This paper tries to explore Wordsworth＇s poetics through a discussion of his important poetic conception of＂poetic spontaneity＂ or ＂All good poetry is the spontaneous overflow of powerful feelings＂. Wordsworth＇s...This paper tries to explore Wordsworth＇s poetics through a discussion of his important poetic conception of＂poetic spontaneity＂ or ＂All good poetry is the spontaneous overflow of powerful feelings＂. Wordsworth＇s poetic point ＂All good poetry is the spontaneous overflow of powerful feelings＂ is stated in his important work The Preface to Lyrical Ballads （1801）, and this theoretical point is actually validated by many good poems of his own. This paper demonstrates the significance of the theoretical point by a close examination of The Preface and its textual meanings. And then it presents an understanding of the theory through a detailed analysis of his masterpiece Tintern Abbey （1798） and I Wandered lonely as a cloud （1804）. It also demonstrates the importance and influence of his ＂poetic spontaneity＂ by comparing it with the Neo-classicalism in the 18th century and the Modernism in the 20th century.展开更多
This study presents a novel method to fabricate metal-decorated,sulfur-doped layered double hydroxides(M/SLDH)through spontaneous redox and sulfurization processes.The developed Ag/SLDH and Pt/SLDH catalysts with abun...This study presents a novel method to fabricate metal-decorated,sulfur-doped layered double hydroxides(M/SLDH)through spontaneous redox and sulfurization processes.The developed Ag/SLDH and Pt/SLDH catalysts with abundant heterogeneous interfaces and hierarchical nanostructures demonstrated outstanding oxygen evolution reaction(OER)and hydrogen evolution reaction(HER)performance,achieving low overpotentials of 212 and 35 mV at 10 mA cm^(-2)in 1 M KOH,respectively.As both anode and cathode in water splitting,they required only 1.47 V to reach 10 mA cm^(-2)and exhibited high structural robustness,maintaining stability at 1000 mA cm^(-2)for 300 h.In-situ Raman analysis revealed that the synergistic effects of metal nanoparticles and S doping significantly promote the transformation into the S-Co1-xFexOOH layer,which serves as the active phase for water oxidation.Additionally,ultraviolet photoelectron spectroscopy(UPS)and density functional theory(DFT)analyses indicated that incorporating metal nanoparticles and S doping increase electron density near the Fermi level and reduce reaction energy barriers,thus enhancing intrinsic OER and HER activities.This study provides a scalable strategy for synthesizing high-performance electrocatalysts for water splitting,with promising potential for broader applications.展开更多
BACKGROUND Complicated crown–root fracture (CRF) involves severe injury to the crown, root,and pulp, and may be accompanied by multiple root fractures. The loss of a toothhas lifelong consequences for children and te...BACKGROUND Complicated crown–root fracture (CRF) involves severe injury to the crown, root,and pulp, and may be accompanied by multiple root fractures. The loss of a toothhas lifelong consequences for children and teenagers, but the maintenance of pulphealth and the calcific healing of multiple root fractures are rarely reported in theliterature.CASE SUMMARY This case reports healing of a permanent tooth with complicated crown–root andadditional root fractures, in which pulp health was maintained. A 10-year-old girlfell and fractured the root of her maxillary left central incisor at the cervical level.After the coronal fragment was repositioned, the tooth was splinted until thetooth was no longer mobile, 2 years later. Eight years after treatment, the toothhas remained asymptomatic with vital pulp and localized gingival overgrowth.Cone-beam computed tomography revealed not only calcified healing of the CRFbut also spontaneous healing in an additional undiagnosed root fracture. Thefracture line on the enamel could not be healed by hard tissue and formed agroove in the cervical crown. It was speculated that the groove was related to thelocalized gingival overgrowth.CONCLUSION This case provides a clinical perspective of the treatment of a tooth with acomplicated CRF and an additional root fracture.展开更多
Acute spontaneous urticaria has a high incidence,with sudden and severe symptoms that can significantly impact daily life and work.If not properly managed,it may lead to severe reactions such as angioedema,gastrointes...Acute spontaneous urticaria has a high incidence,with sudden and severe symptoms that can significantly impact daily life and work.If not properly managed,it may lead to severe reactions such as angioedema,gastrointestinal symptoms,or even anaphylactic shock.Research on acute spontaneous urticaria is limited,with unclear etiology,and treatment largely relies on antihistamines and corticosteroids,which may not prevent progression to chronic urticaria.In this study,three patients with acute spontaneous urticaria,unresponsive to conventional treatments,chose a single 300mg subcutaneous injection of Omalizumab after evaluating the risks and benefits.Within 1-3 days,all patients showed significant symptom improvement,with near-complete resolution of lesions.Within a week,they resumed normal daily activities,and no recurrence was observed during 12 months of follow-up,with no adverse reactions.This study demonstrates the efficacy and safety of Omalizumab for acute spontaneous urticaria,particularly in cases resistant to antihistamines and corticosteroids.Early administration of Omalizumab can effectively control disease progression,reduce impact on daily life,and may lower the risk of developing chronic urticaria.These findings suggest that Omalizumab should be considered a valuable option in treating acute spontaneous urticaria,especially when conventional therapies fail,offering rapid symptom relief and long-term disease control.展开更多
Introduction Neurosurgical emergencies such as spontaneous intracerebral hemorrhage(ICH),traumatic brain injury(TBI),and acute brain herniation are among the most time-sensitive and high-stakes conditions in modern me...Introduction Neurosurgical emergencies such as spontaneous intracerebral hemorrhage(ICH),traumatic brain injury(TBI),and acute brain herniation are among the most time-sensitive and high-stakes conditions in modern medicine.Clinical decisions often must be made within minutes,yet these decisions are traditionally guided by limited information,heuristic reasoning,and past experience.In this context,the rise of medical data mining and real-time analytics offers a transformative opportunity:to extract actionable intelligence from the flood of clinical,imaging,and physiological data already being collected,and to use this intelligence to guide care in real time[1–3](Figure 1).展开更多
Perovskite ferroelectrics play an essential role in modern science and technology.The excellent properties of perovskites are closely related to their lattice dynamics.Potassium tantalate niobate(KTa_(1-x)Nb_(x)O_(3),...Perovskite ferroelectrics play an essential role in modern science and technology.The excellent properties of perovskites are closely related to their lattice dynamics.Potassium tantalate niobate(KTa_(1-x)Nb_(x)O_(3),abbreviated as KTN)is a typical solid-solution perovskite with superior properties.Although the optical and electrical performances of KTN crystals have been widely explored,information on their lattice dynamics is still scarce,which partially limits the research and performance optimization of KTN.As a solid-solution,spontaneous polarization of KTN exhibits strong tunability,and there is stress within KTN.Here,we performed first-principles calculations in conjunction with experiments to investigate the polarization-and stress-related lattice dynamics in KTN.We assigned the vibration modes of observed Raman peaks,and established the relationship between spontaneous polarization and vibration.Especially,the lattice dynamics evolution of KTN crystal under stress was investigated.And the results provide insights into the regulatory effect of stress on dielectric property from the perspective of lattice dynamics.Finally,the variation trends of phonons under stress,as well as the mechanism of stress effect in tetragonal perovskites were explained.The conclusions drawn for KTN crystal were generalized to tetragonal ferroelectric systems.Our results help to reflect spontaneous polarization and structural characteristics distribution through non-destructive Raman spectra,and give a reference for improving performance by regulating lattice dynamics.The findings will hopefully guide research on performance origin and refined design of perovskite functional materials.展开更多
BACKGROUND Boerhaave syndrome,or spontaneous esophageal rupture,is a rare and lifethreatening emergency,typically caused by a sudden increase in esophageal pressure due to violent coughing or vomiting.Early diagnosis ...BACKGROUND Boerhaave syndrome,or spontaneous esophageal rupture,is a rare and lifethreatening emergency,typically caused by a sudden increase in esophageal pressure due to violent coughing or vomiting.Early diagnosis is challenging as its symptoms often resemble those of other diseases.Understanding its pathological features and treatment strategies is therefore critical for clinical practice.CASE SUMMARY This report describes a case of spontaneous esophageal rupture triggered by violent coughing in a 55-year-old male with a history of smoking and hypertension.Following severe coughing,the patient developed chest pain,vomiting,and respiratory distress.Initial clinical evaluation was inconclusive,with a suspected diagnosis of cardiovascular or gastrointestinal conditions.After further examination,the diagnosis of spontaneous esophageal rupture was confirmed.Chest X-ray,computed tomography,and endoscopy revealed a rupture in the lower esophagus,along with mediastinal abscess and pleural effusion.Laboratory tests showed mild infection markers.The patient underwent surgical repair of the esophageal rupture(approximately 3 cm in length)with mediastinal drainage.Postoperatively,the patient’s temperature normalized within 3 days,respiratory function improved,and pleural effusion significantly decreased.After two weeks of treatment,the patient was discharged without complications and had a favorable prognosis.The study suggests that while violent coughing is a rare trigger,it can lead to severe damage,and imaging techniques play a crucial role in diagnosis.CONCLUSION Spontaneous esophageal rupture presents significant diagnostic and therapeutic challenges.Early recognition and timely intervention are crucial for improving prognosis.This case highlights the importance of imaging and surgical treatment,offering new insights for managing similar cases and providing valuable clinical guidance.展开更多
Young women’s physical and mental health is seriously impacted by recurrent spontaneous abortion(RSA),a prevalent obstetric complication that is becoming more commonplace worldwide.Therefore,a thorough investigation ...Young women’s physical and mental health is seriously impacted by recurrent spontaneous abortion(RSA),a prevalent obstetric complication that is becoming more commonplace worldwide.Therefore,a thorough investigation into the pathophysiology of RSA and the development of novel therapeutic strategies are imperative.Recent developments suggest that mesenchymal stem cell(MSC)-based therapies may be viable for addressing RSA.Through a variety of mechanisms,the immunological circumstances at the maternal-fetal contact can be altered,including regulating immune cell homeostasis,enhancing immune tolerance,alleviating inflammatory responses,promoting angiogenic processes,and promoting tissue regeneration.MSCs exhibit a remarkable capacity for multidifferentiation that could enhance pregnancy outcomes.This article provides compelling studies supporting the efficacy of MSC-based therapies in improving pregnancy outcomes in women with RSA.展开更多
Hypertension is one of the most prevalent cardiovascular diseases,and autophagy is known to play a significant role in the pathogenesis and progression of cardiovascular conditions.This study aimed to evaluate the eff...Hypertension is one of the most prevalent cardiovascular diseases,and autophagy is known to play a significant role in the pathogenesis and progression of cardiovascular conditions.This study aimed to evaluate the effects of Huanglian Jiedu decoction(HLJDD)on myocardial mitochondrial autophagy in spontaneously hypertensive rats(SHRs)and to further explore the relationship between autophagy,myocardial remodeling,and injury.The SHRs were randomly assigned to five groups:the model group,the HLJDD low-dose group,the HLJDD medium-dose group,the HLJDD high-dose group,and a positive control group treated with captopril.Additionally,a blank control group was established using Wistar Kyoto(WKY)rats,with 10 rats in each group.The model and blank control groups were administered an equivalent volume of physiological saline via oral gavage,while the treatment groups received their respective doses of HLJDD or captopril by oral gavage.Following the treatments,various parameters were assessed,including blood pressure(systolic,diastolic,and mean arterial pressure),mitochondrial swelling and membrane potential,free ATPase activity,as well as the mRNA and protein levels of autophagy-related factors.The results showed that HLJDD significantly reduced blood pressure(systolic,diastolic,and mean arterial pressure)in SHR rats.Moreover,it enhanced mitochondrial swelling and membrane potential,increased mitochondrial ATPase activity,and decreased the mRNA and protein expression levels of autophagy-related genes(AKT,mTOR,Beclin-1,and LC3-II)in SHRs.The findings of this study suggested that HLJDD could effectively ameliorate myocardial tissue injury in SHRs,and its protective effects on the heart might be attributed to the reduction of autophagy in cardiomyocyte mitochondria.This provided insights into the potential therapeutic use of HLJDD in managing hypertension-induced myocardial injury and remodeling.展开更多
Tetracycline hydrochloride(TCH)exists in various forms in aqueous solution due to pH changes,which not only alters the reactivity of TCH,but also affects the process of reactive oxygen species(ROS)attacking the molecu...Tetracycline hydrochloride(TCH)exists in various forms in aqueous solution due to pH changes,which not only alters the reactivity of TCH,but also affects the process of reactive oxygen species(ROS)attacking the molecule.Therefore,the rational design of piezo-photocatalytic materials coupled with a comprehensive understanding of the degradation mechanisms of various TCH species constitutes a critical approach to addressing tetracycline antibiotic contamination.In the design and preparation of piezo-photocatalysts,controlling the oxygen vacancy concentration is crucial as it governs the coupling efficiency between piezoelectric response and photocatalytic activity,as well as the strength of spontaneous polarization.Meanwhile,the morphology of the material is a key factor influencing the migration pathways of charge carriers.In this work,hollow spherical Bi_(4)Ti_(3)O_(12) was synthesized using an inorganic titanium source,demonstrating exceptional piezo-photocatalytic activity.The degradation rate was 1.57 and 5.29 times higher than that of traditional spherical and plate-like morphologies,with a rate constant of k=0.127.In an innovative approach,density functional theory calculations of local softness and hyper-softness were employed to analyze the reactivity changes of TCH in its different deprotonated states toward reactive oxygen species.Combined with molecular electronegativity analysis,the factors influencing the degradation efficiency were identified.This study provides a solid foundation for developing efficient and environmentally friendly piezo-photocatalysts and offers new insights into the degradation mechanism of TCH.展开更多
Background:The incidence of spontaneously ruptured hepatocellular carcinoma(srHCC)has been shown to significantly elevate mortality rates.However,the precise mechanisms underlying srHCC remain poorly understood.Method...Background:The incidence of spontaneously ruptured hepatocellular carcinoma(srHCC)has been shown to significantly elevate mortality rates.However,the precise mechanisms underlying srHCC remain poorly understood.Methods:Analysis was conducted on the data of 198 hepatocellular carcinoma(HCC)patients to inves-tigate the factors contributing to srHCC.The clinical data of 33 transcriptome HCC patients were served for verification.An in-depth transcriptome analysis was conducted to investigate the distinctions between 26 cases of srHCC and 35 cases of non-ruptured hepatocellular carcinoma(nrHCC).Weighted Gene Co-expression Network Analysis(WGCNA)tool was utilized to develop a gene co-expression network.Gene ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG)pathways enrichment,and protein-protein interaction(PPI)network were carried out.The corresponding samples for spontaneously rup-tured hepatocellular carcinoma tissue(srHCC-T)and ruptured hepatocellular carcinoma paracancerous tissue(srHCC-P)were selected for verification.Transcriptional data were validated through reverse tran-scription quantitative polymerase chain reaction(RT-qPCR).Immunofluorescence(IF),immunohistochem-istry(IHC)and Western blot were used to detect the protein expression.Results:Our results showed that white blood cell(WBC)and monocyte levels were significant inde-pendent risk factors for srHCC(P<0.05).There was a strong association between the srHCC-T and the expression of cell cycle-related genes BUB1B and macrophage function-related gene MACRO.Furthermore,chemokines and the PI3K/AKT signaling pathway play a crucial role in regulating the cell cycle process through a complex network of interactions,ultimately impacting the occurrence of srHCC.Conclusions:Our study confirms that chemokines and the PI3K/AKT signaling pathway mediate the occur-rence of HCC rupture by regulating the cell cycle.We provide a theoretical basis for the clinical treatment of srHCC.展开更多
Objective Heat wave exposure significantly impacts human health.Nevertheless,studies on the long-term effects of heat wave exposure during adolescence on adverse pregnancy outcomes(APOs)are rare.This study aimed to in...Objective Heat wave exposure significantly impacts human health.Nevertheless,studies on the long-term effects of heat wave exposure during adolescence on adverse pregnancy outcomes(APOs)are rare.This study aimed to investigate the relationship between the long-term effects of heat wave exposure during adolescence and APOs.Methods We analyzed data from 3,376 female and 3,013 male participants across 31 provinces in China.All adolescents(10–19 years old),early adolescents(10–14),and late adolescents(15–19)were chosen as exposure windows.Heat waves were defined as periods lasting 2‒4 consecutive days with the daily temperature exceeding the 75th,90th,and 92.5th percentiles.We employed multivariate logistic regression models to assess the associations between exposure to heat waves during adolescence and APOs.Results The results revealed significant associations between male exposure to heat wave events during late adolescence and spontaneous abortion(P<0.05),which was more pronounced in South China.In contrast,no statistically significant associations were detected between males’exposure to heat wave events during adolescence and their partners’preterm birth(P>0.05 for all comparisons).The exposure of females to heat waves during adolescence was not significantly associated with subsequent spontaneous abortion or preterm birth(P>0.05 for all comparisons).Conclusions This study demonstrates that spontaneous abortion in females is associated with heat wave exposure in their male partner during adolescence.展开更多
Background:Spontaneous intracerebral hemorrhage(ICH)is a severe neurological emergency with high morbidity and mortality.The effectiveness of surgical intervention remains controversial,partly due to significant heter...Background:Spontaneous intracerebral hemorrhage(ICH)is a severe neurological emergency with high morbidity and mortality.The effectiveness of surgical intervention remains controversial,partly due to significant heterogeneity among patients.Traditional clinical criteria often fail to identify those most likely to benefit from surgery.Methods:This nationwide retrospective study in China included 2,167 ICH patients from 31 hospitals.Using machine learning techniques,we integrated clinical and radiomic data to perform unsupervised clustering and identify distinct phenogroups.Dimensionality reduction and cross-validation were applied to minimize overfitting.External validation was conducted using data from the INTERACT3 trial,and a prospective cohort was used to assess real-world applicability.Results:Three phenogroups were identified.Among them,only Phenogroup 1-characterized by older age,moderate hematoma volume,and intermediate Glasgow Coma Scale scores-showed significant benefit from early surgical intervention,with a 42%reduction in 3-month mortality and improved functional outcomes.In contrast,surgery did not significantly affect outcomes in Phenogroups 0 and 2.These findings were consistent across multiple machine learning models and validated externally.Conclusion:Machine learning-driven phenotypic stratification can effectively identify ICH patients who are most likely to benefit from surgical treatment.This approach supports personalized treatment strategies and may improve clinical decision-making in ICH management.Further validation in diverse populations is warranted.展开更多
This paper investigated the use of magnesium phosphate cement (MPC) for solidifying sludge with different humic acid (HA) content (ranging from 0 to 4.5%) and explored the solidification mechanism. Fluidity, setting t...This paper investigated the use of magnesium phosphate cement (MPC) for solidifying sludge with different humic acid (HA) content (ranging from 0 to 4.5%) and explored the solidification mechanism. Fluidity, setting time, unconfined compressive strength (UCS), the strength formation mechanism, and the spontaneous imbibition process of solidified sludge (SS) were studied. The results indicate that MPC can be used as a low-alkalinity curing agent. As the HA content increases, fluidity and setting time also increase, while hydration temperature and strength decrease. Additionally, the failure mode of SS transitions from brittleness to ductility. The strength of SS is composed of the cementation strength provided by MPC hydration products, matric suction, osmotic suction, and the structural strength of the sludge. MPC reduces the structural strength caused by the shrinkage of pure sludge under the action of matric suction, but the incorporation of MPC significantly improved the strength when the sludge is eroded by water. X-ray diffraction (XRD) and scanning electron microscopy (SEM) show that the sludge and MPC can form a dense solid body, forming various hydration products, and synergistically improve the mechanical properties of the sludge.展开更多
Fluid imbibition from hydraulic fractures into shale formations is mainly affected by a combination of capillary forces and viscous resistance,both of which are closely related to the pore geometry.This study establis...Fluid imbibition from hydraulic fractures into shale formations is mainly affected by a combination of capillary forces and viscous resistance,both of which are closely related to the pore geometry.This study established five self-imbibition models with idealized pore structures and conducted a comparative analysis of these models.These models include circular,square,and equilateral triangular capillaries;a triangular star-shaped cross-section formed by three tangent spherical particles;and a traditional porous medium representation method.All these models are derived based on Newton’s second law,where capillary pressure is described by the Young-Laplace equation and viscous resistance is characterized by the Hagen-Poiret equation and Darcy’s law.All derived models predict that the fluid imbibition distance is proportional to the square root of time,in accordance with the classical Lucas-Washburn law.However,different pore structures exhibit significantly different characteristic imbibition rates.Compared to the single pore model,the conventional Darcy’s law-based model for porous media predicts significantly lower imbibition rates,which is consistent with the relatively slower uptake rates in actual shale nanoscale pore networks.These findings emphasize the important role played by pore geometry in fluid imbibition dynamics and further point to the need for optimizing pore structure to extend fluid imbibition duration in shale reservoirs in practical operations.展开更多
BACKGROUND Birt-Hogg-Dubé(BHD)syndrome is a rare genetic disorder associated with mutations in the BHD gene,which can manifest symptoms at any age,including dermatological and pulmonary complications,as well as r...BACKGROUND Birt-Hogg-Dubé(BHD)syndrome is a rare genetic disorder associated with mutations in the BHD gene,which can manifest symptoms at any age,including dermatological and pulmonary complications,as well as renal tumors.This study presents a case of a BHD patient who experienced spontaneous pneumothorax,aiming to enhance the understanding of this syndrome.CASE SUMMARY A 42-year-old female patient presented with left-sided chest pain and tightness lasting three days.Chest computed tomography scans revealed left-sided pneumothorax and multiple pulmonary bullae.Physical examination indicated decreased vocal fremitus and tympanic percussion on the left side.A thorough family history revealed a pattern of pulmonary disorders,including emphysema,spontaneous pneumothorax,and lung cancer among relatives.Genetic testing identified a heterozygous frameshift mutation in the FLCN gene at the 17p11.2 locus.Based on the clinical presentation,imaging findings,family history,and genetic results,the patient was suspected to have BHD syndrome.CONCLUSION We present a case of a heterozygous mutation in the FLCN gene in a patient with BHD syndrome,aiming to review the associated clinical characteristics and genetic mechanisms of this condition.This case serves as a reference point to offer insights into the diagnosis of multiple pulmonary cysts and spontaneous pneumo-thorax of unknown etiology in clinical practice.展开更多
Background: Puffy hand syndrome (PHS) is a rare complication primarily associated with intravenous drug use (IVDU), characterized by chronic swelling and fibrosis of the hands due to lymphatic damage. Concurrent pulmo...Background: Puffy hand syndrome (PHS) is a rare complication primarily associated with intravenous drug use (IVDU), characterized by chronic swelling and fibrosis of the hands due to lymphatic damage. Concurrent pulmonary complications, such as pneumonia and pneumothorax, significantly contribute to increased morbidity in this population. Case Presentation: We report the case of a 28-year-old female who injects drugs, and presents with fever, bilateral hand edema, and respiratory symptoms. Clinical evaluation revealed erythema and edema of both hands, elevated inflammatory markers, and a left lower lobe infiltration that progressed to pneumothorax. A diagnosis of PHS and left lower lobe pneumonia complicated by pneumothorax was established. Management and Outcomes: The patient was treated with broad-spectrum antibiotics, including ceftriaxone, levofloxacin, dexamethasone, and oxygen supplementation, as well as antipyretics. She demonstrated partial clinical improvement and was referred to another hospital’s thoracic surgery department for specialized care. Conclusions: This case underscores the importance of early recognition and multidisciplinary management of rare but serious complications in IVDU patients. Further research is necessary to elucidate the interplay between lymphatic dysfunction and pulmonary pathophysiology in this demographic.展开更多
Spontaneous bacterial peritonitis(SBP)is a common complication of liver failure.It is an acute bacterial infection of the ascitic fluid in patients with liver cirrhosis.SBP presents a significant challenge for hepatol...Spontaneous bacterial peritonitis(SBP)is a common complication of liver failure.It is an acute bacterial infection of the ascitic fluid in patients with liver cirrhosis.SBP presents a significant challenge for hepatologists owing to its associated complications.While diagnostic paracentesis with polymorphonuclear count is highly accurate,it can be troublesome for some patients as it is an invasive procedure with associated risks.Several studies have proposed new diagnostic methods to improve current practices,many of which remain invasive.Although some serum tests show promise in the diagnosis of SBP,the results are still preliminary.Recent advancements in artificial intelligence and machine learning have introduced predictive models and scoring systems for diagnosis.However,these models still lack sufficient sensitivity,specificity,and the ability to effe-ctively assess treatment response.展开更多
BACKGROUND Cerebrospinal fluid(CSF)leaks in the temporal bone arise from osteodural defects,resulting in an abnormal connection between the subarachnoid space and the adjacent tympanomastoid cavity,which often manifes...BACKGROUND Cerebrospinal fluid(CSF)leaks in the temporal bone arise from osteodural defects,resulting in an abnormal connection between the subarachnoid space and the adjacent tympanomastoid cavity,which often manifests as otorrhea.Patients typically exhibit symptoms such as headache,unilateral hearing impairment,aural fullness,or even meningitis.Imaging studies are critical for identifying and differentiating the location and characteristics of CSF leaks.However,when the leak's origin remains ambiguous,diagnostic surgery may be warranted to both confirm the diagnosis and facilitate treatment.This report discusses an uncommon case while reviewing relevant literature,focusing on the surgical diagnostic intervention in a 58-year-old male with spontaneous temporal bone CSF leaks.CASE SUMMARY The patient,a 58-year-old man,was admitted for evaluation of left ear fullness,hearing loss,and nasal discharge.Notably,when supine,clear fluid drained from the left nasal cavity,with improvement noted upon sitting.A nasal examination did not reveal significant findings,while the otologic evaluation indicated an intact periosteum;however,considerable fluid accumulation was identified within the left middle ear.Despite undergoing multiple periosteal punctures and conservative medical management,the middle ear effusion persisted.Imaging studies,including magnetic resonance imaging(MRI)and computed tomography,confirmed the presence of left-sided CSF otorrhea,and the head MRI indicated potential CSF rhinorrhea.This raised challenges in determining whether the CSF leak originated from the sphenoid sinus or the temporal bone.Given that CSF otorrhea may drain through the external auditory canal and CSF rhinorrhea from the sellar region can present as nasal leakage,differentiation proved complex.In this case,with an intact external auditory canal,CSF from the middle ear was observed to flow into the nasal cavity via the Eustachian tube.Therefore,leakage from both sites could be misconstrued as CSF rhinorrhea,complicating the diagnostic process.Consequently,an exploratory surgical procedure was performed,revealing an incomplete dura mater on the temporal aspect of the petrous bone,which was subsequently repaired.CONCLUSION Benign intracranial hypertension can result in meningeal protrusion or meningoencephalocele,which may lead to CSF leakage that generally responds favorably to mucosal repair.In instances where imaging fails to identify the source of the leak or when diagnostic options are limited,proactive exploratory surgery is advisable.Although surgical interventions carry inherent risks,the application of endoscopic techniques by experienced surgeons renders this approach a feasible choice for addressing both diagnostic and therapeutic challenges.展开更多
Deep mining,characterized by high stress,elevated geothermal gradients,and significant moisture content,significantly increases the risk of Coal Spontaneous Combustion(CSC),posing a major threat to mine safety.This st...Deep mining,characterized by high stress,elevated geothermal gradients,and significant moisture content,significantly increases the risk of Coal Spontaneous Combustion(CSC),posing a major threat to mine safety.This study delves into the impact of these factors on the self-ignition properties of coal,leveraging data from four distinctmines inHeilongjiang Province,China:ShuangyashanDongrongNo.2 Mine,Hegang JundeCoal Mine,Qitaihe Longhu Coal Mine,and Jixi Ronghua No.1Mine.We have honed the theoretical framework to account for variations in gas content during CSC.Our investigation,conducted through programmed temperature rise experiments,scrutinized the generation and temperature-dependent evolution of gases,emphasizing individual indicators such as CO,O_(2),and CxHy,in addition to composite indicators like the ratio of change in CO to change in O_(2) concentration(∂C_(CO)/∂t:−∂C_(O_(2))/∂t)and the ratio of C2H4 to C_(2)H_(6).These insights have catalyzed the development of a CSC state energy level transition model and a precise method for phase-based quantification of combustion progression.Our findings furnish a scientific foundation for the formulation of early warning and prevention strategies in deep mining settings.展开更多
文摘This paper tries to explore Wordsworth＇s poetics through a discussion of his important poetic conception of＂poetic spontaneity＂ or ＂All good poetry is the spontaneous overflow of powerful feelings＂. Wordsworth＇s poetic point ＂All good poetry is the spontaneous overflow of powerful feelings＂ is stated in his important work The Preface to Lyrical Ballads （1801）, and this theoretical point is actually validated by many good poems of his own. This paper demonstrates the significance of the theoretical point by a close examination of The Preface and its textual meanings. And then it presents an understanding of the theory through a detailed analysis of his masterpiece Tintern Abbey （1798） and I Wandered lonely as a cloud （1804）. It also demonstrates the importance and influence of his ＂poetic spontaneity＂ by comparing it with the Neo-classicalism in the 18th century and the Modernism in the 20th century.
基金National Programs for NanoKey Project(2022YFA1504002)National Natural Science Foundation of China(22078233)。
文摘This study presents a novel method to fabricate metal-decorated,sulfur-doped layered double hydroxides(M/SLDH)through spontaneous redox and sulfurization processes.The developed Ag/SLDH and Pt/SLDH catalysts with abundant heterogeneous interfaces and hierarchical nanostructures demonstrated outstanding oxygen evolution reaction(OER)and hydrogen evolution reaction(HER)performance,achieving low overpotentials of 212 and 35 mV at 10 mA cm^(-2)in 1 M KOH,respectively.As both anode and cathode in water splitting,they required only 1.47 V to reach 10 mA cm^(-2)and exhibited high structural robustness,maintaining stability at 1000 mA cm^(-2)for 300 h.In-situ Raman analysis revealed that the synergistic effects of metal nanoparticles and S doping significantly promote the transformation into the S-Co1-xFexOOH layer,which serves as the active phase for water oxidation.Additionally,ultraviolet photoelectron spectroscopy(UPS)and density functional theory(DFT)analyses indicated that incorporating metal nanoparticles and S doping increase electron density near the Fermi level and reduce reaction energy barriers,thus enhancing intrinsic OER and HER activities.This study provides a scalable strategy for synthesizing high-performance electrocatalysts for water splitting,with promising potential for broader applications.
基金Supported by 2021 Disciplinary Construction Project in School of Dentistry,Anhui Medical University,No.2021kqxkFY05.
文摘BACKGROUND Complicated crown–root fracture (CRF) involves severe injury to the crown, root,and pulp, and may be accompanied by multiple root fractures. The loss of a toothhas lifelong consequences for children and teenagers, but the maintenance of pulphealth and the calcific healing of multiple root fractures are rarely reported in theliterature.CASE SUMMARY This case reports healing of a permanent tooth with complicated crown–root andadditional root fractures, in which pulp health was maintained. A 10-year-old girlfell and fractured the root of her maxillary left central incisor at the cervical level.After the coronal fragment was repositioned, the tooth was splinted until thetooth was no longer mobile, 2 years later. Eight years after treatment, the toothhas remained asymptomatic with vital pulp and localized gingival overgrowth.Cone-beam computed tomography revealed not only calcified healing of the CRFbut also spontaneous healing in an additional undiagnosed root fracture. Thefracture line on the enamel could not be healed by hard tissue and formed agroove in the cervical crown. It was speculated that the groove was related to thelocalized gingival overgrowth.CONCLUSION This case provides a clinical perspective of the treatment of a tooth with acomplicated CRF and an additional root fracture.
文摘Acute spontaneous urticaria has a high incidence,with sudden and severe symptoms that can significantly impact daily life and work.If not properly managed,it may lead to severe reactions such as angioedema,gastrointestinal symptoms,or even anaphylactic shock.Research on acute spontaneous urticaria is limited,with unclear etiology,and treatment largely relies on antihistamines and corticosteroids,which may not prevent progression to chronic urticaria.In this study,three patients with acute spontaneous urticaria,unresponsive to conventional treatments,chose a single 300mg subcutaneous injection of Omalizumab after evaluating the risks and benefits.Within 1-3 days,all patients showed significant symptom improvement,with near-complete resolution of lesions.Within a week,they resumed normal daily activities,and no recurrence was observed during 12 months of follow-up,with no adverse reactions.This study demonstrates the efficacy and safety of Omalizumab for acute spontaneous urticaria,particularly in cases resistant to antihistamines and corticosteroids.Early administration of Omalizumab can effectively control disease progression,reduce impact on daily life,and may lower the risk of developing chronic urticaria.These findings suggest that Omalizumab should be considered a valuable option in treating acute spontaneous urticaria,especially when conventional therapies fail,offering rapid symptom relief and long-term disease control.
文摘Introduction Neurosurgical emergencies such as spontaneous intracerebral hemorrhage(ICH),traumatic brain injury(TBI),and acute brain herniation are among the most time-sensitive and high-stakes conditions in modern medicine.Clinical decisions often must be made within minutes,yet these decisions are traditionally guided by limited information,heuristic reasoning,and past experience.In this context,the rise of medical data mining and real-time analytics offers a transformative opportunity:to extract actionable intelligence from the flood of clinical,imaging,and physiological data already being collected,and to use this intelligence to guide care in real time[1–3](Figure 1).
基金financially supported by the National Natural Science Foundation of China(Nos.12004085 and 12074092)the Fundamental Research Funds for the Central Universities(No.2023FRFK06004)+2 种基金the Natural Science Foundation of Heilongjiang Province of China(Nos.YQ2022A010 and ZD2022E003)the fellow-ship of China National Postdoctoral Program for Innovative Talents(No.BX20200111)the Heilongjiang Postdoctoral Funds(Nos.LBH-Z20065 and LBH-Z22121).
文摘Perovskite ferroelectrics play an essential role in modern science and technology.The excellent properties of perovskites are closely related to their lattice dynamics.Potassium tantalate niobate(KTa_(1-x)Nb_(x)O_(3),abbreviated as KTN)is a typical solid-solution perovskite with superior properties.Although the optical and electrical performances of KTN crystals have been widely explored,information on their lattice dynamics is still scarce,which partially limits the research and performance optimization of KTN.As a solid-solution,spontaneous polarization of KTN exhibits strong tunability,and there is stress within KTN.Here,we performed first-principles calculations in conjunction with experiments to investigate the polarization-and stress-related lattice dynamics in KTN.We assigned the vibration modes of observed Raman peaks,and established the relationship between spontaneous polarization and vibration.Especially,the lattice dynamics evolution of KTN crystal under stress was investigated.And the results provide insights into the regulatory effect of stress on dielectric property from the perspective of lattice dynamics.Finally,the variation trends of phonons under stress,as well as the mechanism of stress effect in tetragonal perovskites were explained.The conclusions drawn for KTN crystal were generalized to tetragonal ferroelectric systems.Our results help to reflect spontaneous polarization and structural characteristics distribution through non-destructive Raman spectra,and give a reference for improving performance by regulating lattice dynamics.The findings will hopefully guide research on performance origin and refined design of perovskite functional materials.
基金Supported by Guangzhou Municipal Science and Technology Bureau,No.SL2024AD3JD0112.
文摘BACKGROUND Boerhaave syndrome,or spontaneous esophageal rupture,is a rare and lifethreatening emergency,typically caused by a sudden increase in esophageal pressure due to violent coughing or vomiting.Early diagnosis is challenging as its symptoms often resemble those of other diseases.Understanding its pathological features and treatment strategies is therefore critical for clinical practice.CASE SUMMARY This report describes a case of spontaneous esophageal rupture triggered by violent coughing in a 55-year-old male with a history of smoking and hypertension.Following severe coughing,the patient developed chest pain,vomiting,and respiratory distress.Initial clinical evaluation was inconclusive,with a suspected diagnosis of cardiovascular or gastrointestinal conditions.After further examination,the diagnosis of spontaneous esophageal rupture was confirmed.Chest X-ray,computed tomography,and endoscopy revealed a rupture in the lower esophagus,along with mediastinal abscess and pleural effusion.Laboratory tests showed mild infection markers.The patient underwent surgical repair of the esophageal rupture(approximately 3 cm in length)with mediastinal drainage.Postoperatively,the patient’s temperature normalized within 3 days,respiratory function improved,and pleural effusion significantly decreased.After two weeks of treatment,the patient was discharged without complications and had a favorable prognosis.The study suggests that while violent coughing is a rare trigger,it can lead to severe damage,and imaging techniques play a crucial role in diagnosis.CONCLUSION Spontaneous esophageal rupture presents significant diagnostic and therapeutic challenges.Early recognition and timely intervention are crucial for improving prognosis.This case highlights the importance of imaging and surgical treatment,offering new insights for managing similar cases and providing valuable clinical guidance.
基金Supported by the Natural Science Foundation of Liaoning Province,No.2024-MSLH-525.
文摘Young women’s physical and mental health is seriously impacted by recurrent spontaneous abortion(RSA),a prevalent obstetric complication that is becoming more commonplace worldwide.Therefore,a thorough investigation into the pathophysiology of RSA and the development of novel therapeutic strategies are imperative.Recent developments suggest that mesenchymal stem cell(MSC)-based therapies may be viable for addressing RSA.Through a variety of mechanisms,the immunological circumstances at the maternal-fetal contact can be altered,including regulating immune cell homeostasis,enhancing immune tolerance,alleviating inflammatory responses,promoting angiogenic processes,and promoting tissue regeneration.MSCs exhibit a remarkable capacity for multidifferentiation that could enhance pregnancy outcomes.This article provides compelling studies supporting the efficacy of MSC-based therapies in improving pregnancy outcomes in women with RSA.
基金The Shandong Provincial Key Project of TCM Science and Technology(Grant Nos.M-2023170,M-2022233)the Binzhou Medical College Student Innovation and Entrepreneurship Training Program(Grant Nos.X202410440414,X2024225030120)。
文摘Hypertension is one of the most prevalent cardiovascular diseases,and autophagy is known to play a significant role in the pathogenesis and progression of cardiovascular conditions.This study aimed to evaluate the effects of Huanglian Jiedu decoction(HLJDD)on myocardial mitochondrial autophagy in spontaneously hypertensive rats(SHRs)and to further explore the relationship between autophagy,myocardial remodeling,and injury.The SHRs were randomly assigned to five groups:the model group,the HLJDD low-dose group,the HLJDD medium-dose group,the HLJDD high-dose group,and a positive control group treated with captopril.Additionally,a blank control group was established using Wistar Kyoto(WKY)rats,with 10 rats in each group.The model and blank control groups were administered an equivalent volume of physiological saline via oral gavage,while the treatment groups received their respective doses of HLJDD or captopril by oral gavage.Following the treatments,various parameters were assessed,including blood pressure(systolic,diastolic,and mean arterial pressure),mitochondrial swelling and membrane potential,free ATPase activity,as well as the mRNA and protein levels of autophagy-related factors.The results showed that HLJDD significantly reduced blood pressure(systolic,diastolic,and mean arterial pressure)in SHR rats.Moreover,it enhanced mitochondrial swelling and membrane potential,increased mitochondrial ATPase activity,and decreased the mRNA and protein expression levels of autophagy-related genes(AKT,mTOR,Beclin-1,and LC3-II)in SHRs.The findings of this study suggested that HLJDD could effectively ameliorate myocardial tissue injury in SHRs,and its protective effects on the heart might be attributed to the reduction of autophagy in cardiomyocyte mitochondria.This provided insights into the potential therapeutic use of HLJDD in managing hypertension-induced myocardial injury and remodeling.
文摘Tetracycline hydrochloride(TCH)exists in various forms in aqueous solution due to pH changes,which not only alters the reactivity of TCH,but also affects the process of reactive oxygen species(ROS)attacking the molecule.Therefore,the rational design of piezo-photocatalytic materials coupled with a comprehensive understanding of the degradation mechanisms of various TCH species constitutes a critical approach to addressing tetracycline antibiotic contamination.In the design and preparation of piezo-photocatalysts,controlling the oxygen vacancy concentration is crucial as it governs the coupling efficiency between piezoelectric response and photocatalytic activity,as well as the strength of spontaneous polarization.Meanwhile,the morphology of the material is a key factor influencing the migration pathways of charge carriers.In this work,hollow spherical Bi_(4)Ti_(3)O_(12) was synthesized using an inorganic titanium source,demonstrating exceptional piezo-photocatalytic activity.The degradation rate was 1.57 and 5.29 times higher than that of traditional spherical and plate-like morphologies,with a rate constant of k=0.127.In an innovative approach,density functional theory calculations of local softness and hyper-softness were employed to analyze the reactivity changes of TCH in its different deprotonated states toward reactive oxygen species.Combined with molecular electronegativity analysis,the factors influencing the degradation efficiency were identified.This study provides a solid foundation for developing efficient and environmentally friendly piezo-photocatalysts and offers new insights into the degradation mechanism of TCH.
基金supported by grants from the National Natu-ral Science Foundation of China(52072005 and 51872279).
文摘Background:The incidence of spontaneously ruptured hepatocellular carcinoma(srHCC)has been shown to significantly elevate mortality rates.However,the precise mechanisms underlying srHCC remain poorly understood.Methods:Analysis was conducted on the data of 198 hepatocellular carcinoma(HCC)patients to inves-tigate the factors contributing to srHCC.The clinical data of 33 transcriptome HCC patients were served for verification.An in-depth transcriptome analysis was conducted to investigate the distinctions between 26 cases of srHCC and 35 cases of non-ruptured hepatocellular carcinoma(nrHCC).Weighted Gene Co-expression Network Analysis(WGCNA)tool was utilized to develop a gene co-expression network.Gene ontology(GO)and Kyoto encyclopedia of genes and genomes(KEGG)pathways enrichment,and protein-protein interaction(PPI)network were carried out.The corresponding samples for spontaneously rup-tured hepatocellular carcinoma tissue(srHCC-T)and ruptured hepatocellular carcinoma paracancerous tissue(srHCC-P)were selected for verification.Transcriptional data were validated through reverse tran-scription quantitative polymerase chain reaction(RT-qPCR).Immunofluorescence(IF),immunohistochem-istry(IHC)and Western blot were used to detect the protein expression.Results:Our results showed that white blood cell(WBC)and monocyte levels were significant inde-pendent risk factors for srHCC(P<0.05).There was a strong association between the srHCC-T and the expression of cell cycle-related genes BUB1B and macrophage function-related gene MACRO.Furthermore,chemokines and the PI3K/AKT signaling pathway play a crucial role in regulating the cell cycle process through a complex network of interactions,ultimately impacting the occurrence of srHCC.Conclusions:Our study confirms that chemokines and the PI3K/AKT signaling pathway mediate the occur-rence of HCC rupture by regulating the cell cycle.We provide a theoretical basis for the clinical treatment of srHCC.
基金funded by the Key Project of the University Outstanding Youth Backbone Talented Person Foreign Visits Study Does Research of Anhui Province(No.gxgwfx2020025).
文摘Objective Heat wave exposure significantly impacts human health.Nevertheless,studies on the long-term effects of heat wave exposure during adolescence on adverse pregnancy outcomes(APOs)are rare.This study aimed to investigate the relationship between the long-term effects of heat wave exposure during adolescence and APOs.Methods We analyzed data from 3,376 female and 3,013 male participants across 31 provinces in China.All adolescents(10–19 years old),early adolescents(10–14),and late adolescents(15–19)were chosen as exposure windows.Heat waves were defined as periods lasting 2‒4 consecutive days with the daily temperature exceeding the 75th,90th,and 92.5th percentiles.We employed multivariate logistic regression models to assess the associations between exposure to heat waves during adolescence and APOs.Results The results revealed significant associations between male exposure to heat wave events during late adolescence and spontaneous abortion(P<0.05),which was more pronounced in South China.In contrast,no statistically significant associations were detected between males’exposure to heat wave events during adolescence and their partners’preterm birth(P>0.05 for all comparisons).The exposure of females to heat waves during adolescence was not significantly associated with subsequent spontaneous abortion or preterm birth(P>0.05 for all comparisons).Conclusions This study demonstrates that spontaneous abortion in females is associated with heat wave exposure in their male partner during adolescence.
基金supported by the Shanghai Municipal Health Commission(201840063,201801075)the Science and Technology Commission of Shanghai Municipality(18441903300).
文摘Background:Spontaneous intracerebral hemorrhage(ICH)is a severe neurological emergency with high morbidity and mortality.The effectiveness of surgical intervention remains controversial,partly due to significant heterogeneity among patients.Traditional clinical criteria often fail to identify those most likely to benefit from surgery.Methods:This nationwide retrospective study in China included 2,167 ICH patients from 31 hospitals.Using machine learning techniques,we integrated clinical and radiomic data to perform unsupervised clustering and identify distinct phenogroups.Dimensionality reduction and cross-validation were applied to minimize overfitting.External validation was conducted using data from the INTERACT3 trial,and a prospective cohort was used to assess real-world applicability.Results:Three phenogroups were identified.Among them,only Phenogroup 1-characterized by older age,moderate hematoma volume,and intermediate Glasgow Coma Scale scores-showed significant benefit from early surgical intervention,with a 42%reduction in 3-month mortality and improved functional outcomes.In contrast,surgery did not significantly affect outcomes in Phenogroups 0 and 2.These findings were consistent across multiple machine learning models and validated externally.Conclusion:Machine learning-driven phenotypic stratification can effectively identify ICH patients who are most likely to benefit from surgical treatment.This approach supports personalized treatment strategies and may improve clinical decision-making in ICH management.Further validation in diverse populations is warranted.
基金This research work was financially supported by the National Natural Science Foundation of China(Grant No.51972209).
文摘This paper investigated the use of magnesium phosphate cement (MPC) for solidifying sludge with different humic acid (HA) content (ranging from 0 to 4.5%) and explored the solidification mechanism. Fluidity, setting time, unconfined compressive strength (UCS), the strength formation mechanism, and the spontaneous imbibition process of solidified sludge (SS) were studied. The results indicate that MPC can be used as a low-alkalinity curing agent. As the HA content increases, fluidity and setting time also increase, while hydration temperature and strength decrease. Additionally, the failure mode of SS transitions from brittleness to ductility. The strength of SS is composed of the cementation strength provided by MPC hydration products, matric suction, osmotic suction, and the structural strength of the sludge. MPC reduces the structural strength caused by the shrinkage of pure sludge under the action of matric suction, but the incorporation of MPC significantly improved the strength when the sludge is eroded by water. X-ray diffraction (XRD) and scanning electron microscopy (SEM) show that the sludge and MPC can form a dense solid body, forming various hydration products, and synergistically improve the mechanical properties of the sludge.
文摘Fluid imbibition from hydraulic fractures into shale formations is mainly affected by a combination of capillary forces and viscous resistance,both of which are closely related to the pore geometry.This study established five self-imbibition models with idealized pore structures and conducted a comparative analysis of these models.These models include circular,square,and equilateral triangular capillaries;a triangular star-shaped cross-section formed by three tangent spherical particles;and a traditional porous medium representation method.All these models are derived based on Newton’s second law,where capillary pressure is described by the Young-Laplace equation and viscous resistance is characterized by the Hagen-Poiret equation and Darcy’s law.All derived models predict that the fluid imbibition distance is proportional to the square root of time,in accordance with the classical Lucas-Washburn law.However,different pore structures exhibit significantly different characteristic imbibition rates.Compared to the single pore model,the conventional Darcy’s law-based model for porous media predicts significantly lower imbibition rates,which is consistent with the relatively slower uptake rates in actual shale nanoscale pore networks.These findings emphasize the important role played by pore geometry in fluid imbibition dynamics and further point to the need for optimizing pore structure to extend fluid imbibition duration in shale reservoirs in practical operations.
文摘BACKGROUND Birt-Hogg-Dubé(BHD)syndrome is a rare genetic disorder associated with mutations in the BHD gene,which can manifest symptoms at any age,including dermatological and pulmonary complications,as well as renal tumors.This study presents a case of a BHD patient who experienced spontaneous pneumothorax,aiming to enhance the understanding of this syndrome.CASE SUMMARY A 42-year-old female patient presented with left-sided chest pain and tightness lasting three days.Chest computed tomography scans revealed left-sided pneumothorax and multiple pulmonary bullae.Physical examination indicated decreased vocal fremitus and tympanic percussion on the left side.A thorough family history revealed a pattern of pulmonary disorders,including emphysema,spontaneous pneumothorax,and lung cancer among relatives.Genetic testing identified a heterozygous frameshift mutation in the FLCN gene at the 17p11.2 locus.Based on the clinical presentation,imaging findings,family history,and genetic results,the patient was suspected to have BHD syndrome.CONCLUSION We present a case of a heterozygous mutation in the FLCN gene in a patient with BHD syndrome,aiming to review the associated clinical characteristics and genetic mechanisms of this condition.This case serves as a reference point to offer insights into the diagnosis of multiple pulmonary cysts and spontaneous pneumo-thorax of unknown etiology in clinical practice.
文摘Background: Puffy hand syndrome (PHS) is a rare complication primarily associated with intravenous drug use (IVDU), characterized by chronic swelling and fibrosis of the hands due to lymphatic damage. Concurrent pulmonary complications, such as pneumonia and pneumothorax, significantly contribute to increased morbidity in this population. Case Presentation: We report the case of a 28-year-old female who injects drugs, and presents with fever, bilateral hand edema, and respiratory symptoms. Clinical evaluation revealed erythema and edema of both hands, elevated inflammatory markers, and a left lower lobe infiltration that progressed to pneumothorax. A diagnosis of PHS and left lower lobe pneumonia complicated by pneumothorax was established. Management and Outcomes: The patient was treated with broad-spectrum antibiotics, including ceftriaxone, levofloxacin, dexamethasone, and oxygen supplementation, as well as antipyretics. She demonstrated partial clinical improvement and was referred to another hospital’s thoracic surgery department for specialized care. Conclusions: This case underscores the importance of early recognition and multidisciplinary management of rare but serious complications in IVDU patients. Further research is necessary to elucidate the interplay between lymphatic dysfunction and pulmonary pathophysiology in this demographic.
文摘Spontaneous bacterial peritonitis(SBP)is a common complication of liver failure.It is an acute bacterial infection of the ascitic fluid in patients with liver cirrhosis.SBP presents a significant challenge for hepatologists owing to its associated complications.While diagnostic paracentesis with polymorphonuclear count is highly accurate,it can be troublesome for some patients as it is an invasive procedure with associated risks.Several studies have proposed new diagnostic methods to improve current practices,many of which remain invasive.Although some serum tests show promise in the diagnosis of SBP,the results are still preliminary.Recent advancements in artificial intelligence and machine learning have introduced predictive models and scoring systems for diagnosis.However,these models still lack sufficient sensitivity,specificity,and the ability to effe-ctively assess treatment response.
文摘BACKGROUND Cerebrospinal fluid(CSF)leaks in the temporal bone arise from osteodural defects,resulting in an abnormal connection between the subarachnoid space and the adjacent tympanomastoid cavity,which often manifests as otorrhea.Patients typically exhibit symptoms such as headache,unilateral hearing impairment,aural fullness,or even meningitis.Imaging studies are critical for identifying and differentiating the location and characteristics of CSF leaks.However,when the leak's origin remains ambiguous,diagnostic surgery may be warranted to both confirm the diagnosis and facilitate treatment.This report discusses an uncommon case while reviewing relevant literature,focusing on the surgical diagnostic intervention in a 58-year-old male with spontaneous temporal bone CSF leaks.CASE SUMMARY The patient,a 58-year-old man,was admitted for evaluation of left ear fullness,hearing loss,and nasal discharge.Notably,when supine,clear fluid drained from the left nasal cavity,with improvement noted upon sitting.A nasal examination did not reveal significant findings,while the otologic evaluation indicated an intact periosteum;however,considerable fluid accumulation was identified within the left middle ear.Despite undergoing multiple periosteal punctures and conservative medical management,the middle ear effusion persisted.Imaging studies,including magnetic resonance imaging(MRI)and computed tomography,confirmed the presence of left-sided CSF otorrhea,and the head MRI indicated potential CSF rhinorrhea.This raised challenges in determining whether the CSF leak originated from the sphenoid sinus or the temporal bone.Given that CSF otorrhea may drain through the external auditory canal and CSF rhinorrhea from the sellar region can present as nasal leakage,differentiation proved complex.In this case,with an intact external auditory canal,CSF from the middle ear was observed to flow into the nasal cavity via the Eustachian tube.Therefore,leakage from both sites could be misconstrued as CSF rhinorrhea,complicating the diagnostic process.Consequently,an exploratory surgical procedure was performed,revealing an incomplete dura mater on the temporal aspect of the petrous bone,which was subsequently repaired.CONCLUSION Benign intracranial hypertension can result in meningeal protrusion or meningoencephalocele,which may lead to CSF leakage that generally responds favorably to mucosal repair.In instances where imaging fails to identify the source of the leak or when diagnostic options are limited,proactive exploratory surgery is advisable.Although surgical interventions carry inherent risks,the application of endoscopic techniques by experienced surgeons renders this approach a feasible choice for addressing both diagnostic and therapeutic challenges.
基金This paper is supported by“Unveiling the List and Leading the Way”Science and Technology Research Project from Heilongjiang Province(2021ZXJ02A03)Major Science and Technology Support Action Plan for the“Millions”Project in Heilongjiang Province(2020ZX04A01)the Natural Science Foundation of Heilongjiang Province(LH2024E112).
文摘Deep mining,characterized by high stress,elevated geothermal gradients,and significant moisture content,significantly increases the risk of Coal Spontaneous Combustion(CSC),posing a major threat to mine safety.This study delves into the impact of these factors on the self-ignition properties of coal,leveraging data from four distinctmines inHeilongjiang Province,China:ShuangyashanDongrongNo.2 Mine,Hegang JundeCoal Mine,Qitaihe Longhu Coal Mine,and Jixi Ronghua No.1Mine.We have honed the theoretical framework to account for variations in gas content during CSC.Our investigation,conducted through programmed temperature rise experiments,scrutinized the generation and temperature-dependent evolution of gases,emphasizing individual indicators such as CO,O_(2),and CxHy,in addition to composite indicators like the ratio of change in CO to change in O_(2) concentration(∂C_(CO)/∂t:−∂C_(O_(2))/∂t)and the ratio of C2H4 to C_(2)H_(6).These insights have catalyzed the development of a CSC state energy level transition model and a precise method for phase-based quantification of combustion progression.Our findings furnish a scientific foundation for the formulation of early warning and prevention strategies in deep mining settings.
