO)is suspected and excluded frequently in functional gastrointestinal(GI)disorders.Children presenting with various esophago-gastro-duodenal(upper GI)symptoms are rarely subjected to investig-ations for SIBO.AIM To estimate the frequency of SIBO in children having functional upper GI sym-ptoms(as cases)and to compare the result of the SIBO status to that of the con-trols.METHODS Children aged 6 to 18 who presented with upper GI symptoms were selected for the study.All children were subjected to upper GI endoscopy before being advised of any proton pump inhibitors(PPIs).Children with normal endoscopy were assigned as cases,and children having any endoscopic lesion were design-ated as controls.Both groups were subjected to a glucose-hydrogen breath test by Bedfont Gastrolyser.RESULTS A total of 129 consecutive children who were naive to PPIs and had normal ba-seline investigations were included in the study.Among them,67 patients had endoscopic lesions and served as the control group,with six cases being excluded due to the presence of Helicobacter pylori in gastric biopsies.Sixty-two children with normal endoscopy results formed the case group.In the case group,35 children(59%)tested positive for hydrogen breath tests,compared to 13 children(21%)in the control group.The calculated odds ratio was 5.38(95%confidence interval:2.41-12.0),which was statistically significant.Further analysis of symptoms revealed that nausea,halitosis,foul-smelling eructation,and epigastric fullness were positive predictors of SIBO.CONCLUSION It is worthwhile to investigate and treat SIBO in all children presenting with upper GI symptoms that are not explained by endoscopy findings.
基金the financial support from the Fujian Science Foundation for Outstanding Youth(2023J06039)the National Natural Science Foundation of China(Grant No.41977259,U2005205,41972268)the Independent Research Project of Technology Innovation Center for Monitoring and Restoration Engineering of Ecological Fragile Zone in Southeast China(KY-090000-04-2022-019)。
文摘Shotcrete is one of the common solutions for shallow sliding.It works by forming a protective layer with high strength and cementing the loose soil particles on the slope surface to prevent shallow sliding.However,the solidification time of conventional cement paste is long when shotcrete is used to treat cohesionless soil landslide.The idea of reinforcing slope with polyurethane solidified soil(i.e.,mixture of polyurethane and sand)was proposed.Model tests and finite element analysis were carried out to study the effectiveness of the proposed new method on the emergency treatment of cohesionless soil landslide.Surcharge loading on the crest of the slope was applied step by step until landslide was triggered so as to test and compare the stability and bearing capacity of slope models with different conditions.The simulated slope displacements were relatively close to the measured results,and the simulated slope deformation characteristics were in good agreement with the observed phenomena,which verifies the accuracy of the numerical method.Under the condition of surcharge loading on the crest of the slope,the unreinforced slope slid when the surcharge loading exceeded 30 k Pa,which presented a failure mode of local instability and collapse at the shallow layer of slope top.The reinforced slope remained stable even when the surcharge loading reached 48 k Pa.The displacement of the reinforced slope was reduced by more than 95%.Overall,this study verifies the effectiveness of polyurethane in the emergency treatment of cohesionless soil landslide and should have broad application prospects in the field of geological disasters concerning the safety of people's live.
基金supported by the National Natural Science Foundation of China (Grant No.52108361)the Sichuan Science and Technology Program of China (Grant No.2023YFS0436)the State Key Laboratory of Geohazard Prevention and Geoenvironment Protection Independent Research Project (Grant No.SKLGP2022Z015).
文摘Bedding parallel stepped rock slopes exist widely in nature and are used in slope engineering.They are characterized by complex topography and geological structure and are vulnerable to shattering under strong earthquakes.However,no previous studies have assessed the mechanisms underlying seismic failure in rock slopes.In this study,large-scale shaking table tests and numerical simulations were conducted to delineate the seismic failure mechanism in terms of acceleration,displacement,and earth pressure responses combined with shattering failure phenomena.The results reveal that acceleration response mutations usually occur within weak interlayers owing to their inferior performance,and these mutations may transform into potential sliding surfaces,thereby intensifying the nonlinear seismic response characteristics.Cumulative permanent displacements at the internal corners of the berms can induce quasi-rigid displacements at the external corners,leading to greater permanent displacements at the internal corners.Therefore,the internal corners are identified as the most susceptible parts of the slope.In addition,the concept of baseline offset was utilized to explain the mechanism of earth pressure responses,and the result indicates that residual earth pressures at the internal corners play a dominant role in causing deformation or shattering damage.Four evolutionary deformation phases characterize the processes of seismic responses and shattering failure of the bedding parallel stepped rock slope,i.e.the formation of tensile cracks at the internal corners of the berm,expansion of tensile cracks and bedding surface dislocation,development of vertical tensile cracks at the rear edge,and rock mass slipping leading to slope instability.Overall,this study provides a scientific basis for the seismic design of engineering slopes and offers valuable insights for further studies on preventing seismic disasters in bedding parallel stepped rock slopes.
文摘Point-of-care testing(POCT)refers to a category of diagnostic tests that are performed at or near to the site of the patients(also called bedside testing)and is capable of obtaining accurate results in a short time by using portable diagnostic devices,avoiding sending samples to the medical laboratories.It has been extensively explored for diagnosing and monitoring patients’diseases and health conditions with the assistance of development in biochemistry and microfluidics.Microfluidic paper-based analytical devices(μPADs)have gained dramatic popularity in POCT because of their simplicity,user-friendly,fast and accurate result reading and low cost.SeveralμPADs have been successfully commercialized and received excellent feedback during the past several decades.This review briefly discusses the main types ofμPADs,preparation methods and their detection principles,followed by a few representative examples.The future perspectives of the development inμPADs are also provided.
