BACKGROUND Liver transplantation aims to increase the survival of patients with end-stage liver diseases and improve their quality of life.The number of organs available for transplantation is lower than the demand.To...BACKGROUND Liver transplantation aims to increase the survival of patients with end-stage liver diseases and improve their quality of life.The number of organs available for transplantation is lower than the demand.To provide fair organ distribution,predictive mortality scores have been developed.AIM To compare the Acute Physiology and Chronic Health Evaluation IV(APACHE IV),balance of risk(BAR),and model for end-stage liver disease(MELD)scores as predictors of mortality.METHODS Retrospective cohort study,which included 283 adult patients in the postoperative period of deceased donor liver transplantation from 2014 to 2018.RESULTS The transplant recipients were mainly male,with a mean age of 58.1 years.Donors were mostly male,with a mean age of 41.6 years.The median cold ischemia time was 3.1 hours,and the median intensive care unit stay was 5 days.For APACHE IV,a mean of 59.6 was found,BAR 10.7,and MELD 24.2.The 28-day mortality rate was 9.5%,and at 90 days,it was 3.5%.The 28-day mortality prediction for APACHE IV was very good[area under the curve(AUC):0.85,P<0.001,95%CI:0.76-0.94],P<0.001,BAR(AUC:0.70,P<0.001,95%CI:0.58–0.81),and MELD(AUC:0.66,P<0.006,95%CI:0.55-0.78),P<0.008.At 90 days,the data for APACHE IV were very good(AUC:0.80,P<0.001,95%CI:0.71–0.90)and moderate for BAR and MELD,respectively,(AUC:0.66,P<0.004,95%CI:0.55–0.77),(AUC:0.62,P<0.026,95%CI:0.51–0.72).All showed good discrimination between deaths and survivors.As for the best value for liver transplantation,it was significant only for APACHE IV(P<0.001).CONCLUSION The APACHE IV assessment score was more accurate than BAR and MELD in predicting mortality in deceased donor liver transplant recipients.展开更多
In the current era marked by energy shortages,the advancement of nuclear energy stands as an inevitable progression.The reprocessing of spent nuclear fuel plays a crucial role in determining the sustainability of nucl...In the current era marked by energy shortages,the advancement of nuclear energy stands as an inevitable progression.The reprocessing of spent nuclear fuel plays a crucial role in determining the sustainability of nuclear energy as a viable energy source.Among these processes,the separation and recovery of Pu(Ⅳ)from high-level liquid waste(HLLW)hold paramount significance in terms of safety and strategic implications.Herein,this work focused on the synthesis of two acid-and radiation-resistant pyridine-based sp^(2)c-COFs(COF-IHEP3 and COF-IHEP4),followed by the creation of two pyridine-based ionized sp^(2)c-COFs named COF-IHEP3-CH_(3)NO_(3)and COF-IHEP4-CH3NO3through post-modification.These materials have potential anion exchange capacity for the selective separation of Pu(Ⅳ)in highly acidic conditions.Notably,in 8 mol/L nitric acid solution,COF-IHEP3-CH3NO3demonstrated the capability to eliminate plutonium within 20 min in 98%removal efficiency with a Kdvalue of 2450 m L/g.Experimental and theoretical analysis suggest that the ionized sp^(2)c-COFs exhibit exceptional stability,selectivity,and prevention of secondary contamination towards Pu(Ⅳ)in the presence of multiple ions environments.In short,this work provides an appropriate anion exchange strategy to design ionic sp^(2)c-COFs as a promising platform for Pu(Ⅳ)recovery from HLLW.展开更多
BACKGROUND Stage IV pancreatic cancer(PC)has a poor prognosis and lacks individualized prognostic tools.Current survival prediction models are limited,and there is a need for more accurate,personalized methods.The Sur...BACKGROUND Stage IV pancreatic cancer(PC)has a poor prognosis and lacks individualized prognostic tools.Current survival prediction models are limited,and there is a need for more accurate,personalized methods.The Surveillance,Epidemiology,and End Results(SEER)database offers a valuable resource for studying large patient cohorts,yet machine learning-based nomograms for stage IV PC prognosis remain underexplored.This study hypothesizes that a machine learning-based nomogram can predict cancer-specific survival(CSS)and overall survival(OS)with high accuracy in stage IV PC patients.AIM To construct and validate a machine learning-based nomogram for predicting survival in stage IV PC patients using real-world data.METHODS Clinical data from stage IV PC patients diagnosed via pathology from 2000 to 2019 INTRODUCTION Pancreatic cancer(PC)is a significant human health issue and,by 2025,is projected to surpass breast cancer as the third leading cause of cancer-related deaths[1].In the United States,an estimated 66440 new cases and 51750 deaths due to PC were reported in 2024.PC is often asymptomatic in its early stages,with more than half of patients presenting with distant organ metastasis at the time of initial diagnosis[2].Consequently,the prognosis is very poor,with a 5-year relative survival rate of only 12.8%[2]In clinical practice,considerable heterogeneity in survival outcomes has been observed among patients with stage IV PC,highlighting the need for an individualized survival prediction tool for this population.Nomograms,which are visual tools incorporating multiple prognostic factors to predict patient survival,aid in person-alized treatment planning and clinical decision-making and are widely used in cancer prognosis evaluation[3-6].Machine learning,a core technique within artificial intelligence,employs algorithms to analyze data,learn from patterns,and predict real-world events with high accuracy,and is increasingly applied in health assessment,medical decision-making,prognosis,and personalized treatment[7-9].This study leverages the large sample size and comprehensive clinical data from the United State Surveillance,Epidemiology,and End Results(SEER)database to develop a prognostic nomogram for stage IV PC patients using machine learning,with the aim of providing individualized prognostic assessments to improve clinical decision-making.展开更多
A reliable and accurate HPLC/UV method was developed for the quantitative determination of astragaloside IV in ＇Huang-Qi-Si-Wu＇ Capsules, a widely used prescription of traditional Chinese medicines （TCM）. The chro...A reliable and accurate HPLC/UV method was developed for the quantitative determination of astragaloside IV in ＇Huang-Qi-Si-Wu＇ Capsules, a widely used prescription of traditional Chinese medicines （TCM）. The chromatographic separation conditions employed for HPLC/UV were optimized using a Hypersil-ODS column （250 mm^4.6 mm, 5.0 pm） with isocratic elution. Acetonitrile-water （32：68, v/v） were used as the mobile phase pumped at a flow rate of 1.0 mL/min and a detection wavelength at 203 nm was used. The method was fully validated with respect to linearity, precision, accuracy, specificity and robustness. The validated method was applied successfully to the quantification of astragaloside IV in the extract of ＇Huang-Qi- Si-Wu＇ Capsules from different production batches. The results indicate that the established HPLC/UV method is suitable for the quantitative analysis and quality control of ＇Huang-Qi-Si-Wu＇ Capsules and other related botanical drugs.展开更多
AIM: Nonalcoholic steatohepatitis (NASH) is a severe form of nonalcoholic fatty liver disease (NAFLD), and progresses to the end stage of liver disease. Biochemical markers of liver fibrosis are strongly associated wi...AIM: Nonalcoholic steatohepatitis (NASH) is a severe form of nonalcoholic fatty liver disease (NAFLD), and progresses to the end stage of liver disease. Biochemical markers of liver fibrosis are strongly associated with the degree of histological liver fibrosis in patients with chronic liver disease. However, data are few on the usefulness of markers in NAFLD patients. The aim of this study was to identify better noninvasive predictors of hepatic fibrosis, with special focus on markers of liver fibrosis, type VI collagen 7S domain and hyaluronic acid. METHODS: One hundred and twelve patients with histologically proven NAFLD were studied. RESULTS: The histological stage of NAFLD correlated with several clinical and biochemical variables, the extent of hepatic fibrosis and the markers of liver fibrosis were relatively strong associated. The best cutoff values to detect NASH were assessed by using receiver operating characteristic analysis: type VI collagen 75 domain ≥5.0 ng/mL, hyaluronic acid ≥43 ng/mL. Both markers had a high positive predictive value: type VI collagen 7S domain, 86% and hyaluronic acid, 92%. Diagnostic accuracies of these markers were evaluated to detect severe fibrosis. Both markers showed high negative predictive values: type VI collagen 7S domain (≥5.0 ng/mL), 84% and hyaluronic acid (≥50 ng/mL), 78%, and were significantly and independently associated with the presence of NASH or severe fibrosis by logistic regression analysis. CONCLUSION: Both markers of liver fibrosis are useful in discriminating NASH from fatty liver alone or patients with severe fibrosis from patients with non-severe fibrosis.展开更多
Platinum-based anticancer agents such as cisplatin and its analogues are widely used for treating multiple cancers. However, due to the inferior water-solubility, chemoresistance and consequent adverse side effects, t...Platinum-based anticancer agents such as cisplatin and its analogues are widely used for treating multiple cancers. However, due to the inferior water-solubility, chemoresistance and consequent adverse side effects, their clinical applications are limited. Herein, choles Pt(IV), a lipophilic platinum(IV) prodrug was synthesized for manufacture of Choles Pt(IV)-Liposomes aiming to resolve the predefined obstacles encountered by platinum drugs. Following systematic screening, Choles Pt(IV)-Liposomes showed a small particle size(105.6 nm), the rapid release of platinum(Pt) ions, and notable apoptosis of cancer cells.In addition, according to the fluidity and safety results of animal experiments in mice, Choles Pt(IV)-Liposomes also showed better therapeutic effect, which significantly inhibited the growth of patientderived xenograft tumors of hepatocellular carcinoma with an inhibition ratio of 80.7%, and effectively alleviated the drug toxicity brought by traditional platinum drugs. Overall, this study provides a promising route to enhance the therapeutic efficiency of platinum drugs in cancer treatment.展开更多
利用便携式排放测试系统(Portable Emission Measurement System,简称PEMS)和GPS系统(Global Position System,简称GPS)选取多辆天津市机动车进行了道路测试,并对其排放及行驶数据进行了研究,分析了在IVE(International Vehicle Emissio...利用便携式排放测试系统(Portable Emission Measurement System,简称PEMS)和GPS系统(Global Position System,简称GPS)选取多辆天津市机动车进行了道路测试,并对其排放及行驶数据进行了研究,分析了在IVE(International Vehicle Emissions,简称IVE)模型中不同区间的划分方法下,机动车比功率(Vehicle Specific Power,简称VSP)与排放相关系数的差异.CO、CO_2、NO_x排放与VSP相关系数在Paps(Preaverage Power Stress,前平均比功率负载,简称Paps)方案下进行划分时的平均值从原有的引擎负载(Engine Stress,简称ES)方案下的0.1以下上升到0.4以上;但是HC排放与VSP相关系数在ES方案下的均值为0.0370,在Paps方案下却为-0.0766.分别计算污染物实测排放因子与IVE模型改进前和改进后的污染物排放因子的比值,发现采用Paps区间划分方法计算得出的排放因子数据比ES区间划分方法得出的数据显著接近于实测排放因子,显示Paps区间划分方法有助于改善机动车排放估算的准确度.展开更多
文摘BACKGROUND Liver transplantation aims to increase the survival of patients with end-stage liver diseases and improve their quality of life.The number of organs available for transplantation is lower than the demand.To provide fair organ distribution,predictive mortality scores have been developed.AIM To compare the Acute Physiology and Chronic Health Evaluation IV(APACHE IV),balance of risk(BAR),and model for end-stage liver disease(MELD)scores as predictors of mortality.METHODS Retrospective cohort study,which included 283 adult patients in the postoperative period of deceased donor liver transplantation from 2014 to 2018.RESULTS The transplant recipients were mainly male,with a mean age of 58.1 years.Donors were mostly male,with a mean age of 41.6 years.The median cold ischemia time was 3.1 hours,and the median intensive care unit stay was 5 days.For APACHE IV,a mean of 59.6 was found,BAR 10.7,and MELD 24.2.The 28-day mortality rate was 9.5%,and at 90 days,it was 3.5%.The 28-day mortality prediction for APACHE IV was very good[area under the curve(AUC):0.85,P<0.001,95%CI:0.76-0.94],P<0.001,BAR(AUC:0.70,P<0.001,95%CI:0.58–0.81),and MELD(AUC:0.66,P<0.006,95%CI:0.55-0.78),P<0.008.At 90 days,the data for APACHE IV were very good(AUC:0.80,P<0.001,95%CI:0.71–0.90)and moderate for BAR and MELD,respectively,(AUC:0.66,P<0.004,95%CI:0.55–0.77),(AUC:0.62,P<0.026,95%CI:0.51–0.72).All showed good discrimination between deaths and survivors.As for the best value for liver transplantation,it was significant only for APACHE IV(P<0.001).CONCLUSION The APACHE IV assessment score was more accurate than BAR and MELD in predicting mortality in deceased donor liver transplant recipients.
基金supported by the National Natural Science Foundation of China(Nos.U2067212,22176191)the National Science Fund for Distinguished Young Scholars(No.21925603)。
文摘In the current era marked by energy shortages,the advancement of nuclear energy stands as an inevitable progression.The reprocessing of spent nuclear fuel plays a crucial role in determining the sustainability of nuclear energy as a viable energy source.Among these processes,the separation and recovery of Pu(Ⅳ)from high-level liquid waste(HLLW)hold paramount significance in terms of safety and strategic implications.Herein,this work focused on the synthesis of two acid-and radiation-resistant pyridine-based sp^(2)c-COFs(COF-IHEP3 and COF-IHEP4),followed by the creation of two pyridine-based ionized sp^(2)c-COFs named COF-IHEP3-CH_(3)NO_(3)and COF-IHEP4-CH3NO3through post-modification.These materials have potential anion exchange capacity for the selective separation of Pu(Ⅳ)in highly acidic conditions.Notably,in 8 mol/L nitric acid solution,COF-IHEP3-CH3NO3demonstrated the capability to eliminate plutonium within 20 min in 98%removal efficiency with a Kdvalue of 2450 m L/g.Experimental and theoretical analysis suggest that the ionized sp^(2)c-COFs exhibit exceptional stability,selectivity,and prevention of secondary contamination towards Pu(Ⅳ)in the presence of multiple ions environments.In short,this work provides an appropriate anion exchange strategy to design ionic sp^(2)c-COFs as a promising platform for Pu(Ⅳ)recovery from HLLW.
基金Supported by Mianyang Health and Health Committee 2023 Scientific Research Project,No.202309Chengdu University of Traditional Chinese Medicine University-Hospital Joint Innovation Fund,No.LH202402010Mianyang Chinese Medicine Association 2024 Traditional Chinese Medicine Inheritance and Innovation Science and Technology Project,No.MYSZYYXH-202426.
文摘BACKGROUND Stage IV pancreatic cancer(PC)has a poor prognosis and lacks individualized prognostic tools.Current survival prediction models are limited,and there is a need for more accurate,personalized methods.The Surveillance,Epidemiology,and End Results(SEER)database offers a valuable resource for studying large patient cohorts,yet machine learning-based nomograms for stage IV PC prognosis remain underexplored.This study hypothesizes that a machine learning-based nomogram can predict cancer-specific survival(CSS)and overall survival(OS)with high accuracy in stage IV PC patients.AIM To construct and validate a machine learning-based nomogram for predicting survival in stage IV PC patients using real-world data.METHODS Clinical data from stage IV PC patients diagnosed via pathology from 2000 to 2019 INTRODUCTION Pancreatic cancer(PC)is a significant human health issue and,by 2025,is projected to surpass breast cancer as the third leading cause of cancer-related deaths[1].In the United States,an estimated 66440 new cases and 51750 deaths due to PC were reported in 2024.PC is often asymptomatic in its early stages,with more than half of patients presenting with distant organ metastasis at the time of initial diagnosis[2].Consequently,the prognosis is very poor,with a 5-year relative survival rate of only 12.8%[2]In clinical practice,considerable heterogeneity in survival outcomes has been observed among patients with stage IV PC,highlighting the need for an individualized survival prediction tool for this population.Nomograms,which are visual tools incorporating multiple prognostic factors to predict patient survival,aid in person-alized treatment planning and clinical decision-making and are widely used in cancer prognosis evaluation[3-6].Machine learning,a core technique within artificial intelligence,employs algorithms to analyze data,learn from patterns,and predict real-world events with high accuracy,and is increasingly applied in health assessment,medical decision-making,prognosis,and personalized treatment[7-9].This study leverages the large sample size and comprehensive clinical data from the United State Surveillance,Epidemiology,and End Results(SEER)database to develop a prognostic nomogram for stage IV PC patients using machine learning,with the aim of providing individualized prognostic assessments to improve clinical decision-making.
基金Scientific and Technological Innovation Project Foundation of Shanxi,China(Grant No.20090321099)
文摘A reliable and accurate HPLC/UV method was developed for the quantitative determination of astragaloside IV in ＇Huang-Qi-Si-Wu＇ Capsules, a widely used prescription of traditional Chinese medicines （TCM）. The chromatographic separation conditions employed for HPLC/UV were optimized using a Hypersil-ODS column （250 mm^4.6 mm, 5.0 pm） with isocratic elution. Acetonitrile-water （32：68, v/v） were used as the mobile phase pumped at a flow rate of 1.0 mL/min and a detection wavelength at 203 nm was used. The method was fully validated with respect to linearity, precision, accuracy, specificity and robustness. The validated method was applied successfully to the quantification of astragaloside IV in the extract of ＇Huang-Qi- Si-Wu＇ Capsules from different production batches. The results indicate that the established HPLC/UV method is suitable for the quantitative analysis and quality control of ＇Huang-Qi-Si-Wu＇ Capsules and other related botanical drugs.
文摘AIM: Nonalcoholic steatohepatitis (NASH) is a severe form of nonalcoholic fatty liver disease (NAFLD), and progresses to the end stage of liver disease. Biochemical markers of liver fibrosis are strongly associated with the degree of histological liver fibrosis in patients with chronic liver disease. However, data are few on the usefulness of markers in NAFLD patients. The aim of this study was to identify better noninvasive predictors of hepatic fibrosis, with special focus on markers of liver fibrosis, type VI collagen 7S domain and hyaluronic acid. METHODS: One hundred and twelve patients with histologically proven NAFLD were studied. RESULTS: The histological stage of NAFLD correlated with several clinical and biochemical variables, the extent of hepatic fibrosis and the markers of liver fibrosis were relatively strong associated. The best cutoff values to detect NASH were assessed by using receiver operating characteristic analysis: type VI collagen 75 domain ≥5.0 ng/mL, hyaluronic acid ≥43 ng/mL. Both markers had a high positive predictive value: type VI collagen 7S domain, 86% and hyaluronic acid, 92%. Diagnostic accuracies of these markers were evaluated to detect severe fibrosis. Both markers showed high negative predictive values: type VI collagen 7S domain (≥5.0 ng/mL), 84% and hyaluronic acid (≥50 ng/mL), 78%, and were significantly and independently associated with the presence of NASH or severe fibrosis by logistic regression analysis. CONCLUSION: Both markers of liver fibrosis are useful in discriminating NASH from fatty liver alone or patients with severe fibrosis from patients with non-severe fibrosis.
基金financially supported by the GDNRC [Guangdong Nature Resource Center](2020)(037)National Natural Science Foundation of China (Nos. 81773642, 52073139)+3 种基金the Natural Science Foundation of Guangdong Province (No. 2019A1515011619)Guangdong Provincial Science and Technology Department (No.2016A030311015)the Key R&D Plan of Chenzhou (No.ZDYF202008)the Discipline Leader Startup Fund of Huazhong University of Science and Technoloy Union Shenzhen Hospital (No.YN2021002)。
文摘Platinum-based anticancer agents such as cisplatin and its analogues are widely used for treating multiple cancers. However, due to the inferior water-solubility, chemoresistance and consequent adverse side effects, their clinical applications are limited. Herein, choles Pt(IV), a lipophilic platinum(IV) prodrug was synthesized for manufacture of Choles Pt(IV)-Liposomes aiming to resolve the predefined obstacles encountered by platinum drugs. Following systematic screening, Choles Pt(IV)-Liposomes showed a small particle size(105.6 nm), the rapid release of platinum(Pt) ions, and notable apoptosis of cancer cells.In addition, according to the fluidity and safety results of animal experiments in mice, Choles Pt(IV)-Liposomes also showed better therapeutic effect, which significantly inhibited the growth of patientderived xenograft tumors of hepatocellular carcinoma with an inhibition ratio of 80.7%, and effectively alleviated the drug toxicity brought by traditional platinum drugs. Overall, this study provides a promising route to enhance the therapeutic efficiency of platinum drugs in cancer treatment.
文摘利用便携式排放测试系统(Portable Emission Measurement System,简称PEMS)和GPS系统(Global Position System,简称GPS)选取多辆天津市机动车进行了道路测试,并对其排放及行驶数据进行了研究,分析了在IVE(International Vehicle Emissions,简称IVE)模型中不同区间的划分方法下,机动车比功率(Vehicle Specific Power,简称VSP)与排放相关系数的差异.CO、CO_2、NO_x排放与VSP相关系数在Paps(Preaverage Power Stress,前平均比功率负载,简称Paps)方案下进行划分时的平均值从原有的引擎负载(Engine Stress,简称ES)方案下的0.1以下上升到0.4以上;但是HC排放与VSP相关系数在ES方案下的均值为0.0370,在Paps方案下却为-0.0766.分别计算污染物实测排放因子与IVE模型改进前和改进后的污染物排放因子的比值,发现采用Paps区间划分方法计算得出的排放因子数据比ES区间划分方法得出的数据显著接近于实测排放因子,显示Paps区间划分方法有助于改善机动车排放估算的准确度.
