This study investigates the impacts of mixing time,execution procedure,cement dosage(α),and total water-to-cement ratio(W_(Total)/C)on the mixing energy(E)of deep soil mixing(DSM)columns and how E influences the stre...This study investigates the impacts of mixing time,execution procedure,cement dosage(α),and total water-to-cement ratio(W_(Total)/C)on the mixing energy(E)of deep soil mixing(DSM)columns and how E influences the strength of treated sand.Columns with a diameter of 7.5 cm were constructed using three mixing times(130,190,and 250 s),two execution procedures(normal and zigzag),threeαvalues(300,400,and 500 kg/m^(3)),and three W_(Total)/C ratios(2.5,3.0,and 3.5).For comparison,equivalent laboratory samples were also examined.Results revealed that increasing the mixing time andα,adopting the zigzag execution procedure,and reducing the W_(Total)/C ratio increase E.Outcomes indicated that an increase in E from 0.49-0.70 kJ to 0.70-0.90 kJ,0.90-1.10 kJ,and 1.10-1.40 kJ improves the unconfined compressive strength(UCS)of columns on average by 66%,124%,and 179%,respectively,and the secant modulus by 61%,110%,and 152%.Average strain at maximum stress also rises from 0.68%to 0.75%,0.81%,and 0.84%,respectively.The study identified a threshold in the direct relationship between E and the strength ratio(λ),beyond whichλdid not increase significantly with further increases in E.Additionally,at low and high E levels,DSM samples mainly failed by crushing and cracking modes,respectively.In DSM columns withα=500 kg/m^(3)and W_(Total)/C=2.5,increasing average E from 0.77 kJ to 0.95 kJ,1.08 kJ,and 1.28 kJ resulted in a reduction of coefficients of variation of UCS from 30.4%to 27.8%,24.5%,and 21.1%,respectively.展开更多
In this article,we conduct a study on mixed quasi-martingale Hardy spaces that are defined by means of the mixed L_(p)-norm.By utilizing Doob’s inequalities,we explore the atomic decomposition and quasi-martingale in...In this article,we conduct a study on mixed quasi-martingale Hardy spaces that are defined by means of the mixed L_(p)-norm.By utilizing Doob’s inequalities,we explore the atomic decomposition and quasi-martingale inequalities of mixed quasi-martingale Hardy spaces.Moreover,we furnish sufficient conditions for the boundedness ofσ-sublinear operators in these spaces.These findings extend the existing conclusions regarding mixed quasi-martingale Hardy spaces defined with the help of the mixed L_(p)-norm.展开更多
Objectives This review aimed to systematically synthesize the available research on the disclosure of diagnosis and related issues in childhood cancer from the perspectives of healthcare professionals,with the goal of...Objectives This review aimed to systematically synthesize the available research on the disclosure of diagnosis and related issues in childhood cancer from the perspectives of healthcare professionals,with the goal of informing the optimization of disclosure processes and meeting the communication needs of affected families.Methods In accordance with the Joanna Briggs Institute(JBI)methodology for mixed methods systematic reviews,the convergent segregated approach was used in this review.Articles were retrieved from 11 databases,including PubMed,Web of Science,CINAHL,CENTRAL,Embase,Ovid/Medline,PsycINFO,PsycArticles,Scopus,ERIC,and China National Knowledge Infrastructure(CNKI).The quality of the selected articles was assessed using the Mixed Method Appraisal Tool(MMAT).The review protocol was registered on PROSPERO(CRD42024542746).Results A total of 21 studies from 10 countries were included.Their methodological quality was generally medium to high,with MMAT scores ranging from 60%to 100%.The synthesis yielded three core themes:1)the spectrum of professional and societal attitudes toward disclosure;2)the dynamic practices of navigating disclosure amid uncertainty,including timing and environment,stakeholders,and content of disclosure;and 3)factors influencing disclosure,including children’s,parental,healthcare professionals’,and socio-cultural factors.Conclusions This review synthesized the perspectives and experiences of healthcare professionals regarding disclosure in childhood cancer,highlighting the complexity and multidimensional nature of this process in clinical practice.Future research should further investigate the experiences and needs of children and their parents,explore cultural variations in disclosure practices,develop context-appropriate assessment tools,and construct multidimensional intervention strategies to enhance the humanistic care and professional effectiveness of the disclosure process.展开更多
This mixed-methods study investigated how AI-enhanced English as a Foreign Language(EFL)learning environments influence students’psychological well-being through the mediating roles of motivation and language learnin...This mixed-methods study investigated how AI-enhanced English as a Foreign Language(EFL)learning environments influence students’psychological well-being through the mediating roles of motivation and language learning anxiety and the moderating role of trust.Participants were Chinese university students(N=310,62%female,mean age=18.9,SD=0.8),of whom 15 completed interviews to both add to and to clarify the evidence from the surveys.Structural equation modeling results revealed that AI use had significant indirect effects on well-being through increased motivation and reduced language learning anxiety.Trust in AI significantly moderated both paths,amplifying the motivational benefits and anxiety reduction associated with AI use.Thematic analysis supported these results,identifying three experiential themes:(1)motivational empowerment through personalization,(2)anxiety regulation through safe practice and feedback,and(3)trust as the emotional bridge between AI and well-being.The study extends AI psychology applications by empirically linking technology engagement with affective outcomes and underscores the need for human-centered and trust-enhancing design in AI-supported education.From these findings,we conclude that adaptive,transparent,and autonomy-supportive AI systems promote self-determined motivation,emotional safety,and overall psychological health among EFL learners.展开更多
The advantages of genome selection(GS) in animal and plant breeding are self-evident.Traditional parametric models have disadvantage in better fit the increasingly large sequencing data and capture complex effects acc...The advantages of genome selection(GS) in animal and plant breeding are self-evident.Traditional parametric models have disadvantage in better fit the increasingly large sequencing data and capture complex effects accurately.Machine learning models have demonstrated remarkable potential in addressing these challenges.In this study,we introduced the concept of mixed kernel functions to explore the performance of support vector machine regression(SVR) in GS.Six single kernel functions(SVR_L,SVR_C,SVR_G,SVR_P,SVR_S,SVR_L) and four mixed kernel functions(SVR_GS,SVR_GP,SVR_LS,SVR_LP) were used to predict genome breeding values.The prediction accuracy,mean squared error(MSE) and mean absolute error(MAE) were used as evaluation indicators to compare with two traditional parametric models(GBLUP,BayesB) and two popular machine learning models(RF,KcRR).The results indicate that in most cases,the performance of the mixed kernel function model significantly outperforms that of GBLUP,BayesB and single kernel function.For instance,for T1 in the pig dataset,the predictive accuracy of SVR_GS is improved by 10% compared to GBLUP,and by approximately 4.4 and 18.6% compared to SVR_G and SVR_S respectively.For E1 in the wheat dataset,SVR_GS achieves 13.3% higher prediction accuracy than GBLUP.Among single kernel functions,the Laplacian and Gaussian kernel functions yield similar results,with the Gaussian kernel function performing better.The mixed kernel function notably reduces the MSE and MAE when compared to all single kernel functions.Furthermore,regarding runtime,SVR_GS and SVR_GP mixed kernel functions run approximately three times faster than GBLUP in the pig dataset,with only a slight increase in runtime compared to the single kernel function model.In summary,the mixed kernel function model of SVR demonstrates speed and accuracy competitiveness,and the model such as SVR_GS has important application potential for GS.展开更多
This paper investigates the following mixed local and nonlocal elliptic problem fea-turing concave-convex nonlinearities and a discontinuous right-hand side:{L(u)=H(u−μ)|u|^(p−2)u+λ|u|^(q−2)u,x∈Ω,u≥0,x∈Ω,u=0,x...This paper investigates the following mixed local and nonlocal elliptic problem fea-turing concave-convex nonlinearities and a discontinuous right-hand side:{L(u)=H(u−μ)|u|^(p−2)u+λ|u|^(q−2)u,x∈Ω,u≥0,x∈Ω,u=0,x∈R^(N)\Ω,where Ω ⊂R^(N)(N>2)is a bounded domain,μ≥0 and λ>0 are real parameters,H denotes the Heaviside function(H(t)=0 for t<0,H(t)=1 for t>0),and the mixed local and nolocal operator is defined as L(u)=−Δu+(−Δ)^(s)u with(−Δ)^(s) being the restricted fractional Laplace(0<s<1).The exponents satisfy 1<q<2<p.By employing a novel non-smooth variational principle,we establish the existence of an M-solution for this problem and identify a range for the exponent p.展开更多
This paper presents the high-order nonlinear spectrum of six-wave mixing(SWM)influenced by ionizing Rydberg atom environment in rubidium thermal vapor.The experimentally measured transmitted SWM signals reveal signifi...This paper presents the high-order nonlinear spectrum of six-wave mixing(SWM)influenced by ionizing Rydberg atom environment in rubidium thermal vapor.The experimentally measured transmitted SWM signals reveal significant spectrum shifts and novel regularities,providing nonlinear spectrum insights into the ionization characteristics of Rydberg atoms.The detailed spectrum variations with increasing ion density are presented,paving the way for multi-wave mixing distribution of plasma and demonstrating SWM’s potential as a tool for measuring the electric field induced by the ionization process.展开更多
Pesticide poisoning remains a critical public health challenge worldwide.At present,chlorfenapyr,classifi ed by the World Health Organization(WHO)as a moderately toxic insecticide,is increasingly used in agriculture,l...Pesticide poisoning remains a critical public health challenge worldwide.At present,chlorfenapyr,classifi ed by the World Health Organization(WHO)as a moderately toxic insecticide,is increasingly used in agriculture,leading to more poisoning incidents.It has a fatality rate as high as 76%after poisoning.[1]Here,we report a successful treatment of a patient with mixed pesticide poisoning caused by lethaldose emamectin benzoate(EB)and chlorfenapyr in the Department of Critical Care Medicine,Yangzhou Hongquan Hospital.展开更多
To fully utilize the resources provided by optical fiber networks,a cross-band quantum light source generating photon pairs,where one photon in a pair is at C band and the other is at O band,is proposed in this work.T...To fully utilize the resources provided by optical fiber networks,a cross-band quantum light source generating photon pairs,where one photon in a pair is at C band and the other is at O band,is proposed in this work.This source is based on spontaneous four-wave mixing(SFWM)in a piece of shallow-ridge silicon waveguide.Theoretical analysis shows that the waveguide dispersion could be tailored by adjusting the ridge width,enabling broadband photon pair generation by SFWM across C band and O band.The spontaneous Raman scattering(SpRS)in silicon waveguides is also investigated experimentally.It shows that there are two regions in the spectrum of generated photons from SpRS,which could be used to achieve cross-band photon pair generation.A chip of shallow-ridge silicon waveguide samples with different ridge widths has been fabricated,through which cross-band photon pair generation is demonstrated experimentally.The experimental results show that the source can be achieved using dispersion-optimized shallow-ridge silicon waveguides.This cross-band quantum light source provides a way to develop new fiber-based quantum communication functions utilizing both C band and O band and extends applications of quantum networks.展开更多
This study investigated the factors contributing to intravenous admixture preparation errors(IAPEs)within Pharmacy Intravenous Admixture Services(PIVAS).A retrospective analysis was conducted on IAPEs documented in th...This study investigated the factors contributing to intravenous admixture preparation errors(IAPEs)within Pharmacy Intravenous Admixture Services(PIVAS).A retrospective analysis was conducted on IAPEs documented in the PIVAS unit of a large multi-specialty hospital in China,which houses over 2000 beds,covering the period from January 1,2015 to December 31,2022.Drug preparation records were examined using a generalized linear mixed model(GLMM)to identify both univariate and multivariate factors associated with IAPE occurrences.A total of 824 IAPE cases were recorded during the study period,yielding an overall error rate of 0.018%.Univariate analysis identified drug categories(general drugs,anti-infective drugs,and antineoplastic drugs),preparation time(workdays),and years of work experience as significant determinants(P<0.05).Multivariate analysis further confirmed that drug categories(general and antineoplastic drugs),preparation time(workdays),and work experience remained statistically significant predictors of IAPE incidence(P<0.05).IAPEs in PIVAS were influenced by multiple factors,predominantly those related to personnel and drug characteristics.Targeted interventions,informed by multivariate analysis,are essential to mitigating these errors and enhancing medication safety.展开更多
A reshock experiment for investigating the growth of material mixing driven by the Richtmyer–Meshkov instability has been conducted at the SG 100 kJ Laser Facility.We present a novel measurement technique for capturi...A reshock experiment for investigating the growth of material mixing driven by the Richtmyer–Meshkov instability has been conducted at the SG 100 kJ Laser Facility.We present a novel measurement technique for capturing the density field and the temporal evolution of the mixing width in rough aluminum subjected to reshocks under extreme conditions.The temporal evolution of the aluminum layer width obtained from backlit X-ray radiography demonstrates a sharp increase in width caused by reshocks,and simulations using the BHR-2 turbulent mixing model show excellent agreement with the measured aluminum layer width.Moreover,by utilizing a quasi-monochromatic X-ray imaging system at 5.2 keV,based on Bragg reflection from a spherically curved quartz crystal,we demonstrate direct quantification of the aluminum density field in mixed regions for the first time in a indirectly driven reshock experiment.The deviation between the calculated and actual density values is significantly less than 10%when the density of the aluminum region is below 0.7 g/cm3.The density field provides further information about variable-density turbulent mixing,which improves the constraints on simulations and enhances predictive capabilities for inertial confinement fusion target design and astrophysical shock scenarios.展开更多
BACKGROUND Mixed connective tissue disease(MCTD)is a rare autoimmune disorder charac-terized by overlapping features of systemic lupus erythematosus,systemic sc-lerosis,and polymyositis,and presence of anti-U1 ribonuc...BACKGROUND Mixed connective tissue disease(MCTD)is a rare autoimmune disorder charac-terized by overlapping features of systemic lupus erythematosus,systemic sc-lerosis,and polymyositis,and presence of anti-U1 ribonucleoprotein antibodies.Coexistence with tuberculosis(TB),a common infectious disease in endemic areas,poses a significant diagnostic challenge due to overlapping clinical and radio-logical features.CASE SUMMARY We report a 35-year-old Pakistani female presenting with oral ulcers,body rash,worsening dyspnea,and a history of joint pains initially treated as rheumatoid arthritis.She was on antituberculous therapy(ATT)for presumed pulmonary TB.Laboratory findings revealed anemia,leukopenia,raised erythrocyte sedimen-tation rate,positive anti-Sm/RNP,anti-dsDNA,and anti-SSA/Ro antibodies,confirming MCTD with clinical features of systemic lupus erythematosus,Sjogren syndrome,and systemic sclerosis.The patient was also positive for hepatitis C and active TB.Treatment involved corticosteroids alongside continuation of ATT,resulting in significant clinical improvement over 12 days,with resolution of symptoms and improved laboratory parameters.The patient remained stable on follow-up with hydroxychloroquine and prednisolone.CONCLUSION This case highlights the diagnostic complexity when autoimmune diseases coexist with TB,particularly in TB-endemic regions.Early recognition and integrated management of both conditions are crucial to improving outcomes.Clinicians should maintain a broad differential diagnosis and perform compre-hensive immunological workup in patients with overlapping symptoms.展开更多
In this study,Pebax■2533 polymer was used as the continuous phase and UiO-67 was employed as the filler to prepare mixed matrix membranes.UiO-67 is usually synthesized using two ligands:biphenyl-4,4'-dicarboxylat...In this study,Pebax■2533 polymer was used as the continuous phase and UiO-67 was employed as the filler to prepare mixed matrix membranes.UiO-67 is usually synthesized using two ligands:biphenyl-4,4'-dicarboxylate(bpdc)and 2,2'-bipyridine-5,5'-dicarboxylic acid(bpy).In this research,UiO-67 was synthesized not only with these two ligands but also using a mixed ligand approach(50% bpdc and 50% bpy).The synthesized UiOs were incorporated into the polymer matrix at mass percentages ranging from 0% to 2% to form the mixed matrix membranes(MMMs).Membranes containing UiO-67 with mixed ligands exhibited a greater affinity for CO_(2) compared to other membranes.Various analytical techniques,including X-ray diffraction,thermogravimetric analyzer,Fourier transform infrared spectroscope(FTIR),field emission scanning electron micro scope(FESEM),and differential scanning calorimetry,were used to analyze the properties of the prepared membranes.The FTIR spectrum confirmed all desired bands of Pebax?2533 and UiO-67 in the MMMs.The FESEM images showed that the pure Pebax membrane has a uniform structure,and the developed membranes are uniformly incorporated with the synthesized UiO-67 nanoparticles.Gas permeation measurements indicated that CO_(2) permeability and CO_(2)/CH_4 selectivity increased from 402.7 Barrer(1 Barrer=1.33×10^(-14)m^(3)(STP)·m·m^(-2)·s^(-1)·kPa^(-1))and 9.32 for the pure Pebax membrane at 1.0 MPa to 770.1 Barrer and 16.96 in the modified membrane.Additionally,the gas permeation test results demonstrated that adding functionalized porous nanofillers increases the CO_(2)separation performance.Permeability tests at different temperatures revealed that as temperature was raised,at constant pressure,CO_(2) permeability for the membrane containing the mixed ligand increased from 682.2 Barrer to 733.5 Barrer,While CO_(2)/CH_(4) selectivity decreased from 15.46 to 13.43.展开更多
The formation,evolution and modelling of organized flow structures(e.g.,segregated regions and centre-surface vortices) and their destruction in unbaffled stirred tank reactors(UBSTRs) have been a hot research topic i...The formation,evolution and modelling of organized flow structures(e.g.,segregated regions and centre-surface vortices) and their destruction in unbaffled stirred tank reactors(UBSTRs) have been a hot research topic in the field of fluid mixing.In this paper,the relevant researches in the past 30 years were reviewed,focusing on the application of asymmetric mixing.In particular,by drawing on chaotic phenomena in nature and human society(e.g.,kneading-dough,traffic flow,frightened school of fish),we propose a fluid mixing mechanism:squeezing-induced chaotic mixing,and further propose a bionics-imitation-simulation design concept for UBSTRs.This concept is also an important inspiration for the design of other chemical reactors.展开更多
Topological band theory has been studied for free fermions for decades,and one of the most profound physical results is the bulk-boundary correspondence.Recently a focus in topological physics is extending topological...Topological band theory has been studied for free fermions for decades,and one of the most profound physical results is the bulk-boundary correspondence.Recently a focus in topological physics is extending topological classification to mixed states.Here,we focus on Gaussian mixed states for which the modular Hamiltonians of the density matrix are quadratic free fermion models with U(1)symmetry and can be classified by topological invariants.The bulk-boundary correspondence is then manifested as stable gapless modes of the modular Hamiltonian and degenerate spectrum of the density matrix.In this article,we show that these gapless modes can be detected by the full counting statistics,mathematically described by a function introduced as F(θ).A divergent derivative atθ=πcan be used to probe the gapless modes in the modular Hamiltonian.Based on this,a topological indicator,whose quantization to unity senses topologically nontrivial mixed states,is introduced.We present the physical intuition of these results and also demonstrate these results with concrete models in both one-and two-dimensions.Our results pave the way for revealing the physical significance of topology in mixed states.展开更多
Space-division multiplexing(SDM)offers a promising route to scaling data throughput in fiber-optic networks,but it also introduces challenges such as mode-dependent loss(MDL)and intermodal crosstalk,which increase the...Space-division multiplexing(SDM)offers a promising route to scaling data throughput in fiber-optic networks,but it also introduces challenges such as mode-dependent loss(MDL)and intermodal crosstalk,which increase the computational load on digital signal processing(DSP).Periodic mode mixing has been shown to mitigate these effects by redistributing loss and gain across modes and shortening the effective temporal impulse response over which crosstalk accumulates.In this work,we present a novel and compact mode-scrambling device,3D printed directly onto the facet of a few-mode fiber.展开更多
BACKGROUND Mixed lineage kinase domain-like protein(MLKL)serves as a critical mediator in necroptosis,a form of regulated cell death linked to various liver diseases.This study aims to specifically investigate the rol...BACKGROUND Mixed lineage kinase domain-like protein(MLKL)serves as a critical mediator in necroptosis,a form of regulated cell death linked to various liver diseases.This study aims to specifically investigate the role of MLKL’s adenosine triphosphate(ATP)-binding pocket in facilitating necroptosis-independent pathways that may contribute to liver disease progression.By focusing on this mechanism,we seek to identify potential therapeutic targets that can modulate MLKL activity,offering new strategies for the prevention and treatment of liver-related pathologies.AIM To investigate the possibility of using the ATP-binding pocket-associated,necro-ptosis-independent MLKL pathway as a target for liver diseases.METHODS Cell death following necroptosis stimuli was evaluated using cell proliferation assays,flow cytometry,and electron microscopy in various cells.The human liver organoid system was used to evaluate whether the MLKL ATP pocket-binding inhibitor could attenuate inflammation.Additionally,alcoholic and non-alcoholic fatty liver diseases animal models were used to determine whether MLKL ATP pocket inhibitors could attenuate liver injury.RESULTS While an MLKL ATP pocket-binding inhibitor did not prevent necroptosis-induced cell death in RAW 264.7 cells,it did reduce the necroptosis-led expression of CXCL2,ICAM,and VCAM.Notably,MLKL ATP pocket inhibitor diminishes the expression of CXCL2,ICAM,and VCAM by inhibiting the IκB kinase and nuclear factor kappa-B pathways without inducing necroptosis-induced cell death in two-dimensional cell culture as well as the human-derived liver organoid system.Although MLKL ATP-binding inhibitor was ineffective in non-alcoholic fatty liver disease animal models,MLKL ATP-binding inhibitor attenuated hepatic inflammation in the alcoholic liver disease model.CONCLUSION MLKL ATP pocket-binding inhibitor exerted anti-inflammatory effects through the necroptosis-independent MLKL pathway in an animal model of alcoholic liver disease.展开更多
BACKGROUND Mixed tumors of the colon and rectum,composed of a combination of epithelial and endocrine elements of benign and malignant potential are rare neoplasms.These can occur anywhere in the gastrointestinal trac...BACKGROUND Mixed tumors of the colon and rectum,composed of a combination of epithelial and endocrine elements of benign and malignant potential are rare neoplasms.These can occur anywhere in the gastrointestinal tract and are often diagnosed incidentally.Though they have been a well-documented entity in the pancreas,where the exocrine-endocrine mixed tumors have been known for a while,recognition and accurate diagnosis of these tumors in the colon and rectum,to date,remains a challenge.This is further compounded by the different terminologies that have been attributed to these lesions over the years adding to increased confusion and misclassification.Therefore,dedicated literature reviews of these lesions in the colon and rectum are inconsistent and are predominantly limited to case reports and case series of limited case numbers.Though,most of these tumors are high grade and of advanced stage,intermediate and low grade lesions of these mixed tumors are also increasingly been reported.There are no established independent consensus based guidelines for the therapeutic patient management of these unique lesions.AIM To provide a comprehensive targeted literature review of these complex mixed tumors in the colon and rectum that chronicles the evolution over time with summarization of historical perspectives of terminology and to further our understanding regarding their pathogenesis including genomic landscape,clinicoradiological features,pathology,treatment,prognosis,the current status of the management of the primary lesions,their recurrences and metastases.METHODS A comprehensive review of the published English literature was conducted using the search engines PubMed,MEDLINE and GOOGLE scholar.The following search terms[“mixed tumors colon”OR mixed endocrine/neuroendocrine tumor/neoplasm/lesion colon OR adenocarcinoma and endocrine/neuroendocrine tumor colon OR mixed adenocarcinoma and endocrine/neuroendocrine carcinoma colon OR Amphicrine tumors OR Collision tumors]were used.Eligibility criteria were defined and all potential relevant items,including full articles and/or abstracts were independently reviewed,assessed and agreed upon items were selected for in-depth analysis.RESULTS In total 237 full articles/abstracts documents were considered for eligibility of which 45 articles were illegible resulting in a total of 192 articles that were assessed for eligibility of which 139 have been selected for reference in this current review.This seminal manuscript is a one stop article that provides a detailed outlook on the evolution over time with summarization of historical perspectives,nomenclature,clinicoradiological features,pathology,treatment,prognosis and the current status of the management of both the primary lesions,their recurrences and metastases.Gaps in knowledge have also been identified and discussed.An important outcome of this manuscript is the justified proposal for a new,simple,clinically relevant,non-ambiguous terminology for these lesions to be referred to as mixed epithelial endocrine neoplasms(MEENs).CONCLUSION MEEN of the colon and rectum are poorly understood rare entities that encompass an extensive range of heterogeneous tumors with a wide variety of combinations leading to tumors of high,intermediate or low grade malignant potential.This proposed new revised terminology of MEEN will solve the biggest hurdle of confusion and misclassification that plagues these rare unique colorectal neoplasms thus facilitating the future design of multi institutional prospective randomized controlled clinical trials to develop and evaluate newer therapeutic strategies that are recommended for continued improved understanding and personal optimization of clinical management of these unique colorectal neoplasms.展开更多
BACKGROUND A total of 100 patients diagnosed with mixed hemorrhoids from October 2022 to September 2023 in our hospital were randomly divided into groups by dice rolling and compared with the efficacy of different tre...BACKGROUND A total of 100 patients diagnosed with mixed hemorrhoids from October 2022 to September 2023 in our hospital were randomly divided into groups by dice rolling and compared with the efficacy of different treatment options.AIM To analyze the clinical effect and prognosis of mixed hemorrhoids treated with polidocanol injection combined with automatic elastic thread ligation operation(RPH).METHODS A total of 100 patients with mixed hemorrhoids who visited our hospital from October 2022 to September 2023 were selected and randomly divided into the control group(n=50)and the treatment group(n=50)by rolling the dice.The procedure for prolapse and hemorrhoids(PPH)was adopted in the control group,while polidocanol foam injection+RPH was adopted in the treatment group.The therapeutic effects,operation time,wound healing time,hospital stay,pain situation(24 hours post-operative pain score,first defecation pain score),quality of life(QOL),incidence of complications(post-operative hemorrhage,edema,infection),incidence of anal stenosis 3 months post-operatively and recurrence rate 1 year post-operatively of the two groups were compared.RESULTS Compared with the control group,the total effective rate of treatment group was higher,and the difference was significant(P<0.05).The operation time/wound healing time/hospital stay in the treatment group were shorter than those in the control group(P<0.05).The pain scores at 24 hours after operation/first defecation pain score of the treatment group was significantly lower than those in the control group(P<0.05).After surgery,the QOL scores of the two groups decreased,with the treatment group having higher scores than that of the control group(P<0.05).Compared with the control group,the incidence of postoperative complications in the treatment group was lower,and the difference was significant(P<0.05);However,there was no significant difference in the incidence of postoperative bleeding between the two groups(P>0.05);There was no significant difference in the incidence of anal stenosis 3 months after operation and the recurrence rate 1 year after operation between the two groups(P>0.05).CONCLUSION For patients with mixed hemorrhoids,the therapeutic effect achieved by using polidocanol injection combined with RPH was better.The wounds of the patients healed faster,the postoperative pain was milder,QOL improved,and the incidence of complications was lower,and the short-term and long-term prognosis was good.展开更多
文摘This study investigates the impacts of mixing time,execution procedure,cement dosage(α),and total water-to-cement ratio(W_(Total)/C)on the mixing energy(E)of deep soil mixing(DSM)columns and how E influences the strength of treated sand.Columns with a diameter of 7.5 cm were constructed using three mixing times(130,190,and 250 s),two execution procedures(normal and zigzag),threeαvalues(300,400,and 500 kg/m^(3)),and three W_(Total)/C ratios(2.5,3.0,and 3.5).For comparison,equivalent laboratory samples were also examined.Results revealed that increasing the mixing time andα,adopting the zigzag execution procedure,and reducing the W_(Total)/C ratio increase E.Outcomes indicated that an increase in E from 0.49-0.70 kJ to 0.70-0.90 kJ,0.90-1.10 kJ,and 1.10-1.40 kJ improves the unconfined compressive strength(UCS)of columns on average by 66%,124%,and 179%,respectively,and the secant modulus by 61%,110%,and 152%.Average strain at maximum stress also rises from 0.68%to 0.75%,0.81%,and 0.84%,respectively.The study identified a threshold in the direct relationship between E and the strength ratio(λ),beyond whichλdid not increase significantly with further increases in E.Additionally,at low and high E levels,DSM samples mainly failed by crushing and cracking modes,respectively.In DSM columns withα=500 kg/m^(3)and W_(Total)/C=2.5,increasing average E from 0.77 kJ to 0.95 kJ,1.08 kJ,and 1.28 kJ resulted in a reduction of coefficients of variation of UCS from 30.4%to 27.8%,24.5%,and 21.1%,respectively.
基金Supported by the National Natural Science Foundation of China(11871195)。
文摘In this article,we conduct a study on mixed quasi-martingale Hardy spaces that are defined by means of the mixed L_(p)-norm.By utilizing Doob’s inequalities,we explore the atomic decomposition and quasi-martingale inequalities of mixed quasi-martingale Hardy spaces.Moreover,we furnish sufficient conditions for the boundedness ofσ-sublinear operators in these spaces.These findings extend the existing conclusions regarding mixed quasi-martingale Hardy spaces defined with the help of the mixed L_(p)-norm.
基金supported by the Fuxing Nursing Research Foundation of Fudan University[FNF202352].
文摘Objectives This review aimed to systematically synthesize the available research on the disclosure of diagnosis and related issues in childhood cancer from the perspectives of healthcare professionals,with the goal of informing the optimization of disclosure processes and meeting the communication needs of affected families.Methods In accordance with the Joanna Briggs Institute(JBI)methodology for mixed methods systematic reviews,the convergent segregated approach was used in this review.Articles were retrieved from 11 databases,including PubMed,Web of Science,CINAHL,CENTRAL,Embase,Ovid/Medline,PsycINFO,PsycArticles,Scopus,ERIC,and China National Knowledge Infrastructure(CNKI).The quality of the selected articles was assessed using the Mixed Method Appraisal Tool(MMAT).The review protocol was registered on PROSPERO(CRD42024542746).Results A total of 21 studies from 10 countries were included.Their methodological quality was generally medium to high,with MMAT scores ranging from 60%to 100%.The synthesis yielded three core themes:1)the spectrum of professional and societal attitudes toward disclosure;2)the dynamic practices of navigating disclosure amid uncertainty,including timing and environment,stakeholders,and content of disclosure;and 3)factors influencing disclosure,including children’s,parental,healthcare professionals’,and socio-cultural factors.Conclusions This review synthesized the perspectives and experiences of healthcare professionals regarding disclosure in childhood cancer,highlighting the complexity and multidimensional nature of this process in clinical practice.Future research should further investigate the experiences and needs of children and their parents,explore cultural variations in disclosure practices,develop context-appropriate assessment tools,and construct multidimensional intervention strategies to enhance the humanistic care and professional effectiveness of the disclosure process.
文摘This mixed-methods study investigated how AI-enhanced English as a Foreign Language(EFL)learning environments influence students’psychological well-being through the mediating roles of motivation and language learning anxiety and the moderating role of trust.Participants were Chinese university students(N=310,62%female,mean age=18.9,SD=0.8),of whom 15 completed interviews to both add to and to clarify the evidence from the surveys.Structural equation modeling results revealed that AI use had significant indirect effects on well-being through increased motivation and reduced language learning anxiety.Trust in AI significantly moderated both paths,amplifying the motivational benefits and anxiety reduction associated with AI use.Thematic analysis supported these results,identifying three experiential themes:(1)motivational empowerment through personalization,(2)anxiety regulation through safe practice and feedback,and(3)trust as the emotional bridge between AI and well-being.The study extends AI psychology applications by empirically linking technology engagement with affective outcomes and underscores the need for human-centered and trust-enhancing design in AI-supported education.From these findings,we conclude that adaptive,transparent,and autonomy-supportive AI systems promote self-determined motivation,emotional safety,and overall psychological health among EFL learners.
基金supported by the China Agriculture Research System of MOF and MARAthe National Natural Science Foundation of China (31872337 and 31501919)the Agricultural Science and Technology Innovation Project,China (ASTIP-IAS02)。
文摘The advantages of genome selection(GS) in animal and plant breeding are self-evident.Traditional parametric models have disadvantage in better fit the increasingly large sequencing data and capture complex effects accurately.Machine learning models have demonstrated remarkable potential in addressing these challenges.In this study,we introduced the concept of mixed kernel functions to explore the performance of support vector machine regression(SVR) in GS.Six single kernel functions(SVR_L,SVR_C,SVR_G,SVR_P,SVR_S,SVR_L) and four mixed kernel functions(SVR_GS,SVR_GP,SVR_LS,SVR_LP) were used to predict genome breeding values.The prediction accuracy,mean squared error(MSE) and mean absolute error(MAE) were used as evaluation indicators to compare with two traditional parametric models(GBLUP,BayesB) and two popular machine learning models(RF,KcRR).The results indicate that in most cases,the performance of the mixed kernel function model significantly outperforms that of GBLUP,BayesB and single kernel function.For instance,for T1 in the pig dataset,the predictive accuracy of SVR_GS is improved by 10% compared to GBLUP,and by approximately 4.4 and 18.6% compared to SVR_G and SVR_S respectively.For E1 in the wheat dataset,SVR_GS achieves 13.3% higher prediction accuracy than GBLUP.Among single kernel functions,the Laplacian and Gaussian kernel functions yield similar results,with the Gaussian kernel function performing better.The mixed kernel function notably reduces the MSE and MAE when compared to all single kernel functions.Furthermore,regarding runtime,SVR_GS and SVR_GP mixed kernel functions run approximately three times faster than GBLUP in the pig dataset,with only a slight increase in runtime compared to the single kernel function model.In summary,the mixed kernel function model of SVR demonstrates speed and accuracy competitiveness,and the model such as SVR_GS has important application potential for GS.
基金Supported by the National Natural Science Foundation of China(Grant No.12361026)the Discipline Construction Fund Project of Northwest Minzu University.
文摘This paper investigates the following mixed local and nonlocal elliptic problem fea-turing concave-convex nonlinearities and a discontinuous right-hand side:{L(u)=H(u−μ)|u|^(p−2)u+λ|u|^(q−2)u,x∈Ω,u≥0,x∈Ω,u=0,x∈R^(N)\Ω,where Ω ⊂R^(N)(N>2)is a bounded domain,μ≥0 and λ>0 are real parameters,H denotes the Heaviside function(H(t)=0 for t<0,H(t)=1 for t>0),and the mixed local and nolocal operator is defined as L(u)=−Δu+(−Δ)^(s)u with(−Δ)^(s) being the restricted fractional Laplace(0<s<1).The exponents satisfy 1<q<2<p.By employing a novel non-smooth variational principle,we establish the existence of an M-solution for this problem and identify a range for the exponent p.
基金Project supported by the Science and Technology Project of State Grid Corporation of China(Grant No.5700-202355839A-4-3-WL).
文摘This paper presents the high-order nonlinear spectrum of six-wave mixing(SWM)influenced by ionizing Rydberg atom environment in rubidium thermal vapor.The experimentally measured transmitted SWM signals reveal significant spectrum shifts and novel regularities,providing nonlinear spectrum insights into the ionization characteristics of Rydberg atoms.The detailed spectrum variations with increasing ion density are presented,paving the way for multi-wave mixing distribution of plasma and demonstrating SWM’s potential as a tool for measuring the electric field induced by the ionization process.
文摘Pesticide poisoning remains a critical public health challenge worldwide.At present,chlorfenapyr,classifi ed by the World Health Organization(WHO)as a moderately toxic insecticide,is increasingly used in agriculture,leading to more poisoning incidents.It has a fatality rate as high as 76%after poisoning.[1]Here,we report a successful treatment of a patient with mixed pesticide poisoning caused by lethaldose emamectin benzoate(EB)and chlorfenapyr in the Department of Critical Care Medicine,Yangzhou Hongquan Hospital.
基金supported by the Quantum Science and Technology-National Science and Technology Major Project (Grant No.2024ZD0302502 for WZ)the National Natural Science Foundation of China(Grant No.92365210 for WZ)+1 种基金Tsinghua Initiative Scientific Research Program (for WZ)the project of Tsinghua University-Zhuhai Huafa Industrial Share Company Joint Institute for Architecture Optoelectronic Technologies (JIAOT,for YH)。
文摘To fully utilize the resources provided by optical fiber networks,a cross-band quantum light source generating photon pairs,where one photon in a pair is at C band and the other is at O band,is proposed in this work.This source is based on spontaneous four-wave mixing(SFWM)in a piece of shallow-ridge silicon waveguide.Theoretical analysis shows that the waveguide dispersion could be tailored by adjusting the ridge width,enabling broadband photon pair generation by SFWM across C band and O band.The spontaneous Raman scattering(SpRS)in silicon waveguides is also investigated experimentally.It shows that there are two regions in the spectrum of generated photons from SpRS,which could be used to achieve cross-band photon pair generation.A chip of shallow-ridge silicon waveguide samples with different ridge widths has been fabricated,through which cross-band photon pair generation is demonstrated experimentally.The experimental results show that the source can be achieved using dispersion-optimized shallow-ridge silicon waveguides.This cross-band quantum light source provides a way to develop new fiber-based quantum communication functions utilizing both C band and O band and extends applications of quantum networks.
基金The National Natural Science Foundation of China(Grant No.72474013)the Beijing Health Technology Promotion Project(Grant No.BHTPP2024007)。
文摘This study investigated the factors contributing to intravenous admixture preparation errors(IAPEs)within Pharmacy Intravenous Admixture Services(PIVAS).A retrospective analysis was conducted on IAPEs documented in the PIVAS unit of a large multi-specialty hospital in China,which houses over 2000 beds,covering the period from January 1,2015 to December 31,2022.Drug preparation records were examined using a generalized linear mixed model(GLMM)to identify both univariate and multivariate factors associated with IAPE occurrences.A total of 824 IAPE cases were recorded during the study period,yielding an overall error rate of 0.018%.Univariate analysis identified drug categories(general drugs,anti-infective drugs,and antineoplastic drugs),preparation time(workdays),and years of work experience as significant determinants(P<0.05).Multivariate analysis further confirmed that drug categories(general and antineoplastic drugs),preparation time(workdays),and work experience remained statistically significant predictors of IAPE incidence(P<0.05).IAPEs in PIVAS were influenced by multiple factors,predominantly those related to personnel and drug characteristics.Targeted interventions,informed by multivariate analysis,are essential to mitigating these errors and enhancing medication safety.
基金supported by the National Key R&D Program of China(Grant No.2023YFA1608400)the National Natural Science Foundation of China(Grant Nos.12205275 and 12588301).
文摘A reshock experiment for investigating the growth of material mixing driven by the Richtmyer–Meshkov instability has been conducted at the SG 100 kJ Laser Facility.We present a novel measurement technique for capturing the density field and the temporal evolution of the mixing width in rough aluminum subjected to reshocks under extreme conditions.The temporal evolution of the aluminum layer width obtained from backlit X-ray radiography demonstrates a sharp increase in width caused by reshocks,and simulations using the BHR-2 turbulent mixing model show excellent agreement with the measured aluminum layer width.Moreover,by utilizing a quasi-monochromatic X-ray imaging system at 5.2 keV,based on Bragg reflection from a spherically curved quartz crystal,we demonstrate direct quantification of the aluminum density field in mixed regions for the first time in a indirectly driven reshock experiment.The deviation between the calculated and actual density values is significantly less than 10%when the density of the aluminum region is below 0.7 g/cm3.The density field provides further information about variable-density turbulent mixing,which improves the constraints on simulations and enhances predictive capabilities for inertial confinement fusion target design and astrophysical shock scenarios.
文摘BACKGROUND Mixed connective tissue disease(MCTD)is a rare autoimmune disorder charac-terized by overlapping features of systemic lupus erythematosus,systemic sc-lerosis,and polymyositis,and presence of anti-U1 ribonucleoprotein antibodies.Coexistence with tuberculosis(TB),a common infectious disease in endemic areas,poses a significant diagnostic challenge due to overlapping clinical and radio-logical features.CASE SUMMARY We report a 35-year-old Pakistani female presenting with oral ulcers,body rash,worsening dyspnea,and a history of joint pains initially treated as rheumatoid arthritis.She was on antituberculous therapy(ATT)for presumed pulmonary TB.Laboratory findings revealed anemia,leukopenia,raised erythrocyte sedimen-tation rate,positive anti-Sm/RNP,anti-dsDNA,and anti-SSA/Ro antibodies,confirming MCTD with clinical features of systemic lupus erythematosus,Sjogren syndrome,and systemic sclerosis.The patient was also positive for hepatitis C and active TB.Treatment involved corticosteroids alongside continuation of ATT,resulting in significant clinical improvement over 12 days,with resolution of symptoms and improved laboratory parameters.The patient remained stable on follow-up with hydroxychloroquine and prednisolone.CONCLUSION This case highlights the diagnostic complexity when autoimmune diseases coexist with TB,particularly in TB-endemic regions.Early recognition and integrated management of both conditions are crucial to improving outcomes.Clinicians should maintain a broad differential diagnosis and perform compre-hensive immunological workup in patients with overlapping symptoms.
基金Babol Noshirvani University of Technology for financially support of this project(BNUT/393054/2023)。
文摘In this study,Pebax■2533 polymer was used as the continuous phase and UiO-67 was employed as the filler to prepare mixed matrix membranes.UiO-67 is usually synthesized using two ligands:biphenyl-4,4'-dicarboxylate(bpdc)and 2,2'-bipyridine-5,5'-dicarboxylic acid(bpy).In this research,UiO-67 was synthesized not only with these two ligands but also using a mixed ligand approach(50% bpdc and 50% bpy).The synthesized UiOs were incorporated into the polymer matrix at mass percentages ranging from 0% to 2% to form the mixed matrix membranes(MMMs).Membranes containing UiO-67 with mixed ligands exhibited a greater affinity for CO_(2) compared to other membranes.Various analytical techniques,including X-ray diffraction,thermogravimetric analyzer,Fourier transform infrared spectroscope(FTIR),field emission scanning electron micro scope(FESEM),and differential scanning calorimetry,were used to analyze the properties of the prepared membranes.The FTIR spectrum confirmed all desired bands of Pebax?2533 and UiO-67 in the MMMs.The FESEM images showed that the pure Pebax membrane has a uniform structure,and the developed membranes are uniformly incorporated with the synthesized UiO-67 nanoparticles.Gas permeation measurements indicated that CO_(2) permeability and CO_(2)/CH_4 selectivity increased from 402.7 Barrer(1 Barrer=1.33×10^(-14)m^(3)(STP)·m·m^(-2)·s^(-1)·kPa^(-1))and 9.32 for the pure Pebax membrane at 1.0 MPa to 770.1 Barrer and 16.96 in the modified membrane.Additionally,the gas permeation test results demonstrated that adding functionalized porous nanofillers increases the CO_(2)separation performance.Permeability tests at different temperatures revealed that as temperature was raised,at constant pressure,CO_(2) permeability for the membrane containing the mixed ligand increased from 682.2 Barrer to 733.5 Barrer,While CO_(2)/CH_(4) selectivity decreased from 15.46 to 13.43.
基金the National Key Research and Development Program of China (2022YFB3504300)the Graduate Research and Innovation Foundation of Chongqing (CYB240045)+1 种基金the Fundamental Research Funds for the Central Universities(2024CDJXY010)the Large-scale Instrument and Equipment Function Development Program of Chongqing University(gnkf2024019) for supporting this work。
文摘The formation,evolution and modelling of organized flow structures(e.g.,segregated regions and centre-surface vortices) and their destruction in unbaffled stirred tank reactors(UBSTRs) have been a hot research topic in the field of fluid mixing.In this paper,the relevant researches in the past 30 years were reviewed,focusing on the application of asymmetric mixing.In particular,by drawing on chaotic phenomena in nature and human society(e.g.,kneading-dough,traffic flow,frightened school of fish),we propose a fluid mixing mechanism:squeezing-induced chaotic mixing,and further propose a bionics-imitation-simulation design concept for UBSTRs.This concept is also an important inspiration for the design of other chemical reactors.
基金supported by the National Key R&D Program of China(Grant No.2023YFA1406702)the Innovation Program for Quantum Science and Technology 2021ZD0302005+1 种基金the XPLORER Prizepartly supported by the Start-up Research Fund of Southeast University(RF1028624190)。
文摘Topological band theory has been studied for free fermions for decades,and one of the most profound physical results is the bulk-boundary correspondence.Recently a focus in topological physics is extending topological classification to mixed states.Here,we focus on Gaussian mixed states for which the modular Hamiltonians of the density matrix are quadratic free fermion models with U(1)symmetry and can be classified by topological invariants.The bulk-boundary correspondence is then manifested as stable gapless modes of the modular Hamiltonian and degenerate spectrum of the density matrix.In this article,we show that these gapless modes can be detected by the full counting statistics,mathematically described by a function introduced as F(θ).A divergent derivative atθ=πcan be used to probe the gapless modes in the modular Hamiltonian.Based on this,a topological indicator,whose quantization to unity senses topologically nontrivial mixed states,is introduced.We present the physical intuition of these results and also demonstrate these results with concrete models in both one-and two-dimensions.Our results pave the way for revealing the physical significance of topology in mixed states.
基金Horizon 2020 Framework Programme(619732)Ministry of Innovation,Science and Technology,Fulbright U.S.Scholar Program。
文摘Space-division multiplexing(SDM)offers a promising route to scaling data throughput in fiber-optic networks,but it also introduces challenges such as mode-dependent loss(MDL)and intermodal crosstalk,which increase the computational load on digital signal processing(DSP).Periodic mode mixing has been shown to mitigate these effects by redistributing loss and gain across modes and shortening the effective temporal impulse response over which crosstalk accumulates.In this work,we present a novel and compact mode-scrambling device,3D printed directly onto the facet of a few-mode fiber.
基金Supported by the National Research Foundation of Korea Grant Funded by the Korea Government,No.RS-2024-00440477the Korea Institute of Science and Technology Institutional Program,No.2E33111-24-042.
文摘BACKGROUND Mixed lineage kinase domain-like protein(MLKL)serves as a critical mediator in necroptosis,a form of regulated cell death linked to various liver diseases.This study aims to specifically investigate the role of MLKL’s adenosine triphosphate(ATP)-binding pocket in facilitating necroptosis-independent pathways that may contribute to liver disease progression.By focusing on this mechanism,we seek to identify potential therapeutic targets that can modulate MLKL activity,offering new strategies for the prevention and treatment of liver-related pathologies.AIM To investigate the possibility of using the ATP-binding pocket-associated,necro-ptosis-independent MLKL pathway as a target for liver diseases.METHODS Cell death following necroptosis stimuli was evaluated using cell proliferation assays,flow cytometry,and electron microscopy in various cells.The human liver organoid system was used to evaluate whether the MLKL ATP pocket-binding inhibitor could attenuate inflammation.Additionally,alcoholic and non-alcoholic fatty liver diseases animal models were used to determine whether MLKL ATP pocket inhibitors could attenuate liver injury.RESULTS While an MLKL ATP pocket-binding inhibitor did not prevent necroptosis-induced cell death in RAW 264.7 cells,it did reduce the necroptosis-led expression of CXCL2,ICAM,and VCAM.Notably,MLKL ATP pocket inhibitor diminishes the expression of CXCL2,ICAM,and VCAM by inhibiting the IκB kinase and nuclear factor kappa-B pathways without inducing necroptosis-induced cell death in two-dimensional cell culture as well as the human-derived liver organoid system.Although MLKL ATP-binding inhibitor was ineffective in non-alcoholic fatty liver disease animal models,MLKL ATP-binding inhibitor attenuated hepatic inflammation in the alcoholic liver disease model.CONCLUSION MLKL ATP pocket-binding inhibitor exerted anti-inflammatory effects through the necroptosis-independent MLKL pathway in an animal model of alcoholic liver disease.
文摘BACKGROUND Mixed tumors of the colon and rectum,composed of a combination of epithelial and endocrine elements of benign and malignant potential are rare neoplasms.These can occur anywhere in the gastrointestinal tract and are often diagnosed incidentally.Though they have been a well-documented entity in the pancreas,where the exocrine-endocrine mixed tumors have been known for a while,recognition and accurate diagnosis of these tumors in the colon and rectum,to date,remains a challenge.This is further compounded by the different terminologies that have been attributed to these lesions over the years adding to increased confusion and misclassification.Therefore,dedicated literature reviews of these lesions in the colon and rectum are inconsistent and are predominantly limited to case reports and case series of limited case numbers.Though,most of these tumors are high grade and of advanced stage,intermediate and low grade lesions of these mixed tumors are also increasingly been reported.There are no established independent consensus based guidelines for the therapeutic patient management of these unique lesions.AIM To provide a comprehensive targeted literature review of these complex mixed tumors in the colon and rectum that chronicles the evolution over time with summarization of historical perspectives of terminology and to further our understanding regarding their pathogenesis including genomic landscape,clinicoradiological features,pathology,treatment,prognosis,the current status of the management of the primary lesions,their recurrences and metastases.METHODS A comprehensive review of the published English literature was conducted using the search engines PubMed,MEDLINE and GOOGLE scholar.The following search terms[“mixed tumors colon”OR mixed endocrine/neuroendocrine tumor/neoplasm/lesion colon OR adenocarcinoma and endocrine/neuroendocrine tumor colon OR mixed adenocarcinoma and endocrine/neuroendocrine carcinoma colon OR Amphicrine tumors OR Collision tumors]were used.Eligibility criteria were defined and all potential relevant items,including full articles and/or abstracts were independently reviewed,assessed and agreed upon items were selected for in-depth analysis.RESULTS In total 237 full articles/abstracts documents were considered for eligibility of which 45 articles were illegible resulting in a total of 192 articles that were assessed for eligibility of which 139 have been selected for reference in this current review.This seminal manuscript is a one stop article that provides a detailed outlook on the evolution over time with summarization of historical perspectives,nomenclature,clinicoradiological features,pathology,treatment,prognosis and the current status of the management of both the primary lesions,their recurrences and metastases.Gaps in knowledge have also been identified and discussed.An important outcome of this manuscript is the justified proposal for a new,simple,clinically relevant,non-ambiguous terminology for these lesions to be referred to as mixed epithelial endocrine neoplasms(MEENs).CONCLUSION MEEN of the colon and rectum are poorly understood rare entities that encompass an extensive range of heterogeneous tumors with a wide variety of combinations leading to tumors of high,intermediate or low grade malignant potential.This proposed new revised terminology of MEEN will solve the biggest hurdle of confusion and misclassification that plagues these rare unique colorectal neoplasms thus facilitating the future design of multi institutional prospective randomized controlled clinical trials to develop and evaluate newer therapeutic strategies that are recommended for continued improved understanding and personal optimization of clinical management of these unique colorectal neoplasms.
文摘BACKGROUND A total of 100 patients diagnosed with mixed hemorrhoids from October 2022 to September 2023 in our hospital were randomly divided into groups by dice rolling and compared with the efficacy of different treatment options.AIM To analyze the clinical effect and prognosis of mixed hemorrhoids treated with polidocanol injection combined with automatic elastic thread ligation operation(RPH).METHODS A total of 100 patients with mixed hemorrhoids who visited our hospital from October 2022 to September 2023 were selected and randomly divided into the control group(n=50)and the treatment group(n=50)by rolling the dice.The procedure for prolapse and hemorrhoids(PPH)was adopted in the control group,while polidocanol foam injection+RPH was adopted in the treatment group.The therapeutic effects,operation time,wound healing time,hospital stay,pain situation(24 hours post-operative pain score,first defecation pain score),quality of life(QOL),incidence of complications(post-operative hemorrhage,edema,infection),incidence of anal stenosis 3 months post-operatively and recurrence rate 1 year post-operatively of the two groups were compared.RESULTS Compared with the control group,the total effective rate of treatment group was higher,and the difference was significant(P<0.05).The operation time/wound healing time/hospital stay in the treatment group were shorter than those in the control group(P<0.05).The pain scores at 24 hours after operation/first defecation pain score of the treatment group was significantly lower than those in the control group(P<0.05).After surgery,the QOL scores of the two groups decreased,with the treatment group having higher scores than that of the control group(P<0.05).Compared with the control group,the incidence of postoperative complications in the treatment group was lower,and the difference was significant(P<0.05);However,there was no significant difference in the incidence of postoperative bleeding between the two groups(P>0.05);There was no significant difference in the incidence of anal stenosis 3 months after operation and the recurrence rate 1 year after operation between the two groups(P>0.05).CONCLUSION For patients with mixed hemorrhoids,the therapeutic effect achieved by using polidocanol injection combined with RPH was better.The wounds of the patients healed faster,the postoperative pain was milder,QOL improved,and the incidence of complications was lower,and the short-term and long-term prognosis was good.
