The relative dispersion of cloud and fog droplets has significant impacts on aerosol indirect effects,radiative transfer,and microphysical processes.However,previous studies have been mostly concerned with clouds,with...The relative dispersion of cloud and fog droplets has significant impacts on aerosol indirect effects,radiative transfer,and microphysical processes.However,previous studies have been mostly concerned with clouds,with limited studies on fog,particularly those that examine the combined influences of all key physical processes and their roles during fog evolution.As such,this study aims to conduct a comprehensive investigation by examining the relationships between relative dispersion and other microphysical variables,as well as the underlying microphysical and dynamic processes,based on field fog campaigns in polluted and clean conditions.In polluted fog,droplet concentrations are higher,leading to smaller droplets and increased dispersion.The correlation between dispersion and droplet volume-mean radius is positive in the polluted fog,but shifts to negative in clean fog.We attribute the difference to various microphysical processes like aerosol activation,condensation,collision-coalescence,and entrainment-mixing.In polluted fog,high aerosol concentrations,low supersaturations,and strong turbulence(entrainment-mixing)provide suitable conditions for the simultaneous occurrence of droplet condensation and aerosol activation,resulting in a positive correlation between dispersion and volume-mean radius,especially during the fog formation stage.In contrast,during the mature stage in clean fog,condensation is dominant with weak aerosol activation leading to a negative correlation between relative dispersion and volume-mean radius.The collision-coalescence process is more active in the mature stage,increasing radii and leading to the negative correlation between dispersion and volume-mean radius.This result sheds new light on understanding the relative dispersion and mechanisms in fog under different aerosol backgrounds.展开更多
BACKGROUND Early screening,preoperative staging,and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer(GC).AIM To evaluate the diagnostic value of combined multidetector compu...BACKGROUND Early screening,preoperative staging,and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer(GC).AIM To evaluate the diagnostic value of combined multidetector computed tomography(MDCT)and gastrointestinal endoscopy for GC screening,preoperative staging,and lymph node metastasis detection,thereby providing a reference for clinical diagnosis and treatment.METHODS In this retrospective study clinical and imaging data of 134 patients with suspected GC who were admitted between January 2023 and October 2024 were initially reviewed.According to the inclusion and exclusion criteria,102 patients were finally enrolled in the analysis.All enrolled patients had undergone both MDCT and gastrointestinal endoscopy examinations prior to surgical intervention.Preoperative clinical staging and lymph node metastasis findings were compared with pathological results.RESULTS The combined use of MDCT and gastrointestinal endoscopy demonstrated a sensitivity of 98.53%,specificity of 97.06%,accuracy of 98.04%,positive predictive value of 98.53%,and negative predictive value of 97.06%for diagnosing GC.These factors were all significantly higher than those of MDCT or endoscopy alone(P<0.05).The accuracy rates of the combined approach for detecting clinical T and N stages were 97.06%and 92.65%,respectively,outperforming MDCT alone(86.76% and 79.41%)and endoscopy alone(85.29% and 70.59%)(P<0.05).Among 68 patients with confirmed GC,50(73.53%)were pathologically diagnosed with lymph node metastasis.The accuracy for detecting lymph node metastasis was 66.00%with endoscopy,76.00%with MDCT,and 92.00% with the combined approach,all with statistically significant differences(P<0.05).CONCLUSION The combined application of MDCT and gastrointestinal endoscopy enhanced diagnostic accuracy for GC,provided greater consistency in preoperative staging,and improved the detection of lymph node metastasis,thereby demonstrating significant clinical utility.展开更多
Grouting is an essential technique for reinforcing tunnel rock masses following deformation and failure.However,the mechanisms and effectiveness evaluation of grouting in fractured rock masses that have experienced su...Grouting is an essential technique for reinforcing tunnel rock masses following deformation and failure.However,the mechanisms and effectiveness evaluation of grouting in fractured rock masses that have experienced substantial deformation and transition into the residual stage remain insufficiently understood.To elucidate the relationship between grouting effectiveness and pre-cracking strain,grouting and subsequent re-fracturing tests were conducted on sandy mudstone specimens with varying levels of pre-cracking strain.Additionally,a model was developed to determine the optimal grouting timing during the residual stage.The results indicate that the failure mode of specimens in the residual stage exhibits banded and localized distribution patterns.As pre-cracking strain increases,both the maximum fracture aperture and the relative grout injection ratio increase,with the increases becoming more pronounced at higher strain levels.After grouting,the consolidation coefficient and strength enhancement coefficient exhibit a positive correlation with pre-cracking strain,although the rate of increase gradually decreases.Grouting does not alter the initial failure mode of residual-stage fractured specimens but effectively suppresses secondary crack propagation in regions distant from primary fractures.At the microscale,grout bonds within the rock matrix form cavity structures that delay tensile failure and generate an interconnected network,thereby enhancing crack resistance.Based on the evolution of rock damage and the efficiency of grouting materials utilization,a method is proposed to determine the optimal grouting timing for fractured specimens in the residual stage.At the optimal timing,specimens exhibit moderate damage while maintaining high reinforcement efficiency per unit mass of grout.展开更多
Objective:To determine whether immunotherapy can bring new hope for patients with limited-stage small-cell lung cancer(LS-SCLC).We conducted this retrospective study to evaluate whether immunotherapy can achieve bette...Objective:To determine whether immunotherapy can bring new hope for patients with limited-stage small-cell lung cancer(LS-SCLC).We conducted this retrospective study to evaluate whether immunotherapy can achieve better efficacy in LS-SCLC patients.Methods:We evaluated 122 LS-SCLC patients who received concurrent chemoradiotherapy(CCRT)or sequential chemoradiotherapy(SCRT)(Group A)and immunotherapy combined with CCRT/SCRT followed by immunotherapy(Group B),to assess the objective response rate(ORR),disease control rate(DCR),and progression-free survival(PFS).Factors affecting prognosis were also explored using Cox analysis.The prognosis of patients with type 2 diabetes and patients with different TNM stages was compared to guide the selection of clinical regimens.Results:The overall ORR was 55.93%.The overall DCR was 98.31%.The DCR was 100%in Group A and 96.61%in Group B.There was no statistical difference in ORR and DCR.The overall median PFS was 9.86 months(95%CI,8.62-11.10),and the difference in median PFS between the two groups was statistically significant(8.94 vs.11.89 months,p=0.03).The Cox regression analysis showed type 2 diabetes was associated with the survival prognosis.Patients with type 2 diabetes tended to choose immunotherapy combined with CCRT/SCRT.Patients in TNM stage IIIB had a significantly worse prognosis than those in stage I+II+IIIA.Conclusion:We suggest that LS-SCLC patients who receive immunotherapy combined with CCRT/SCRT can achieve longer PFS than those with CCRT/SCRT.Type 2 diabetes and TNM stage affect the survival prognosis.Patients with type 2 diabetes may benefit from immunotherapy combination treatments.展开更多
The root-to-shoot(R/S)ratio is a critical indicator of the balance between root biomass and shoot biomass,representing the ecological strategies and adaptive responses of plants to environmental conditions.However,the...The root-to-shoot(R/S)ratio is a critical indicator of the balance between root biomass and shoot biomass,representing the ecological strategies and adaptive responses of plants to environmental conditions.However,the patterns of change in community R/S ratios during forest succession and their response to moisture levels across broad geographic gradients remains unclear.Based on forest biomass data from a national field inventory of 5,825 plots conducted across China between 2011 and 2015,this study looked into allocating biomass shoots and roots at the early,middle,and late stages of growth in plantations and succession in natural forests,and evaluated how moisture availability influences this allocation.The results revealed a significant decline in R/S ratios from early to late stages for both plantations and natural forests.Shoot and root biomass in plantations grew isometrically during the early and middle succession stages but shifted to allometric growth in the late stage,with the slope of the log-transformed shoot-root biomass relationship differing significantly across growth stages.Natural forests,in contrast,maintained isometric growth across successional stages,showing no significant variation in the slope of the log-transformed shoot-root biomass relationship.Environmental factors,particularly moisture levels,strongly influenced R/S ratios.Moisture levels significantly affected size-corrected R/S ratios,particularly in the middle stage of plantations and the early and middle stages of natural forests,supporting the hypothesis of optimal allocation.These findings suggest that in water-limited regions,forest management should prioritize drought-tolerant,deep-rooted native species,encourage mixed-species planting in the early stage,and reduce logging intensity in mature plantations.Conserving natural forests to maintain successional dynamics is essential for long-term ecological resilience.These findings emphasize the importance of balancing productivity with ecological sustainability by adapting practices to specific environments and forest types under climate change.展开更多
Background:According to the 2022 update of the BCLC strategy,laparoscopic liver resection(LLR)is considered feasible for BCLC stage 0-A hepatocellular carcinoma(HCC)patients with clinically significant portal hyperten...Background:According to the 2022 update of the BCLC strategy,laparoscopic liver resection(LLR)is considered feasible for BCLC stage 0-A hepatocellular carcinoma(HCC)patients with clinically significant portal hypertension(CSPH).However,there is still no research to explore the outcomes of laparoscopic versus open liver resection(OLR)in the specific patients with BCLC stage 0-A HCC and CSPH.Methods:Patients diagnosed with BCLC stage 0-A HCC and CSPH who underwent liver resection at West China Hospital of Sichuan University from February 2018 to December 2022 were analyzed.Demographic characteristics,pathological findings and postoperative outcomes were compared using propensity score matching(PSM).Long-term outcomes after surgery were analyzed using Kaplan-Meier analysis both before and after PSM.Results:A total of 409 patients,including 261 LLRs and 148 OLRs,were enrolled in this study.There were imbalances between the groups in baseline information.After 1:1 PSM,118 patients were included in each group with comparable baseline characteristics.Patients in the LLR group had significantly less intraoperative blood loss compared to those in the OLR group(median 223 vs.318 mL,P<0.001),and fewer postoperative complications(33.9%vs.57.6%,P<0.001),including lower rates of postoperative liver decompensation(16.9%vs.28.0%,P=0.043),postoperative ascites(18.6%vs.31.4%,P=0.024)and pulmonary infections(12.7%vs.29.7%,P=0.001).The long-term follow-up showed that overall survival(P=0.154)and recurrence-free survival(P=0.376)were comparable between the two groups.In subgroup analysis,patients with PLT≤75×10^(9)/L suffered more postoperative liver decompensation(PLD)and ascites than patiens with PLT>75×10^(9)/L.Conclusions:Compared with OLR,LLR had less intraoperative blood loss,fewer postoperative complications and comparable oncological outcomes for patients with BCLC stage 0/A HCC and CSPH.展开更多
The role of ore metals in magmatic fluids during the magmatic-hydrothermal transition in porphyry systems remains unclear,and their contributions to porphyry ore genesis are unclear.This study offers fresh perspective...The role of ore metals in magmatic fluids during the magmatic-hydrothermal transition in porphyry systems remains unclear,and their contributions to porphyry ore genesis are unclear.This study offers fresh perspectives on the ore-forming process during this critical transition,focusing on the Hongyuan porphyry Mo(Cu) deposit(PMCD) in West Junggar,China.We find that sulfide-quartz-rich miarolitic cavities(MCs),characterized by micrographic quartz and feldspar,indicate the formation of initial mineralizing fluids from magmatic fluids.This conclusion is supported by three key observations: the simultaneous formation of feldspar and sulfides in the micrographic zones of MCs,the high formation temperatures(approaching 750 ℃) suggested by the sectorzoned bright CL cores of quartz phenocrysts,and the magmatic sulfur source indicated by the narrow sulfur isotopic composition ranges(+0.18‰ to +4.63‰).LA-ICP-MS analyses reveal distinct trace element distribution patterns between the early magmatic and transition stages and the later hydrothermal stage.Chalcopyrite from the early stages has higher Cd and lower Zn contents,while molybdenite has higher Re contents,and pyrite has higher Co and Ni contents than its counterparts in the hydrothermal stage.The decrease in sulfur concentrations at sulfide saturation from granite porphyry to micrographic quartz-feldspar melts(from 200 ppm to 100 ppm) suggests that nearly half of the sulfur was exsolved during the formation of feldspar and quartz intergrowths from fractionated granitic magma.These findings indicate that the initial mineralizing fluids of the porphyry deposit were high-temperature,melt-bearing,and ore-rich and originated from magma.The transition from initial melt-bearing,metal-rich fluids to hydrothermal ore-forming fluids is marked by decreasing temperatures and logf_(S2) values,underscoring the critical role of sulfide formation during the magmatic-hydrothermal transition in the development of porphyry deposits.展开更多
Alzheimer’s disease(AD)remains an incurable neurodegenerative disorder with devastating societal and personal impacts.Despite decades of intensive research,therapeutic efforts targeting the clinical stages of AD have...Alzheimer’s disease(AD)remains an incurable neurodegenerative disorder with devastating societal and personal impacts.Despite decades of intensive research,therapeutic efforts targeting the clinical stages of AD have largely failed to halt or reverse disease progression.This has prompted a critical shift in focus toward the earlier,preclinical stages of AD,where interventions may hold greater promise for altering the disease trajectory.展开更多
The Barcelona Clinic Liver Cancer(BCLC)system was proposed in 1999 with the intent to improve a therapeutic algorithm for the management of patients with hepatocellular carcinoma(HCC)[1].Both the European and the Amer...The Barcelona Clinic Liver Cancer(BCLC)system was proposed in 1999 with the intent to improve a therapeutic algorithm for the management of patients with hepatocellular carcinoma(HCC)[1].Both the European and the American Guidelines on the Treatment of HCC have endorsed the BCLC as the standard staging algorithm with prognostic and therapeutic implications[2,3].The BCLC staging system stratifies HCC patients into five stages(0,A,B,C and D).According to the algorithm,liver transplantation(LT)is indicated only in patients in the stages BCLC 0 and A,special situations provided.展开更多
AIM To ascertain the prognostic role of the T4 and N2 category in stage Ⅲ pancreatic cancer according to the 8 th edition of the American Joint Committee on Cancer(AJCC) classification.METHODS Patients were collected...AIM To ascertain the prognostic role of the T4 and N2 category in stage Ⅲ pancreatic cancer according to the 8 th edition of the American Joint Committee on Cancer(AJCC) classification.METHODS Patients were collected from the Surveillance Epidemiology and End Results(SEER) database(2004-2013) and were divided into three groups: T(1-3)N2, T4 N(0-1), and T4 N2. Overall survival(OS) and disease-specific survival(DSS) of patients were evaluated by the Kaplan-Meier method. RESULTS For the first time, we found a significant difference in OS and DSS between T(1-3)N2/T4 N(0-1) and T4 N2 butnot between T(1-3)N2 and T4 N(0-1). A higher grading correlated with a worse prognosis in the T(1-3)N2 and T4 N2 groups.CONCLUSION Patients with stage T4 N2 had a worse prognosis than those with stage T(1-3)N2/T4 N(0-1) in the 8 th edition AJCC staging system for pancreatic cancer. We recommend that stage Ⅲ should be subclassified into stage ⅢA [T(1-3)N2/T4 N(0-1)] and stage ⅢB(T4 N2).展开更多
BACKGROUND Gastric cancer(GC)is a prevalent malignancy with a substantial health burden and high mortality rate,despite advances in prevention,early detection,and treatment.Compared with the global average,Asia,notabl...BACKGROUND Gastric cancer(GC)is a prevalent malignancy with a substantial health burden and high mortality rate,despite advances in prevention,early detection,and treatment.Compared with the global average,Asia,notably China,reports disproportionately high GC incidences.The disease often progresses asymptoma-tically in the early stages,leading to delayed diagnosis and compromised out-comes.Thus,it is crucial to identify early diagnostic biomarkers and enhance treatment strategies to improve patient outcomes and reduce mortality.METHODS Retrospectively analyzed the clinical data of 148 patients with GC treated at the Civil Aviation Shanghai Hospital between December 2022 and December 2023.The associations of coagulation indices-partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen,fibrinogen degradation products(FDP),fasting blood glucose,and D-dimer(D-D)with TNM stage and distant metastasis were examined.RESULTS Prolongation of APTT,PT,and TT was significantly correlated with the GC TNM stage.Hence,abnormal coagulation system activation was closely related to disease progression.Elevated FDP and D-D were significantly associated with distant metastasis in GC(P<0.05),suggesting that increased fibrinolytic activity contributes to increased metastatic risk.CONCLUSION Our Results reveal coagulation indices,FDPs as GC biomarkers,reflecting abnormal coagulation/fibrinolysis,aiding disease progression,metastasis prediction,and helping clinicians assess thrombotic risk for early intervention and personalized treatment plans.展开更多
Objective：Prognosis of patients with locally advanced rectal cancer（LARC）but achieving yp T1–2N0 stage after neoadjuvant concurrent chemo-radiotherapy（CRT）has been shown to be favorable.This study aims to determ...Objective：Prognosis of patients with locally advanced rectal cancer（LARC）but achieving yp T1–2N0 stage after neoadjuvant concurrent chemo-radiotherapy（CRT）has been shown to be favorable.This study aims to determine whether the long-term outcome of yp T1–2N0 cases can be comparable to that of p T1–2N0 cohort that received definitive surgery for early disease.Method：From January 2008 to December 2013,449 consecutive patients with rectal cancer were treated and their outcome maintained in a database.Patients with LARC underwent total mesorectal excision（TME）surgery at4–8 weeks after completion of CRT,and those achieving stage yp I were identified as a group.As a comparison,stage p I group pertains to patients whose initially limited disease was not upstaged after TME surgery alone.After propensity score matching（PSM）,comparisons of local regional control（LC）,distant metastasis-free survival（DMFS）,disease-free survival（DFS）and overall survival（OS）were performed using Kaplan-Meier analysis and log-rank test between yp I and p I groups.Down-staging depth score（DDS）,a novel method of evaluating CRT response,was used for subset analysis.Results：Of the 449 patients,168 matched cases were generated for analysis.Five-year LC,DMFS,DFS and OS for stage p I vs.yp I groups were 96.7%vs.96.4%（P=0.796）,92.7%vs.73.6%（P=0.025）,91.2%vs.73.6%（P=0.080）and 93.1%vs.72.3%（P=0.040）,respectively.In the DDS-favorable subset of the yp I group,LC,DMFS,DFS and OS resulted in no significant differences in comparison with the p I group（P=0.384,0.368,0.277 and0.458,respectively）.Conclusions：LC was comparable in both groups;however,distant metastasis developed more frequently in down-staged LARC than de novo early stage cases,reflecting the need to improve the efficacy of systemic treatment despite excellent pathologic response.DDS can be an indicator to identify a subset of the yp I group whose longterm oncologic outcomes are as good as those of stage p I cohort.展开更多
Pancreatic cancer is recognized as one of the leading causes of cancer mortality,representing the second most common source of cancer-related deaths within the gastrointestinal domain.Surgical resection is currently t...Pancreatic cancer is recognized as one of the leading causes of cancer mortality,representing the second most common source of cancer-related deaths within the gastrointestinal domain.Surgical resection is currently the only definitive treatment;however,the subtle emergence of symptoms often leads to a diagnosis at an advanced stage,with merely 10%-15%of patients being eligible for surgical intervention.The primary obstacle to achieving a potential radical resection is the presence of distant metastatic disease or invasion of adjacent major vascular structures.This review aims to highlight the critical role of endoscopic ultrasound in the diagnosis and staging of pancreatic tumors.We systematically searched PubMed,MEDLINE and Web of Science by using‘pancreatic cancer’and‘endoscopic ultrasonography’as keywords.Relevant studies were reviewed and analyzed.Endoscopic ultrasonography(EUS)is efficient in the diagnosis and staging of pancreatic cancer,past studies reported the accuracy of EUS is 63%to 94%for T-staging and 44%to 82%for N-staging but there are still limitations that need to be comprehensively applied with other diagnostic methods to evaluation of distant metastasis for surgical resectability.Our review aims to reveal the value for the staging of pancreatic cancer.展开更多
The wheat above-ground biomass(AGB)is an important index that shows the life activity of vegetation,which is of great significance for wheat growth monitoring and yield prediction.Traditional biomass estimation method...The wheat above-ground biomass(AGB)is an important index that shows the life activity of vegetation,which is of great significance for wheat growth monitoring and yield prediction.Traditional biomass estimation methods specifically include sample surveys and harvesting statistics.Although these methods have high estimation accuracy,they are time-consuming,destructive,and difficult to implement to monitor the biomass at a large scale.The main objective of this study is to optimize the traditional remote sensing methods to estimate the wheat AGBbased on improved convolutional features(CFs).Low-cost unmanned aerial vehicles(UAV)were used as the main data acquisition equipment.This study acquired image data acquired by RGB camera(RGB)and multi-spectral(MS)image data of the wheat population canopy for two wheat varieties and five key growth stages.Then,field measurements were conducted to obtain the actual wheat biomass data for validation.Based on the remote sensing indices(RSIs),structural features(SFs),and CFs,this study proposed a new feature named AUR-50(multi-source combination based on convolutional feature optimization)to estimate the wheat AGB.The results show that AUR-50 could estimate the wheat AGB more accurately than RSIs and SFs,and the average R^(2) exceeded 0.77.In the overwintering period,AUR-50_(MS)(multi-source combination with convolutional feature optimization using multispectral imagery)had the highest estimation accuracy(R^(2) of 0.88).In addition,AUR-50 reduced the effect of the vegetation index saturation on the biomass estimation accuracy by adding CFs,where the highest R^(2) was 0.69 at the flowering stage.The results of this study provide an effective method to evaluate the AGB in wheat with high throughput and a research reference for the phenotypic parameters of other crops.展开更多
The unavoidable dendrite growth and shuttle effect have long been stranglehold challenges limiting the safety and practicality of lithium-sulfur batteries.Herein,we propose a dual-action strategy to address the lithiu...The unavoidable dendrite growth and shuttle effect have long been stranglehold challenges limiting the safety and practicality of lithium-sulfur batteries.Herein,we propose a dual-action strategy to address the lithium dendrite issue in stages by constructing a multifunctional surface-negatively-charged nanodiamond layer with high ductility and robust puncture resistance on polypropylene (PP) separator.The uniformly loaded compact negative layer can not only significantly enhance electron transmission efficiency and promote uniform lithium deposition,but also reduce the formation of dendrite during early deposition stage.Most importantly,under the strong puncture stress encountered during the deterioration of lithium dendrite growth under limiting current,the high ductility and robust puncture resistance(145.88 MPa) of as-obtained nanodiamond layer can effectively prevent short circuits caused by unavoidable lithium dendrite.The Li||Li symmetrical cells assembled with nanodiamond layer modified PP demonstrated a stable cycle of over 1000 h at 2 mA cm^(-2)with a polarization voltage of only 29.3 mV.Additionally,the negative charged layer serves as a physical barrier blocking lithium polysulfide ions,effectively mitigating capacity attenuation.The improved cells achieved a capacity decay of only 0.042%per cycle after 700 cycles at 3 C,demonstrating effective suppression of dendrite growth and capacity attenuation,showing promising prospect.展开更多
Peri-implant keratinized mucosa(PIKM)augmentation refers to surgical procedures aimed at increasing the width of PIKM.Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-ter...Peri-implant keratinized mucosa(PIKM)augmentation refers to surgical procedures aimed at increasing the width of PIKM.Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health.Currently,several surgical techniques have been validated for their effectiveness in increasing PIKM.However,the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques,variations in clinical scenarios,and anatomical differences.Therefore,clear guidelines and considerations for PIKM augmentation are needed.This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery.It aims to establish a standardized framework for assessing,planning,and executing PIKM augmentation procedures,with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.展开更多
基金supported by the Chinese National Natural Science Foundation under Grant Nos.(41975181,42325503,42375197,42575207,42205090)Y.LIU is supported by the U.S.Department of Energy’s Atmospheric System Research(ASR)program.
文摘The relative dispersion of cloud and fog droplets has significant impacts on aerosol indirect effects,radiative transfer,and microphysical processes.However,previous studies have been mostly concerned with clouds,with limited studies on fog,particularly those that examine the combined influences of all key physical processes and their roles during fog evolution.As such,this study aims to conduct a comprehensive investigation by examining the relationships between relative dispersion and other microphysical variables,as well as the underlying microphysical and dynamic processes,based on field fog campaigns in polluted and clean conditions.In polluted fog,droplet concentrations are higher,leading to smaller droplets and increased dispersion.The correlation between dispersion and droplet volume-mean radius is positive in the polluted fog,but shifts to negative in clean fog.We attribute the difference to various microphysical processes like aerosol activation,condensation,collision-coalescence,and entrainment-mixing.In polluted fog,high aerosol concentrations,low supersaturations,and strong turbulence(entrainment-mixing)provide suitable conditions for the simultaneous occurrence of droplet condensation and aerosol activation,resulting in a positive correlation between dispersion and volume-mean radius,especially during the fog formation stage.In contrast,during the mature stage in clean fog,condensation is dominant with weak aerosol activation leading to a negative correlation between relative dispersion and volume-mean radius.The collision-coalescence process is more active in the mature stage,increasing radii and leading to the negative correlation between dispersion and volume-mean radius.This result sheds new light on understanding the relative dispersion and mechanisms in fog under different aerosol backgrounds.
文摘BACKGROUND Early screening,preoperative staging,and diagnosis of lymph node metastasis are crucial for improving the prognosis of gastric cancer(GC).AIM To evaluate the diagnostic value of combined multidetector computed tomography(MDCT)and gastrointestinal endoscopy for GC screening,preoperative staging,and lymph node metastasis detection,thereby providing a reference for clinical diagnosis and treatment.METHODS In this retrospective study clinical and imaging data of 134 patients with suspected GC who were admitted between January 2023 and October 2024 were initially reviewed.According to the inclusion and exclusion criteria,102 patients were finally enrolled in the analysis.All enrolled patients had undergone both MDCT and gastrointestinal endoscopy examinations prior to surgical intervention.Preoperative clinical staging and lymph node metastasis findings were compared with pathological results.RESULTS The combined use of MDCT and gastrointestinal endoscopy demonstrated a sensitivity of 98.53%,specificity of 97.06%,accuracy of 98.04%,positive predictive value of 98.53%,and negative predictive value of 97.06%for diagnosing GC.These factors were all significantly higher than those of MDCT or endoscopy alone(P<0.05).The accuracy rates of the combined approach for detecting clinical T and N stages were 97.06%and 92.65%,respectively,outperforming MDCT alone(86.76% and 79.41%)and endoscopy alone(85.29% and 70.59%)(P<0.05).Among 68 patients with confirmed GC,50(73.53%)were pathologically diagnosed with lymph node metastasis.The accuracy for detecting lymph node metastasis was 66.00%with endoscopy,76.00%with MDCT,and 92.00% with the combined approach,all with statistically significant differences(P<0.05).CONCLUSION The combined application of MDCT and gastrointestinal endoscopy enhanced diagnostic accuracy for GC,provided greater consistency in preoperative staging,and improved the detection of lymph node metastasis,thereby demonstrating significant clinical utility.
基金supported by the National Natural Science Foundation of China(Grant Nos.52274091 and 51974193).
文摘Grouting is an essential technique for reinforcing tunnel rock masses following deformation and failure.However,the mechanisms and effectiveness evaluation of grouting in fractured rock masses that have experienced substantial deformation and transition into the residual stage remain insufficiently understood.To elucidate the relationship between grouting effectiveness and pre-cracking strain,grouting and subsequent re-fracturing tests were conducted on sandy mudstone specimens with varying levels of pre-cracking strain.Additionally,a model was developed to determine the optimal grouting timing during the residual stage.The results indicate that the failure mode of specimens in the residual stage exhibits banded and localized distribution patterns.As pre-cracking strain increases,both the maximum fracture aperture and the relative grout injection ratio increase,with the increases becoming more pronounced at higher strain levels.After grouting,the consolidation coefficient and strength enhancement coefficient exhibit a positive correlation with pre-cracking strain,although the rate of increase gradually decreases.Grouting does not alter the initial failure mode of residual-stage fractured specimens but effectively suppresses secondary crack propagation in regions distant from primary fractures.At the microscale,grout bonds within the rock matrix form cavity structures that delay tensile failure and generate an interconnected network,thereby enhancing crack resistance.Based on the evolution of rock damage and the efficiency of grouting materials utilization,a method is proposed to determine the optimal grouting timing for fractured specimens in the residual stage.At the optimal timing,specimens exhibit moderate damage while maintaining high reinforcement efficiency per unit mass of grout.
基金funded by the National Natural Science Foundation of China(grant no.82273162)the National Natural Science Foundation of China(grant no.82203272)the Science and Technology Development Foundation of Nanjing Medical University(grant NMUB20240119)。
文摘Objective:To determine whether immunotherapy can bring new hope for patients with limited-stage small-cell lung cancer(LS-SCLC).We conducted this retrospective study to evaluate whether immunotherapy can achieve better efficacy in LS-SCLC patients.Methods:We evaluated 122 LS-SCLC patients who received concurrent chemoradiotherapy(CCRT)or sequential chemoradiotherapy(SCRT)(Group A)and immunotherapy combined with CCRT/SCRT followed by immunotherapy(Group B),to assess the objective response rate(ORR),disease control rate(DCR),and progression-free survival(PFS).Factors affecting prognosis were also explored using Cox analysis.The prognosis of patients with type 2 diabetes and patients with different TNM stages was compared to guide the selection of clinical regimens.Results:The overall ORR was 55.93%.The overall DCR was 98.31%.The DCR was 100%in Group A and 96.61%in Group B.There was no statistical difference in ORR and DCR.The overall median PFS was 9.86 months(95%CI,8.62-11.10),and the difference in median PFS between the two groups was statistically significant(8.94 vs.11.89 months,p=0.03).The Cox regression analysis showed type 2 diabetes was associated with the survival prognosis.Patients with type 2 diabetes tended to choose immunotherapy combined with CCRT/SCRT.Patients in TNM stage IIIB had a significantly worse prognosis than those in stage I+II+IIIA.Conclusion:We suggest that LS-SCLC patients who receive immunotherapy combined with CCRT/SCRT can achieve longer PFS than those with CCRT/SCRT.Type 2 diabetes and TNM stage affect the survival prognosis.Patients with type 2 diabetes may benefit from immunotherapy combination treatments.
基金supported by the China National Science Foundation(No.42130506,42071031)the Special Technology Innovation Fund of Carbon Peak and Carbon Neutrality in Jiangsu Province(BK20231515)+1 种基金the Spanish Government grant PID2022-140808NB-I00 funded by MICIU/AEI/https://doi.org/10.13039/501100011033the Catalan Government grants SGR 2021-1333 and AGAUR2023 CLIMA 00118.
文摘The root-to-shoot(R/S)ratio is a critical indicator of the balance between root biomass and shoot biomass,representing the ecological strategies and adaptive responses of plants to environmental conditions.However,the patterns of change in community R/S ratios during forest succession and their response to moisture levels across broad geographic gradients remains unclear.Based on forest biomass data from a national field inventory of 5,825 plots conducted across China between 2011 and 2015,this study looked into allocating biomass shoots and roots at the early,middle,and late stages of growth in plantations and succession in natural forests,and evaluated how moisture availability influences this allocation.The results revealed a significant decline in R/S ratios from early to late stages for both plantations and natural forests.Shoot and root biomass in plantations grew isometrically during the early and middle succession stages but shifted to allometric growth in the late stage,with the slope of the log-transformed shoot-root biomass relationship differing significantly across growth stages.Natural forests,in contrast,maintained isometric growth across successional stages,showing no significant variation in the slope of the log-transformed shoot-root biomass relationship.Environmental factors,particularly moisture levels,strongly influenced R/S ratios.Moisture levels significantly affected size-corrected R/S ratios,particularly in the middle stage of plantations and the early and middle stages of natural forests,supporting the hypothesis of optimal allocation.These findings suggest that in water-limited regions,forest management should prioritize drought-tolerant,deep-rooted native species,encourage mixed-species planting in the early stage,and reduce logging intensity in mature plantations.Conserving natural forests to maintain successional dynamics is essential for long-term ecological resilience.These findings emphasize the importance of balancing productivity with ecological sustainability by adapting practices to specific environments and forest types under climate change.
基金supported by grants from the Sichuan Science and Technology Program(2023YFQ0094)the 1.3.5 project for disciplines of excellence,West China Hospital,Sichuan University(25HXJS028).
文摘Background:According to the 2022 update of the BCLC strategy,laparoscopic liver resection(LLR)is considered feasible for BCLC stage 0-A hepatocellular carcinoma(HCC)patients with clinically significant portal hypertension(CSPH).However,there is still no research to explore the outcomes of laparoscopic versus open liver resection(OLR)in the specific patients with BCLC stage 0-A HCC and CSPH.Methods:Patients diagnosed with BCLC stage 0-A HCC and CSPH who underwent liver resection at West China Hospital of Sichuan University from February 2018 to December 2022 were analyzed.Demographic characteristics,pathological findings and postoperative outcomes were compared using propensity score matching(PSM).Long-term outcomes after surgery were analyzed using Kaplan-Meier analysis both before and after PSM.Results:A total of 409 patients,including 261 LLRs and 148 OLRs,were enrolled in this study.There were imbalances between the groups in baseline information.After 1:1 PSM,118 patients were included in each group with comparable baseline characteristics.Patients in the LLR group had significantly less intraoperative blood loss compared to those in the OLR group(median 223 vs.318 mL,P<0.001),and fewer postoperative complications(33.9%vs.57.6%,P<0.001),including lower rates of postoperative liver decompensation(16.9%vs.28.0%,P=0.043),postoperative ascites(18.6%vs.31.4%,P=0.024)and pulmonary infections(12.7%vs.29.7%,P=0.001).The long-term follow-up showed that overall survival(P=0.154)and recurrence-free survival(P=0.376)were comparable between the two groups.In subgroup analysis,patients with PLT≤75×10^(9)/L suffered more postoperative liver decompensation(PLD)and ascites than patiens with PLT>75×10^(9)/L.Conclusions:Compared with OLR,LLR had less intraoperative blood loss,fewer postoperative complications and comparable oncological outcomes for patients with BCLC stage 0/A HCC and CSPH.
基金jointly supported by the National Natural Science Foundation of China (Nos.42272075,42302083,and 92162323)Guangdong Province Introduced Innovative R&D Team of Big Data-Mathematical Earth Sciences and Extreme Geological Events Team (No.2021ZT09H399)+1 种基金the National Key R&D Program of China (Nos.2017YFC0601201,2018YFC0604002)the Fundamental Research Funds for the Central Universities,Sun Yat-sen University (No.22qntd2101)。
文摘The role of ore metals in magmatic fluids during the magmatic-hydrothermal transition in porphyry systems remains unclear,and their contributions to porphyry ore genesis are unclear.This study offers fresh perspectives on the ore-forming process during this critical transition,focusing on the Hongyuan porphyry Mo(Cu) deposit(PMCD) in West Junggar,China.We find that sulfide-quartz-rich miarolitic cavities(MCs),characterized by micrographic quartz and feldspar,indicate the formation of initial mineralizing fluids from magmatic fluids.This conclusion is supported by three key observations: the simultaneous formation of feldspar and sulfides in the micrographic zones of MCs,the high formation temperatures(approaching 750 ℃) suggested by the sectorzoned bright CL cores of quartz phenocrysts,and the magmatic sulfur source indicated by the narrow sulfur isotopic composition ranges(+0.18‰ to +4.63‰).LA-ICP-MS analyses reveal distinct trace element distribution patterns between the early magmatic and transition stages and the later hydrothermal stage.Chalcopyrite from the early stages has higher Cd and lower Zn contents,while molybdenite has higher Re contents,and pyrite has higher Co and Ni contents than its counterparts in the hydrothermal stage.The decrease in sulfur concentrations at sulfide saturation from granite porphyry to micrographic quartz-feldspar melts(from 200 ppm to 100 ppm) suggests that nearly half of the sulfur was exsolved during the formation of feldspar and quartz intergrowths from fractionated granitic magma.These findings indicate that the initial mineralizing fluids of the porphyry deposit were high-temperature,melt-bearing,and ore-rich and originated from magma.The transition from initial melt-bearing,metal-rich fluids to hydrothermal ore-forming fluids is marked by decreasing temperatures and logf_(S2) values,underscoring the critical role of sulfide formation during the magmatic-hydrothermal transition in the development of porphyry deposits.
基金supported by the Canadian Institutes of Health Research Project grant (PJT-169197) to QYsupported by a CGS-M fellowship from the Canadian Institutes of Health Research
文摘Alzheimer’s disease(AD)remains an incurable neurodegenerative disorder with devastating societal and personal impacts.Despite decades of intensive research,therapeutic efforts targeting the clinical stages of AD have largely failed to halt or reverse disease progression.This has prompted a critical shift in focus toward the earlier,preclinical stages of AD,where interventions may hold greater promise for altering the disease trajectory.
文摘The Barcelona Clinic Liver Cancer(BCLC)system was proposed in 1999 with the intent to improve a therapeutic algorithm for the management of patients with hepatocellular carcinoma(HCC)[1].Both the European and the American Guidelines on the Treatment of HCC have endorsed the BCLC as the standard staging algorithm with prognostic and therapeutic implications[2,3].The BCLC staging system stratifies HCC patients into five stages(0,A,B,C and D).According to the algorithm,liver transplantation(LT)is indicated only in patients in the stages BCLC 0 and A,special situations provided.
文摘AIM To ascertain the prognostic role of the T4 and N2 category in stage Ⅲ pancreatic cancer according to the 8 th edition of the American Joint Committee on Cancer(AJCC) classification.METHODS Patients were collected from the Surveillance Epidemiology and End Results(SEER) database(2004-2013) and were divided into three groups: T(1-3)N2, T4 N(0-1), and T4 N2. Overall survival(OS) and disease-specific survival(DSS) of patients were evaluated by the Kaplan-Meier method. RESULTS For the first time, we found a significant difference in OS and DSS between T(1-3)N2/T4 N(0-1) and T4 N2 butnot between T(1-3)N2 and T4 N(0-1). A higher grading correlated with a worse prognosis in the T(1-3)N2 and T4 N2 groups.CONCLUSION Patients with stage T4 N2 had a worse prognosis than those with stage T(1-3)N2/T4 N(0-1) in the 8 th edition AJCC staging system for pancreatic cancer. We recommend that stage Ⅲ should be subclassified into stage ⅢA [T(1-3)N2/T4 N(0-1)] and stage ⅢB(T4 N2).
文摘BACKGROUND Gastric cancer(GC)is a prevalent malignancy with a substantial health burden and high mortality rate,despite advances in prevention,early detection,and treatment.Compared with the global average,Asia,notably China,reports disproportionately high GC incidences.The disease often progresses asymptoma-tically in the early stages,leading to delayed diagnosis and compromised out-comes.Thus,it is crucial to identify early diagnostic biomarkers and enhance treatment strategies to improve patient outcomes and reduce mortality.METHODS Retrospectively analyzed the clinical data of 148 patients with GC treated at the Civil Aviation Shanghai Hospital between December 2022 and December 2023.The associations of coagulation indices-partial thromboplastin time(APTT),prothrombin time(PT),thrombin time(TT),fibrinogen,fibrinogen degradation products(FDP),fasting blood glucose,and D-dimer(D-D)with TNM stage and distant metastasis were examined.RESULTS Prolongation of APTT,PT,and TT was significantly correlated with the GC TNM stage.Hence,abnormal coagulation system activation was closely related to disease progression.Elevated FDP and D-D were significantly associated with distant metastasis in GC(P<0.05),suggesting that increased fibrinolytic activity contributes to increased metastatic risk.CONCLUSION Our Results reveal coagulation indices,FDPs as GC biomarkers,reflecting abnormal coagulation/fibrinolysis,aiding disease progression,metastasis prediction,and helping clinicians assess thrombotic risk for early intervention and personalized treatment plans.
基金supported by Natural Science Foundation of China (No.81773241)Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (No.2017I2M-1-006)
文摘Objective：Prognosis of patients with locally advanced rectal cancer（LARC）but achieving yp T1–2N0 stage after neoadjuvant concurrent chemo-radiotherapy（CRT）has been shown to be favorable.This study aims to determine whether the long-term outcome of yp T1–2N0 cases can be comparable to that of p T1–2N0 cohort that received definitive surgery for early disease.Method：From January 2008 to December 2013,449 consecutive patients with rectal cancer were treated and their outcome maintained in a database.Patients with LARC underwent total mesorectal excision（TME）surgery at4–8 weeks after completion of CRT,and those achieving stage yp I were identified as a group.As a comparison,stage p I group pertains to patients whose initially limited disease was not upstaged after TME surgery alone.After propensity score matching（PSM）,comparisons of local regional control（LC）,distant metastasis-free survival（DMFS）,disease-free survival（DFS）and overall survival（OS）were performed using Kaplan-Meier analysis and log-rank test between yp I and p I groups.Down-staging depth score（DDS）,a novel method of evaluating CRT response,was used for subset analysis.Results：Of the 449 patients,168 matched cases were generated for analysis.Five-year LC,DMFS,DFS and OS for stage p I vs.yp I groups were 96.7%vs.96.4%（P=0.796）,92.7%vs.73.6%（P=0.025）,91.2%vs.73.6%（P=0.080）and 93.1%vs.72.3%（P=0.040）,respectively.In the DDS-favorable subset of the yp I group,LC,DMFS,DFS and OS resulted in no significant differences in comparison with the p I group（P=0.384,0.368,0.277 and0.458,respectively）.Conclusions：LC was comparable in both groups;however,distant metastasis developed more frequently in down-staged LARC than de novo early stage cases,reflecting the need to improve the efficacy of systemic treatment despite excellent pathologic response.DDS can be an indicator to identify a subset of the yp I group whose longterm oncologic outcomes are as good as those of stage p I cohort.
文摘Pancreatic cancer is recognized as one of the leading causes of cancer mortality,representing the second most common source of cancer-related deaths within the gastrointestinal domain.Surgical resection is currently the only definitive treatment;however,the subtle emergence of symptoms often leads to a diagnosis at an advanced stage,with merely 10%-15%of patients being eligible for surgical intervention.The primary obstacle to achieving a potential radical resection is the presence of distant metastatic disease or invasion of adjacent major vascular structures.This review aims to highlight the critical role of endoscopic ultrasound in the diagnosis and staging of pancreatic tumors.We systematically searched PubMed,MEDLINE and Web of Science by using‘pancreatic cancer’and‘endoscopic ultrasonography’as keywords.Relevant studies were reviewed and analyzed.Endoscopic ultrasonography(EUS)is efficient in the diagnosis and staging of pancreatic cancer,past studies reported the accuracy of EUS is 63%to 94%for T-staging and 44%to 82%for N-staging but there are still limitations that need to be comprehensively applied with other diagnostic methods to evaluation of distant metastasis for surgical resectability.Our review aims to reveal the value for the staging of pancreatic cancer.
基金supported by the Postgraduate Research&Practice Innovation Program of Jiangsu Province,China(SJCX23_1973)the National Natural Science Foundation of China(32172110,32071945)+7 种基金the Key Research and Development Program(Modern Agriculture)of Jiangsu Province,China(BE2022342-2,BE2020319)the Anhui Province Crop Intelligent Planting and Processing Technology Engineering Research Center Open Project,China(ZHKF04)the National Key Research and Development Program of China(2023YFD2300201,2023YFD1202200)the Special Funds for Scientific and Technological Innovation of Jiangsu Province,China(BE2022425)the Priority Academic Program Development of Jiangsu Higher Education Institutions,China(PAPD)the Central Publicinterest Scientific Institution Basal Research Fund,China(JBYW-AII-2023-08)the Science and Technology Innovation Project of the Chinese Academy of Agricultural Sciences(CAAS-CS-202201)the Special Fund for Independent Innovation of Agriculture Science and Technology in Jiangsu Province,China(CX(22)3112)。
文摘The wheat above-ground biomass(AGB)is an important index that shows the life activity of vegetation,which is of great significance for wheat growth monitoring and yield prediction.Traditional biomass estimation methods specifically include sample surveys and harvesting statistics.Although these methods have high estimation accuracy,they are time-consuming,destructive,and difficult to implement to monitor the biomass at a large scale.The main objective of this study is to optimize the traditional remote sensing methods to estimate the wheat AGBbased on improved convolutional features(CFs).Low-cost unmanned aerial vehicles(UAV)were used as the main data acquisition equipment.This study acquired image data acquired by RGB camera(RGB)and multi-spectral(MS)image data of the wheat population canopy for two wheat varieties and five key growth stages.Then,field measurements were conducted to obtain the actual wheat biomass data for validation.Based on the remote sensing indices(RSIs),structural features(SFs),and CFs,this study proposed a new feature named AUR-50(multi-source combination based on convolutional feature optimization)to estimate the wheat AGB.The results show that AUR-50 could estimate the wheat AGB more accurately than RSIs and SFs,and the average R^(2) exceeded 0.77.In the overwintering period,AUR-50_(MS)(multi-source combination with convolutional feature optimization using multispectral imagery)had the highest estimation accuracy(R^(2) of 0.88).In addition,AUR-50 reduced the effect of the vegetation index saturation on the biomass estimation accuracy by adding CFs,where the highest R^(2) was 0.69 at the flowering stage.The results of this study provide an effective method to evaluate the AGB in wheat with high throughput and a research reference for the phenotypic parameters of other crops.
基金National Natural Science Foundation of China (Grant 52372083, 52173255)Opening Project of the Jiangsu Key Laboratory for Chemistry of Low-Dimensional Materials (JSKC24025)+1 种基金Special Funds for the Trans-formation of Scientific and Technological Achievements in Jiangsu Province(BA2023003)Collaborative Innovation Center for Advanced Micro/nanomaterials and Equipment (Co-constructed by Jiangsu Province and Ministry of Education)。
文摘The unavoidable dendrite growth and shuttle effect have long been stranglehold challenges limiting the safety and practicality of lithium-sulfur batteries.Herein,we propose a dual-action strategy to address the lithium dendrite issue in stages by constructing a multifunctional surface-negatively-charged nanodiamond layer with high ductility and robust puncture resistance on polypropylene (PP) separator.The uniformly loaded compact negative layer can not only significantly enhance electron transmission efficiency and promote uniform lithium deposition,but also reduce the formation of dendrite during early deposition stage.Most importantly,under the strong puncture stress encountered during the deterioration of lithium dendrite growth under limiting current,the high ductility and robust puncture resistance(145.88 MPa) of as-obtained nanodiamond layer can effectively prevent short circuits caused by unavoidable lithium dendrite.The Li||Li symmetrical cells assembled with nanodiamond layer modified PP demonstrated a stable cycle of over 1000 h at 2 mA cm^(-2)with a polarization voltage of only 29.3 mV.Additionally,the negative charged layer serves as a physical barrier blocking lithium polysulfide ions,effectively mitigating capacity attenuation.The improved cells achieved a capacity decay of only 0.042%per cycle after 700 cycles at 3 C,demonstrating effective suppression of dendrite growth and capacity attenuation,showing promising prospect.
基金supported by the Natural Science Foundation of Sichuan Province(grant number:25NSFSC0265).
文摘Peri-implant keratinized mucosa(PIKM)augmentation refers to surgical procedures aimed at increasing the width of PIKM.Consensus reports emphasize the necessity of maintaining a minimum width of PIKM to ensure long-term peri-implant health.Currently,several surgical techniques have been validated for their effectiveness in increasing PIKM.However,the selection and application of PIKM augmentation methods may present challenges for dental practitioners due to heterogeneity in surgical techniques,variations in clinical scenarios,and anatomical differences.Therefore,clear guidelines and considerations for PIKM augmentation are needed.This expert consensus focuses on the commonly employed surgical techniques for PIKM augmentation and the factors influencing their selection at second-stage surgery.It aims to establish a standardized framework for assessing,planning,and executing PIKM augmentation procedures,with the goal of offering evidence-based guidance to enhance the predictability and success of PIKM augmentation.
