BACKGROUND Major depressive disorder(MDD)and obesity(OB)are bidirectionally comorbid conditions with common neurobiological underpinnings.However,the neurocognitive mechanisms of their comorbidity remain poorly unders...BACKGROUND Major depressive disorder(MDD)and obesity(OB)are bidirectionally comorbid conditions with common neurobiological underpinnings.However,the neurocognitive mechanisms of their comorbidity remain poorly understood.AIM To examine regional abnormalities in spontaneous brain activity among patients with MDD-OB comorbidity.METHODS This study adopted a regional homogeneity(ReHo)analysis of resting-state functional magnetic resonance imaging.The study included 149 hospital patients divided into four groups:Patients experiencing their first episode of drug-naive MDD with OB,patients with MDD without OB,and age-and sex-matched healthy individuals with and without OB.Whole-brain ReHo analysis was conducted using SPM12 software and RESTplus toolkits,with group comparisons via ANOVA and post-hoc tests.Correlations between ReHo values and behavioral measures were examined.RESULTS ANOVA revealed significant whole-brain ReHo differences among the four groups in four key regions:The left middle temporal gyrus(MTG.L),right cuneus,left precuneus,and left thalamus.Post-hoc analyses confirmed pairwise differences between all groups across these regions(P<0.05).OB was associated with ReHo alterations in the MTG.L,right cuneus,and left thalamus,whereas abnormalities in the precuneus suggested synergistic pathological mechanisms between MDD and OB.Statistically significant correlations were found between the drive and fun-seeking dimensions of the behavioral activation system,as well as behavioral inhibition and the corresponding ReHo values.CONCLUSION Our findings provide novel evidence for the neuroadaptive mechanisms underlying the MDD-OB comorbidity.Further validation could lead to personalized interventions targeting MTG.L hyperactivity and targeting healthy food cues.展开更多
BACKGROUND Edwardsiella tarda(E.tarda)belongs to the family Enterobacteriaceae and is generally seen to cause infections mainly in fish,but is also capable of infecting humans.Extraintestinal infections occur in patie...BACKGROUND Edwardsiella tarda(E.tarda)belongs to the family Enterobacteriaceae and is generally seen to cause infections mainly in fish,but is also capable of infecting humans.Extraintestinal infections occur in patients with certain risk factors,including immunocompromised status.We recently diagnosed a case of spontaneous bacterial peritonitis(SBP)due to E.tarda in an immuno-compromised dialysis patient.CASE SUMMARY Patient was a 55-year-old male,with a history of diabetic nephropathy being treated with hemodialysis three times a week.He was referred to our hospital due to an increased volume of ascites,and blood examination revealed increased inflammatory reaction.At our emergency department,he developed fever,disturbance of consciousness,abdominal distension,and abdomen-wide pain.In addition,a dialysis shunt was confirmed in his right forearm,and the shunt site showed no signs of inflammation.No wounds were confirmed on or in his body.A blood examination revealed increased values of white blood cells,C-reactive protein,and creatinine.Plain chest and abdominal computed tomography scanning revealed increased ascites volume.Abdominal paracentesis was performed and a Gram stain revealed Gramnegative bacillus.These findings prompted diagnosis of SBP.The patient was admitted and treated with cefmetazole,causing fever resolution and symptom improvements.Later,E.tarda was identified in ascites culture.The patient improved with decreased inflammatory response and was discharged on the 12th day of hospitalization.The antibiotic was terminated after 14 days of treatment.SBP in this case may have developed from chronic renal failure and diabetes mellitus.CONCLUSION We report the first known case of SBP due to E.tarda in an immuno-compromised dialysis patient.展开更多
To fully utilize the resources provided by optical fiber networks,a cross-band quantum light source generating photon pairs,where one photon in a pair is at C band and the other is at O band,is proposed in this work.T...To fully utilize the resources provided by optical fiber networks,a cross-band quantum light source generating photon pairs,where one photon in a pair is at C band and the other is at O band,is proposed in this work.This source is based on spontaneous four-wave mixing(SFWM)in a piece of shallow-ridge silicon waveguide.Theoretical analysis shows that the waveguide dispersion could be tailored by adjusting the ridge width,enabling broadband photon pair generation by SFWM across C band and O band.The spontaneous Raman scattering(SpRS)in silicon waveguides is also investigated experimentally.It shows that there are two regions in the spectrum of generated photons from SpRS,which could be used to achieve cross-band photon pair generation.A chip of shallow-ridge silicon waveguide samples with different ridge widths has been fabricated,through which cross-band photon pair generation is demonstrated experimentally.The experimental results show that the source can be achieved using dispersion-optimized shallow-ridge silicon waveguides.This cross-band quantum light source provides a way to develop new fiber-based quantum communication functions utilizing both C band and O band and extends applications of quantum networks.展开更多
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
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
BACKGROUND Individuals with liver cirrhosis(LC)are likely to experience multiple infectious processes due to the immune dysfunction caused by the disease.Our hypothesis is that this group of patients is predisposed to...BACKGROUND Individuals with liver cirrhosis(LC)are likely to experience multiple infectious processes due to the immune dysfunction caused by the disease.Our hypothesis is that this group of patients is predisposed to fungal infections.To date,the incidence of spontaneous fungal peritonitis(SFP)has not been determined in Mexico;this endeavor is of great importance because many patients may be suffering from this condition without receiving targeted treatment,which may increase mortality.AIM To report the incidence of SFP in patients presenting with decompensated LC with ascites.METHODS This was a prospective,single-center,descriptive,observational and crosssectional study where patients presenting with decompensated LC with ascites were evaluated from November 2023 to May 2024 in Mexico City.Fungal cultures of ascites were performed and the samples kept in an incubator for 10 days to 14 days,and molecular tests(the API 20 C AUX test)were used for molecular characterization.RESULTS Of the 48 patients included,54.2%were women,77.1%had a comorbidity,47.9%had LC secondary to metabolic dysfunction,43.8%were classified as Child-Pugh C with a model for end-stage liver disease 3.0 median score of 22,and 10.4%were in secondary prophylaxis for spontaneous bacterial peritonitis(SBP).Only four patients had positive cultures where Candida parapsilosis and Candida albicans were isolated,with two of the four patients being positive for Rhodotorula minuta;an SBP incidence of 8.3%was thus calculated.Chronic kidney disease[P=0.012 and relative risk(RR)=15]and secondary prophylaxis for SBP(P=0.049 with RR=8.6)were statistically significant and associated with a high mortality risk(P=0.001 with RR=33).CONCLUSION The presence of infection of fungal origin in ascites in patients presenting with cirrhosis increases short-and medium-term mortality;therefore,it is recommended that fungal culture tests are performed in those patients who visit the emergency room or experience continuous admission with acute decompensation and no bacteria identified in ascites cultures,and even more so in patients with chronic kidney disease and a history of antibiotic use as prophylaxis for SBP.Further studies are needed for the identification of clinical and biochemical data that can help to define SFP so that its presence may be assessed without the need to wait for a positive fungal culture.Thus,treatment may be initiated early in the hope of having a positive impact on the prognosis in this group of patients.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
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
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
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 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
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
The elastic properties of membranes are typically characterized by a few phenomenological parameters,including bending and Gaussian curvature moduli measuring the membrane rigidity against its deformation and topologi...The elastic properties of membranes are typically characterized by a few phenomenological parameters,including bending and Gaussian curvature moduli measuring the membrane rigidity against its deformation and topological change,as well as spontaneous curvature arising from the asymmetry between the two leaflets in the lipid bilayers.Though tether-based and fluctuationbased experiments are commonly utilized to measure the bending modulus,measuring the Gaussian curvature modulus and the spontaneous curvature of the membrane is considered to be much more difficult.In this paper,we study the buckling process of a circular membrane with nonzero spontaneous curvature under compressive stresses.It is found that when the stress exceeds a critical value,the circular membrane will transform from a spherical cap to a buckled shape,with its buckling degree enhanced with the increase of stress until its base is constricted to almost zero.As the stress-strain relationship of the buckled membrane strongly depends on the Gaussian curvature modulus and the spontaneous curvature,we therefore propose a method to determine the Gaussian curvature modulus and the spontaneous curvature simultaneously by measuring its stress-strain relationship during a buckling process.展开更多
Natural surfactants that are present in complex crude oil may induce spontaneous emulsification in the oil and brine phases that co-exist in rock pores.This process is known to be affected by the salinity of brine.How...Natural surfactants that are present in complex crude oil may induce spontaneous emulsification in the oil and brine phases that co-exist in rock pores.This process is known to be affected by the salinity of brine.However,the role of salinity in water-oil micro-emulsification is not fully understood.In this paper,we report on our experimental studies of the effect of salinity on spontaneous emulsification in a“mixture”of dodecane and brine.The dodecane contains SPAN 80 surfactant and brine with different salinity values,varying from 0.2%to 20%(by weight).For our observations,we use dynamic light scattering(DLS)technique to capture nano-scale emulsion formation and pendant drop method to observe micro-scale emulsion dynamics.The DLS experiments show that small(2.2 nm)and medium-sized emulsions(100 nm)are formed at low salinities,while at higher salinities only smaller droplets are formed and emulsification is reduced.In pendant drop experiments,dodecane and heptane systems were tested over 13 h.Heptane exhibited faster emulsification at water-oil interfaces in the cases with pure water and low salinity brine(0.2%),where the changes at interfacial area occurring within two hours and significant droplet shrinkage by 13 h.Lower salinity enhances micelle activity and emulsification,while higher salinities(2%,5%,and 20%)stabilize the oil-water interface and suppress emulsion formation.Dodecane exhibits a similar trend in emulsification but forms more stable emulsions and maintains a more stable water-oil interface compared to heptane.Additionally,we present the theory of reverse micelle exclusion through a theoretical derivation,providing a deeper understanding of the emulsification mechanism.Four distinct scenarios are schematically presented to explain the influence of salinity on spontaneous emulsification,illustrating how varying salinity levels affect micelle formation and emulsion behaviour.This study provides valuable insights into optimizing salinity levels in enhanced oil recovery.展开更多
Eosinophilic granulomatosis with polyangitis(EGPA)is a rare multi-system disease that presents significant diagnostic challenges due to its complexity and low incidence(White and Dubey,2023).It affects males and femal...Eosinophilic granulomatosis with polyangitis(EGPA)is a rare multi-system disease that presents significant diagnostic challenges due to its complexity and low incidence(White and Dubey,2023).It affects males and females equally,though males may exhibit more active disease at diagnosis and often require more aggressive treatment(Liu et al.,2023).The hallmark features of EGPA include delayed-onset asthma,eosinophilia in tissues and blood,and vasculitis affecting small to medium-sized arteries(White and Dubey,2023).EGPA falls under the category of antineutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV),whereas only about half of EGPA patients test positive for ANCA(Khoury et al.,2023).展开更多
Periodic metal nanoarrays serving as cavities can support directional-tunable amplified spontaneous emission that goes beyond the diffraction limit due to the hybrid states of surface plasmons and Bloch surface waves....Periodic metal nanoarrays serving as cavities can support directional-tunable amplified spontaneous emission that goes beyond the diffraction limit due to the hybrid states of surface plasmons and Bloch surface waves.Most of these modes'interactions remain within the weak coupling regime,yet strong coupling is also anticipated to occur.In this work,we present an intriguing case of amplified spontaneous emission(ASE),amplified by the splitting upper polariton mode within a strong coupling system,stemming from a square lattice of plasmonic cone lattices(PCLs).The PCLs are fabricated using an anodized aluminum oxide membrane(AAO),which facilitates strong coupling between surface plasmons and Bloch surface wave modes,with the maximum Rabi splitting observed at 0.258 eV for the sample with an aspect ratio of 0.33.A 13.5-fold increase in amplified spontaneous emission is recorded when the emission from Nile Red coincides with this flat energy branch of upper polariton,which exhibits a high photon density of states.Reduced group velocity can prolong photon lifetime and boost the probability of light-matter interaction.The observed ASE phenomenon in this strong coupling plasmonic system widens the scope for applications in nanolasing and polariton lasing.展开更多
BACKGROUND Intracerebral hemorrhage(ICH)comprises 9%-27%of stroke patients.Hematoma expansion(HE)occurs in approximately 20%of patients following ICH,typically within the first 24 hours.HE increases mortality and long...BACKGROUND Intracerebral hemorrhage(ICH)comprises 9%-27%of stroke patients.Hematoma expansion(HE)occurs in approximately 20%of patients following ICH,typically within the first 24 hours.HE increases mortality and long-term disability in these patients and is being investigated as a therapeutic target to improve the outcome in these patients by limiting HE.Non-contrast computed tomography(NCCT)has potential in predicting HE,which can identify the individuals at risk.AIM To evaluate NCCT markers for predicting HE in patients with ICH and to develop a simple,practical grading system for risk stratification.METHODS This prospective observational study evaluated 192 patients with spontaneous ICH who underwent a baseline NCCT within four hours of admission,followed by a follow-up scan after six hours or earlier if there was clinical deterioration.Hematoma volumes and imaging characteristics that predicted HE were evaluated.A simple five-point grading system score was created to predict HE.In RESULTS Of the 192 patients studied,HE was seen in 106(55.2%).The mean baseline hematoma volume was significantly greater among patients in the HE group(44.1 mL)compared to those in the non-HE group(12.2 mL),with a P-value<0.05.Additionally,imaging biomarkers such as the island sign,swirl sign,and black hole sign were observed with significantly higher frequency in the HE group relative to the non-HE cohort(all P-values<0.05).The island sign was strongly associated with HE[odds ratio(OR)13.7;95%confidence interval(CI):10.15-16.37;P<0.001].Similarly,the black hole sign(OR 9.4;95%CI:7.4-11.62;P<0.001)and the swirl sign(OR 5.2;95%CI:3.72-6.53;P<0.001)emerged as significant predictors of HE.Initial hematoma volume≥30 mL also showed a sig-nificant association(OR 1.9;95%CI:1.41-2.74;P=0.039).A five-point predictive scoring model demonstrated a strong positive association between increasing scores and the probability of HE.Specifically,the likelihood of HE corresponding to scores of 0,1,2,3,4,and 5 was 7.4%,37.5%,75%,85%,93.3%,and 100%,respectively.CONCLUSION The five variables demonstrated statistically significant associations with HE.This simple and practical 5-point prediction score can enable identification of patients at elevated risk of HE based on baseline NCCT findings.This can facilitate timely recognition of high-risk individuals who may benefit from targeted anti-expansion therapy.展开更多
基金Supported by Provincial Key Research Project of Henan Province,No.232102310081.
文摘BACKGROUND Major depressive disorder(MDD)and obesity(OB)are bidirectionally comorbid conditions with common neurobiological underpinnings.However,the neurocognitive mechanisms of their comorbidity remain poorly understood.AIM To examine regional abnormalities in spontaneous brain activity among patients with MDD-OB comorbidity.METHODS This study adopted a regional homogeneity(ReHo)analysis of resting-state functional magnetic resonance imaging.The study included 149 hospital patients divided into four groups:Patients experiencing their first episode of drug-naive MDD with OB,patients with MDD without OB,and age-and sex-matched healthy individuals with and without OB.Whole-brain ReHo analysis was conducted using SPM12 software and RESTplus toolkits,with group comparisons via ANOVA and post-hoc tests.Correlations between ReHo values and behavioral measures were examined.RESULTS ANOVA revealed significant whole-brain ReHo differences among the four groups in four key regions:The left middle temporal gyrus(MTG.L),right cuneus,left precuneus,and left thalamus.Post-hoc analyses confirmed pairwise differences between all groups across these regions(P<0.05).OB was associated with ReHo alterations in the MTG.L,right cuneus,and left thalamus,whereas abnormalities in the precuneus suggested synergistic pathological mechanisms between MDD and OB.Statistically significant correlations were found between the drive and fun-seeking dimensions of the behavioral activation system,as well as behavioral inhibition and the corresponding ReHo values.CONCLUSION Our findings provide novel evidence for the neuroadaptive mechanisms underlying the MDD-OB comorbidity.Further validation could lead to personalized interventions targeting MTG.L hyperactivity and targeting healthy food cues.
文摘BACKGROUND Edwardsiella tarda(E.tarda)belongs to the family Enterobacteriaceae and is generally seen to cause infections mainly in fish,but is also capable of infecting humans.Extraintestinal infections occur in patients with certain risk factors,including immunocompromised status.We recently diagnosed a case of spontaneous bacterial peritonitis(SBP)due to E.tarda in an immuno-compromised dialysis patient.CASE SUMMARY Patient was a 55-year-old male,with a history of diabetic nephropathy being treated with hemodialysis three times a week.He was referred to our hospital due to an increased volume of ascites,and blood examination revealed increased inflammatory reaction.At our emergency department,he developed fever,disturbance of consciousness,abdominal distension,and abdomen-wide pain.In addition,a dialysis shunt was confirmed in his right forearm,and the shunt site showed no signs of inflammation.No wounds were confirmed on or in his body.A blood examination revealed increased values of white blood cells,C-reactive protein,and creatinine.Plain chest and abdominal computed tomography scanning revealed increased ascites volume.Abdominal paracentesis was performed and a Gram stain revealed Gramnegative bacillus.These findings prompted diagnosis of SBP.The patient was admitted and treated with cefmetazole,causing fever resolution and symptom improvements.Later,E.tarda was identified in ascites culture.The patient improved with decreased inflammatory response and was discharged on the 12th day of hospitalization.The antibiotic was terminated after 14 days of treatment.SBP in this case may have developed from chronic renal failure and diabetes mellitus.CONCLUSION We report the first known case of SBP due to E.tarda in an immuno-compromised dialysis patient.
基金supported by the Quantum Science and Technology-National Science and Technology Major Project (Grant No.2024ZD0302502 for WZ)the National Natural Science Foundation of China(Grant No.92365210 for WZ)+1 种基金Tsinghua Initiative Scientific Research Program (for WZ)the project of Tsinghua University-Zhuhai Huafa Industrial Share Company Joint Institute for Architecture Optoelectronic Technologies (JIAOT,for YH)。
文摘To fully utilize the resources provided by optical fiber networks,a cross-band quantum light source generating photon pairs,where one photon in a pair is at C band and the other is at O band,is proposed in this work.This source is based on spontaneous four-wave mixing(SFWM)in a piece of shallow-ridge silicon waveguide.Theoretical analysis shows that the waveguide dispersion could be tailored by adjusting the ridge width,enabling broadband photon pair generation by SFWM across C band and O band.The spontaneous Raman scattering(SpRS)in silicon waveguides is also investigated experimentally.It shows that there are two regions in the spectrum of generated photons from SpRS,which could be used to achieve cross-band photon pair generation.A chip of shallow-ridge silicon waveguide samples with different ridge widths has been fabricated,through which cross-band photon pair generation is demonstrated experimentally.The experimental results show that the source can be achieved using dispersion-optimized shallow-ridge silicon waveguides.This cross-band quantum light source provides a way to develop new fiber-based quantum communication functions utilizing both C band and O band and extends applications of quantum networks.
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BACKGROUND Individuals with liver cirrhosis(LC)are likely to experience multiple infectious processes due to the immune dysfunction caused by the disease.Our hypothesis is that this group of patients is predisposed to fungal infections.To date,the incidence of spontaneous fungal peritonitis(SFP)has not been determined in Mexico;this endeavor is of great importance because many patients may be suffering from this condition without receiving targeted treatment,which may increase mortality.AIM To report the incidence of SFP in patients presenting with decompensated LC with ascites.METHODS This was a prospective,single-center,descriptive,observational and crosssectional study where patients presenting with decompensated LC with ascites were evaluated from November 2023 to May 2024 in Mexico City.Fungal cultures of ascites were performed and the samples kept in an incubator for 10 days to 14 days,and molecular tests(the API 20 C AUX test)were used for molecular characterization.RESULTS Of the 48 patients included,54.2%were women,77.1%had a comorbidity,47.9%had LC secondary to metabolic dysfunction,43.8%were classified as Child-Pugh C with a model for end-stage liver disease 3.0 median score of 22,and 10.4%were in secondary prophylaxis for spontaneous bacterial peritonitis(SBP).Only four patients had positive cultures where Candida parapsilosis and Candida albicans were isolated,with two of the four patients being positive for Rhodotorula minuta;an SBP incidence of 8.3%was thus calculated.Chronic kidney disease[P=0.012 and relative risk(RR)=15]and secondary prophylaxis for SBP(P=0.049 with RR=8.6)were statistically significant and associated with a high mortality risk(P=0.001 with RR=33).CONCLUSION The presence of infection of fungal origin in ascites in patients presenting with cirrhosis increases short-and medium-term mortality;therefore,it is recommended that fungal culture tests are performed in those patients who visit the emergency room or experience continuous admission with acute decompensation and no bacteria identified in ascites cultures,and even more so in patients with chronic kidney disease and a history of antibiotic use as prophylaxis for SBP.Further studies are needed for the identification of clinical and biochemical data that can help to define SFP so that its presence may be assessed without the need to wait for a positive fungal culture.Thus,treatment may be initiated early in the hope of having a positive impact on the prognosis in this group of patients.
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.
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.
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.
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.
基金the financial support from the National Natural Science Foundation of China under Grant Nos.12174323 and 12474199Fundamental Research Funds for Central Universities of China under Grant No.20720240144(RM)111 project B16029。
文摘The elastic properties of membranes are typically characterized by a few phenomenological parameters,including bending and Gaussian curvature moduli measuring the membrane rigidity against its deformation and topological change,as well as spontaneous curvature arising from the asymmetry between the two leaflets in the lipid bilayers.Though tether-based and fluctuationbased experiments are commonly utilized to measure the bending modulus,measuring the Gaussian curvature modulus and the spontaneous curvature of the membrane is considered to be much more difficult.In this paper,we study the buckling process of a circular membrane with nonzero spontaneous curvature under compressive stresses.It is found that when the stress exceeds a critical value,the circular membrane will transform from a spherical cap to a buckled shape,with its buckling degree enhanced with the increase of stress until its base is constricted to almost zero.As the stress-strain relationship of the buckled membrane strongly depends on the Gaussian curvature modulus and the spontaneous curvature,we therefore propose a method to determine the Gaussian curvature modulus and the spontaneous curvature simultaneously by measuring its stress-strain relationship during a buckling process.
基金the funding from National Natural Science Foundation of China(Grant No.52474105).
文摘Natural surfactants that are present in complex crude oil may induce spontaneous emulsification in the oil and brine phases that co-exist in rock pores.This process is known to be affected by the salinity of brine.However,the role of salinity in water-oil micro-emulsification is not fully understood.In this paper,we report on our experimental studies of the effect of salinity on spontaneous emulsification in a“mixture”of dodecane and brine.The dodecane contains SPAN 80 surfactant and brine with different salinity values,varying from 0.2%to 20%(by weight).For our observations,we use dynamic light scattering(DLS)technique to capture nano-scale emulsion formation and pendant drop method to observe micro-scale emulsion dynamics.The DLS experiments show that small(2.2 nm)and medium-sized emulsions(100 nm)are formed at low salinities,while at higher salinities only smaller droplets are formed and emulsification is reduced.In pendant drop experiments,dodecane and heptane systems were tested over 13 h.Heptane exhibited faster emulsification at water-oil interfaces in the cases with pure water and low salinity brine(0.2%),where the changes at interfacial area occurring within two hours and significant droplet shrinkage by 13 h.Lower salinity enhances micelle activity and emulsification,while higher salinities(2%,5%,and 20%)stabilize the oil-water interface and suppress emulsion formation.Dodecane exhibits a similar trend in emulsification but forms more stable emulsions and maintains a more stable water-oil interface compared to heptane.Additionally,we present the theory of reverse micelle exclusion through a theoretical derivation,providing a deeper understanding of the emulsification mechanism.Four distinct scenarios are schematically presented to explain the influence of salinity on spontaneous emulsification,illustrating how varying salinity levels affect micelle formation and emulsion behaviour.This study provides valuable insights into optimizing salinity levels in enhanced oil recovery.
基金supported by the National Natural Science Foundation of China(No.82070200)。
文摘Eosinophilic granulomatosis with polyangitis(EGPA)is a rare multi-system disease that presents significant diagnostic challenges due to its complexity and low incidence(White and Dubey,2023).It affects males and females equally,though males may exhibit more active disease at diagnosis and often require more aggressive treatment(Liu et al.,2023).The hallmark features of EGPA include delayed-onset asthma,eosinophilia in tissues and blood,and vasculitis affecting small to medium-sized arteries(White and Dubey,2023).EGPA falls under the category of antineutrophil cytoplasmic antibody(ANCA)-associated vasculitis(AAV),whereas only about half of EGPA patients test positive for ANCA(Khoury et al.,2023).
基金financial supports from National Natural Science Foundation of China(No.61905051)Natural Science Foundation of Heilongjiang Province(No.LH2020F027).
文摘Periodic metal nanoarrays serving as cavities can support directional-tunable amplified spontaneous emission that goes beyond the diffraction limit due to the hybrid states of surface plasmons and Bloch surface waves.Most of these modes'interactions remain within the weak coupling regime,yet strong coupling is also anticipated to occur.In this work,we present an intriguing case of amplified spontaneous emission(ASE),amplified by the splitting upper polariton mode within a strong coupling system,stemming from a square lattice of plasmonic cone lattices(PCLs).The PCLs are fabricated using an anodized aluminum oxide membrane(AAO),which facilitates strong coupling between surface plasmons and Bloch surface wave modes,with the maximum Rabi splitting observed at 0.258 eV for the sample with an aspect ratio of 0.33.A 13.5-fold increase in amplified spontaneous emission is recorded when the emission from Nile Red coincides with this flat energy branch of upper polariton,which exhibits a high photon density of states.Reduced group velocity can prolong photon lifetime and boost the probability of light-matter interaction.The observed ASE phenomenon in this strong coupling plasmonic system widens the scope for applications in nanolasing and polariton lasing.
文摘BACKGROUND Intracerebral hemorrhage(ICH)comprises 9%-27%of stroke patients.Hematoma expansion(HE)occurs in approximately 20%of patients following ICH,typically within the first 24 hours.HE increases mortality and long-term disability in these patients and is being investigated as a therapeutic target to improve the outcome in these patients by limiting HE.Non-contrast computed tomography(NCCT)has potential in predicting HE,which can identify the individuals at risk.AIM To evaluate NCCT markers for predicting HE in patients with ICH and to develop a simple,practical grading system for risk stratification.METHODS This prospective observational study evaluated 192 patients with spontaneous ICH who underwent a baseline NCCT within four hours of admission,followed by a follow-up scan after six hours or earlier if there was clinical deterioration.Hematoma volumes and imaging characteristics that predicted HE were evaluated.A simple five-point grading system score was created to predict HE.In RESULTS Of the 192 patients studied,HE was seen in 106(55.2%).The mean baseline hematoma volume was significantly greater among patients in the HE group(44.1 mL)compared to those in the non-HE group(12.2 mL),with a P-value<0.05.Additionally,imaging biomarkers such as the island sign,swirl sign,and black hole sign were observed with significantly higher frequency in the HE group relative to the non-HE cohort(all P-values<0.05).The island sign was strongly associated with HE[odds ratio(OR)13.7;95%confidence interval(CI):10.15-16.37;P<0.001].Similarly,the black hole sign(OR 9.4;95%CI:7.4-11.62;P<0.001)and the swirl sign(OR 5.2;95%CI:3.72-6.53;P<0.001)emerged as significant predictors of HE.Initial hematoma volume≥30 mL also showed a sig-nificant association(OR 1.9;95%CI:1.41-2.74;P=0.039).A five-point predictive scoring model demonstrated a strong positive association between increasing scores and the probability of HE.Specifically,the likelihood of HE corresponding to scores of 0,1,2,3,4,and 5 was 7.4%,37.5%,75%,85%,93.3%,and 100%,respectively.CONCLUSION The five variables demonstrated statistically significant associations with HE.This simple and practical 5-point prediction score can enable identification of patients at elevated risk of HE based on baseline NCCT findings.This can facilitate timely recognition of high-risk individuals who may benefit from targeted anti-expansion therapy.
