After the publication of History and Class Consciousness, the concept of totality became an important role through Georg Lukacs’ development of thought. Yet, this concept changed with his thinking. Indeed, totality a...After the publication of History and Class Consciousness, the concept of totality became an important role through Georg Lukacs’ development of thought. Yet, this concept changed with his thinking. Indeed, totality as an idea had emerged in his critique of capitalist culture in his pre-Marxism;we can claim that the concept of totality as Marxist dialectics originated in that period. Thus, it is necessary to interpret his idea of totality in pre-Marxism in order to understand wholly the concept of totality.展开更多
Setting out from the categories of totality and histori（ci）sm in Kosik＇s Dialectics of the Concrete, we look at the relationship between theory and praxis： empty, abstract totality versus concrete, reified and ali...Setting out from the categories of totality and histori（ci）sm in Kosik＇s Dialectics of the Concrete, we look at the relationship between theory and praxis： empty, abstract totality versus concrete, reified and alienated practice （Lukacs, Habermas, Honneth）; a bad totality, in which the real polydimensional subject is replaced by the one-dimensional, mythologized, fetishized, and economistically reduced ＂subject＂ of consummation （Marcuse, Baudrillard）. The dialectics of concrete totality implies a marxistic critique of the ethical and juristic universalism, in the context of the ＂positive＂ side of globalization and political unilateralism, as a concrete, militant, hegemonistic, post-colonial, and neo-imperial practice （Apel, Habermas, Chomsky, Zinoviev）; globalization as totali（tari）zation, the ＂last man,＂ the ＂end of history,＂ and the ＂end＂ of dialectics in its neo-liberal, eschatological, empty ideological ＂realization＂ （Hegel, Marx, Fukuyama, Arendt）; the totality of the （invariable） being as a pseudo-concrete and pseudo-dialectical ontologistic speculation （Heidegger）： A ＂return＂ to a concrete history and a return of the ＂positive＂ dialectics as a critical awareness, mind, and method in the discourse ＂game＂ of human＇s cognitive, creative, and practical powers. The assumption of Kosik＇s humanism is a synchrony of nature and history in the ＂absolute＂ totality of human＇s concrete existence （Lukacs, Goldmann, Adorno, Sartre, Kosik）.展开更多
The Comedy is another of Chen Yan's masterpieces of realism after The Backstage Clan and The Protagonist.The difference is that the portrayal of He Jiabei in The Comedy echoes the theoretical idea of"typical ...The Comedy is another of Chen Yan's masterpieces of realism after The Backstage Clan and The Protagonist.The difference is that the portrayal of He Jiabei in The Comedy echoes the theoretical idea of"typical characters under typical circumstances."Through studies on Chen Yan's writing in a tensive theoretical space of"typicality,"we find that he has applied several important"typical"theories to his novels.He Jiabei,as a"typical character under typical circumstances"no longer embodies the ideal value as did Yi Qin'e in The Protagonist.The function of this character regardsthe communication between individuals and thetimes,phenomenon and essence."Typical characters under typical circumstances"is a theory generated from an analysis of realism inseparable from the"totality"of the times and history.The focus of The Comedy,a novel based on this theory,has also shifted from creating characters with distinct traits toexploring the historical essence of theera of"comedy."展开更多
Builders of a New Life(Chuangyeshi)is a novel that takes a deep dive into the essence of historical materialism and dialectical materialism.The novel creates a literary form of political metanarrative and presents the...Builders of a New Life(Chuangyeshi)is a novel that takes a deep dive into the essence of historical materialism and dialectical materialism.The novel creates a literary form of political metanarrative and presents the literary narrative of the rural cooperative movement in China within the framework of socialist revolution,through a plot with the connotation of documentary political economy.At the literary narrative level,Builders of a New Life develops the narrative through the subjective perspectives of numerous characters,which pushes the development of the plot forward and bridges the text world with external reality.The result is the creation of a world of general literature unifying thought,emotion and action,along with the development of a distinctive epic narrative form.展开更多
This study investigates the distinct impacts of eastern Pacific(EP)and central Pacific(CP)El Niño events on winter shortwave solar radiation(SSR)in southern China,revealing different spatial distributions and und...This study investigates the distinct impacts of eastern Pacific(EP)and central Pacific(CP)El Niño events on winter shortwave solar radiation(SSR)in southern China,revealing different spatial distributions and underlying mechanisms.The results show that,during the developing winter of EP El Niño,significant SSR reductions occur in southwestern China and the east coast of southern China due to a strong,zonally extended Northwest Pacific anticyclone that transports moisture from the tropical Northwest Pacific and North Indian Ocean,while the northeast of southern China experiences a weak increase in SSR.In contrast,during the developing winter of CP El Niño,SSR decreases in the east of southern China with a significant decrease in the lower basin of the Yangtze River but an increase in the west of southern China with a remarkable increase in eastern Yunnan.The pronounced east-west dipole pattern in SSR anomalies is driven by a meridionally elongated Northwest Pacific anticyclone,which enhances northward moisture transport to the east of southern China while leaving western areas drier.Further research reveals that distinct moisture anomalies during the developing winter of EP and CP events result in divergent SSR distributions across southern China,primarily through modulating the total cloud cover.These findings highlight the critical need to differentiate between El Niño types when predicting medium and long-term variability of radiation in southern China.展开更多
BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different ...BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different factors.AIM To investigate the key determinants of aseptic loosening,we performed a systematic review and meta-analysis.METHODS A comprehensive search of PubMed,Web of Science,EMBASE,and the Cochrane Library was conducted,encompassing studies from database inception to January 1,2025.Meta-analyses were performed to evaluate factors associated with aseptic loosening following pTHA.Inclusion and exclusion criteria were systematically applied at each stage to ensure methodological transparency and reproducibility.Study quality was assessed using standardized categories.Pooled odds ratio(OR)with corresponding 95%confidence interval were calculated with random-or fixed-effects models to generate reliability estimates,and study heterogeneity was visualized using forest plots.Ten factors,categorized into patient-,surgeon-,and device-related domains,were reviewed and meta-analyzed.Funnel plot analysis demonstrated a relatively symmetrical distribution,suggesting minimal publication bias.RESULTS A meta-analysis of 20 studies(520789 participants)found a pooled prevalence of 1.96%.Significant risk factors for aseptic loosening after pTHA included elevated body mass index(OR=1.116,P<0.001),higher Charlson comorbidity index(OR=1.378,P<0.001),prosthesis-related factors(OR=1.497,P<0.001),and adverse lifestyles(OR=2.198,P=0.037).Protective factors were non-white race(OR=0.445,P<0.001)and favorable genetics(OR=0.723,P<0.001).Male sex increased risk(OR=1.232,P=0.016),while age and anatomy were not significant.Surgical expertise showed a slight protective effect(OR=1.048,P<0.001).A comprehensive understanding of the modifiable and non-modifiable factors contributing to aseptic loosening after pTHA requires consideration of patient-related factors,surgical expertise,and prosthesis characteristics.CONCLUSION The identification of these factors is critical for risk mitigation.High-risk patients should receive targeted counseling regarding individualized profiles.Further studies are warranted to establish clearer causal relationships and identify additional contributing factors.展开更多
BACKGROUND Salvage of the infected long stem revision total knee arthroplasty is challenging due to the presence of well-fixed ingrown or cemented stems.Reconstructive options are limited.Above knee amputation(AKA)is ...BACKGROUND Salvage of the infected long stem revision total knee arthroplasty is challenging due to the presence of well-fixed ingrown or cemented stems.Reconstructive options are limited.Above knee amputation(AKA)is often recommended.We present a surgical technique that was successfully used on four such patients to convert them to a knee fusion(KF)using a cephalomedullary nail.CASE SUMMARY Four patients with infected long stem revision knee replacements that refused AKA had a single stage removal of their infected revision total knee followed by a KF.They were all treated with a statically locked antegrade cephalomedullary fusion nail,augmented with antibiotic impregnated bone cement.All patients had successful limb salvage and were ambulatory with assistive devices at the time of last follow-up.All were infection free at an average follow-up of 25.5 months(range 16-31).CONCLUSION Single stage cephalomedullary nailing can result in a successful KF in patients with infected long stem revision total knees.展开更多
Leg-length discrepancy(LLD)in individuals experiencing total hip arthroplasty(THA)is related to a substantially higher fall risk,length of post-operative hospital in-patient stay,elevated implant-related adverse event...Leg-length discrepancy(LLD)in individuals experiencing total hip arthroplasty(THA)is related to a substantially higher fall risk,length of post-operative hospital in-patient stay,elevated implant-related adverse events,and earlier revision.Therefore,it is essential to try to avoid LLD when implanting a THA.Several studies focus on this issue,including the following:Accelerometer-based portable navigation system,preoperative digital templating,robot-assisted surgery,the anatomical marker positioning method(shoulder-to-shoulder)and the artificial intelligence-based three-dimensional planning software system.The aforementioned methods should be familiar to surgeons who perform THA procedures,as a fundamental objective of this surgical intervention is to avoid LLD.展开更多
BACKGROUND The optimal surgical approach for patients with primary glenohumeral osteoarthritis(GHOA)and an intact rotator cuff remains debated.While anatomic total shoulder arthroplasty(TSA)has traditionally been favo...BACKGROUND The optimal surgical approach for patients with primary glenohumeral osteoarthritis(GHOA)and an intact rotator cuff remains debated.While anatomic total shoulder arthroplasty(TSA)has traditionally been favoured,reverse TSA(RTSA)is increasingly utilized.AIM To systematically compare the outcomes of RTSA and TSA in this specific patient population.METHODS A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines.Retrospective comparative studies evaluating RTSA and TSA in patients with GHOA and intact rotator cuff were included.Key outcomes assessed included complication and reoperation rates,patient-reported outcome measures(PROMs),and range of motion.Risk of bias was assessed using the Risk of Bias in Non-randomized Studies of Interventions tool.RESULTS Twelve studies encompassing 1608 patients(580 RTSA,1028 TSA)met inclusion criteria.RTSA was associated with a lower reoperation rate compared to TSA[odds ratio=0.37;95%confidence interval(CI):0.14-0.94;P value=0.04],while no significant difference in overall complication rates was observed(odds ratio=0.47;95%CI:0.19-1.16;P value=0.10).RTSA patients showed superior outcomes in University of California Los Angeles,Simple Shoulder Test,and Shoulder Pain and Disability Index scores;however,the differences did not exceed the minimal clinically important difference.TSA patients had significantly better external rotation(mean difference=-9.0°;95%CI:-13.21 to-5.02;P value<0.0001).No significant differences were found in other range of motion measures or satisfaction scores.The overall methodological quality of included studies was moderate to serious.CONCLUSION In patients with GHOA and an intact rotator cuff,RTSA may offer comparable or improved outcomes to TSA with lower reoperation rates and similar complication profiles.Functional outcomes favour RTSA in certain patientreported outcome measures,while TSA retains an advantage in external rotation.Surgical decision-making should remain individualized based on patient characteristics and functional demands.展开更多
BACKGROUND Medial dished(MD)liner designs for cruciate-retaining(CR)total knee arthroplasty(TKA)are a relatively novel development.MD tibial inserts have a more constraining medial side,which allows for more similar k...BACKGROUND Medial dished(MD)liner designs for cruciate-retaining(CR)total knee arthroplasty(TKA)are a relatively novel development.MD tibial inserts have a more constraining medial side,which allows for more similar kinematics and function to a native knee.AIM To evaluate the clinical results and patient-reported outcomes after CR TKA procedures utilizing a kinematically designed medial dish system.METHODS A multicenter,retrospective cohort review of 139 primary elective TKAs utilizing a kinematically designed CR Knee System(JOURNEY™II CR MD;Smith and Nephew,Memphis,TN,United States)at three different institutions with a minimum of two years of follow-up.Demographic information,clinical outcomes,and patient-reported outcome measures were collected and analyzed.RESULTS With up to 3.7 years from surgery,overall implant survivorship was 98.6%.There were significant postoperative increases in the average Knee Injury and Osteoarthritis Outcome Score for Joint Replacement scores(17.4 at 6 months,26.1 points at two years or more,P<0.001).CONCLUSION The combination of high implant survivorship and substantial improvements in patient-reported outcome measures suggests that the medial dish tibial insert represents a safe and effective option within TKA.Additional investigation is necessary to evaluate the long-term survivorship of this design.展开更多
In this editorial,we reviewed the article by Fadlallah et al that was recently published in the World Journal of Clinical Oncology.The article provided a comprehensive and in-depth view of the management and treatment...In this editorial,we reviewed the article by Fadlallah et al that was recently published in the World Journal of Clinical Oncology.The article provided a comprehensive and in-depth view of the management and treatment of colorectal cancer(CRC),one of the leading causes of cancer-related morbidity and mortality worldwide.The article analyzed the therapeutic modalities and their sequencing,focusing on total neoadjuvant therapy for locally advanced rectal cancer.It highlighted the role of immunotherapy in tumors with high microsatellite instability or deficient mismatch repair,addressing recent advances that have improved prognosis and therapeutic response in localized and metastatic CRC.Innovations in surgical techniques,advanced radiotherapy,and systemic agents targeting specific mutational profiles are also discussed,reflecting on how they revolutionized clinical management.Circulating tumor DNA has emerged as a promising tool for detecting minimal residual disease,prognosis,and therapeutic monitoring,solidifying its role in precision oncology.This review emphasized the importance of technological and therapeutic advancements in improving clinical outcomes and personalizing CRC treatment.展开更多
BACKGROUND With the continuous development of laparoscopic techniques in recent years,laparoscopic total mesorectal excision(LapTME)and laparoscopic-assisted transanal total mesorectal excision(TaTME)have gradually be...BACKGROUND With the continuous development of laparoscopic techniques in recent years,laparoscopic total mesorectal excision(LapTME)and laparoscopic-assisted transanal total mesorectal excision(TaTME)have gradually become important surgical techniques for treating low-lying rectal cancer(LRC).However,there is still controversy over the efficacy and safety of these two surgical modalities in LRC treatment.AIM To compare the efficacy of LapTME vs TaTME in patients with LRC.METHODS Ninety-four patients with LRC who visited and were treated at the Affiliated Hengyang Hospital of Hunan Normal University&Hengyang Central Hospital between December 2022 and March 2024 were selected and divided into the LapTME(n=44)and TaTME(n=50)groups.Clinical operation indexes,postoperative recovery indicators,and postoperative complications were recorded.The anal resting pressure(ARP),anal maximum systolic pressure(MSP),and maximum tolerated volume(MTV)of the anal canal were also measured.The intestinal function of patients was evaluated by the Memorial Sloan Kettering Cancer Center(MSKCC)bowel function questionnaire.Serum norepinephrine(NE),adrenaline(AD),and cortisol(Cor)levels were measured.The Quality of Life Questionnaire Core 30(QLQC30)was used for quality of life assessment.RESULTS Compared with the LapTME group,the surgery time in the TaTME group was longer;intraoperative blood loss was low;time of anal exhaust,first postoperative ambulation,intestinal recovery,and hospital stay were shorter;and the distal incisal margin and specimen lengths were longer.The TaTME group also showed higher ARP,MSP,and MTV values and higher MSKCC and QLQ-C30 scores than the LapTME group 3 months postoperatively.Cor,AD,and NE levels were lower in the TaTME group than those in the LapTME group during recovery.CONCLUSION We demonstrated that TaTME better improved anal function,reduced postoperative stress,and accelerated postoperative recovery and,hence,was safer for patients with LRC.展开更多
With the continuous control of anthropogenic emissions,China’s air quality has improved significantly in recent years.Given this background,research on how the short-term exposure risks caused by air pollution in Chi...With the continuous control of anthropogenic emissions,China’s air quality has improved significantly in recent years.Given this background,research on how the short-term exposure risks caused by air pollution in China have changed is insufficient.This study utilized hourly concentration data from ground observation stations and the official air quality guidelines of the Ministry of Ecology and Environment of China and the World Health Organization as standards to systematically investigate the spatiotemporal characteristics and short-term exposure risks of air pollution in China from 2015 to 2022.The results indicate that various atmospheric pollutants except for ozone showed a decreasing trend yearly.Nationwide,both single pollutant air pollution days(SAPDs)and multiple pollutant air pollution days(MAPDs)showed varying degrees of reduction within 15 and 25 days,respectively.SAPD was dominated mainly by excessive PM_(2.5)and PM_(10)pollutants,while MAPD was dominated mainly by excessive pollutant combinations,including PM_(2.5)+PM_(10),CO+PM_(2.5)+PM_(10),and SO_(2)+PM_(2.5)+PM_(10).As the concentration of atmospheric pollutants decreased,the total excess risk(ER)decreased yearly from 2015 to 2022,but there were significant regional differences.Now,the ER is less than 0.25%in southern China,in the range of 0.25%-0.5%in the North China Plain and some cities in the northeast,and higher than 1%in the northwest.Particulate matter is currently the primary pollutant posing short-term exposure risk in China,especially due to the impact of sandstorm weather.This study indicates that China’s atmospheric cleaning action is significantly beneficial for reducing health risks.展开更多
To explore water level variations and their dynamic influence on the water quality of Huayang Lakes,the water level from 1967 to 2023 and water quality from 2015 to 2023 were analyzed using the Mann–Kendall trend tes...To explore water level variations and their dynamic influence on the water quality of Huayang Lakes,the water level from 1967 to 2023 and water quality from 2015 to 2023 were analyzed using the Mann–Kendall trend test,box plots,and violin plots.The results show a notable hydrological rhythm of water level alternation between dry and flood seasons in Huayang Lakes,with an average water level of 12.82 m and a monthly range of 11.21–17.24m.Since 2017,the water level of Huayang Rivers has shown a decreasing trend of–0.02 m/a.Total phosphorus(TP)has become the primary pollutant.The TP concentrations in Longgan Lake(the largest lake)during the dry,rising,flood,and retreating seasons from 2015 to 2023were 0.083,0.061,0.050,and 0.059 mg/L,respectively.The effect of water level on TP was mainly observed during the low-water period.When the water level in the dry season rose to 12.25 and 13.00 m,the percentage of TP exceeding 0.1 mg/L in Longgan Lake decreased to 55.8%and 33.3%,respectively.During the dry season,wind and wave disturbances caused the release of endogenous phosphorus in Huayang Lakes.This led to drastic fluctuations in TP concentration,reducing the correlation between water level and TP.When external control is limited,the water level during the dry season should be maintained between 12.25 and 13.0 m.Additionally,it is necessary to accelerate the restoration of submerged macrophyte species(such as Hydrilla verticillata and Vallisneria natans)in the Huayang Rivers.展开更多
Total hip arthroplasty for adults with sequelae from childhood hip disorders poses significant challenges due to altered anatomy.The paper published by Oommen et al reviews the essential management strategies for thes...Total hip arthroplasty for adults with sequelae from childhood hip disorders poses significant challenges due to altered anatomy.The paper published by Oommen et al reviews the essential management strategies for these complex cases.This article explores the integration of finite element analysis(FEA)to enhance surgical precision and outcomes.FEA provides detailed biomechanical insights,aiding in preoperative planning,implant design,and surgical technique optimization.By simulating implant configurations and assessing bone quality,FEA helps in customizing implants and evaluating surgical techniques like subtrochanteric shortening osteotomy.Advanced imaging techniques,such as 3D printing,virtual reality,and augmented reality,further enhance total hip arthroplasty precision.Future research should focus on validating FEA models,developing patient-specific simulations,and promoting multidisciplinary collaboration.Integrating FEA and advanced technologies in total hip arthroplasty can improve functional outcomes,reduce complications,and enhance quality of life for patients with childhood hip disorder sequelae.展开更多
BACKGROUND Gastric cancer is the most common malignancy of the digestive system and surgical resection is the primary treatment.Advances in surgical technology have reduced the risk of complications after radical gast...BACKGROUND Gastric cancer is the most common malignancy of the digestive system and surgical resection is the primary treatment.Advances in surgical technology have reduced the risk of complications after radical gastrectomy;however,post-surgical pancreatic fistula remain a serious issue.These fistulas can lead to abdominal infections,anastomotic leakage,increased costs,and pain;thus,early diagnosis and prevention are crucial for a better prognosis.Currently,C-reactive protein(CRP),procalcitonin(PCT),and total bilirubin(TBil)levels are used to predict post-operative infections and anastomotic leakage.However,their predictive value for pancreatic fistula after radical gastrectomy for gastric cancer remains unclear.The present study was conducted to determine their predictive value.AIM To determine the predictive value of CRP,PCT,and TBil levels for pancreatic fistula after gastric cancer surgery.METHODS In total,158 patients who underwent radical gastrectomy for gastric cancer at our hospital between January 2019 and January 2023 were included.The patients were assigned to a pancreatic fistula group or a non-pancreatic fistula group.Multivariate logistic analysis was conducted to assess the factors influencing development of a fistula.Receiver operating characteristic(ROC)curves were used to determine the predictive value of serum CRP,PCT,and TBil levels on day 1 postsurgery.RESULTS On day 1 post-surgery,the CRP,PCT,and TBil levels were significantly higher in the pancreatic fistula group than in the non-pancreatic fistula group(P<0.05).A higher fistula grade was associated with higher levels of the indices.Univariate analysis revealed significant differences in the presence of diabetes,hyperlipidemia,pancreatic injury,splenectomy,and the biomarker levels(P<0.05).Logistic multivariate analysis identified diabetes,hyperlipidemia,pancreatic injury,CRP level,and PCT level as independent risk factors.ROC curves yielded predictive values for CRP,PCT,and TBil levels,with the PCT level having the highest area under the curve(AUC)of 0.80[95%confidence interval(CI):0.72-0.90].Combined indicators improved the predictive value,with an AUC of 0.86(95%CI:0.78-0.93).CONCLUSION Elevated CRP,PCT,and TBil levels predict risk of pancreatic fistula post-gastrectomy for gastric cancer.展开更多
This article introduces a novel 20 V radiation-hardened high-voltage metal-oxide-semiconductor field-effect transistor(MOSFET)driver with an optimized input circuit and a drain-surrounding-source(DSS)structure.The inp...This article introduces a novel 20 V radiation-hardened high-voltage metal-oxide-semiconductor field-effect transistor(MOSFET)driver with an optimized input circuit and a drain-surrounding-source(DSS)structure.The input circuit of a conventional inverter consists of a thick-gate-oxide n-type MOSFET(NMOS).These conventional drivers can tolerate a total ionizing dose(TID)of up to 100 krad(Si).In contrast,the proposed comparator input circuit uses both a thick-gate-oxide p-type MOSFET(PMOS)and thin-gate-oxide NMOS to offer a high input voltage and higher TID tolerance.Because the thick-gate-oxide PMOS and thin-gate-oxide NMOS collectively provide better TID tolerance than the thick-gate-oxide NMOS,the circuit exhibits enhanced TID tolerance of>300 krad(Si).Simulations and experimental date indicate that the DSS structure reduces the probability of unwanted parasitic bipolar junction transistor activation,yielding a better single-event effect tolerance of over 81.8 MeVcm^(2)mg^(-1).The innovative strategy proposed in this study involves circuit and layout design optimization,and does not require any specialized process flow.Hence,the proposed circuit can be manufactured using common commercial 0.35μm BCD processes.展开更多
The alpine ecosystem has great potential for carbon sequestration.Soil organic carbon(SOC)and total nitrogen(TN)are highly sensitive to climate change,and their dynamics are crucial to revealing the effect of climate ...The alpine ecosystem has great potential for carbon sequestration.Soil organic carbon(SOC)and total nitrogen(TN)are highly sensitive to climate change,and their dynamics are crucial to revealing the effect of climate change on the structure,function,and services of the ecosystem.However,the spatial distribution and controlling factors of SOC and TN across various soil layers and vegetation types within this unique ecosystem remain inadequately understood.In this study,256 soil samples in 89 sites were collected from the Three River Headwaters Region(TRHR)in China to investigate SOC and TN and to explore the primary factors affecting their distribution,including soil,vegetation,climate,and geography factors.The results show that SOC and TN contents in 0-20,20-40,40-60,and 60-80 cm soil layers are 24.40,18.03,14.04,12.40 g/kg and 2.46,1.90,1.51,1.17 g/kg,respectively;with higher concentrations observed in the southeastern region compared to the northwest of the TRHR.One-way analysis of variance reveals that SOC and TN levels are elevated in the alpine meadow and the alpine shrub relative to the alpine steppe in the 0-60 cm soil layers.The structural equation model explores that soil water content is the main controlling factor affecting the variation of SOC and TN.Moreover,the geography,climate,and vegetation factors notably indirectly affect SOC and TN through soil factors.Therefore,it can effectively improve soil water and nutrient conditions through vegetation restoration,soil improvement,and grazing management,and the change of SOC and TN can be fully understood by establishing monitoring networks to better protect soil carbon and nitrogen.展开更多
Continuous research on Cephalotaxus plants has ultimately led to the US food and drug administration (FDA) ap-provalof homoharringtonine in 2012 for the treatment of chronic myeloid leukemia. Additionally, another imp...Continuous research on Cephalotaxus plants has ultimately led to the US food and drug administration (FDA) ap-provalof homoharringtonine in 2012 for the treatment of chronic myeloid leukemia. Additionally, another important class of natural products from Cephalotaxus plants is cephalotane diterpenoids. Since the discovery of the first member, harring-tonolide,in 1978, cephalotane diterpenoids have garnered significant attention from the scientific community due to their re-markableanti-cancer activity. The unique structural features of cephalotane diterpenoids, a 7/6/5/6-fused tetracyclic carbon skeleton and a bridged lactone, make them ideal targets for synthetic chemists. Successfully synthesizing these complex diterpenoids is of great importance for the discovery and development of anti-tumor drugs. To date, ten research groups have completed the total synthesis of 24 cephalotane diterpenoids. The latest progress in the total synthesis of cephalotane diterpe-noidsis reviewed, showcasing the importance of these innovative synthetic strategies in the efficient synthesis of complex natural products and their potential significance in advancing the field of drug discovery.展开更多
文摘After the publication of History and Class Consciousness, the concept of totality became an important role through Georg Lukacs’ development of thought. Yet, this concept changed with his thinking. Indeed, totality as an idea had emerged in his critique of capitalist culture in his pre-Marxism;we can claim that the concept of totality as Marxist dialectics originated in that period. Thus, it is necessary to interpret his idea of totality in pre-Marxism in order to understand wholly the concept of totality.
文摘Setting out from the categories of totality and histori（ci）sm in Kosik＇s Dialectics of the Concrete, we look at the relationship between theory and praxis： empty, abstract totality versus concrete, reified and alienated practice （Lukacs, Habermas, Honneth）; a bad totality, in which the real polydimensional subject is replaced by the one-dimensional, mythologized, fetishized, and economistically reduced ＂subject＂ of consummation （Marcuse, Baudrillard）. The dialectics of concrete totality implies a marxistic critique of the ethical and juristic universalism, in the context of the ＂positive＂ side of globalization and political unilateralism, as a concrete, militant, hegemonistic, post-colonial, and neo-imperial practice （Apel, Habermas, Chomsky, Zinoviev）; globalization as totali（tari）zation, the ＂last man,＂ the ＂end of history,＂ and the ＂end＂ of dialectics in its neo-liberal, eschatological, empty ideological ＂realization＂ （Hegel, Marx, Fukuyama, Arendt）; the totality of the （invariable） being as a pseudo-concrete and pseudo-dialectical ontologistic speculation （Heidegger）： A ＂return＂ to a concrete history and a return of the ＂positive＂ dialectics as a critical awareness, mind, and method in the discourse ＂game＂ of human＇s cognitive, creative, and practical powers. The assumption of Kosik＇s humanism is a synchrony of nature and history in the ＂absolute＂ totality of human＇s concrete existence （Lukacs, Goldmann, Adorno, Sartre, Kosik）.
文摘The Comedy is another of Chen Yan's masterpieces of realism after The Backstage Clan and The Protagonist.The difference is that the portrayal of He Jiabei in The Comedy echoes the theoretical idea of"typical characters under typical circumstances."Through studies on Chen Yan's writing in a tensive theoretical space of"typicality,"we find that he has applied several important"typical"theories to his novels.He Jiabei,as a"typical character under typical circumstances"no longer embodies the ideal value as did Yi Qin'e in The Protagonist.The function of this character regardsthe communication between individuals and thetimes,phenomenon and essence."Typical characters under typical circumstances"is a theory generated from an analysis of realism inseparable from the"totality"of the times and history.The focus of The Comedy,a novel based on this theory,has also shifted from creating characters with distinct traits toexploring the historical essence of theera of"comedy."
文摘Builders of a New Life(Chuangyeshi)is a novel that takes a deep dive into the essence of historical materialism and dialectical materialism.The novel creates a literary form of political metanarrative and presents the literary narrative of the rural cooperative movement in China within the framework of socialist revolution,through a plot with the connotation of documentary political economy.At the literary narrative level,Builders of a New Life develops the narrative through the subjective perspectives of numerous characters,which pushes the development of the plot forward and bridges the text world with external reality.The result is the creation of a world of general literature unifying thought,emotion and action,along with the development of a distinctive epic narrative form.
基金funded by a Project from China Southern Power Grid Company Ltd.(Nos.ZBKJXM20232481 and ZBKJXM20232482)。
文摘This study investigates the distinct impacts of eastern Pacific(EP)and central Pacific(CP)El Niño events on winter shortwave solar radiation(SSR)in southern China,revealing different spatial distributions and underlying mechanisms.The results show that,during the developing winter of EP El Niño,significant SSR reductions occur in southwestern China and the east coast of southern China due to a strong,zonally extended Northwest Pacific anticyclone that transports moisture from the tropical Northwest Pacific and North Indian Ocean,while the northeast of southern China experiences a weak increase in SSR.In contrast,during the developing winter of CP El Niño,SSR decreases in the east of southern China with a significant decrease in the lower basin of the Yangtze River but an increase in the west of southern China with a remarkable increase in eastern Yunnan.The pronounced east-west dipole pattern in SSR anomalies is driven by a meridionally elongated Northwest Pacific anticyclone,which enhances northward moisture transport to the east of southern China while leaving western areas drier.Further research reveals that distinct moisture anomalies during the developing winter of EP and CP events result in divergent SSR distributions across southern China,primarily through modulating the total cloud cover.These findings highlight the critical need to differentiate between El Niño types when predicting medium and long-term variability of radiation in southern China.
基金Supported by the National Natural Science Foundation of China,No.82402789Beijing Jishuitan Hospital Youcai Plan,No.KYYC202402+2 种基金Beijing Jishuitan Research Funding,No.HL202402and Beijing Natural Science Foundation,No.L232062No.L222063.
文摘BACKGROUND Aseptic loosening remains the leading cause of revision in primary total hip arthroplasty(pTHA).However,the literature demonstrates significant variability regarding the relative contributions of different factors.AIM To investigate the key determinants of aseptic loosening,we performed a systematic review and meta-analysis.METHODS A comprehensive search of PubMed,Web of Science,EMBASE,and the Cochrane Library was conducted,encompassing studies from database inception to January 1,2025.Meta-analyses were performed to evaluate factors associated with aseptic loosening following pTHA.Inclusion and exclusion criteria were systematically applied at each stage to ensure methodological transparency and reproducibility.Study quality was assessed using standardized categories.Pooled odds ratio(OR)with corresponding 95%confidence interval were calculated with random-or fixed-effects models to generate reliability estimates,and study heterogeneity was visualized using forest plots.Ten factors,categorized into patient-,surgeon-,and device-related domains,were reviewed and meta-analyzed.Funnel plot analysis demonstrated a relatively symmetrical distribution,suggesting minimal publication bias.RESULTS A meta-analysis of 20 studies(520789 participants)found a pooled prevalence of 1.96%.Significant risk factors for aseptic loosening after pTHA included elevated body mass index(OR=1.116,P<0.001),higher Charlson comorbidity index(OR=1.378,P<0.001),prosthesis-related factors(OR=1.497,P<0.001),and adverse lifestyles(OR=2.198,P=0.037).Protective factors were non-white race(OR=0.445,P<0.001)and favorable genetics(OR=0.723,P<0.001).Male sex increased risk(OR=1.232,P=0.016),while age and anatomy were not significant.Surgical expertise showed a slight protective effect(OR=1.048,P<0.001).A comprehensive understanding of the modifiable and non-modifiable factors contributing to aseptic loosening after pTHA requires consideration of patient-related factors,surgical expertise,and prosthesis characteristics.CONCLUSION The identification of these factors is critical for risk mitigation.High-risk patients should receive targeted counseling regarding individualized profiles.Further studies are warranted to establish clearer causal relationships and identify additional contributing factors.
文摘BACKGROUND Salvage of the infected long stem revision total knee arthroplasty is challenging due to the presence of well-fixed ingrown or cemented stems.Reconstructive options are limited.Above knee amputation(AKA)is often recommended.We present a surgical technique that was successfully used on four such patients to convert them to a knee fusion(KF)using a cephalomedullary nail.CASE SUMMARY Four patients with infected long stem revision knee replacements that refused AKA had a single stage removal of their infected revision total knee followed by a KF.They were all treated with a statically locked antegrade cephalomedullary fusion nail,augmented with antibiotic impregnated bone cement.All patients had successful limb salvage and were ambulatory with assistive devices at the time of last follow-up.All were infection free at an average follow-up of 25.5 months(range 16-31).CONCLUSION Single stage cephalomedullary nailing can result in a successful KF in patients with infected long stem revision total knees.
文摘Leg-length discrepancy(LLD)in individuals experiencing total hip arthroplasty(THA)is related to a substantially higher fall risk,length of post-operative hospital in-patient stay,elevated implant-related adverse events,and earlier revision.Therefore,it is essential to try to avoid LLD when implanting a THA.Several studies focus on this issue,including the following:Accelerometer-based portable navigation system,preoperative digital templating,robot-assisted surgery,the anatomical marker positioning method(shoulder-to-shoulder)and the artificial intelligence-based three-dimensional planning software system.The aforementioned methods should be familiar to surgeons who perform THA procedures,as a fundamental objective of this surgical intervention is to avoid LLD.
文摘BACKGROUND The optimal surgical approach for patients with primary glenohumeral osteoarthritis(GHOA)and an intact rotator cuff remains debated.While anatomic total shoulder arthroplasty(TSA)has traditionally been favoured,reverse TSA(RTSA)is increasingly utilized.AIM To systematically compare the outcomes of RTSA and TSA in this specific patient population.METHODS A systematic review and meta-analysis were conducted in accordance with PRISMA guidelines.Retrospective comparative studies evaluating RTSA and TSA in patients with GHOA and intact rotator cuff were included.Key outcomes assessed included complication and reoperation rates,patient-reported outcome measures(PROMs),and range of motion.Risk of bias was assessed using the Risk of Bias in Non-randomized Studies of Interventions tool.RESULTS Twelve studies encompassing 1608 patients(580 RTSA,1028 TSA)met inclusion criteria.RTSA was associated with a lower reoperation rate compared to TSA[odds ratio=0.37;95%confidence interval(CI):0.14-0.94;P value=0.04],while no significant difference in overall complication rates was observed(odds ratio=0.47;95%CI:0.19-1.16;P value=0.10).RTSA patients showed superior outcomes in University of California Los Angeles,Simple Shoulder Test,and Shoulder Pain and Disability Index scores;however,the differences did not exceed the minimal clinically important difference.TSA patients had significantly better external rotation(mean difference=-9.0°;95%CI:-13.21 to-5.02;P value<0.0001).No significant differences were found in other range of motion measures or satisfaction scores.The overall methodological quality of included studies was moderate to serious.CONCLUSION In patients with GHOA and an intact rotator cuff,RTSA may offer comparable or improved outcomes to TSA with lower reoperation rates and similar complication profiles.Functional outcomes favour RTSA in certain patientreported outcome measures,while TSA retains an advantage in external rotation.Surgical decision-making should remain individualized based on patient characteristics and functional demands.
文摘BACKGROUND Medial dished(MD)liner designs for cruciate-retaining(CR)total knee arthroplasty(TKA)are a relatively novel development.MD tibial inserts have a more constraining medial side,which allows for more similar kinematics and function to a native knee.AIM To evaluate the clinical results and patient-reported outcomes after CR TKA procedures utilizing a kinematically designed medial dish system.METHODS A multicenter,retrospective cohort review of 139 primary elective TKAs utilizing a kinematically designed CR Knee System(JOURNEY™II CR MD;Smith and Nephew,Memphis,TN,United States)at three different institutions with a minimum of two years of follow-up.Demographic information,clinical outcomes,and patient-reported outcome measures were collected and analyzed.RESULTS With up to 3.7 years from surgery,overall implant survivorship was 98.6%.There were significant postoperative increases in the average Knee Injury and Osteoarthritis Outcome Score for Joint Replacement scores(17.4 at 6 months,26.1 points at two years or more,P<0.001).CONCLUSION The combination of high implant survivorship and substantial improvements in patient-reported outcome measures suggests that the medial dish tibial insert represents a safe and effective option within TKA.Additional investigation is necessary to evaluate the long-term survivorship of this design.
文摘In this editorial,we reviewed the article by Fadlallah et al that was recently published in the World Journal of Clinical Oncology.The article provided a comprehensive and in-depth view of the management and treatment of colorectal cancer(CRC),one of the leading causes of cancer-related morbidity and mortality worldwide.The article analyzed the therapeutic modalities and their sequencing,focusing on total neoadjuvant therapy for locally advanced rectal cancer.It highlighted the role of immunotherapy in tumors with high microsatellite instability or deficient mismatch repair,addressing recent advances that have improved prognosis and therapeutic response in localized and metastatic CRC.Innovations in surgical techniques,advanced radiotherapy,and systemic agents targeting specific mutational profiles are also discussed,reflecting on how they revolutionized clinical management.Circulating tumor DNA has emerged as a promising tool for detecting minimal residual disease,prognosis,and therapeutic monitoring,solidifying its role in precision oncology.This review emphasized the importance of technological and therapeutic advancements in improving clinical outcomes and personalizing CRC treatment.
基金Supported by Health Research Project of Hunan Provincial Health Commission,No.D202315018915.
文摘BACKGROUND With the continuous development of laparoscopic techniques in recent years,laparoscopic total mesorectal excision(LapTME)and laparoscopic-assisted transanal total mesorectal excision(TaTME)have gradually become important surgical techniques for treating low-lying rectal cancer(LRC).However,there is still controversy over the efficacy and safety of these two surgical modalities in LRC treatment.AIM To compare the efficacy of LapTME vs TaTME in patients with LRC.METHODS Ninety-four patients with LRC who visited and were treated at the Affiliated Hengyang Hospital of Hunan Normal University&Hengyang Central Hospital between December 2022 and March 2024 were selected and divided into the LapTME(n=44)and TaTME(n=50)groups.Clinical operation indexes,postoperative recovery indicators,and postoperative complications were recorded.The anal resting pressure(ARP),anal maximum systolic pressure(MSP),and maximum tolerated volume(MTV)of the anal canal were also measured.The intestinal function of patients was evaluated by the Memorial Sloan Kettering Cancer Center(MSKCC)bowel function questionnaire.Serum norepinephrine(NE),adrenaline(AD),and cortisol(Cor)levels were measured.The Quality of Life Questionnaire Core 30(QLQC30)was used for quality of life assessment.RESULTS Compared with the LapTME group,the surgery time in the TaTME group was longer;intraoperative blood loss was low;time of anal exhaust,first postoperative ambulation,intestinal recovery,and hospital stay were shorter;and the distal incisal margin and specimen lengths were longer.The TaTME group also showed higher ARP,MSP,and MTV values and higher MSKCC and QLQ-C30 scores than the LapTME group 3 months postoperatively.Cor,AD,and NE levels were lower in the TaTME group than those in the LapTME group during recovery.CONCLUSION We demonstrated that TaTME better improved anal function,reduced postoperative stress,and accelerated postoperative recovery and,hence,was safer for patients with LRC.
基金supported by the National Natural Science Foundation of China(No.42205178)China Postdoctoral Science Foundation(No.2022M720459).
文摘With the continuous control of anthropogenic emissions,China’s air quality has improved significantly in recent years.Given this background,research on how the short-term exposure risks caused by air pollution in China have changed is insufficient.This study utilized hourly concentration data from ground observation stations and the official air quality guidelines of the Ministry of Ecology and Environment of China and the World Health Organization as standards to systematically investigate the spatiotemporal characteristics and short-term exposure risks of air pollution in China from 2015 to 2022.The results indicate that various atmospheric pollutants except for ozone showed a decreasing trend yearly.Nationwide,both single pollutant air pollution days(SAPDs)and multiple pollutant air pollution days(MAPDs)showed varying degrees of reduction within 15 and 25 days,respectively.SAPD was dominated mainly by excessive PM_(2.5)and PM_(10)pollutants,while MAPD was dominated mainly by excessive pollutant combinations,including PM_(2.5)+PM_(10),CO+PM_(2.5)+PM_(10),and SO_(2)+PM_(2.5)+PM_(10).As the concentration of atmospheric pollutants decreased,the total excess risk(ER)decreased yearly from 2015 to 2022,but there were significant regional differences.Now,the ER is less than 0.25%in southern China,in the range of 0.25%-0.5%in the North China Plain and some cities in the northeast,and higher than 1%in the northwest.Particulate matter is currently the primary pollutant posing short-term exposure risk in China,especially due to the impact of sandstorm weather.This study indicates that China’s atmospheric cleaning action is significantly beneficial for reducing health risks.
基金The Joint Research Project for Yangtze River Conservation,No.2022-LHYJ-02-0504-05-08Anhui Provincial Scientific Research Project for Universities,China No.2023AH050508。
文摘To explore water level variations and their dynamic influence on the water quality of Huayang Lakes,the water level from 1967 to 2023 and water quality from 2015 to 2023 were analyzed using the Mann–Kendall trend test,box plots,and violin plots.The results show a notable hydrological rhythm of water level alternation between dry and flood seasons in Huayang Lakes,with an average water level of 12.82 m and a monthly range of 11.21–17.24m.Since 2017,the water level of Huayang Rivers has shown a decreasing trend of–0.02 m/a.Total phosphorus(TP)has become the primary pollutant.The TP concentrations in Longgan Lake(the largest lake)during the dry,rising,flood,and retreating seasons from 2015 to 2023were 0.083,0.061,0.050,and 0.059 mg/L,respectively.The effect of water level on TP was mainly observed during the low-water period.When the water level in the dry season rose to 12.25 and 13.00 m,the percentage of TP exceeding 0.1 mg/L in Longgan Lake decreased to 55.8%and 33.3%,respectively.During the dry season,wind and wave disturbances caused the release of endogenous phosphorus in Huayang Lakes.This led to drastic fluctuations in TP concentration,reducing the correlation between water level and TP.When external control is limited,the water level during the dry season should be maintained between 12.25 and 13.0 m.Additionally,it is necessary to accelerate the restoration of submerged macrophyte species(such as Hydrilla verticillata and Vallisneria natans)in the Huayang Rivers.
文摘Total hip arthroplasty for adults with sequelae from childhood hip disorders poses significant challenges due to altered anatomy.The paper published by Oommen et al reviews the essential management strategies for these complex cases.This article explores the integration of finite element analysis(FEA)to enhance surgical precision and outcomes.FEA provides detailed biomechanical insights,aiding in preoperative planning,implant design,and surgical technique optimization.By simulating implant configurations and assessing bone quality,FEA helps in customizing implants and evaluating surgical techniques like subtrochanteric shortening osteotomy.Advanced imaging techniques,such as 3D printing,virtual reality,and augmented reality,further enhance total hip arthroplasty precision.Future research should focus on validating FEA models,developing patient-specific simulations,and promoting multidisciplinary collaboration.Integrating FEA and advanced technologies in total hip arthroplasty can improve functional outcomes,reduce complications,and enhance quality of life for patients with childhood hip disorder sequelae.
文摘BACKGROUND Gastric cancer is the most common malignancy of the digestive system and surgical resection is the primary treatment.Advances in surgical technology have reduced the risk of complications after radical gastrectomy;however,post-surgical pancreatic fistula remain a serious issue.These fistulas can lead to abdominal infections,anastomotic leakage,increased costs,and pain;thus,early diagnosis and prevention are crucial for a better prognosis.Currently,C-reactive protein(CRP),procalcitonin(PCT),and total bilirubin(TBil)levels are used to predict post-operative infections and anastomotic leakage.However,their predictive value for pancreatic fistula after radical gastrectomy for gastric cancer remains unclear.The present study was conducted to determine their predictive value.AIM To determine the predictive value of CRP,PCT,and TBil levels for pancreatic fistula after gastric cancer surgery.METHODS In total,158 patients who underwent radical gastrectomy for gastric cancer at our hospital between January 2019 and January 2023 were included.The patients were assigned to a pancreatic fistula group or a non-pancreatic fistula group.Multivariate logistic analysis was conducted to assess the factors influencing development of a fistula.Receiver operating characteristic(ROC)curves were used to determine the predictive value of serum CRP,PCT,and TBil levels on day 1 postsurgery.RESULTS On day 1 post-surgery,the CRP,PCT,and TBil levels were significantly higher in the pancreatic fistula group than in the non-pancreatic fistula group(P<0.05).A higher fistula grade was associated with higher levels of the indices.Univariate analysis revealed significant differences in the presence of diabetes,hyperlipidemia,pancreatic injury,splenectomy,and the biomarker levels(P<0.05).Logistic multivariate analysis identified diabetes,hyperlipidemia,pancreatic injury,CRP level,and PCT level as independent risk factors.ROC curves yielded predictive values for CRP,PCT,and TBil levels,with the PCT level having the highest area under the curve(AUC)of 0.80[95%confidence interval(CI):0.72-0.90].Combined indicators improved the predictive value,with an AUC of 0.86(95%CI:0.78-0.93).CONCLUSION Elevated CRP,PCT,and TBil levels predict risk of pancreatic fistula post-gastrectomy for gastric cancer.
基金supported by the National Natural Science Foundation of China(U2241221).
文摘This article introduces a novel 20 V radiation-hardened high-voltage metal-oxide-semiconductor field-effect transistor(MOSFET)driver with an optimized input circuit and a drain-surrounding-source(DSS)structure.The input circuit of a conventional inverter consists of a thick-gate-oxide n-type MOSFET(NMOS).These conventional drivers can tolerate a total ionizing dose(TID)of up to 100 krad(Si).In contrast,the proposed comparator input circuit uses both a thick-gate-oxide p-type MOSFET(PMOS)and thin-gate-oxide NMOS to offer a high input voltage and higher TID tolerance.Because the thick-gate-oxide PMOS and thin-gate-oxide NMOS collectively provide better TID tolerance than the thick-gate-oxide NMOS,the circuit exhibits enhanced TID tolerance of>300 krad(Si).Simulations and experimental date indicate that the DSS structure reduces the probability of unwanted parasitic bipolar junction transistor activation,yielding a better single-event effect tolerance of over 81.8 MeVcm^(2)mg^(-1).The innovative strategy proposed in this study involves circuit and layout design optimization,and does not require any specialized process flow.Hence,the proposed circuit can be manufactured using common commercial 0.35μm BCD processes.
基金supported by the National Science Foundation for Distinguished Young Scholars(No.42425107)Ecological Civilization Special Project of Key Research&and Development Program in Gansu Province(No.24YFFA009)the Top Talent Project of Gansu Province,Chinese Academy of Sciences Young Crossover Team Project(No.JCTD-2022-18)。
文摘The alpine ecosystem has great potential for carbon sequestration.Soil organic carbon(SOC)and total nitrogen(TN)are highly sensitive to climate change,and their dynamics are crucial to revealing the effect of climate change on the structure,function,and services of the ecosystem.However,the spatial distribution and controlling factors of SOC and TN across various soil layers and vegetation types within this unique ecosystem remain inadequately understood.In this study,256 soil samples in 89 sites were collected from the Three River Headwaters Region(TRHR)in China to investigate SOC and TN and to explore the primary factors affecting their distribution,including soil,vegetation,climate,and geography factors.The results show that SOC and TN contents in 0-20,20-40,40-60,and 60-80 cm soil layers are 24.40,18.03,14.04,12.40 g/kg and 2.46,1.90,1.51,1.17 g/kg,respectively;with higher concentrations observed in the southeastern region compared to the northwest of the TRHR.One-way analysis of variance reveals that SOC and TN levels are elevated in the alpine meadow and the alpine shrub relative to the alpine steppe in the 0-60 cm soil layers.The structural equation model explores that soil water content is the main controlling factor affecting the variation of SOC and TN.Moreover,the geography,climate,and vegetation factors notably indirectly affect SOC and TN through soil factors.Therefore,it can effectively improve soil water and nutrient conditions through vegetation restoration,soil improvement,and grazing management,and the change of SOC and TN can be fully understood by establishing monitoring networks to better protect soil carbon and nitrogen.
文摘Continuous research on Cephalotaxus plants has ultimately led to the US food and drug administration (FDA) ap-provalof homoharringtonine in 2012 for the treatment of chronic myeloid leukemia. Additionally, another important class of natural products from Cephalotaxus plants is cephalotane diterpenoids. Since the discovery of the first member, harring-tonolide,in 1978, cephalotane diterpenoids have garnered significant attention from the scientific community due to their re-markableanti-cancer activity. The unique structural features of cephalotane diterpenoids, a 7/6/5/6-fused tetracyclic carbon skeleton and a bridged lactone, make them ideal targets for synthetic chemists. Successfully synthesizing these complex diterpenoids is of great importance for the discovery and development of anti-tumor drugs. To date, ten research groups have completed the total synthesis of 24 cephalotane diterpenoids. The latest progress in the total synthesis of cephalotane diterpe-noidsis reviewed, showcasing the importance of these innovative synthetic strategies in the efficient synthesis of complex natural products and their potential significance in advancing the field of drug discovery.
