Fenton-like technology based on peroxymonosulfate activation has shown great potential in refractory organics degradation.In this work,single Fe atom catalysts were synthesized through facile ball milling and exhibite...Fenton-like technology based on peroxymonosulfate activation has shown great potential in refractory organics degradation.In this work,single Fe atom catalysts were synthesized through facile ball milling and exhibited very high performance in peroxymonosulfate activation.The Fe single-atom filled an N vacancy on the triazine ring edge of C_(3)N_(4),as confirmed through X-ray absorption fine structure,density functional calculation and elec-tron paramagnetic resonance.The SAFe_(0.4)–C_(3)N_(4)/PMS system could completely remove phenol(20 mg/L)within 10 min and its first-order kinetic constant was 12.3 times that of the Fe_(3)O_(4)/PMS system.Under different ini-tial pH levels and in various anionic environments,SAFe_(0.4)–C_(3)N_(4) still demonstrated excellent catalytic activity,achieving a removal rate of over 90%for phenol within 12 min.In addition,SAFe_(0.4)–C_(3)N_(4) exhibited outstanding selectivity in reaction systems with different pollutants,showing excellent degradation effects on electron-rich pollutants only.Hydroxyl radicals(•OH),singlet oxygen(1O_(2))and high-valent iron oxide(Fe(Ⅳ)=O)were de-tected in the SAFe_(0.4)–C_(3)N_(4)/PMS system through free radical capture experiments.Further experiments on the quenching of active species and a methyl phenyl sulfoxide probe confirmed that 1O_(2) and Fe(Ⅳ)=O played dom-inant roles.Additionally,the change in the current response after adding PMS and phenol in succession proved that a direct electron transfer path between organic matter and the catalyst surface was unlikely to exist in the SAFe_(0.4)–C_(3)N_(4)/PMS/Phenol degradation system.This study provides a new demonstration of the catalytic mech-anism of single-atom catalysts.展开更多
1 Production and Running Status of China’s Refractories Industry in 20241.1 Production and Running Status In 2024,according to the statistical data from The Association of China Refractories Industry,China’s refract...1 Production and Running Status of China’s Refractories Industry in 20241.1 Production and Running Status In 2024,according to the statistical data from The Association of China Refractories Industry,China’s refractories output was 22.0711million tons,decreasing by 3.73%YOY;in which the outputs of dense shaped refractory products,insulating refractory products and monolithic refractories were 11.3163 million tons decreasing by 6.07%YOY,83.77 thousand tons increasing by 11.17%YOY,and 9.9971 million tons decreasing by 2.07%YOY,respectively.The outputs of the main varieties are shown in Fig.1.展开更多
Refractory high-entropy alloys(RHEAs),composed of multiple refractory elements,such as Nb,Mo,Ta,W,Ti,Zr,Hf,in nearor non-equiatomic ratios,have recently emerged as promising structural materials for extreme environmen...Refractory high-entropy alloys(RHEAs),composed of multiple refractory elements,such as Nb,Mo,Ta,W,Ti,Zr,Hf,in nearor non-equiatomic ratios,have recently emerged as promising structural materials for extreme environments due to their high melting points,excellent high-temperature mechanical properties,and superior micro structural stability.Compared to conventional HEAs based on elements like Ni,Fe,or Cr,RHEAs offer enhanced elevated-temperature performance but face challenges including segregation during solidification,relatively poor room-temperature ductility,and,most important,high-temperature oxidation.展开更多
Dear Editor,I diopathic macular telangiectasia(MacTel)type 1 is a retinal vascular disease characterized by abnormal dilation of macular capillaries,leading to metamorphopsia,progressive vision loss,and temporal scoto...Dear Editor,I diopathic macular telangiectasia(MacTel)type 1 is a retinal vascular disease characterized by abnormal dilation of macular capillaries,leading to metamorphopsia,progressive vision loss,and temporal scotoma enlargement.Currently,there is no standardized treatment protocol for MacTel type 1[1-2].Treatment outcomes can vary significantly among individuals,highlighting the ongoing need for further exploration of new and more effective treatment options.This paper presents a case of refractory macular edema associated with MacTel type 1,which showed a favorable response to pars plana vitrectomy(PPV)and internal limiting membrane(ILM)peeling.展开更多
Introducing B2 ordering can effectively improve the mechanical properties of lightweight refractory high-entropy alloys(LRHEAs).However,(Zr,Al)-enriched B2 precipitates generally reduce the ductility because their ord...Introducing B2 ordering can effectively improve the mechanical properties of lightweight refractory high-entropy alloys(LRHEAs).However,(Zr,Al)-enriched B2 precipitates generally reduce the ductility because their ordering characteristic is destroyed after dislocation shearing.Meanwhile,the local chemical order(LCO)cannot provide an adequate strengthening effect due to its small size.展开更多
Up-and-coming high-temperature materials,refractory high entropy alloys,are suffering from lower oxidation resistance,restricting their applications in the aerospace field.In this study,two novel treatments of Al-depo...Up-and-coming high-temperature materials,refractory high entropy alloys,are suffering from lower oxidation resistance,restricting their applications in the aerospace field.In this study,two novel treatments of Al-deposited and remelted were developed to refine the microstructure and enhance the oxidation resistance of refractory high entropy alloy using electron beam freeform fabrication(EBF3).Finer and short-range ordering structures were observed in the remelted sample,whereas the Al-deposited sample showcased the formation of silicide and intermetallic phases.High-temperature cyclic and isothermal oxidation tests at 1000℃ were carried out.The total weight gain after 60 h of cyclic oxidation decreased by 17.49%and 30.46%for the remelted and deposited samples,respectively,compared to the as-cast state.Oxidation kinetics reveal an evident lower mass gain and oxidation rate in the treated samples.A multilayer oxide consisting of TiO_(2)+Al_(2)O_(3)+SiO_(2)+AlNbO_(4) was studied for its excellent oxidation resistance.The oxidation behavior of rutile,corundum and other oxides was analyzed using first principles calculations and chemical defect analysis.Overall,this research,which introduces novel treatments,offers promising insights for enhancing the inherent oxidation resistance of refractory high entropy alloys.展开更多
Refractory wounds cause significant harm to the health of patients and the most common treatments in clinical practice are surgical debridement and wound dressings.However,certain challenges,including surgical difficu...Refractory wounds cause significant harm to the health of patients and the most common treatments in clinical practice are surgical debridement and wound dressings.However,certain challenges,including surgical difficulty,lengthy recovery times,and a high recurrence rate persist.Conductive hydrogel dressings with combined monitoring and therapeutic properties have strong advantages in promoting wound healing due to the stimulation of endogenous current on wounds and are the focus of recent advancements.Therefore,this review introduces the mechanism of conductive hydrogel used for wound monitoring and healing,the materials selection of conductive hydrogel dressings used for wound monitoring,focuses on the conductive hydrogel sensor to monitor the output categories of wound status signals,proving invaluable for non-invasive,real-time evaluation of wound condition to encourage wound healing.Notably,the research of artificial intelligence(AI)model based on sensor derived data to predict the wound healing state,AI makes use of this abundant data set to forecast and optimize the trajectory of tissue regeneration and assess the stage of wound healing.Finally,refractory wounds including pressure ulcers,diabetes ulcers and articular wounds,and the corresponding wound monitoring and healing process are discussed in detail.This manuscript supports the growth of clinically linked disciplines and offers motivation to researchers working in the multidisciplinary field of conductive hydrogel dressings.展开更多
Refractory high/medium-entropy alloys(RH/MEAs)are known for their outstanding performance at el-evated temperatures;however,they usually exhibit poor room-temperature plasticity,which can be at-tributed to the non-uni...Refractory high/medium-entropy alloys(RH/MEAs)are known for their outstanding performance at el-evated temperatures;however,they usually exhibit poor room-temperature plasticity,which can be at-tributed to the non-uniform deformation that occurs at room temperature.Once cracks nucleate,they will rapidly propagate into vertical splitting cracks.Here,we introduce multiple phases including FCC and HCP phases into the NbMoTa RMEA via appropriate addition of carbon.The results show that multiple-phase synergy effectively suppresses non-uniform deformation,thereby delaying the onset of vertical splitting cracks.An optimal combination of compressive strength-plasticity is achieved by the(NbMoTa)_(92.5)C_(7.5) alloy.The significant improvement in room-temperature mechanical properties can be attributed to its hierarchical microstructure:in the mesoscale,the BCC matrix is divided by eutectic structures;while at the microscale,the BCC matrix is further refined by abundant lath-like FCC precipitates.The FCC precip-itates contain high-density stacking faults,acting as a dislocation source under compressive loading.The HCP phase in the eutectic microstructures,in turn,acts as a strong barrier to dislocation movement and simultaneously increases the dislocation storage capacity.These findings open a new route to tailor the microstructure and mechanical properties of RH/MEAs.展开更多
Grain boundary engineering plays a significant role in the improvement of strength and plasticity of alloys. However, in refractory high-entropy alloys, the susceptibility of grain boundaries to oxygen presents a bott...Grain boundary engineering plays a significant role in the improvement of strength and plasticity of alloys. However, in refractory high-entropy alloys, the susceptibility of grain boundaries to oxygen presents a bottleneck in achieving high mechanical performance. Creating a large number of clean grain boundaries in refractory high-entropy alloys is a challenge. In this study, an ultrafine-grained (UFG) NbMoTaW alloy with high grain-boundary cohesion was prepared by powder metallurgy, taking advantages of rapid hot-pressing sintering and full-process inert atmosphere protection from powder synthesis to sintering. By oxygen control and an increase in the proportion of grain boundaries, the segregation of oxygen and formation of oxides at grain boundaries were strongly mitigated, thus the intrinsic high cohesion of the interfaces was preserved. Compared to the coarse-grained alloys prepared by arc-melting and those sintered by traditional powder metallurgy methods, the UFG NbMoTaW alloy demonstrated simultaneously increased strength and plasticity at ambient temperature. The highly cohesive grain boundaries not only reduce brittle fractures effectively but also promote intragranular deformation. Consequently, the UFG NbMoTaW alloy achieved a high yield strength even at elevated temperatures, with a remarkable performance of 1117 MPa at 1200 ℃. This work provides a feasible solution for producing refractory high-entropy alloys with low impurity content, refined microstructure, and excellent mechanical performance.展开更多
BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a ...BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a total of 13 procedures within our medical facility,including five performed under local anesthesia and eight performed under general anesthesia.The source of the ailment was ultimately identified as Enterobacter cloacae.After the last procedure,the patient's symptoms were alleviated,and the recovery process was satisfactory.Three months post-operation,the Japanese Orthopaedic Association scores had improved to 100%.Imageological examination revealed a satisfactory position of internal fixation,and the abnormal signals in the vertebral body and intervertebral space had been eliminated when compared to the pre-operative results.CONCLUSION The study demonstrates that the extreme lateral approach debridement combined with multiple VSD operations is a secure and successful method of treatment for recurrent spinal infection,providing an alternative to traditional surgery.展开更多
Refractory high-entropy alloys(RHEAs)are promising for high-temperature applications due to their ex-ceptional mechanical properties at high temperatures.However,limited studies on their high-temperature fatigue behav...Refractory high-entropy alloys(RHEAs)are promising for high-temperature applications due to their ex-ceptional mechanical properties at high temperatures.However,limited studies on their high-temperature fatigue behavior hinder further development.This study systematically investigates the low-cycle fatigue(LCF)behavior of HfNbTiZr RHEA at room temperature(25℃)and elevated temperatures(350,450,and 600℃)through a combination of experimental analyses and dislocation-based damage-coupled crystal plasticity finite element(CPFE)simulations,to unveil the effects of creep damage on LCF behavior at varying temperatures.The results indicate that the LCF life dramatically decreases at an increased tem-perature,shifting from transgranular fatigue damage at lower temperatures(25-350℃)to a dual damage mechanism involving both intergranular fatigue and creep damage at higher temperatures(450-600℃).At 600℃,creep damage notably contributes to the accumulation of geometrically necessary dislocations(GNDs),crack initiation,and propagation at grain boundaries,and thus accelerates LCF failure.Compara-tive CPFE simulations reveal that creep damage significantly contributes to cyclic softening and reduction in elastic modulus,which also amplifies the strain localization under the LCF loading.The contribution of creep damage to the total stored energy density(SED)representing the overall damage increases with temperatures,accounting for 11%at 600℃.Additionally,CPFE simulations indicate that the creep dam-age notably influences the magnitude of GND density localized at grain boundaries.This study provides critical insights into the fatigue damage mechanisms of RHEAs,offering valuable guidance for their ap-plication in high temperatures.展开更多
Hydrogen-based mineral phase transformation(HMPT)technology has demonstrated its effectiveness in separating iron and enriching rare earths from Bayan Obo refractory ores.However,further research is needed to clarify ...Hydrogen-based mineral phase transformation(HMPT)technology has demonstrated its effectiveness in separating iron and enriching rare earths from Bayan Obo refractory ores.However,further research is needed to clarify the phase composition and floatability of rare earths obtained after HMPT owing to the associated phase transformations.This study explored the mineralogical characteristics and separation behavior of rare earths in HMPT-treated iron tailings.Process mineralogy studies conducted via BGRIMM process mineralogy analysis and X-ray diffraction revealed that the main valuable minerals in the tailings included rare-earth oxides(9.15wt%),monazite(5.31wt%),and fluorite(23.52wt%).The study also examined the impact of mineral liberation and gangue mineral intergrowth on flotation performance.Flotation tests achieved a rare-earth oxide(REO)grade of 74.12wt% with a recovery of 34.17% in open-circuit flotation,whereas closed-circuit flotation resulted in a REO grade of 60.27wt% with a recovery of 73%.Transmission electron microscopy and scanning electron microscopy coupled with energy-dispersive spectroscopy revealed that monazite remained stable during the HMPT process,while bastnaesite was transformed into Ce_(7)O_(12)and CeF_(3),leading to increased collector consumption.Nonetheless,the HMPT process did not significantly affect the flotation performance of rare earths.The enrichment of fluorite in the tailings highlighted its further recovery potential.The integration of HMPT with magnetic separation and flotation presents an efficient strategy for recovering rare earths,iron,and fluorite from Bayan Obo ores.展开更多
AIM:To assess the efficacy and safety of ultrasound cycloplasty(UCP)in lowering intraocular pressure(IOP)among Chinese patients suffering from refractory glaucoma.METHODS:In this 12-month retrospective study,28 patien...AIM:To assess the efficacy and safety of ultrasound cycloplasty(UCP)in lowering intraocular pressure(IOP)among Chinese patients suffering from refractory glaucoma.METHODS:In this 12-month retrospective study,28 patients with refractory glaucoma(IOP≥25 mm Hg)were treated with 8-second UCP using either 8 or 10 probe sectors.The principal measure of efficacy was the decrease in IOP at the following intervals after UCP:1d,1,3,6,and 12mo,with each measurement compared to baseline.RESULTS:Mean IOP(in mm Hg)was reduced from 46.8±8.9 to 24.5±3.2,27.0±4.8,29.1±4.6,26.1±4.5,and 28.3±4.8 at 1d,1,3,6,and 12mo postoperatively,respectively.Compared to baseline,IOP reductions at these time points were 45.0%,39.9%,35.3%,41.4%,and 36.7%,respectively.Most patients experienced relief from ocular pain after surgery.No cases of choroidal detachment or hypotony was observed.CONCLUSION:UCP is effective in reducing IOP among Chinese patients with refractory glaucoma and shows a favorable safety profile.展开更多
Refractory autoimmune hepatitis(AIH)is defined as intolerance of or unresponsiveness to standard immunosuppression and occurs in 10%-20%of children with AIH.Lack of response or slower than expected response to inducti...Refractory autoimmune hepatitis(AIH)is defined as intolerance of or unresponsiveness to standard immunosuppression and occurs in 10%-20%of children with AIH.Lack of response or slower than expected response to induction of remission with steroids,despite good compliance,might be the first clue to refractory AIH.Refractoriness to treatment is associated with an 11.7 times higher risk for liver transplantation or death due to liver disease.The first and foremost consideration for the management is to assess compliance with treatment.It is then important to re-evaluate the diagnosis,assess alternative aetiologies which can mimic the clinical,serological,and histological features of AIH,and address the presence of extra-hepatic co-morbidities.It is important to consider the specific clinical situations,previous therapy,and prior adverse effects before deciding on the most appropriate treatment regimen in refractory AIH.Consideration also should be given to compliance with previous therapy,need for drug level monitoring,growth potential,available formulations,route of administration of medication,and children’s and families’preferences before deciding on the therapy.Treatment should be decided and monitored only in specialized hepatology centers.展开更多
BACKGROUND Despite advances in the treatment of ulcerative colitis(UC),some patients remain refractory to the currently available treatments.Dual biologic therapy(DBT)has emerged as a promising strategy for these pati...BACKGROUND Despite advances in the treatment of ulcerative colitis(UC),some patients remain refractory to the currently available treatments.Dual biologic therapy(DBT)has emerged as a promising strategy for these patients.CASE SUMMARY A patient with extensive UC presented with steroid dependence and contraindications(past medical history included breast cancer and previous myocardial infarction)to treatment with tumor necrosis factor and Janus kinase inhibitors.DBT ofα4β7 integrin antagonist(vedolizumab)and interleukin 23p19 inhibitor(mirikizumab)resulted in a sustained clinical and biochemical remission.No adverse events were recorded during the follow-up.CONCLUSION This case highlighted the challenge of managing refractory UC,especially in frail patients.展开更多
BACKGROUND Refractory septic shock is a critical and multifaceted condition that continues to pose significant challenges in critical care.AIM To systematically review randomized trials on emerging interventions for r...BACKGROUND Refractory septic shock is a critical and multifaceted condition that continues to pose significant challenges in critical care.AIM To systematically review randomized trials on emerging interventions for refractory septic shock,assessing mortality,vasopressor use,intensive care unit(ICU)length of stay,and organ dysfunction.METHODS A systematic search was conducted in PubMed,EMBASE,Cochrane CENTRAL Library,and Web of Science for studies published between 2000 and 2024.Inclusion criteria encompassed randomized controlled trials(RCT)evaluating innovative therapies for refractory septic shock.Variables of interest:The primary outcome was allcause mortality among patients treated with novel interventions.Secondary outcomes included length of stay in the ICU,total hospital length of stay,and use of vasoactive drugs.Methodological rigor was assessed using the Cochrane Risk of Bias tool.RESULTS From 850 records,24 RCTs met the inclusion criteria,evaluating therapies such as methylene blue,vasopressin,terlipressin,and combinations of hydrocortisone,vitamin C,and thiamine.Mortality rates ranged from 28.6%to 56.8%.Methylene blue reduced vasopressor dependency in patients requiring high norepinephrine doses by 1.0 vasopressor-free day,and terlipressin improved renal perfusion by 13.1%.Combination therapies enhanced secondary outcomes,including reductions in Sequential Organ Failure Assessment score.However,no single intervention consistently demonstrated significant survival benefits.CONCLUSION Adjunctive therapies for refractory septic shock may improve hemodynamics and organ function,however,they have not been shown to consistently reduce mortality.Larger trials are needed to confirm these findings.Multimodal approaches targeting inflammation are critical.展开更多
BACKGROUND Refractory ascites(RA)and spontaneous bacterial peritonitis(SBP)are severe complications of decompensated cirrhosis,contributing to high morbidity and mortality.RA develops when ascites persists despite max...BACKGROUND Refractory ascites(RA)and spontaneous bacterial peritonitis(SBP)are severe complications of decompensated cirrhosis,contributing to high morbidity and mortality.RA develops when ascites persists despite maximum diuretic therapy,while SBP arises from bacterial translocation and immune dysfunction in cirrhotic patients with ascites.Identifying key risk factors associated with these conditions is crucial for early intervention and improved patient outcomes.AIM To assess clinical and biochemical predictors of RA and SBP in a cohort of hospitalized patients with cirrhotic ascites.METHODS A retrospective chart review was conducted on patients with cirrhotic ascites diagnosed with RA or SBP at University Medical Center,El Paso,from July 1,2013 to December 31,2023.Patient demographics,clinical history,laboratory parameters,ascitic fluid analysis,and cirrhosis severity scores[Model for End-Stage Liver Disease-Sodium(MELD-Na)and Child-Pugh]were recorded.Statistical analyses,including multivariate logistic regression,were performed to identify independent predictors of RA and SBP,with a significance threshold of P<0.05.RESULTS A total of 179 patients were included,with a mean age of 59.08±13.04 years,predominantly male(55.9%)and Hispanic(98.3%).The most common etiology of cirrhosis was alcohol-related liver disease(45.3%),and most patients had Grade III ascites(95.5%).Among them,115(64.2%)had RA,and 57(31.8%)had SBP.RA was significantly associated with abnormal serum potassium levels[odds ratio(OR)=2.27,95%CI:1.06–4.84,P=0.034],while SBP was independently predicted by gastrointestinal bleeding(OR=2.59,95%CI:1.18–5.64,P=0.017)and thrombocytopenia(platelet count<50000;OR=3.27,95%CI:1.08–9.88,P=0.035).CONCLUSION RA and SBP are major complications of cirrhosis,with electrolyte imbalances and coagulopathy playing key roles in their development.Our study confirms that abnormal potassium levels significantly predict RA,while gastrointestinal bleeding and thrombocytopenia are strong predictors of SBP.These findings emphasize the need for early risk stratification and targeted management strategies to improve outcomes in high-risk cirrhotic patients,particularly in minority populations with limited healthcare access.Further prospective studies are warranted to validate these results and explore potential interventions to reduce RA and SBP incidence.展开更多
Based on the properties of antimony(Sb)and arsenic(As),a method was proposed to enhance gold recovery during iron matte smelting.The impact of Sb and As on gold enhancement capture was investigated using an exclusion ...Based on the properties of antimony(Sb)and arsenic(As),a method was proposed to enhance gold recovery during iron matte smelting.The impact of Sb and As on gold enhancement capture was investigated using an exclusion method.The results demonstrated that both Sb and As significantly improved the gold recovery rate.As the Sb or As content increased,the gold recovery rate increased.The enhancement effect of Sb was better than that of As,and the optimal results were achieved through the synergistic effects of Sb and As.Under optimized conditions,the gold recovery rate reached 97.12%,whereas the gold content in the slag decreased to 1.70 g/t.Sb captured and aggregated free gold as an Au-Sb alloy,whereas As-Fe alloy also captured free gold.The growth of the gold-captured phase size enhanced the settling velocity,thereby promoting gold recovery.展开更多
Multiple myeloma is a complex and challenging blood cancer,particularly in cases where the disease has relapsed or become resistant to treatment.These situations often have a significant impact on both patient surviva...Multiple myeloma is a complex and challenging blood cancer,particularly in cases where the disease has relapsed or become resistant to treatment.These situations often have a significant impact on both patient survival and quality of life.Over recent years,advances in precision medicine and translational medicine have brought about a shift in treatment strategies,moving toward more personalized and targeted approaches.This review highlights the latest developments in the management of refractory and relapsed multiple myeloma,focusing on the current state of precision diagnosis and treatment,the role of translational medicine,and potential future directions in research.By reviewing key studies and clinical trial data,we aim to offer fresh perspectives and strategies that could improve clinical outcomes.展开更多
BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)has an important role in the therapy of complications of portal-hypertension-related ascites.Various guidelines now indicate that TIPS is indicated for ref...BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)has an important role in the therapy of complications of portal-hypertension-related ascites.Various guidelines now indicate that TIPS is indicated for refractory ascites(RA),but TIPS for recurrent nonrefractory ascites(RNRA)achieved better clinical results.AIM To compare the clinical outcomes of TIPS for RA and RNRA in patients with complications related to portal hypertension.METHODS There were 863 patients divided into two main categories who underwent TIPS between September 2016 and September 2021.In category 1,patients had ascites without cirrhotic gastrointestinal bleeding.The patients were divided into group A(RNRA,n=183)and group B(RA,n=217).In category 2,patients had ascites and cirrhotic gastrointestinal bleeding.The patients were divided into group C(RNRA,n=328)and group D(RA,n=135).The clinical outcomes were probability of total hepatic impairment,incidence of hepatic encephalopathy(HE)and mortality.RESULTS The symptoms of ascites disappeared or were relieved within 1 week in group A compared with group B(P=0.032),and in group C compared with group D(P=0.027).By the end of follow-up,there were significant differences in the rate of RA in group A compared with group B(P=0.016),and in group C compared with group D(P=0.012).The probability of total hepatic impairment was significantly different in group A compared with group B(P=0.024),and in group C compared with group D(P=0.019).The total incidence of HE was significantly different in group A compared with group B(P=0.008),and in group C compared with group D(P=0.004).The 6-month,and 1-,2-and 3-year survival rates were significantly different between groups A and B(all P<0.05),and between groups C and D(all P<0.05).CONCLUSION TIPS has a good therapeutic effect on ascites related to cirrhotic portal hypertension,and early TIPS for RNRA can prolong survival,and prevent progression to RA.展开更多
基金supported by the National Natural Science Foundation of China(Nos.22406081,22276086,22306086)the Natural Science Foundation of Jiangxi Province(No.20232BAB213029),all of which are greatly acknowledged by the authors.
文摘Fenton-like technology based on peroxymonosulfate activation has shown great potential in refractory organics degradation.In this work,single Fe atom catalysts were synthesized through facile ball milling and exhibited very high performance in peroxymonosulfate activation.The Fe single-atom filled an N vacancy on the triazine ring edge of C_(3)N_(4),as confirmed through X-ray absorption fine structure,density functional calculation and elec-tron paramagnetic resonance.The SAFe_(0.4)–C_(3)N_(4)/PMS system could completely remove phenol(20 mg/L)within 10 min and its first-order kinetic constant was 12.3 times that of the Fe_(3)O_(4)/PMS system.Under different ini-tial pH levels and in various anionic environments,SAFe_(0.4)–C_(3)N_(4) still demonstrated excellent catalytic activity,achieving a removal rate of over 90%for phenol within 12 min.In addition,SAFe_(0.4)–C_(3)N_(4) exhibited outstanding selectivity in reaction systems with different pollutants,showing excellent degradation effects on electron-rich pollutants only.Hydroxyl radicals(•OH),singlet oxygen(1O_(2))and high-valent iron oxide(Fe(Ⅳ)=O)were de-tected in the SAFe_(0.4)–C_(3)N_(4)/PMS system through free radical capture experiments.Further experiments on the quenching of active species and a methyl phenyl sulfoxide probe confirmed that 1O_(2) and Fe(Ⅳ)=O played dom-inant roles.Additionally,the change in the current response after adding PMS and phenol in succession proved that a direct electron transfer path between organic matter and the catalyst surface was unlikely to exist in the SAFe_(0.4)–C_(3)N_(4)/PMS/Phenol degradation system.This study provides a new demonstration of the catalytic mech-anism of single-atom catalysts.
文摘1 Production and Running Status of China’s Refractories Industry in 20241.1 Production and Running Status In 2024,according to the statistical data from The Association of China Refractories Industry,China’s refractories output was 22.0711million tons,decreasing by 3.73%YOY;in which the outputs of dense shaped refractory products,insulating refractory products and monolithic refractories were 11.3163 million tons decreasing by 6.07%YOY,83.77 thousand tons increasing by 11.17%YOY,and 9.9971 million tons decreasing by 2.07%YOY,respectively.The outputs of the main varieties are shown in Fig.1.
文摘Refractory high-entropy alloys(RHEAs),composed of multiple refractory elements,such as Nb,Mo,Ta,W,Ti,Zr,Hf,in nearor non-equiatomic ratios,have recently emerged as promising structural materials for extreme environments due to their high melting points,excellent high-temperature mechanical properties,and superior micro structural stability.Compared to conventional HEAs based on elements like Ni,Fe,or Cr,RHEAs offer enhanced elevated-temperature performance but face challenges including segregation during solidification,relatively poor room-temperature ductility,and,most important,high-temperature oxidation.
基金Supported by Science and Technology Project of Sichuan Provincial Health Commission(No.24WXXT13)North Sichuan Medical College Doctor Start-up Fund Project(No.CBY24-QDA01).
文摘Dear Editor,I diopathic macular telangiectasia(MacTel)type 1 is a retinal vascular disease characterized by abnormal dilation of macular capillaries,leading to metamorphopsia,progressive vision loss,and temporal scotoma enlargement.Currently,there is no standardized treatment protocol for MacTel type 1[1-2].Treatment outcomes can vary significantly among individuals,highlighting the ongoing need for further exploration of new and more effective treatment options.This paper presents a case of refractory macular edema associated with MacTel type 1,which showed a favorable response to pars plana vitrectomy(PPV)and internal limiting membrane(ILM)peeling.
基金supported by the National Natural Science Foundation of China(Nos.52171166 and U20A20231)the Natural Science Foundation of Hunan Province,China(Nos.2024JJ2060 and 2024JJ5406)+1 种基金the Key Laboratory of Materials in Dynamic Extremes of Sichuan Province(No.2023SCKT1102)the Postgraduate Scientific Research Innovation Project of National University of Defense Technology(No.XJJC2024065).
文摘Introducing B2 ordering can effectively improve the mechanical properties of lightweight refractory high-entropy alloys(LRHEAs).However,(Zr,Al)-enriched B2 precipitates generally reduce the ductility because their ordering characteristic is destroyed after dislocation shearing.Meanwhile,the local chemical order(LCO)cannot provide an adequate strengthening effect due to its small size.
基金supported by the National Key Research and Development Program of China(Grant No.2022YFF0609000)National Natural Science Foundation of China(Grant Nos.52171034 and 52101037)Postdoctoral Fellowship Program of CPSFara(No.GZB20230944).
文摘Up-and-coming high-temperature materials,refractory high entropy alloys,are suffering from lower oxidation resistance,restricting their applications in the aerospace field.In this study,two novel treatments of Al-deposited and remelted were developed to refine the microstructure and enhance the oxidation resistance of refractory high entropy alloy using electron beam freeform fabrication(EBF3).Finer and short-range ordering structures were observed in the remelted sample,whereas the Al-deposited sample showcased the formation of silicide and intermetallic phases.High-temperature cyclic and isothermal oxidation tests at 1000℃ were carried out.The total weight gain after 60 h of cyclic oxidation decreased by 17.49%and 30.46%for the remelted and deposited samples,respectively,compared to the as-cast state.Oxidation kinetics reveal an evident lower mass gain and oxidation rate in the treated samples.A multilayer oxide consisting of TiO_(2)+Al_(2)O_(3)+SiO_(2)+AlNbO_(4) was studied for its excellent oxidation resistance.The oxidation behavior of rutile,corundum and other oxides was analyzed using first principles calculations and chemical defect analysis.Overall,this research,which introduces novel treatments,offers promising insights for enhancing the inherent oxidation resistance of refractory high entropy alloys.
基金supports received from Scientific Research Fund of Liaoning Province Education Department(Grant No.JYTQN 2023025)Scientific Research Fund of Liaoning Province Education Department(Grant No.JYTQN 2023025)+3 种基金the Natural Science Foundation of Liaoning Province(Grant No.2024-MS-075)the National Natural Science Foundation of China(32201179)National Key R&D Program of China(2023YFC2508200)Liaoning Provincial Natural Science Foundation Joint Fund(General Support Program Project)(2023-MSBA-093).
文摘Refractory wounds cause significant harm to the health of patients and the most common treatments in clinical practice are surgical debridement and wound dressings.However,certain challenges,including surgical difficulty,lengthy recovery times,and a high recurrence rate persist.Conductive hydrogel dressings with combined monitoring and therapeutic properties have strong advantages in promoting wound healing due to the stimulation of endogenous current on wounds and are the focus of recent advancements.Therefore,this review introduces the mechanism of conductive hydrogel used for wound monitoring and healing,the materials selection of conductive hydrogel dressings used for wound monitoring,focuses on the conductive hydrogel sensor to monitor the output categories of wound status signals,proving invaluable for non-invasive,real-time evaluation of wound condition to encourage wound healing.Notably,the research of artificial intelligence(AI)model based on sensor derived data to predict the wound healing state,AI makes use of this abundant data set to forecast and optimize the trajectory of tissue regeneration and assess the stage of wound healing.Finally,refractory wounds including pressure ulcers,diabetes ulcers and articular wounds,and the corresponding wound monitoring and healing process are discussed in detail.This manuscript supports the growth of clinically linked disciplines and offers motivation to researchers working in the multidisciplinary field of conductive hydrogel dressings.
基金financial support from the Na-tional Natural Science Foundation of China(No.52231006)National Key Research and Development Program of China(No.2017YFB0702003)the National Natural Science Foundation of China(No.51871217).
文摘Refractory high/medium-entropy alloys(RH/MEAs)are known for their outstanding performance at el-evated temperatures;however,they usually exhibit poor room-temperature plasticity,which can be at-tributed to the non-uniform deformation that occurs at room temperature.Once cracks nucleate,they will rapidly propagate into vertical splitting cracks.Here,we introduce multiple phases including FCC and HCP phases into the NbMoTa RMEA via appropriate addition of carbon.The results show that multiple-phase synergy effectively suppresses non-uniform deformation,thereby delaying the onset of vertical splitting cracks.An optimal combination of compressive strength-plasticity is achieved by the(NbMoTa)_(92.5)C_(7.5) alloy.The significant improvement in room-temperature mechanical properties can be attributed to its hierarchical microstructure:in the mesoscale,the BCC matrix is divided by eutectic structures;while at the microscale,the BCC matrix is further refined by abundant lath-like FCC precipitates.The FCC precip-itates contain high-density stacking faults,acting as a dislocation source under compressive loading.The HCP phase in the eutectic microstructures,in turn,acts as a strong barrier to dislocation movement and simultaneously increases the dislocation storage capacity.These findings open a new route to tailor the microstructure and mechanical properties of RH/MEAs.
基金supported by the National Natural Science Foundation of China(Nos.52371128,52304378,52101031 and 92163107).
文摘Grain boundary engineering plays a significant role in the improvement of strength and plasticity of alloys. However, in refractory high-entropy alloys, the susceptibility of grain boundaries to oxygen presents a bottleneck in achieving high mechanical performance. Creating a large number of clean grain boundaries in refractory high-entropy alloys is a challenge. In this study, an ultrafine-grained (UFG) NbMoTaW alloy with high grain-boundary cohesion was prepared by powder metallurgy, taking advantages of rapid hot-pressing sintering and full-process inert atmosphere protection from powder synthesis to sintering. By oxygen control and an increase in the proportion of grain boundaries, the segregation of oxygen and formation of oxides at grain boundaries were strongly mitigated, thus the intrinsic high cohesion of the interfaces was preserved. Compared to the coarse-grained alloys prepared by arc-melting and those sintered by traditional powder metallurgy methods, the UFG NbMoTaW alloy demonstrated simultaneously increased strength and plasticity at ambient temperature. The highly cohesive grain boundaries not only reduce brittle fractures effectively but also promote intragranular deformation. Consequently, the UFG NbMoTaW alloy achieved a high yield strength even at elevated temperatures, with a remarkable performance of 1117 MPa at 1200 ℃. This work provides a feasible solution for producing refractory high-entropy alloys with low impurity content, refined microstructure, and excellent mechanical performance.
基金Supported by Natural Science Foundation of Shandong Province,No.ZR2023MH331.
文摘BACKGROUND A case study of multiple distinct levels of skipped thoracolumbar spine infection was reported in which 13 successful vacuum sealing drainage(VSD)surgeries were treated.CASE SUMMARY The patient underwent a total of 13 procedures within our medical facility,including five performed under local anesthesia and eight performed under general anesthesia.The source of the ailment was ultimately identified as Enterobacter cloacae.After the last procedure,the patient's symptoms were alleviated,and the recovery process was satisfactory.Three months post-operation,the Japanese Orthopaedic Association scores had improved to 100%.Imageological examination revealed a satisfactory position of internal fixation,and the abnormal signals in the vertebral body and intervertebral space had been eliminated when compared to the pre-operative results.CONCLUSION The study demonstrates that the extreme lateral approach debridement combined with multiple VSD operations is a secure and successful method of treatment for recurrent spinal infection,providing an alternative to traditional surgery.
基金National Science Foundation of China(Nos.52401212 and52401214)the National Science Foundation of Jiangsu Province(No.BK20241020)+1 种基金the Avi-ation Foundation(No.2023Z0530S6004)the Jiangsu Province University Collaborative Innovation Centre(High-Tech Ships)Pro-gram(No.XTCX202401).
文摘Refractory high-entropy alloys(RHEAs)are promising for high-temperature applications due to their ex-ceptional mechanical properties at high temperatures.However,limited studies on their high-temperature fatigue behavior hinder further development.This study systematically investigates the low-cycle fatigue(LCF)behavior of HfNbTiZr RHEA at room temperature(25℃)and elevated temperatures(350,450,and 600℃)through a combination of experimental analyses and dislocation-based damage-coupled crystal plasticity finite element(CPFE)simulations,to unveil the effects of creep damage on LCF behavior at varying temperatures.The results indicate that the LCF life dramatically decreases at an increased tem-perature,shifting from transgranular fatigue damage at lower temperatures(25-350℃)to a dual damage mechanism involving both intergranular fatigue and creep damage at higher temperatures(450-600℃).At 600℃,creep damage notably contributes to the accumulation of geometrically necessary dislocations(GNDs),crack initiation,and propagation at grain boundaries,and thus accelerates LCF failure.Compara-tive CPFE simulations reveal that creep damage significantly contributes to cyclic softening and reduction in elastic modulus,which also amplifies the strain localization under the LCF loading.The contribution of creep damage to the total stored energy density(SED)representing the overall damage increases with temperatures,accounting for 11%at 600℃.Additionally,CPFE simulations indicate that the creep dam-age notably influences the magnitude of GND density localized at grain boundaries.This study provides critical insights into the fatigue damage mechanisms of RHEAs,offering valuable guidance for their ap-plication in high temperatures.
基金the financial support received from the Key Program of National Natural Science Foundation of China(No.52130406)the National Key R&D Program of China(Nos.2021YFC2901000 and 2022YFC2905800)+1 种基金the General Program of National Natural Science Foundation of China(No.52274253)Natural Science Foundation Innovation Group Project of Hubei Province,China(No.2023AFA044)。
文摘Hydrogen-based mineral phase transformation(HMPT)technology has demonstrated its effectiveness in separating iron and enriching rare earths from Bayan Obo refractory ores.However,further research is needed to clarify the phase composition and floatability of rare earths obtained after HMPT owing to the associated phase transformations.This study explored the mineralogical characteristics and separation behavior of rare earths in HMPT-treated iron tailings.Process mineralogy studies conducted via BGRIMM process mineralogy analysis and X-ray diffraction revealed that the main valuable minerals in the tailings included rare-earth oxides(9.15wt%),monazite(5.31wt%),and fluorite(23.52wt%).The study also examined the impact of mineral liberation and gangue mineral intergrowth on flotation performance.Flotation tests achieved a rare-earth oxide(REO)grade of 74.12wt% with a recovery of 34.17% in open-circuit flotation,whereas closed-circuit flotation resulted in a REO grade of 60.27wt% with a recovery of 73%.Transmission electron microscopy and scanning electron microscopy coupled with energy-dispersive spectroscopy revealed that monazite remained stable during the HMPT process,while bastnaesite was transformed into Ce_(7)O_(12)and CeF_(3),leading to increased collector consumption.Nonetheless,the HMPT process did not significantly affect the flotation performance of rare earths.The enrichment of fluorite in the tailings highlighted its further recovery potential.The integration of HMPT with magnetic separation and flotation presents an efficient strategy for recovering rare earths,iron,and fluorite from Bayan Obo ores.
基金Supported by the Shanghai Science and Technology Committee Project Foundation(No.21Y11909700)Guangci Innovative Technology Sailing Plan(Ruijin Hospital 2022).
文摘AIM:To assess the efficacy and safety of ultrasound cycloplasty(UCP)in lowering intraocular pressure(IOP)among Chinese patients suffering from refractory glaucoma.METHODS:In this 12-month retrospective study,28 patients with refractory glaucoma(IOP≥25 mm Hg)were treated with 8-second UCP using either 8 or 10 probe sectors.The principal measure of efficacy was the decrease in IOP at the following intervals after UCP:1d,1,3,6,and 12mo,with each measurement compared to baseline.RESULTS:Mean IOP(in mm Hg)was reduced from 46.8±8.9 to 24.5±3.2,27.0±4.8,29.1±4.6,26.1±4.5,and 28.3±4.8 at 1d,1,3,6,and 12mo postoperatively,respectively.Compared to baseline,IOP reductions at these time points were 45.0%,39.9%,35.3%,41.4%,and 36.7%,respectively.Most patients experienced relief from ocular pain after surgery.No cases of choroidal detachment or hypotony was observed.CONCLUSION:UCP is effective in reducing IOP among Chinese patients with refractory glaucoma and shows a favorable safety profile.
文摘Refractory autoimmune hepatitis(AIH)is defined as intolerance of or unresponsiveness to standard immunosuppression and occurs in 10%-20%of children with AIH.Lack of response or slower than expected response to induction of remission with steroids,despite good compliance,might be the first clue to refractory AIH.Refractoriness to treatment is associated with an 11.7 times higher risk for liver transplantation or death due to liver disease.The first and foremost consideration for the management is to assess compliance with treatment.It is then important to re-evaluate the diagnosis,assess alternative aetiologies which can mimic the clinical,serological,and histological features of AIH,and address the presence of extra-hepatic co-morbidities.It is important to consider the specific clinical situations,previous therapy,and prior adverse effects before deciding on the most appropriate treatment regimen in refractory AIH.Consideration also should be given to compliance with previous therapy,need for drug level monitoring,growth potential,available formulations,route of administration of medication,and children’s and families’preferences before deciding on the therapy.Treatment should be decided and monitored only in specialized hepatology centers.
文摘BACKGROUND Despite advances in the treatment of ulcerative colitis(UC),some patients remain refractory to the currently available treatments.Dual biologic therapy(DBT)has emerged as a promising strategy for these patients.CASE SUMMARY A patient with extensive UC presented with steroid dependence and contraindications(past medical history included breast cancer and previous myocardial infarction)to treatment with tumor necrosis factor and Janus kinase inhibitors.DBT ofα4β7 integrin antagonist(vedolizumab)and interleukin 23p19 inhibitor(mirikizumab)resulted in a sustained clinical and biochemical remission.No adverse events were recorded during the follow-up.CONCLUSION This case highlighted the challenge of managing refractory UC,especially in frail patients.
文摘BACKGROUND Refractory septic shock is a critical and multifaceted condition that continues to pose significant challenges in critical care.AIM To systematically review randomized trials on emerging interventions for refractory septic shock,assessing mortality,vasopressor use,intensive care unit(ICU)length of stay,and organ dysfunction.METHODS A systematic search was conducted in PubMed,EMBASE,Cochrane CENTRAL Library,and Web of Science for studies published between 2000 and 2024.Inclusion criteria encompassed randomized controlled trials(RCT)evaluating innovative therapies for refractory septic shock.Variables of interest:The primary outcome was allcause mortality among patients treated with novel interventions.Secondary outcomes included length of stay in the ICU,total hospital length of stay,and use of vasoactive drugs.Methodological rigor was assessed using the Cochrane Risk of Bias tool.RESULTS From 850 records,24 RCTs met the inclusion criteria,evaluating therapies such as methylene blue,vasopressin,terlipressin,and combinations of hydrocortisone,vitamin C,and thiamine.Mortality rates ranged from 28.6%to 56.8%.Methylene blue reduced vasopressor dependency in patients requiring high norepinephrine doses by 1.0 vasopressor-free day,and terlipressin improved renal perfusion by 13.1%.Combination therapies enhanced secondary outcomes,including reductions in Sequential Organ Failure Assessment score.However,no single intervention consistently demonstrated significant survival benefits.CONCLUSION Adjunctive therapies for refractory septic shock may improve hemodynamics and organ function,however,they have not been shown to consistently reduce mortality.Larger trials are needed to confirm these findings.Multimodal approaches targeting inflammation are critical.
文摘BACKGROUND Refractory ascites(RA)and spontaneous bacterial peritonitis(SBP)are severe complications of decompensated cirrhosis,contributing to high morbidity and mortality.RA develops when ascites persists despite maximum diuretic therapy,while SBP arises from bacterial translocation and immune dysfunction in cirrhotic patients with ascites.Identifying key risk factors associated with these conditions is crucial for early intervention and improved patient outcomes.AIM To assess clinical and biochemical predictors of RA and SBP in a cohort of hospitalized patients with cirrhotic ascites.METHODS A retrospective chart review was conducted on patients with cirrhotic ascites diagnosed with RA or SBP at University Medical Center,El Paso,from July 1,2013 to December 31,2023.Patient demographics,clinical history,laboratory parameters,ascitic fluid analysis,and cirrhosis severity scores[Model for End-Stage Liver Disease-Sodium(MELD-Na)and Child-Pugh]were recorded.Statistical analyses,including multivariate logistic regression,were performed to identify independent predictors of RA and SBP,with a significance threshold of P<0.05.RESULTS A total of 179 patients were included,with a mean age of 59.08±13.04 years,predominantly male(55.9%)and Hispanic(98.3%).The most common etiology of cirrhosis was alcohol-related liver disease(45.3%),and most patients had Grade III ascites(95.5%).Among them,115(64.2%)had RA,and 57(31.8%)had SBP.RA was significantly associated with abnormal serum potassium levels[odds ratio(OR)=2.27,95%CI:1.06–4.84,P=0.034],while SBP was independently predicted by gastrointestinal bleeding(OR=2.59,95%CI:1.18–5.64,P=0.017)and thrombocytopenia(platelet count<50000;OR=3.27,95%CI:1.08–9.88,P=0.035).CONCLUSION RA and SBP are major complications of cirrhosis,with electrolyte imbalances and coagulopathy playing key roles in their development.Our study confirms that abnormal potassium levels significantly predict RA,while gastrointestinal bleeding and thrombocytopenia are strong predictors of SBP.These findings emphasize the need for early risk stratification and targeted management strategies to improve outcomes in high-risk cirrhotic patients,particularly in minority populations with limited healthcare access.Further prospective studies are warranted to validate these results and explore potential interventions to reduce RA and SBP incidence.
基金financially supported from the National Natural Science Foundation of China(No.52274358)the Natural Science Foundation of Hunan Province,China(No.2020JJ4718)+2 种基金the Major Science and Technology Projects of Gansu Province,China(No.22ZD6GC017)the Young Scientists Fund of National Natural Science Foundation of China(No.51404296)the National Key Research and Development Program of China(No.2018YFC1901604).
文摘Based on the properties of antimony(Sb)and arsenic(As),a method was proposed to enhance gold recovery during iron matte smelting.The impact of Sb and As on gold enhancement capture was investigated using an exclusion method.The results demonstrated that both Sb and As significantly improved the gold recovery rate.As the Sb or As content increased,the gold recovery rate increased.The enhancement effect of Sb was better than that of As,and the optimal results were achieved through the synergistic effects of Sb and As.Under optimized conditions,the gold recovery rate reached 97.12%,whereas the gold content in the slag decreased to 1.70 g/t.Sb captured and aggregated free gold as an Au-Sb alloy,whereas As-Fe alloy also captured free gold.The growth of the gold-captured phase size enhanced the settling velocity,thereby promoting gold recovery.
基金supported by grants from the 925th Science Foundation(Grant Nos.2023-3 and 2024-2/3).
文摘Multiple myeloma is a complex and challenging blood cancer,particularly in cases where the disease has relapsed or become resistant to treatment.These situations often have a significant impact on both patient survival and quality of life.Over recent years,advances in precision medicine and translational medicine have brought about a shift in treatment strategies,moving toward more personalized and targeted approaches.This review highlights the latest developments in the management of refractory and relapsed multiple myeloma,focusing on the current state of precision diagnosis and treatment,the role of translational medicine,and potential future directions in research.By reviewing key studies and clinical trial data,we aim to offer fresh perspectives and strategies that could improve clinical outcomes.
文摘BACKGROUND Transjugular intrahepatic portosystemic shunt(TIPS)has an important role in the therapy of complications of portal-hypertension-related ascites.Various guidelines now indicate that TIPS is indicated for refractory ascites(RA),but TIPS for recurrent nonrefractory ascites(RNRA)achieved better clinical results.AIM To compare the clinical outcomes of TIPS for RA and RNRA in patients with complications related to portal hypertension.METHODS There were 863 patients divided into two main categories who underwent TIPS between September 2016 and September 2021.In category 1,patients had ascites without cirrhotic gastrointestinal bleeding.The patients were divided into group A(RNRA,n=183)and group B(RA,n=217).In category 2,patients had ascites and cirrhotic gastrointestinal bleeding.The patients were divided into group C(RNRA,n=328)and group D(RA,n=135).The clinical outcomes were probability of total hepatic impairment,incidence of hepatic encephalopathy(HE)and mortality.RESULTS The symptoms of ascites disappeared or were relieved within 1 week in group A compared with group B(P=0.032),and in group C compared with group D(P=0.027).By the end of follow-up,there were significant differences in the rate of RA in group A compared with group B(P=0.016),and in group C compared with group D(P=0.012).The probability of total hepatic impairment was significantly different in group A compared with group B(P=0.024),and in group C compared with group D(P=0.019).The total incidence of HE was significantly different in group A compared with group B(P=0.008),and in group C compared with group D(P=0.004).The 6-month,and 1-,2-and 3-year survival rates were significantly different between groups A and B(all P<0.05),and between groups C and D(all P<0.05).CONCLUSION TIPS has a good therapeutic effect on ascites related to cirrhotic portal hypertension,and early TIPS for RNRA can prolong survival,and prevent progression to RA.
