We herein present a case involving a 41-year-old woman in whom ultrasound examination revealed multiple liver hemangiomas more than 3 years ago.Follow-up ultrasound examination revealed that the masses had significant...We herein present a case involving a 41-year-old woman in whom ultrasound examination revealed multiple liver hemangiomas more than 3 years ago.Follow-up ultrasound examination revealed that the masses had significantly increased;the largest was located in the right lobe(about 8.2 cm×7.4 cm×6.0cm).Abdominal multidetector computed tomographyrevealed multiple well-circumscribed,heterogeneous,hypodense masses(largest,6.4 cm×6.3 cm×5.0cm)with significant contrast enhancement during the arterial and portal phases and with contrast washout and peripheral enhancement during the delayed phases.Magnetic resonance images demonstrated multiple well-circumscribed,heterogeneous,hypointense hepatic masses with significant contrast enhancement(largest,6.4 cm×6.5 cm×5.1 cm);multiple enlarged porta lymph nodes;and multiple s l i g h t l y e n l a rg e d re t ro p e r i t o n e a l l y m p h n o d e s.Histological and immunohistochemical examination of the right mass biopsy specimen suggested a malignant neoplasm that had originated from a neuroendocrine cell type(grade 2 well-differentiated neuroendocrine carcinoma).After performing a systemic examination to exclude metastasis from an extrahepatic primary site,we considered that the masses had arisen from a primary hepatic neuroendocrine tumor with multiple liver metastases.The patient underwent transcatheter arterial chemoembolization using a combination of oxaliplatin(150 mg)mixed with one bottle of gelatin sponge particles(560-710μm)and lipiodol(6 m L).Primary neuroendocrine tumors of the liver are extremely rare.This case is interesting because of the rarity of this neoplasm and previous misdiagnosis as multiple liver hemangiomas.Previously reported cases in the literature are also reviewed.展开更多
Breast cancer can metastasize to other organs following initial treatment.Bones, liver, and the lung are the most common sites of breast cancer metastases.The digestive tract, on the other hand, is rarely involved.The...Breast cancer can metastasize to other organs following initial treatment.Bones, liver, and the lung are the most common sites of breast cancer metastases.The digestive tract, on the other hand, is rarely involved.The incidence of mesorectal metastasis(a special category of rectal metastases) from breast cancer has not been described before.The case reported herein concerns a 68-year-old woman who underwent mastectomy.A pelvic mass with no symptoms was subsequently identified by computed tomography in the patient.We ultimately confirmed that this mass was a metastasis from breast cancer located in the mesorectum using surgical exploration and pathology results.展开更多
Objective:To evaluate the value of18F-fluorodeoxyglucose positron emission tomography/computed tomography(18F-FDG PET/CT)in the diagnosis of cervical lymph node metastasis of oral carcinoma.Methods:China national know...Objective:To evaluate the value of18F-fluorodeoxyglucose positron emission tomography/computed tomography(18F-FDG PET/CT)in the diagnosis of cervical lymph node metastasis of oral carcinoma.Methods:China national knowledge infrastructure,Wanfang,Chinese sci-tech journal database,PubMed,EMbase,the Cochrane Library and Web of Science were searched for18F-FDG PET/CT in cervical lymph node metastasis oral cancer.Literature screening,data extraction and literature quality evaluation were carried out independently by two researchers according to the unified classification criteria.Stata13.0 software and Meta-Disc1.4 software were used for meta-analysis.Results:A total of 14 studies with 849 cases of patients with cervical metastasis of oral cancer were included,among which 9 studies were conducted on patients,with a total of 299 patients,and 5 studies were conducted on lymph nodes,with 1965 patients with cervical lymph node proved pathologically.The results of meta analysis showed that18F-FDG PET/CT had good sensitivity and specificity in the diagnosis of cervical lymph node metastasis of oral cancer.The results showed that sensitivity=0.81(95%CI:0.73-0.87),specificity=0.90(95%CI:0.83-0.94),combined likelihood ratio=7.9(95%CI:4.9-12.7),negative likelihood ratio=0.21(95%CI:0.15-0.30),diagnostic odds ratio=37(95%CI:20-67),and receiver operating characteristic curve=0.91(95%CI:0.89-0.94).Conclusions:18F-FDG PET/CT has high sensitivity and specificity in the diagnosis of cervical lymph node metastasis,and can be used as an important preoperative evaluation method for oral cancer.展开更多
目的系统评价妊娠早期循环metastin/kisspeptin水平与自然流产(SAB)的相关性。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、中国知网、万方、维普中文科技期刊数据库和中国生物医学文献数据库,搜集有关妊娠...目的系统评价妊娠早期循环metastin/kisspeptin水平与自然流产(SAB)的相关性。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、中国知网、万方、维普中文科技期刊数据库和中国生物医学文献数据库,搜集有关妊娠早期循环kisspeptin水平与SAB相关性的研究,检索文献的时间设置均为从建库至2020年6月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan5.3软件进行meta分析。结果共纳入3个巢式病例对照研究、2个病例对照研究和1个前瞻性队列研究,包括SAB患者157例,作为对照的正常宫内妊娠(IUP)孕妇1018例。meta分析显示,SAB组kisspeptin水平低于IUP组[SMD=-1.68,95%CI:-2.65~-0.72,P=0.0006]。结论循环metastin/kisspeptin水平降低与SAB有一定相关性,受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。展开更多
The liver is a common site for cancer metastasis and a key metabolic organ.Lipid metabolism irregularities are linked to liver metastasis risk,but the mechanisms are not fully understood.Herein,in colorectal cancer li...The liver is a common site for cancer metastasis and a key metabolic organ.Lipid metabolism irregularities are linked to liver metastasis risk,but the mechanisms are not fully understood.Herein,in colorectal cancer liver metastasis(CRLM)clinical samples,lipid metabolism was broadly dysregulated,and lipid metabolites accumulated,as shown by integrated transcriptome and lipidomics analyses.Functionally,lipid deposition promotes liver metastasis in vitro and in vivo.Mechanistically,lipid deposition significantly enhances YTHDF3-mediated m6A modification and degradation of PPARα,which is crucial for liver metastasis.This process reduces theβ-hydroxybutyrylation of YTHDF3,thereby promoting LLPS and increasing the stability of YTHDF3,which in turn facilitates the progression of CRC and liver metastasis.Furthermore,lipid deposition induces the interaction between STAT3 and YAP,activating YTHDF3 transcription.These two regulatory mechanisms synergize to drive YTHDF3 accumulation in lipid-rich metastatic lesions.In summary,our findings reveal that lipid deposition promotes LLPS-mediated m6A modification and decreasesβ-hydroxybutyrylation in liver metastasis,offering new strategies for the treatment of CRLM.展开更多
In microwave communication systems,focusing and imaging have attracted widespread attention due to their application prospects in the information processing and communication fields.Most existing multi-channel focusin...In microwave communication systems,focusing and imaging have attracted widespread attention due to their application prospects in the information processing and communication fields.Most existing multi-channel focusing and imaging are implemented by interleaved metasurfaces.However,the disadvantages of their large size and low efficiency limit their practical applications in large-capacity and low-loss integrated systems.To solve these issues,here,we propose a non-interleaved polarization-frequency multiplexing metasurface for high-efficiency multi-channel focusing and imaging.The meta-atoms of the non-interleaved metasurface are composed of a metallic ground plate,two dielectric layers,a larger cross-shaped metal structure,and a smaller cross-shaped metal structure embedded by a circular metal aperture.By altering the size of two cross-shaped structures,the designed meta-atom can obtain the independent complete 2π phase coverage with high reflection efficiency at two different frequency ranges for two orthogonal linear polarization(LP)incidences,realizing polarization multiplexing and frequency multiplexing.Moreover,two types of metasurfaces based on the above meta-atoms are designed to realize multi-channel focusing and imaging with high efficiency.As a proof,the focusing metasurface is fabricated and measured,and the measured results are well consistent with simulated results.Therefore,the proposed scheme has the advantages of high efficiency,multi-channel,and compact size,which possesses broad application prospects in low-loss and multichannel communication integrated systems.展开更多
In modern science and technology,on-demand control of the polarization and wavefront of electromagnetic(EM)waves is crucial for compact opto-electronic systems.Metasurfaces composed of subwavelength array structures i...In modern science and technology,on-demand control of the polarization and wavefront of electromagnetic(EM)waves is crucial for compact opto-electronic systems.Metasurfaces composed of subwavelength array structures inject infinite vitality to shape this fantastic concept,which has fundamentally changed the way humans engineer matter–wave interactions.However,achieving full-space arbitrarily polarized beams with independent wavefronts in broadband on a single metasurface aperture still remains challenging.Herein,the authors propose a generic method for broadband transmission-reflection-integrated wavefronts shaping with multichannel arbitrary polarization regulation from 8 to 16 GHz,which is based on the chirality effect of full-space non-interleaved tetrameric meta-molecules.Through superimposing eigen-polarization responses of the two kinds of enantiomers,the possibility for high-efficiency evolution of several typical polarization states with specific wavefronts is demonstrated.As proofs-of-concept,the feasibility of our methodology is validated via implementing miscellaneous functionalities,including circularly polarized(CP)beam splitting,linearly polarized(LP)vortex beams generation,and CP and LP multifoci.Meanwhile,numerous simulated and experimental results are in excellent agreement with the theoretical predictions.Encouragingly,this proposed approach imaginatively merges broadband polarization and phase control into one single full-space and shared-aperture EM device,which can extremely enhance the functional richness and information capacity in advanced integrated systems.展开更多
采用证据图梳理近六年中医药治疗糖尿病肾脏病(DKD)的相关临床研究,系统评估该领域的证据现状,以期为现存问题及后续研究方向提供科学依据和决策参考。系统检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、中国生物医学文献服务系统(Sin...采用证据图梳理近六年中医药治疗糖尿病肾脏病(DKD)的相关临床研究,系统评估该领域的证据现状,以期为现存问题及后续研究方向提供科学依据和决策参考。系统检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、EMbase、Web of Science、Cochrane Library等数据库中医药治疗DKD的文献,经过多次筛选,共纳入310篇文献,其中随机对照试验(RCTs)289篇,系统评价/Meta分析13篇,指南/专家共识8篇。整体发文量呈上升趋势,其中干预方式以口服为主,疗程多在2~3个月,样本量集中在50~100例。涉及30种中药汤剂、39种中成药,以参芪地黄汤、益肾化湿颗粒发文量最多。纳入中医证型以气阴两虚、脾肾两虚为主。结局指标纳入较多的有临床有效率、血糖相关、肾功能等指标,缺少对长期结局检测等问题。方法学质量评估方面,多数RCT在分配隐藏、盲法实施等存在严重缺陷,整体质量不高。系统评价/Meta分析的质量评估等级也均为“极低级”。指南/专家共识整体质量尚可,在严谨性和临床应用等方面待进一步完善。后续应重视以上问题,提升临床研究质量,发挥中医药优势,为中医药防治DKD的临床决策提供更可靠的循证依据。展开更多
To the Editor:In recent years,the treatment for metastatic hormone-sensitive prostate cancer(mHSPC)has undergone rapid developments.Docetaxel(DOC)or androgen receptor-targeted agent(ARTA)and androgen deprivation thera...To the Editor:In recent years,the treatment for metastatic hormone-sensitive prostate cancer(mHSPC)has undergone rapid developments.Docetaxel(DOC)or androgen receptor-targeted agent(ARTA)and androgen deprivation therapy(ADT)are the most commonly used systemic therapies.Multiple meta-analyses or network meta-analyses(NMAs)have been undertaken to evaluate and contrast the various treatment options available for mHSPC.However,the clinical efficacy of DOC in triplet therapy for mHSPC is yet to be confirmed,especially in categorizing the patients based on both volume of disease and timing of metastases.Bringing these controversies to light may have a timely and important impact on further clinical trials.Moreover,based on these trials and our NMA study,triplet therapy has evident benefits on overall survival(OS)and progression-free survival(PFS)in patients with mHSPC.The NMA study presented in this thesis is one of the first studies that assessed the efficacy of DOC and selected patients who will benefit from triplet therapy.展开更多
目的系统评价儿童结核病患者家庭照顾者的照护体验。方法检索PubMed、Embase、Web of Science、CINAHL、Cochrane Library、中国知网、万方、中国生物医学文献数据库中相关质性研究,检索时限为建库至2025年12月。结果共纳入12篇文献,提...目的系统评价儿童结核病患者家庭照顾者的照护体验。方法检索PubMed、Embase、Web of Science、CINAHL、Cochrane Library、中国知网、万方、中国生物医学文献数据库中相关质性研究,检索时限为建库至2025年12月。结果共纳入12篇文献,提取27个主题,归纳为8个类别,整合成3个结果:多维耗竭与生活秩序崩解,在制度刚性与支持断裂中寻求生存支点,意义、技能与希望的生成。结论儿童结核病家庭照顾者承受多重压力,但能通过认知重构与技能创新实现主动照护。医护人员应加强个体化赋能、推行家庭为中心的服务模式,并完善政策支持与去污名化宣传,以减轻照顾者负担。展开更多
目的系统分析开颅术后发生手术部位感染(SSI)的危险因素,为SSI防控提供循证依据。方法检索建库至2025年6月的中英文数据库,包括CNKI、万方、维普、CBM、PubMed、Embase、Cochrane Library、Web of Science,收集开颅术后SSI相关文献。经...目的系统分析开颅术后发生手术部位感染(SSI)的危险因素,为SSI防控提供循证依据。方法检索建库至2025年6月的中英文数据库,包括CNKI、万方、维普、CBM、PubMed、Embase、Cochrane Library、Web of Science,收集开颅术后SSI相关文献。经文献筛选后,采用纽卡斯尔-渥太华量表(NOS)评价文献质量,使用RevMan 5.3软件进行数据分析。结果最终纳入15篇文献,共36042例研究对象。Meta分析结果显示,与开颅术后SSI显著相关的危险因素为五项,包括性别(男性)(OR=1.23,95%CI:1.09~1.38,P<0.001)、急诊手术(OR=2.04,95%CI:1.10~3.79,P=0.020)、二次手术(OR=3.44,95%CI:1.82~6.50,P<0.001)、脑脊液漏(OR=13.11,95%CI:5.09~33.77,P<0.001)、术后留置引流管(OR=3.42,95%CI:1.62~7.18,P=0.001)。结论开颅术后发生手术部位感染对患者危害大,多种因素可导致发生发展。临床需重点针对高风险因素实施重点防控,如强化脑脊液漏预防与引流管规范化管理、优化急诊/二次手术操作流程、加强男性患者围术期监测,以有效降低神经外科开颅术后SSI发生率。展开更多
目的分析伏诺拉生(VPZ)治疗消化性溃疡(PU)和内镜黏膜下剥离术(ESD)术后溃疡的安全性与有效性,为临床实践、医疗决策提供循证药学证据。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science、...目的分析伏诺拉生(VPZ)治疗消化性溃疡(PU)和内镜黏膜下剥离术(ESD)术后溃疡的安全性与有效性,为临床实践、医疗决策提供循证药学证据。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science、the Cochrane Library等数据库,获取VPZ治疗PU和ESD术后溃疡相关的Meta分析/系统评价。由2名研究者独立进行文献筛选、数据提取、文献质量评估、文献重叠程度评估,采用伞形评价分析方法;当纳入的文献高度重叠时,对所有相关原始研究数据重新进行Meta分析。结果共纳入17项Meta分析,质量从高质量到极低质量不等;所有涉及的结局指标,在纳入的相关Meta分析中均存在非常高的重叠水平(校正覆盖面积为22.22%~100%)。治疗ESD术后溃疡时,与质子泵抑制剂(PPI)比较,VPZ可显著提高ESD术后4周的溃疡愈合率[RR=1.27,95%CI(1.03,1.56),Z=2.21,P=0.027]和溃疡收缩率[MD=0.08,95%CI(0.00,0.16),Z=2.09,P=0.037],显著降低具有PU病史患者的溃疡复发率[RR=0.49,95%CI(0.32,0.73),Z=3.49,P=0.001];VPZ组延迟出血率较兰索拉唑亚组显著降低[RR=0.47,95%CI(0.25,0.90),Z=2.28,P=0.02]。治疗PU时,十二指肠溃疡亚组中,VPZ的不良事件发生率明显高于PPI[RR=1.13,95%CI(1.02,1.26),Z=2.38,P=0.017]。结论对于ESD术后溃疡,VPZ的治疗效果优于PPI,且可以降低具有PU病史患者的溃疡复发率,但在治疗十二指肠溃疡的安全性方面并不具有优势。展开更多
目的基于Meta分析方法讨论中成药联合替格瑞洛治疗冠心病心绞痛的有效性。方法检索中英文数据库,包括中国知网、万方、维普、PubMed、Embase和Web of Science等,筛选中成药联合替格瑞洛治疗冠心病心绞痛的随机对照试验,检索时间为建库至...目的基于Meta分析方法讨论中成药联合替格瑞洛治疗冠心病心绞痛的有效性。方法检索中英文数据库,包括中国知网、万方、维普、PubMed、Embase和Web of Science等,筛选中成药联合替格瑞洛治疗冠心病心绞痛的随机对照试验,检索时间为建库至2024年12月。采用RevMan5.3软件对纳入的文献进行数据分析及绘图。结果共纳入24篇文献,Meta分析结果提示:与对照组比较,试验组的治疗总有效率升高,每周发作次数和发作持续时间显著降低(P<0.00001)。结论中成药联合替格瑞洛可以提高冠心病心绞痛患者的治疗总有效率,明显减少心绞痛每周发作次数与发作持续时间,这对于缓解患者症状、提升生活质量具有积极意义。展开更多
文摘We herein present a case involving a 41-year-old woman in whom ultrasound examination revealed multiple liver hemangiomas more than 3 years ago.Follow-up ultrasound examination revealed that the masses had significantly increased;the largest was located in the right lobe(about 8.2 cm×7.4 cm×6.0cm).Abdominal multidetector computed tomographyrevealed multiple well-circumscribed,heterogeneous,hypodense masses(largest,6.4 cm×6.3 cm×5.0cm)with significant contrast enhancement during the arterial and portal phases and with contrast washout and peripheral enhancement during the delayed phases.Magnetic resonance images demonstrated multiple well-circumscribed,heterogeneous,hypointense hepatic masses with significant contrast enhancement(largest,6.4 cm×6.5 cm×5.1 cm);multiple enlarged porta lymph nodes;and multiple s l i g h t l y e n l a rg e d re t ro p e r i t o n e a l l y m p h n o d e s.Histological and immunohistochemical examination of the right mass biopsy specimen suggested a malignant neoplasm that had originated from a neuroendocrine cell type(grade 2 well-differentiated neuroendocrine carcinoma).After performing a systemic examination to exclude metastasis from an extrahepatic primary site,we considered that the masses had arisen from a primary hepatic neuroendocrine tumor with multiple liver metastases.The patient underwent transcatheter arterial chemoembolization using a combination of oxaliplatin(150 mg)mixed with one bottle of gelatin sponge particles(560-710μm)and lipiodol(6 m L).Primary neuroendocrine tumors of the liver are extremely rare.This case is interesting because of the rarity of this neoplasm and previous misdiagnosis as multiple liver hemangiomas.Previously reported cases in the literature are also reviewed.
基金Supported by Affiliated Zhongshan Hospital of Dalian University,Dalian,Liaoning,China
文摘Breast cancer can metastasize to other organs following initial treatment.Bones, liver, and the lung are the most common sites of breast cancer metastases.The digestive tract, on the other hand, is rarely involved.The incidence of mesorectal metastasis(a special category of rectal metastases) from breast cancer has not been described before.The case reported herein concerns a 68-year-old woman who underwent mastectomy.A pelvic mass with no symptoms was subsequently identified by computed tomography in the patient.We ultimately confirmed that this mass was a metastasis from breast cancer located in the mesorectum using surgical exploration and pathology results.
文摘Objective:To evaluate the value of18F-fluorodeoxyglucose positron emission tomography/computed tomography(18F-FDG PET/CT)in the diagnosis of cervical lymph node metastasis of oral carcinoma.Methods:China national knowledge infrastructure,Wanfang,Chinese sci-tech journal database,PubMed,EMbase,the Cochrane Library and Web of Science were searched for18F-FDG PET/CT in cervical lymph node metastasis oral cancer.Literature screening,data extraction and literature quality evaluation were carried out independently by two researchers according to the unified classification criteria.Stata13.0 software and Meta-Disc1.4 software were used for meta-analysis.Results:A total of 14 studies with 849 cases of patients with cervical metastasis of oral cancer were included,among which 9 studies were conducted on patients,with a total of 299 patients,and 5 studies were conducted on lymph nodes,with 1965 patients with cervical lymph node proved pathologically.The results of meta analysis showed that18F-FDG PET/CT had good sensitivity and specificity in the diagnosis of cervical lymph node metastasis of oral cancer.The results showed that sensitivity=0.81(95%CI:0.73-0.87),specificity=0.90(95%CI:0.83-0.94),combined likelihood ratio=7.9(95%CI:4.9-12.7),negative likelihood ratio=0.21(95%CI:0.15-0.30),diagnostic odds ratio=37(95%CI:20-67),and receiver operating characteristic curve=0.91(95%CI:0.89-0.94).Conclusions:18F-FDG PET/CT has high sensitivity and specificity in the diagnosis of cervical lymph node metastasis,and can be used as an important preoperative evaluation method for oral cancer.
文摘目的系统评价妊娠早期循环metastin/kisspeptin水平与自然流产(SAB)的相关性。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、中国知网、万方、维普中文科技期刊数据库和中国生物医学文献数据库,搜集有关妊娠早期循环kisspeptin水平与SAB相关性的研究,检索文献的时间设置均为从建库至2020年6月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan5.3软件进行meta分析。结果共纳入3个巢式病例对照研究、2个病例对照研究和1个前瞻性队列研究,包括SAB患者157例,作为对照的正常宫内妊娠(IUP)孕妇1018例。meta分析显示,SAB组kisspeptin水平低于IUP组[SMD=-1.68,95%CI:-2.65~-0.72,P=0.0006]。结论循环metastin/kisspeptin水平降低与SAB有一定相关性,受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。
基金supported by the National Natural Founda tion of China(grant numbers 82130080,82273145,82372042,U24A20726)the Guangdong Basic and Applied Basic Research Foundation(grant numbers 2021A1515010224,2024A1515012816,2023A1515011339).
文摘The liver is a common site for cancer metastasis and a key metabolic organ.Lipid metabolism irregularities are linked to liver metastasis risk,but the mechanisms are not fully understood.Herein,in colorectal cancer liver metastasis(CRLM)clinical samples,lipid metabolism was broadly dysregulated,and lipid metabolites accumulated,as shown by integrated transcriptome and lipidomics analyses.Functionally,lipid deposition promotes liver metastasis in vitro and in vivo.Mechanistically,lipid deposition significantly enhances YTHDF3-mediated m6A modification and degradation of PPARα,which is crucial for liver metastasis.This process reduces theβ-hydroxybutyrylation of YTHDF3,thereby promoting LLPS and increasing the stability of YTHDF3,which in turn facilitates the progression of CRC and liver metastasis.Furthermore,lipid deposition induces the interaction between STAT3 and YAP,activating YTHDF3 transcription.These two regulatory mechanisms synergize to drive YTHDF3 accumulation in lipid-rich metastatic lesions.In summary,our findings reveal that lipid deposition promotes LLPS-mediated m6A modification and decreasesβ-hydroxybutyrylation in liver metastasis,offering new strategies for the treatment of CRLM.
基金National Natural Science Foundation of China(62075052,6227419)National Key Research and Development Program of China(2024YFE0108300)+2 种基金Science and Technology Major Project of Guangxi,China(Gui Ke AA21077015,Gui Ke AA24263032)Science Foundation of the National Key Laboratory of Science and Technology on Advanced Composites in Special Environments(JCKYS2020603C009,6142905212711)Project of Innovative and Entrepreneurship Training Program for College Students in Heilongjiang Province(201810214105)。
文摘In microwave communication systems,focusing and imaging have attracted widespread attention due to their application prospects in the information processing and communication fields.Most existing multi-channel focusing and imaging are implemented by interleaved metasurfaces.However,the disadvantages of their large size and low efficiency limit their practical applications in large-capacity and low-loss integrated systems.To solve these issues,here,we propose a non-interleaved polarization-frequency multiplexing metasurface for high-efficiency multi-channel focusing and imaging.The meta-atoms of the non-interleaved metasurface are composed of a metallic ground plate,two dielectric layers,a larger cross-shaped metal structure,and a smaller cross-shaped metal structure embedded by a circular metal aperture.By altering the size of two cross-shaped structures,the designed meta-atom can obtain the independent complete 2π phase coverage with high reflection efficiency at two different frequency ranges for two orthogonal linear polarization(LP)incidences,realizing polarization multiplexing and frequency multiplexing.Moreover,two types of metasurfaces based on the above meta-atoms are designed to realize multi-channel focusing and imaging with high efficiency.As a proof,the focusing metasurface is fabricated and measured,and the measured results are well consistent with simulated results.Therefore,the proposed scheme has the advantages of high efficiency,multi-channel,and compact size,which possesses broad application prospects in low-loss and multichannel communication integrated systems.
基金National Key Research and Development Program of China(SQ2022YFB3806200)National Natural Science Foundation of China(62301596,62101588)+1 种基金Young Talent Fund of Association for Science and Technology in Shaanxi(20240129)Postdoctoral Fellowship Program of CPSF(GZC20242285)。
文摘In modern science and technology,on-demand control of the polarization and wavefront of electromagnetic(EM)waves is crucial for compact opto-electronic systems.Metasurfaces composed of subwavelength array structures inject infinite vitality to shape this fantastic concept,which has fundamentally changed the way humans engineer matter–wave interactions.However,achieving full-space arbitrarily polarized beams with independent wavefronts in broadband on a single metasurface aperture still remains challenging.Herein,the authors propose a generic method for broadband transmission-reflection-integrated wavefronts shaping with multichannel arbitrary polarization regulation from 8 to 16 GHz,which is based on the chirality effect of full-space non-interleaved tetrameric meta-molecules.Through superimposing eigen-polarization responses of the two kinds of enantiomers,the possibility for high-efficiency evolution of several typical polarization states with specific wavefronts is demonstrated.As proofs-of-concept,the feasibility of our methodology is validated via implementing miscellaneous functionalities,including circularly polarized(CP)beam splitting,linearly polarized(LP)vortex beams generation,and CP and LP multifoci.Meanwhile,numerous simulated and experimental results are in excellent agreement with the theoretical predictions.Encouragingly,this proposed approach imaginatively merges broadband polarization and phase control into one single full-space and shared-aperture EM device,which can extremely enhance the functional richness and information capacity in advanced integrated systems.
文摘采用证据图梳理近六年中医药治疗糖尿病肾脏病(DKD)的相关临床研究,系统评估该领域的证据现状,以期为现存问题及后续研究方向提供科学依据和决策参考。系统检索中国知网(CNKI)、万方(Wanfang)、维普(VIP)、中国生物医学文献服务系统(SinoMed)、PubMed、EMbase、Web of Science、Cochrane Library等数据库中医药治疗DKD的文献,经过多次筛选,共纳入310篇文献,其中随机对照试验(RCTs)289篇,系统评价/Meta分析13篇,指南/专家共识8篇。整体发文量呈上升趋势,其中干预方式以口服为主,疗程多在2~3个月,样本量集中在50~100例。涉及30种中药汤剂、39种中成药,以参芪地黄汤、益肾化湿颗粒发文量最多。纳入中医证型以气阴两虚、脾肾两虚为主。结局指标纳入较多的有临床有效率、血糖相关、肾功能等指标,缺少对长期结局检测等问题。方法学质量评估方面,多数RCT在分配隐藏、盲法实施等存在严重缺陷,整体质量不高。系统评价/Meta分析的质量评估等级也均为“极低级”。指南/专家共识整体质量尚可,在严谨性和临床应用等方面待进一步完善。后续应重视以上问题,提升临床研究质量,发挥中医药优势,为中医药防治DKD的临床决策提供更可靠的循证依据。
基金funded by grants from the Shanghai Science Committee Foundation(No.19411967700)the National Natural Science Foundation of China(No.31570993)the Wu Jieping Medical Foundation(No.320.6750.2020-14-7).
文摘To the Editor:In recent years,the treatment for metastatic hormone-sensitive prostate cancer(mHSPC)has undergone rapid developments.Docetaxel(DOC)or androgen receptor-targeted agent(ARTA)and androgen deprivation therapy(ADT)are the most commonly used systemic therapies.Multiple meta-analyses or network meta-analyses(NMAs)have been undertaken to evaluate and contrast the various treatment options available for mHSPC.However,the clinical efficacy of DOC in triplet therapy for mHSPC is yet to be confirmed,especially in categorizing the patients based on both volume of disease and timing of metastases.Bringing these controversies to light may have a timely and important impact on further clinical trials.Moreover,based on these trials and our NMA study,triplet therapy has evident benefits on overall survival(OS)and progression-free survival(PFS)in patients with mHSPC.The NMA study presented in this thesis is one of the first studies that assessed the efficacy of DOC and selected patients who will benefit from triplet therapy.
文摘目的系统评价儿童结核病患者家庭照顾者的照护体验。方法检索PubMed、Embase、Web of Science、CINAHL、Cochrane Library、中国知网、万方、中国生物医学文献数据库中相关质性研究,检索时限为建库至2025年12月。结果共纳入12篇文献,提取27个主题,归纳为8个类别,整合成3个结果:多维耗竭与生活秩序崩解,在制度刚性与支持断裂中寻求生存支点,意义、技能与希望的生成。结论儿童结核病家庭照顾者承受多重压力,但能通过认知重构与技能创新实现主动照护。医护人员应加强个体化赋能、推行家庭为中心的服务模式,并完善政策支持与去污名化宣传,以减轻照顾者负担。
文摘目的系统分析开颅术后发生手术部位感染(SSI)的危险因素,为SSI防控提供循证依据。方法检索建库至2025年6月的中英文数据库,包括CNKI、万方、维普、CBM、PubMed、Embase、Cochrane Library、Web of Science,收集开颅术后SSI相关文献。经文献筛选后,采用纽卡斯尔-渥太华量表(NOS)评价文献质量,使用RevMan 5.3软件进行数据分析。结果最终纳入15篇文献,共36042例研究对象。Meta分析结果显示,与开颅术后SSI显著相关的危险因素为五项,包括性别(男性)(OR=1.23,95%CI:1.09~1.38,P<0.001)、急诊手术(OR=2.04,95%CI:1.10~3.79,P=0.020)、二次手术(OR=3.44,95%CI:1.82~6.50,P<0.001)、脑脊液漏(OR=13.11,95%CI:5.09~33.77,P<0.001)、术后留置引流管(OR=3.42,95%CI:1.62~7.18,P=0.001)。结论开颅术后发生手术部位感染对患者危害大,多种因素可导致发生发展。临床需重点针对高风险因素实施重点防控,如强化脑脊液漏预防与引流管规范化管理、优化急诊/二次手术操作流程、加强男性患者围术期监测,以有效降低神经外科开颅术后SSI发生率。
文摘目的分析伏诺拉生(VPZ)治疗消化性溃疡(PU)和内镜黏膜下剥离术(ESD)术后溃疡的安全性与有效性,为临床实践、医疗决策提供循证药学证据。方法计算机检索中国知网、万方、维普、中国生物医学文献数据库、PubMed、Embase、Web of Science、the Cochrane Library等数据库,获取VPZ治疗PU和ESD术后溃疡相关的Meta分析/系统评价。由2名研究者独立进行文献筛选、数据提取、文献质量评估、文献重叠程度评估,采用伞形评价分析方法;当纳入的文献高度重叠时,对所有相关原始研究数据重新进行Meta分析。结果共纳入17项Meta分析,质量从高质量到极低质量不等;所有涉及的结局指标,在纳入的相关Meta分析中均存在非常高的重叠水平(校正覆盖面积为22.22%~100%)。治疗ESD术后溃疡时,与质子泵抑制剂(PPI)比较,VPZ可显著提高ESD术后4周的溃疡愈合率[RR=1.27,95%CI(1.03,1.56),Z=2.21,P=0.027]和溃疡收缩率[MD=0.08,95%CI(0.00,0.16),Z=2.09,P=0.037],显著降低具有PU病史患者的溃疡复发率[RR=0.49,95%CI(0.32,0.73),Z=3.49,P=0.001];VPZ组延迟出血率较兰索拉唑亚组显著降低[RR=0.47,95%CI(0.25,0.90),Z=2.28,P=0.02]。治疗PU时,十二指肠溃疡亚组中,VPZ的不良事件发生率明显高于PPI[RR=1.13,95%CI(1.02,1.26),Z=2.38,P=0.017]。结论对于ESD术后溃疡,VPZ的治疗效果优于PPI,且可以降低具有PU病史患者的溃疡复发率,但在治疗十二指肠溃疡的安全性方面并不具有优势。
文摘目的基于Meta分析方法讨论中成药联合替格瑞洛治疗冠心病心绞痛的有效性。方法检索中英文数据库,包括中国知网、万方、维普、PubMed、Embase和Web of Science等,筛选中成药联合替格瑞洛治疗冠心病心绞痛的随机对照试验,检索时间为建库至2024年12月。采用RevMan5.3软件对纳入的文献进行数据分析及绘图。结果共纳入24篇文献,Meta分析结果提示:与对照组比较,试验组的治疗总有效率升高,每周发作次数和发作持续时间显著降低(P<0.00001)。结论中成药联合替格瑞洛可以提高冠心病心绞痛患者的治疗总有效率,明显减少心绞痛每周发作次数与发作持续时间,这对于缓解患者症状、提升生活质量具有积极意义。
