Objective To investigate the clinical predictors of malperfusion in patients with acute type A aortic dissection(ATAAD)and to construct a diagnostic model to identify high-risk individuals.Methods A retrospective anal...Objective To investigate the clinical predictors of malperfusion in patients with acute type A aortic dissection(ATAAD)and to construct a diagnostic model to identify high-risk individuals.Methods A retrospective analysis of 553 ATAAD patients from Tongji Hospital divided into malperfusion and non-malperfusion groups was conducted.Logistic regression was used to identify independent predictors of the outcome.Model performance via the Hosmer–Lemeshow test,decision curve analysis(DCA),the area under the receiver operating characteristic curve(AUC),sensitivity,specificity,and predictive values.Results Malperfusion was observed in 28.4%of ATAAD patients.Significant predictors included elevated lactate dehydrogenase(LDH)(OR:1.0019,95%CI:1.0002–1.0036,P=0.027),alanine aminotransferase(ALT)(OR:0.9936,95%CI:0.987–1.000,P=0.046)and estimated glomerular filtration rate(eGFR)(OR:0.9877,95%CI:0.977–0.998,P=0.021),suggesting roles for tissue ischemia and impaired renal or hepatic function.Other variables,such as D-dimer,uric acid,creatinine,and NT-proBNP,showed trends toward significance but did not reach the 0.05 threshold.The model demonstrated good calibration(Hosmer–Lemeshow P=0.318),moderate discriminatory power(AUC=0.725),high specificity(93.62%),and low sensitivity(26.75%).Conclusion The model based on routine biochemical markers provides a practical approach for the early identification of malperfusion in ATAAD patients.It shows strong specificity and clinical utility,although its limited sensitivity highlights the need for further refinement.Future improvements should focus on incorporating additional clinical or imaging data to increase diagnostic accuracy.展开更多
BACKGROUND Rhabdomyolysis(RML)as an etiological factor causing acute kidney injury(AKI)is sparsely reported in the literature.AIM To study the incidence of RML after surgical repair of an ascending aortic dissection(A...BACKGROUND Rhabdomyolysis(RML)as an etiological factor causing acute kidney injury(AKI)is sparsely reported in the literature.AIM To study the incidence of RML after surgical repair of an ascending aortic dissection(AAD)and to correlate with the outcome,especially regarding renal function.To pinpoint the perioperative risk factors associated with the development of RML and adverse renal outcomes after aortic dissection repair.METHODS Retrospective single-center cohort study conducted in a tertiary cardiac center.We included all patients who underwent AAD repair from 2011-2017.Post-operative RML workup is part of the institutional protocol;studied patients were divided into two groups:Group 1 with RML(creatine kinase above cut-off levels 2500 U/L)and Group 2 without RML.The potential determinants of RML and impact on patient outcome,especially postoperative renal function,were studied.Other outcome parameters studied were markers of cardiac injury,length of ventilation,length of stay in the intensive care unit),and length of hospitalization.RESULTS Out of 33 patients studied,21 patients(64%)developed RML(Group RML),and 12 did not(Group non-RML).Demographic and intraoperative factors,notably body mass index,duration of surgery,and cardiopulmonary bypass,had no significant impact on the incidence of RML.Preoperative visceral/peripheral malperfusion,though not statistically significant,was higher in the RML group.A significantly higher incidence of renal complications,including de novo postoperative dialysis,was noticed in the RML group.Other morbidity parameters were also higher in the RML group.There was a significantly higher incidence of AKI in the RML group(90%)than in the non-RML group(25%).All four patients who required de novo dialysis belonged to the RML group.The peak troponin levels were significantly higher in the RML group.CONCLUSION In this study,we noticed a high incidence of RML after aortic dissection surgery,coupled with an adverse renal outcome and the need for post-operative dialysis.Prompt recognition and management of RML might improve the renal outcome.Further large-scale prospective trials are warranted to investigate the predisposing factors and influence of RML on major morbidity and mortality outcomes.展开更多
AIM:To investigate botulinum toxin A(BTXA)efficacy on small-angle(≤25Δ)acute acquired concomitant esotropia(AACE)in early-stage patients.METHODS:The electronic medical record data of AACE patients during March 2019 ...AIM:To investigate botulinum toxin A(BTXA)efficacy on small-angle(≤25Δ)acute acquired concomitant esotropia(AACE)in early-stage patients.METHODS:The electronic medical record data of AACE patients during March 2019 and June 2023 were collected in this retrospective and hospital-based cohort study.A total of 72 small-angle AACE patients received BTXA extraocular muscle injection.Patients were grouped by onset-to-treatment time(Group A:≤6mo,Group B:>6mo).Deviation of esotropia,eye alignment and stereopsis were analyzed at the period of pre/post-injection(1wk,1,3,and 6mo).Orthophoria rate at 6mo(horizontal deviation<10Δand binocular single vision)were considered as outcome index.RESULTS:There were no significant baseline differences(P>0.05)between two groups except onset-to-treatment time(2mo vs 11mo,P<0.001).Higher orthophoria rates were in Group A at last follow-up(94.74%vs 73.53%,P=0.013).Post-BTXA deviations of two groups at 1mo showed no difference(P>0.05);while in 3 and 6mo Group A was significantly smaller than group B(all P<0.001).No statistically significant differences were observed among all post-BTXA deviations of near and distance in Group A.In Group B,deviation at 3mo(near:2Δvs 0,P<0.001;distance:4Δvs 0,P<0.001)and 6mo(near:6Δvs 0,P<0.001;distance:6Δvs 0,P<0.001)was significant increased compared to deviation at 1wk after treatment.Group A showed better stereopsis recovery in last follow-up compared to Group B(80″vs 200″,P=0.002).Both groups obtained improved stereopsis after treatment(Group A:80″vs 300″,P<0.001;Group B:200″vs 300″,P=0.037).CONCLUSION:BTXA is effective for AACE with small deviation(≤25Δ)in early stage.Delayed treatment(>6mo)may reduce BTXA efficacy.Early BTXA intervention benefits long-term eye alignment and stereopsis recovery.展开更多
BACKGROUND Arterial cannulation sites for the surgical repair of type A aortic dissection(AAD)have evolved from right axillary artery(AA)cannulation to bilateral carotid artery(CA)based of femoral artery(FA)cannulatio...BACKGROUND Arterial cannulation sites for the surgical repair of type A aortic dissection(AAD)have evolved from right axillary artery(AA)cannulation to bilateral carotid artery(CA)based of femoral artery(FA)cannulation.Postoperative descending aorta remodeling is closely linked to the false lumen area ratio(FLAR),defined as false lumen area/aortic area,as well as to the incidence of renal replacement therapy(RRT).AIM To investigate the effect of the updated arterial cannulation strategy on descending aortic remodeling.METHODS A total of 443 AAD patients who received FA combined cannulation between March 2015 and March 2023 were included in the study.Of these,209 received right AA cannulation and 234 received bilateral CA cannulation.The primary outcome was the change in FLAR,as calculated from computed tomography angiography in three segments of the descending aorta:Thoracic(S1),upper abdominal(S2),and lower abdominal(S3).Secondary outcomes were the incidence of RRT and the serum inflammation response,as observed by the levels of high sensitivity C reaction protein(hs-CRP)and Interleukin-6(IL-6).RESULTS The postoperative/preoperative ratio of FLAR in S2 and S3 was higher in the AA group compared to the CA group(S2:0.80±0.08 vs 0.75±0.07,P<0.001;S3:0.57±0.12 vs 0.50±0.12,P<0.001,respectively).The AA group also had a significantly higher incidence of RRT(19.1%vs 8.5%,P=0.001;odds ratio:2.533,95%CI:1.427-4.493)and higher levels of inflammation cytokines 24 h after the procedure[hr-CRP:117±17 vs 104±15 mg/L;IL-6:129(103,166)vs 83(69,101)pg/mL;both P<0.001]compared to the CA group.CONCLUSION The CA cannulation strategy was associated with better abdominal aorta remodeling after AAD repair compared to AA cannulation,as observed by a greater change in FLAR and lower incidence of RRT.展开更多
Background:Recently,microbotulinum,a new technique that involves injecting botulinum toxin type A(BoNTA)microdroplets into superficial cutaneous tissue,has gained popularity.The precise distribution of BoNTA in the ta...Background:Recently,microbotulinum,a new technique that involves injecting botulinum toxin type A(BoNTA)microdroplets into superficial cutaneous tissue,has gained popularity.The precise distribution of BoNTA in the targeted area profoundly affects outcomes.Many factors may influence the effective area of BoNTA in the dermis.This study aimed to determine the dermal distribution properties of BoNTA to guide microbotulinum injection.Methods:Ten healthy males aged 18–65 years without BoNTA treatment in the previous year were recruited to receive intradermal injections in the chest and back.Ultrasound was used to ensure the intradermal delivery of injections and measure the dermal thickness.The minor iodine starch test was performed at baseline and 3 days,7 days,21 days,1 month,and 2 months after treatment.Results:All participants received intradermal injections.The dermis was thinner on the chest(thickness,0.20±0.03 cm)than on the back(thickness,0.39±0.07 cm)(P<0.05).An injection in the thicker dermis had a significantly smaller effective area at every follow-up visit.The drug concentration did not affect the effective area except at 3 days after treatment.Injection speed did not influence the effective area at any follow-up visits.Conclusion:An injection in a thicker dermis leads to a smaller effective area for intradermal injections.When the BoNTA dose is the same,the drug concentration and injection speed do not matter.展开更多
BACKGROUND Low back pain(LBP)is a prevalent issue that orthopedic surgeons frequently address in the outpatient setting.LBP can arise from various causes,with stiffness in the paraspinal muscles being a notable contri...BACKGROUND Low back pain(LBP)is a prevalent issue that orthopedic surgeons frequently address in the outpatient setting.LBP can arise from various causes,with stiffness in the paraspinal muscles being a notable contributor.The administration of Botulinum toxin type A(BoNT-A)has been found to alleviate back pain by relaxing these stiff muscles.While BoNT-A is approved for use in numerous conditions,a limited number of randomized clinical trials(RCTs)validate its efficacy specifically for treating LBP.AIM To study the safety and the efficacy of BoNT-A in minimizing pain and improving functional outcomes in patients of chronic LBP(CLBP).METHODS In this RCT,adults aged 18-60 years with mechanical LBP persisting for at least six months were enrolled.Participants were allocated to either the Drug group,receiving 200 Ipsen Units(2 mL)of BoNT-A,or the Control group,which received a 2 mL placebo.Over a 2-month follow-up period,both groups were assessed using the Visual Analog Scale(VAS)for pain intensity and the Oswestry Disability Index(ODI)for disability at the start and conclusion of the study.A decrease in pain by 50%was deemed clinically significant.RESULTS The study followed 40 patients for two months,with 20 in each group.A clinically significant reduction in pain was observed in 36 participants.There was a statistically significant decrease in both VAS and ODI scores in the groups at the end of two months.Nonetheless,when comparing the mean score changes,only the reduction in ODI scores(15 in the placebo group vs 16.5 in the drug group,clinically insignificant)was statistically significant(P=0.012),whereas the change in mean VAS scores was not significant(P=0.45).CONCLUSION The study concludes that BoNT-A does not offer a short-term advantage over placebo in reducing pain or improving LBP scores in CLBP patients.展开更多
Background Type A aortic dissection,as a cardiovascular emergency,is best treated with early surgical intervention.With advancements in surgical techniques and perioperative management,the clinical cure rate of surger...Background Type A aortic dissection,as a cardiovascular emergency,is best treated with early surgical intervention.With advancements in surgical techniques and perioperative management,the clinical cure rate of surgery has significantly improved.However,the probability of postoperative complications remains high,among which postoperative hepatic dysfunction is one of the common and serious complications affecting prognosis.The purpose of this study was to explore the risk factors associated with postoperative hepatic dysfunction in patients with type A aortic dissection,hoping to identify high-risk patients early,prevent postoperative hepatic dysfunction,and improve patient prognosis.Methods A retrospective analysis was conducted on patients diagnosed with Stanford type A aortic dissection and treated with Sun's procedure at Guangdong Provincial People's Hospital from January 1,2021,to October 1,2022.The Model for End-Stage Liver Disease excluding International Normalized Ratio(MELD-XI)score was used as the evaluation index for postoperative hepatic dysfunction(HD).MELD-XI scores from postoperative day 1 to 7 were collected.Statistical methods were employed to analyze the perioperative clinical data of the two groups of patients.Variables with statistical significance in univariate analysis were included in multivariate logistic regression analysis to identify independent risk factors associated with postoperative HD.Results A total of 241 patients diagnosed with Stanford type A aortic dissection and hospitalized for Sun's procedure treatment were selected using specific inclusion and exclusion criteria.All patients were divided into HD group(MELD-XI score≥12,n=108)and normal group(MELD-XI score<12,n=133),with a postoperative HD incidence rate of 44.81%.There were statistically significant differences(P<0.05)between the two groups in terms of whether the surgery was emergency,gender distribution,preoperative level of white blood cell count,alanine aminotransferase,aspartate aminotransferase,brain natriuretic peptide,high-sensitivity troponin T,and serum creatinine.Statistically significant differences(P<0.05)were also observed in surgical duration,cardiopulmonary bypass time,intraoperative and postoperative 24-hour red blood cell transfusion volume,intraoperative and postoperative 24-hour plasma transfusion volume,and intraoperative bleeding volume.Moreover,patients with postoperative hepatic dysfunction had longer mechanical ventilation time,longer intensive care unit(ICU)and total hospital stay,and higher probabilities of postoperative gastrointestinal bleeding,paraplegia,cerebral complications,re-thoracotomy for hemostasis,reintubation,and extracorporeal membrane oxygenation(ECMO)therapy(P<0.05).The probabilities of acute kidney injury and receiving hemodialysis treatment were also higher(P<0.05).Following multivariate regression analysis,preoperative white blood cell count(OR:1.169,95%CI:1.028-1.329,P=0.017),preoperative serum creat-inine(OR:1.045,95%CI:1.028-1.062,P<0.001),and intraoperative and postoperative 24-hour red blood cell transfusion volume(OR:1.146,95%CI:1.030-1.274,P=0.012)were identified as independent risk factors associated with postoperative hepatic dysfunction in patients with Stanford type A aortic dissection after Sun's procedure.Conclusions In this study,the incidence of postoperative hepatic dysfunction in patients with Stanford type A aortic dissection after Sun's procedure was relatively high,at 44.81%.The independent risk factors associated with postoperative hepatic dysfunction in patients with type A aortic dissection include preoperative white blood cell count,preoperative alanine aminotransferase,and intraoperative and postoperative 24-hour red blood cell transfusion volume.Postoperative hepatic dysfunction significantly affects the prognosis of patients with Stanford type A aortic dissection,increasing the duration of postoperative mechanical ventilation,postoperative hospitalization time,and the probability of postoperative acute kidney injury.展开更多
Hepatic encephalopathy is a serious neuropsychiatric complication caused by liver failure,which is characterized by the development of cognitive and motor disorders into coma.Typically,hepatic encephalopathy can be di...Hepatic encephalopathy is a serious neuropsychiatric complication caused by liver failure,which is characterized by the development of cognitive and motor disorders into coma.Typically,hepatic encephalopathy can be divided into three types(A,B,and C)according to the etiology.Type A hepatic encephalopathy(AHE)caused by acute liver failure seriously affects the prognosis of patients,ranging from mild neuropsychological changes to coma,brain edema,and even death.So far,the research on the pathogenesis of AHE has focused on the toxic effects of ammonia on the central nervous system,metabolic disorders(glutamine and lactate accumulation),neurotransmission alteration,systemic inflammation,especially neuro-inflammation.All these mechanisms are not independent,but mutually have synergistic effects.In clinic,treatment of AHE based on only one mechanism is often ineffective.To clarify the pathogenesis and the interaction among the mechanisms will be beneficial to the effective treatment of AHE and reduce the mortality.The aim of this review is to provide comprehensive scientific evidence for the clinical treatment of AHE via collecting and analyzing the latest mechanism of AHE,and clarifying the relationship among these mechanisms combing the investigation of the latest research progress of drug treatment of acute liver failure.Consequently,we find that the pathogenesis of AHE is a complex neurocognitive disorder shaped by interactions among hyperammonemia,inflammation,and changes in neurotransmission,the signaling pathways thereby integrating the inflammatory and neurological inputs to impact pathophysiological or neurobehavioral outcomes.展开更多
Natural gas hydrate has huge reserves and is widely distributed in marine environment.Its commercial development is of great significance for alleviating the contradiction between energy supply and demand.As an effici...Natural gas hydrate has huge reserves and is widely distributed in marine environment.Its commercial development is of great significance for alleviating the contradiction between energy supply and demand.As an efficient research method,numerical simulation can provide valuable insights for the design and optimization of hydrate development.However,most of the current production models simplify the reservoir as a two-dimensional(2D)horizontal layered model,often ignoring the impact of formation dip angle.To improve the accuracy of production prediction and provide theoretical support for the optimization of production well design,two three-dimensional(3D)geological models with different dip angles based on the geological data from two typical sites are constructed.The vertical well,horizontal well and multilateral wells are deployed in these reservoirs with different permeabilities to perform production trial,and the sensitivity analysis of dip angles is also carried out.The short-term production behaviors in high and low permeability reservoirs with different dip angles are exhibited.The simulation results show that 1)the gas and water production behaviors for different well types in the two typical reservoirs show obviously different variation laws when the short-term depressurization is conducted in the inclined formation;2)the inclined formation will reduce the gas production and increase the water extraction,and the phenomena becomes pronounced as the dip angle increases,particularly in the low-permeability reservoirs;3)and the impact of formation dip on hydrate recovery does not change significantly with the variation of well type.展开更多
Purpose:Accurately assigning the document type of review articles in citation index databases like Web of Science(WoS)and Scopus is important.This study aims to investigate the document type assignation of review arti...Purpose:Accurately assigning the document type of review articles in citation index databases like Web of Science(WoS)and Scopus is important.This study aims to investigate the document type assignation of review articles in Web of Science,Scopus and Publisher’s websites on a large scale.Design/methodology/approach:27,616 papers from 160 journals from 10 review journal series indexed in SCI are analyzed.The document types of these papers labeled on journals’websites,and assigned by WoS and Scopus are retrieved and compared to determine the assigning accuracy and identify the possible reasons for wrongly assigning.For the document type labeled on the website,we further differentiate them into explicit review and implicit review based on whether the website directly indicates it is a review or not.Findings:Overall,WoS and Scopus performed similarly,with an average precision of about 99% and recall of about 80%.However,there were some differences between WoS and Scopus across different journal series and within the same journal series.The assigning accuracy of WoS and Scopus for implicit reviews dropped significantly,especially for Scopus.Research limitations:The document types we used as the gold standard were based on the journal websites’labeling which were not manually validated one by one.We only studied the labeling performance for review articles published during 2017-2018 in review journals.Whether this conclusion can be extended to review articles published in non-review journals and most current situation is not very clear.Practical implications:This study provides a reference for the accuracy of document type assigning of review articles in WoS and Scopus,and the identified pattern for assigning implicit reviews may be helpful to better labeling on websites,WoS and Scopus.Originality/value:This study investigated the assigning accuracy of document type of reviews and identified the some patterns of wrong assignments.展开更多
There is a need to reduce the burden of child drop-off and pick-up for child-rearing generations, but most studies on the actual situation in Japan are based on survey results. In this study, we analyzed differences i...There is a need to reduce the burden of child drop-off and pick-up for child-rearing generations, but most studies on the actual situation in Japan are based on survey results. In this study, we analyzed differences in child drop-off and pick-up by employment type and gender, utilizing the “Metropolitan Area Person Trip Survey,” which is a statistical data set. The study targeted households in which both spouses were between 30 and 49 years old, had children under the age of 6, and included the following three groups. 1) Dual-income Group 1 (both spouses employed/on contract/temporary);2) Dual-income Group 2 (husband employed/on contract/temporary, wife part-time);3) Full-time housewife group (husband employed, wife unemployed). The analysis revealed that a) wives are almost always responsible for dropping off and picking up their children;b) husbands drop off and pick up their children less frequently in dual-income households;and c) households with children raising within 10 to 30 km of Tokyo Station have longer commuting times and need to reduce the burden of dropping off and picking up their children.展开更多
This paper contends that the public sign is a kind of text with such vocative functions as indicating,instructing,restricting,prohibiting,persuading,and publicizing,so it falls into the type of vocative texts.The pape...This paper contends that the public sign is a kind of text with such vocative functions as indicating,instructing,restricting,prohibiting,persuading,and publicizing,so it falls into the type of vocative texts.The paper suggests that conveying the vocative function of the public sign is the essential task of the translator,so as to achieve the intended effect of the public sign.展开更多
The transmetallation reaction of 4 Schiff base type arylmercury compounds with metallic tin has been carried out in refluxing xylene.It was found that the reaction proceeds in the same manner as that of chloro[2-(phen...The transmetallation reaction of 4 Schiff base type arylmercury compounds with metallic tin has been carried out in refluxing xylene.It was found that the reaction proceeds in the same manner as that of chloro[2-(phenylazo)phenyl]mercury(Ⅱ) to give dichlorobisaryltin(Ⅳ).The ~1H NMR spectra of the products provide evidence for the presence of N→Sn intramolecular coordination.The formation of dichlorobisaryltin(Ⅳ)as a unique product probably arises from the N→Sn intramolecular coordination which results in the increasing of the stability of the molecule.展开更多
[Objective] The mating genotype was studied and compared with esterase isozyme of Ganoderma lucidum populations between groups in order to clarify their differences in genetic relationship analysis. [Method] OWE-SOJ t...[Objective] The mating genotype was studied and compared with esterase isozyme of Ganoderma lucidum populations between groups in order to clarify their differences in genetic relationship analysis. [Method] OWE-SOJ technique was applied to identify standard mating types and determinate mating genotype between groups of monokaryons isolates from 24 G. lucidum stains. Genetic relationships were analyzed by combined group mating genotype determination with esterase isozyme assay. [Result] All strains of G. lucidum could be divided into 7 large groups of the mating genotype. Four alleles of A factor, four alleles of B factor and one mixed alleles of A factor were found in this study. Distorted segregation ratio among monokaryon mycelia of G. lucidum had been observed in four kinds of mat- ing types to some extent. Twenty-eight different types of enzyme bands were determined in esterase isozyme test, Twenty-four strains of G. lucidum could be divided into 9 large groups through the cluster analysis when the genetic similarity coefficient was 0.73214. Comparing the results of mating genotype analysis and esterase isozyme analysis, it showed great similarity. [Conclusion] Mating genotype analysis could be used as an important supplementary method for strain identification and genetic diversity research.展开更多
Objective Type A acute aortic dissection(TAAAD)is a dangerous and complicated condition with a high death rate before hospital treatment.Patients who are fortunate to receive prompt surgical treatment still face high ...Objective Type A acute aortic dissection(TAAAD)is a dangerous and complicated condition with a high death rate before hospital treatment.Patients who are fortunate to receive prompt surgical treatment still face high in-hospital mortality.A series of post-operative complications further affects the prognosis.Post-operative pneumonia(POP)also leads to great morbidity and mortality.This study aimed to identify the prevalence as well as the risk factors for POP in TAAAD patients and offer references for clinical decisions to further improve the prognosis of patients who survived the surgical procedure.Methods The study enrolled 89 TAAAD patients who underwent surgical treatment in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei province,China from December 2020 to July 2021 and analyzed the perioperative data and outcomes of these patients.Logistic regression analyses were used to identify the risk factors for POP.Results In the study,31.5%of patients developed POP.Patients with POP had higher proportions of severe oxygenation damage,pneumothorax,reintubation,tracheotomy,renal replacement therapy,arrhythmia,gastrointestinal bleeding,and longer duration of mechanical ventilation,fever,ICU stay,and length of stay(all with P<0.05).The in-hospital mortality was 2.3%.Smoking,preoperative white blood cells,and intraoperative transfusion were the independent risk factors for POP in TAAAD.Conclusion Patients who underwent TAAAD surgery suffered poorer outcomes when they developed POP.Furthermore,patients with risk factors should be treated with caution.展开更多
BACKGROUND A 63-year-old female was diagnosed with acute Stanford type A aortic dissection.The patient had pain in the chest and back for 1 wk.The computed tomography angiography(CTA)showed Stanford type A aortic diss...BACKGROUND A 63-year-old female was diagnosed with acute Stanford type A aortic dissection.The patient had pain in the chest and back for 1 wk.The computed tomography angiography(CTA)showed Stanford type A aortic dissection(Myla type III aortic arch).The intimal tear was located at the top of the aortic arch and retrograded to the ascending aorta.CASE SUMMARY Preoperatively,a three-dimensional(3D)-printed model of the aortic arch was made according to CTA data.Then,under the guidance of the 3D-printed aortic model,a pre-fenestrated stent-graft was customized,and the diameter of the stent-graft was reduced intraoperatively by surgeons.3D printing,triple prefenestration,and reduced diameter techniques were used during the surgery.The CTA examinations were performed at the 3rd mo and 1st year after the surgery;the results showed that the aortic dissection was repaired without endoleak,and all three branches of the aortic arch remained unobstructed.CONCLUSION Applying the triple pre-fenestration technique for aortic arch lesions was feasible and minimally invasive in our case.The technique provides a new avenue for thoracic endovascular aortic repair of Stanford type A aortic dissection.展开更多
In this paper, we report new whole-rock geochemical and zircon U-Pb data for monzogranites in the NE Xing＇an block. These data constrained the petrogenesis of C type （high Sr/Y） adakitic rocks and showed the spatia...In this paper, we report new whole-rock geochemical and zircon U-Pb data for monzogranites in the NE Xing＇an block. These data constrained the petrogenesis of C type （high Sr/Y） adakitic rocks and showed the spatial extent of the influence of the Mongol-Okhostsk ocean tectonic regime and the collision between the Jiamusi Massif and Songliao Terrane. New zircon laser-ablation inductivity coupled plasma mass spectrometry （LA-ICP-MS） U-Pb data indicated that the monzogranites in the studied area were emplaced in the Early Jurassic （～ 180 Ma）. These rocks were characterized by unusally high SiO2 （≥67.49）, and Sr （461-759 ppm）, but strikingly low Y （4.63-8.06 ppm） and HREE （∑HREE = 3.83-6.49 ppm, Yb = 0.5-0.77 ppm） contents, with therefore high Sr/Y （67.2-119） and （La/Yb）N （29.7-41.5） ratios, showing the geochemical characteristics of C type adakitic granite. The data displayed negligible Eu anomalies （Eu/Eu^＊ =0.77-1.08）, LREE-enriched and pronounced negative Nb and Ta anomalies. The C-type adakites in the studied area were most likely derived from the partial melting of a thickened lower continental curst. The magma source is most likely dominated by amphibolites and garnet amphibolites. In combination with previously-reported data from igneous rocks from the Mesozoic in NE China, we conclude that the Xing＇ an block was influenced by the Mongol-Okhotsk subduction tectonic system, and experiences compressive settings from the amalgamation of the Jiamusi block in the east of the CAOB.展开更多
Objective.To introduce the properties of Chinese type A botulinum toxin(CBTXA,made by Lanzhou Institute of Biological Products),and its long?term effect for focal dystonia and hemifacial spasm.Method.The purity and re...Objective.To introduce the properties of Chinese type A botulinum toxin(CBTXA,made by Lanzhou Institute of Biological Products),and its long?term effect for focal dystonia and hemifacial spasm.Method.The purity and recovery of crude and crystalline toxin were tested.Long?term data from305patients with hemifacial spasm(HFS),blepharospasm(BS)and cervical dystonia(CD)were evalu-ated and subgroups of patients received CBTXA injections between1994and2000in at least six sepa-rate treatment sessions,with follow up for2～8years.The therapeutic results of the last session CBTXA injections were analyzed in comparison with the first session.Result.CBTXA purity was high[(2.55～2.60)×10 7 LD50/mgPr ,A260/A280≤0.55,high molecular substance accounted for99.2%of total proteins].Long term treatment with CBTXA in patients with focal dystonia and HFS was not associated with any decline in benefit,and efficacy may improve slightly with repeat treatments.CBTXA is an excellent long-term treatment of HFS,BS and CD.Conclusion.We conclude that Chinese type A botulinum toxin is of botulinum toxin therapy quality standard according to results obtained from the basic study and long?term clinical applications.The re?injection of CBTXA significantly improves the quality of life of most patients and is a safe,effective and comparatively economical treatment for patients with focal dystonia and HFS.展开更多
We report a case of multiple duodenal, pancreatic, and gastric carcinoids. A 67-year old woman was admitted to our hospital for treatment of a duodenal carcinoid. Laboratory tests revealed that the patient was associa...We report a case of multiple duodenal, pancreatic, and gastric carcinoids. A 67-year old woman was admitted to our hospital for treatment of a duodenal carcinoid. Laboratory tests revealed that the patient was associated with macrocytic anemia and hypergastrinemia, and type A gastritis was shown by gastrofiberscopy. During surgery, another tumor was incidentally found in the head of the pancreas. The tumors in the duodenum and pancreas were completely excised by pancreatoduodenectomy and immunohistologically diagnosed as gastrin-and serotonin-producing carcinoids, respectively. Pathological examination revealed that in addition to the grossly found carcinoids, there were subclinical carcinoids, one of which was an endocrine cell micronest, located in the stomach and duodenum. The tumors in the duodenum, pancreas, and stomach showed different characteristics from one another morphologically and immunochemically. Although no definitive evidence has been obtained, some sort of genetic anomaly may have been involved in this case, and hypergastrinemia due to duodenal gastrinoma may induce multiple gastric carcinoids.展开更多
文摘Objective To investigate the clinical predictors of malperfusion in patients with acute type A aortic dissection(ATAAD)and to construct a diagnostic model to identify high-risk individuals.Methods A retrospective analysis of 553 ATAAD patients from Tongji Hospital divided into malperfusion and non-malperfusion groups was conducted.Logistic regression was used to identify independent predictors of the outcome.Model performance via the Hosmer–Lemeshow test,decision curve analysis(DCA),the area under the receiver operating characteristic curve(AUC),sensitivity,specificity,and predictive values.Results Malperfusion was observed in 28.4%of ATAAD patients.Significant predictors included elevated lactate dehydrogenase(LDH)(OR:1.0019,95%CI:1.0002–1.0036,P=0.027),alanine aminotransferase(ALT)(OR:0.9936,95%CI:0.987–1.000,P=0.046)and estimated glomerular filtration rate(eGFR)(OR:0.9877,95%CI:0.977–0.998,P=0.021),suggesting roles for tissue ischemia and impaired renal or hepatic function.Other variables,such as D-dimer,uric acid,creatinine,and NT-proBNP,showed trends toward significance but did not reach the 0.05 threshold.The model demonstrated good calibration(Hosmer–Lemeshow P=0.318),moderate discriminatory power(AUC=0.725),high specificity(93.62%),and low sensitivity(26.75%).Conclusion The model based on routine biochemical markers provides a practical approach for the early identification of malperfusion in ATAAD patients.It shows strong specificity and clinical utility,although its limited sensitivity highlights the need for further refinement.Future improvements should focus on incorporating additional clinical or imaging data to increase diagnostic accuracy.
基金Supported by Hamad Medical Corporation,No.MRC-01-18-073.
文摘BACKGROUND Rhabdomyolysis(RML)as an etiological factor causing acute kidney injury(AKI)is sparsely reported in the literature.AIM To study the incidence of RML after surgical repair of an ascending aortic dissection(AAD)and to correlate with the outcome,especially regarding renal function.To pinpoint the perioperative risk factors associated with the development of RML and adverse renal outcomes after aortic dissection repair.METHODS Retrospective single-center cohort study conducted in a tertiary cardiac center.We included all patients who underwent AAD repair from 2011-2017.Post-operative RML workup is part of the institutional protocol;studied patients were divided into two groups:Group 1 with RML(creatine kinase above cut-off levels 2500 U/L)and Group 2 without RML.The potential determinants of RML and impact on patient outcome,especially postoperative renal function,were studied.Other outcome parameters studied were markers of cardiac injury,length of ventilation,length of stay in the intensive care unit),and length of hospitalization.RESULTS Out of 33 patients studied,21 patients(64%)developed RML(Group RML),and 12 did not(Group non-RML).Demographic and intraoperative factors,notably body mass index,duration of surgery,and cardiopulmonary bypass,had no significant impact on the incidence of RML.Preoperative visceral/peripheral malperfusion,though not statistically significant,was higher in the RML group.A significantly higher incidence of renal complications,including de novo postoperative dialysis,was noticed in the RML group.Other morbidity parameters were also higher in the RML group.There was a significantly higher incidence of AKI in the RML group(90%)than in the non-RML group(25%).All four patients who required de novo dialysis belonged to the RML group.The peak troponin levels were significantly higher in the RML group.CONCLUSION In this study,we noticed a high incidence of RML after aortic dissection surgery,coupled with an adverse renal outcome and the need for post-operative dialysis.Prompt recognition and management of RML might improve the renal outcome.Further large-scale prospective trials are warranted to investigate the predisposing factors and influence of RML on major morbidity and mortality outcomes.
基金Supported by Key Research and Development Program of Hubei Province(No.2022BCA044)the Central Guided Local Science and Technology Development(No.2019ZYYD058).
文摘AIM:To investigate botulinum toxin A(BTXA)efficacy on small-angle(≤25Δ)acute acquired concomitant esotropia(AACE)in early-stage patients.METHODS:The electronic medical record data of AACE patients during March 2019 and June 2023 were collected in this retrospective and hospital-based cohort study.A total of 72 small-angle AACE patients received BTXA extraocular muscle injection.Patients were grouped by onset-to-treatment time(Group A:≤6mo,Group B:>6mo).Deviation of esotropia,eye alignment and stereopsis were analyzed at the period of pre/post-injection(1wk,1,3,and 6mo).Orthophoria rate at 6mo(horizontal deviation<10Δand binocular single vision)were considered as outcome index.RESULTS:There were no significant baseline differences(P>0.05)between two groups except onset-to-treatment time(2mo vs 11mo,P<0.001).Higher orthophoria rates were in Group A at last follow-up(94.74%vs 73.53%,P=0.013).Post-BTXA deviations of two groups at 1mo showed no difference(P>0.05);while in 3 and 6mo Group A was significantly smaller than group B(all P<0.001).No statistically significant differences were observed among all post-BTXA deviations of near and distance in Group A.In Group B,deviation at 3mo(near:2Δvs 0,P<0.001;distance:4Δvs 0,P<0.001)and 6mo(near:6Δvs 0,P<0.001;distance:6Δvs 0,P<0.001)was significant increased compared to deviation at 1wk after treatment.Group A showed better stereopsis recovery in last follow-up compared to Group B(80″vs 200″,P=0.002).Both groups obtained improved stereopsis after treatment(Group A:80″vs 300″,P<0.001;Group B:200″vs 300″,P=0.037).CONCLUSION:BTXA is effective for AACE with small deviation(≤25Δ)in early stage.Delayed treatment(>6mo)may reduce BTXA efficacy.Early BTXA intervention benefits long-term eye alignment and stereopsis recovery.
基金Supported by Huanhua Talent for Discipline Backbone of Sichuan Provincial People’s Hospital,No.SY2022017Science Fund for Distinguished Young Scholars of Sichuan Province,No.2021JDJQ0041+1 种基金Sichuan Science and Technology Program,No.2020YFQ0060National Natural Science and Technology Foundation of China,No.81800274.
文摘BACKGROUND Arterial cannulation sites for the surgical repair of type A aortic dissection(AAD)have evolved from right axillary artery(AA)cannulation to bilateral carotid artery(CA)based of femoral artery(FA)cannulation.Postoperative descending aorta remodeling is closely linked to the false lumen area ratio(FLAR),defined as false lumen area/aortic area,as well as to the incidence of renal replacement therapy(RRT).AIM To investigate the effect of the updated arterial cannulation strategy on descending aortic remodeling.METHODS A total of 443 AAD patients who received FA combined cannulation between March 2015 and March 2023 were included in the study.Of these,209 received right AA cannulation and 234 received bilateral CA cannulation.The primary outcome was the change in FLAR,as calculated from computed tomography angiography in three segments of the descending aorta:Thoracic(S1),upper abdominal(S2),and lower abdominal(S3).Secondary outcomes were the incidence of RRT and the serum inflammation response,as observed by the levels of high sensitivity C reaction protein(hs-CRP)and Interleukin-6(IL-6).RESULTS The postoperative/preoperative ratio of FLAR in S2 and S3 was higher in the AA group compared to the CA group(S2:0.80±0.08 vs 0.75±0.07,P<0.001;S3:0.57±0.12 vs 0.50±0.12,P<0.001,respectively).The AA group also had a significantly higher incidence of RRT(19.1%vs 8.5%,P=0.001;odds ratio:2.533,95%CI:1.427-4.493)and higher levels of inflammation cytokines 24 h after the procedure[hr-CRP:117±17 vs 104±15 mg/L;IL-6:129(103,166)vs 83(69,101)pg/mL;both P<0.001]compared to the CA group.CONCLUSION The CA cannulation strategy was associated with better abdominal aorta remodeling after AAD repair compared to AA cannulation,as observed by a greater change in FLAR and lower incidence of RRT.
基金supported by the National High Level Hospital Clinical Research Funding(grant nos.2022-PUMCH-B-041,2022-PUMCH-A-210,and 2022-PUMCH-C-025).
文摘Background:Recently,microbotulinum,a new technique that involves injecting botulinum toxin type A(BoNTA)microdroplets into superficial cutaneous tissue,has gained popularity.The precise distribution of BoNTA in the targeted area profoundly affects outcomes.Many factors may influence the effective area of BoNTA in the dermis.This study aimed to determine the dermal distribution properties of BoNTA to guide microbotulinum injection.Methods:Ten healthy males aged 18–65 years without BoNTA treatment in the previous year were recruited to receive intradermal injections in the chest and back.Ultrasound was used to ensure the intradermal delivery of injections and measure the dermal thickness.The minor iodine starch test was performed at baseline and 3 days,7 days,21 days,1 month,and 2 months after treatment.Results:All participants received intradermal injections.The dermis was thinner on the chest(thickness,0.20±0.03 cm)than on the back(thickness,0.39±0.07 cm)(P<0.05).An injection in the thicker dermis had a significantly smaller effective area at every follow-up visit.The drug concentration did not affect the effective area except at 3 days after treatment.Injection speed did not influence the effective area at any follow-up visits.Conclusion:An injection in a thicker dermis leads to a smaller effective area for intradermal injections.When the BoNTA dose is the same,the drug concentration and injection speed do not matter.
基金Supported by All India Institute of Medical Sciences Bhubaneswar Research Grant,No.AIIMS/BBSR/RS/2022/372.
文摘BACKGROUND Low back pain(LBP)is a prevalent issue that orthopedic surgeons frequently address in the outpatient setting.LBP can arise from various causes,with stiffness in the paraspinal muscles being a notable contributor.The administration of Botulinum toxin type A(BoNT-A)has been found to alleviate back pain by relaxing these stiff muscles.While BoNT-A is approved for use in numerous conditions,a limited number of randomized clinical trials(RCTs)validate its efficacy specifically for treating LBP.AIM To study the safety and the efficacy of BoNT-A in minimizing pain and improving functional outcomes in patients of chronic LBP(CLBP).METHODS In this RCT,adults aged 18-60 years with mechanical LBP persisting for at least six months were enrolled.Participants were allocated to either the Drug group,receiving 200 Ipsen Units(2 mL)of BoNT-A,or the Control group,which received a 2 mL placebo.Over a 2-month follow-up period,both groups were assessed using the Visual Analog Scale(VAS)for pain intensity and the Oswestry Disability Index(ODI)for disability at the start and conclusion of the study.A decrease in pain by 50%was deemed clinically significant.RESULTS The study followed 40 patients for two months,with 20 in each group.A clinically significant reduction in pain was observed in 36 participants.There was a statistically significant decrease in both VAS and ODI scores in the groups at the end of two months.Nonetheless,when comparing the mean score changes,only the reduction in ODI scores(15 in the placebo group vs 16.5 in the drug group,clinically insignificant)was statistically significant(P=0.012),whereas the change in mean VAS scores was not significant(P=0.45).CONCLUSION The study concludes that BoNT-A does not offer a short-term advantage over placebo in reducing pain or improving LBP scores in CLBP patients.
文摘Background Type A aortic dissection,as a cardiovascular emergency,is best treated with early surgical intervention.With advancements in surgical techniques and perioperative management,the clinical cure rate of surgery has significantly improved.However,the probability of postoperative complications remains high,among which postoperative hepatic dysfunction is one of the common and serious complications affecting prognosis.The purpose of this study was to explore the risk factors associated with postoperative hepatic dysfunction in patients with type A aortic dissection,hoping to identify high-risk patients early,prevent postoperative hepatic dysfunction,and improve patient prognosis.Methods A retrospective analysis was conducted on patients diagnosed with Stanford type A aortic dissection and treated with Sun's procedure at Guangdong Provincial People's Hospital from January 1,2021,to October 1,2022.The Model for End-Stage Liver Disease excluding International Normalized Ratio(MELD-XI)score was used as the evaluation index for postoperative hepatic dysfunction(HD).MELD-XI scores from postoperative day 1 to 7 were collected.Statistical methods were employed to analyze the perioperative clinical data of the two groups of patients.Variables with statistical significance in univariate analysis were included in multivariate logistic regression analysis to identify independent risk factors associated with postoperative HD.Results A total of 241 patients diagnosed with Stanford type A aortic dissection and hospitalized for Sun's procedure treatment were selected using specific inclusion and exclusion criteria.All patients were divided into HD group(MELD-XI score≥12,n=108)and normal group(MELD-XI score<12,n=133),with a postoperative HD incidence rate of 44.81%.There were statistically significant differences(P<0.05)between the two groups in terms of whether the surgery was emergency,gender distribution,preoperative level of white blood cell count,alanine aminotransferase,aspartate aminotransferase,brain natriuretic peptide,high-sensitivity troponin T,and serum creatinine.Statistically significant differences(P<0.05)were also observed in surgical duration,cardiopulmonary bypass time,intraoperative and postoperative 24-hour red blood cell transfusion volume,intraoperative and postoperative 24-hour plasma transfusion volume,and intraoperative bleeding volume.Moreover,patients with postoperative hepatic dysfunction had longer mechanical ventilation time,longer intensive care unit(ICU)and total hospital stay,and higher probabilities of postoperative gastrointestinal bleeding,paraplegia,cerebral complications,re-thoracotomy for hemostasis,reintubation,and extracorporeal membrane oxygenation(ECMO)therapy(P<0.05).The probabilities of acute kidney injury and receiving hemodialysis treatment were also higher(P<0.05).Following multivariate regression analysis,preoperative white blood cell count(OR:1.169,95%CI:1.028-1.329,P=0.017),preoperative serum creat-inine(OR:1.045,95%CI:1.028-1.062,P<0.001),and intraoperative and postoperative 24-hour red blood cell transfusion volume(OR:1.146,95%CI:1.030-1.274,P=0.012)were identified as independent risk factors associated with postoperative hepatic dysfunction in patients with Stanford type A aortic dissection after Sun's procedure.Conclusions In this study,the incidence of postoperative hepatic dysfunction in patients with Stanford type A aortic dissection after Sun's procedure was relatively high,at 44.81%.The independent risk factors associated with postoperative hepatic dysfunction in patients with type A aortic dissection include preoperative white blood cell count,preoperative alanine aminotransferase,and intraoperative and postoperative 24-hour red blood cell transfusion volume.Postoperative hepatic dysfunction significantly affects the prognosis of patients with Stanford type A aortic dissection,increasing the duration of postoperative mechanical ventilation,postoperative hospitalization time,and the probability of postoperative acute kidney injury.
基金supported by the National Nature Science Foundation of China(Grants 81974533,81530098).
文摘Hepatic encephalopathy is a serious neuropsychiatric complication caused by liver failure,which is characterized by the development of cognitive and motor disorders into coma.Typically,hepatic encephalopathy can be divided into three types(A,B,and C)according to the etiology.Type A hepatic encephalopathy(AHE)caused by acute liver failure seriously affects the prognosis of patients,ranging from mild neuropsychological changes to coma,brain edema,and even death.So far,the research on the pathogenesis of AHE has focused on the toxic effects of ammonia on the central nervous system,metabolic disorders(glutamine and lactate accumulation),neurotransmission alteration,systemic inflammation,especially neuro-inflammation.All these mechanisms are not independent,but mutually have synergistic effects.In clinic,treatment of AHE based on only one mechanism is often ineffective.To clarify the pathogenesis and the interaction among the mechanisms will be beneficial to the effective treatment of AHE and reduce the mortality.The aim of this review is to provide comprehensive scientific evidence for the clinical treatment of AHE via collecting and analyzing the latest mechanism of AHE,and clarifying the relationship among these mechanisms combing the investigation of the latest research progress of drug treatment of acute liver failure.Consequently,we find that the pathogenesis of AHE is a complex neurocognitive disorder shaped by interactions among hyperammonemia,inflammation,and changes in neurotransmission,the signaling pathways thereby integrating the inflammatory and neurological inputs to impact pathophysiological or neurobehavioral outcomes.
基金supported by the National Natural Science Foundation of China(Nos.42372361 and 51904280)the Key Research and Development Program of China(No.2018YFE0126400).
文摘Natural gas hydrate has huge reserves and is widely distributed in marine environment.Its commercial development is of great significance for alleviating the contradiction between energy supply and demand.As an efficient research method,numerical simulation can provide valuable insights for the design and optimization of hydrate development.However,most of the current production models simplify the reservoir as a two-dimensional(2D)horizontal layered model,often ignoring the impact of formation dip angle.To improve the accuracy of production prediction and provide theoretical support for the optimization of production well design,two three-dimensional(3D)geological models with different dip angles based on the geological data from two typical sites are constructed.The vertical well,horizontal well and multilateral wells are deployed in these reservoirs with different permeabilities to perform production trial,and the sensitivity analysis of dip angles is also carried out.The short-term production behaviors in high and low permeability reservoirs with different dip angles are exhibited.The simulation results show that 1)the gas and water production behaviors for different well types in the two typical reservoirs show obviously different variation laws when the short-term depressurization is conducted in the inclined formation;2)the inclined formation will reduce the gas production and increase the water extraction,and the phenomena becomes pronounced as the dip angle increases,particularly in the low-permeability reservoirs;3)and the impact of formation dip on hydrate recovery does not change significantly with the variation of well type.
文摘Purpose:Accurately assigning the document type of review articles in citation index databases like Web of Science(WoS)and Scopus is important.This study aims to investigate the document type assignation of review articles in Web of Science,Scopus and Publisher’s websites on a large scale.Design/methodology/approach:27,616 papers from 160 journals from 10 review journal series indexed in SCI are analyzed.The document types of these papers labeled on journals’websites,and assigned by WoS and Scopus are retrieved and compared to determine the assigning accuracy and identify the possible reasons for wrongly assigning.For the document type labeled on the website,we further differentiate them into explicit review and implicit review based on whether the website directly indicates it is a review or not.Findings:Overall,WoS and Scopus performed similarly,with an average precision of about 99% and recall of about 80%.However,there were some differences between WoS and Scopus across different journal series and within the same journal series.The assigning accuracy of WoS and Scopus for implicit reviews dropped significantly,especially for Scopus.Research limitations:The document types we used as the gold standard were based on the journal websites’labeling which were not manually validated one by one.We only studied the labeling performance for review articles published during 2017-2018 in review journals.Whether this conclusion can be extended to review articles published in non-review journals and most current situation is not very clear.Practical implications:This study provides a reference for the accuracy of document type assigning of review articles in WoS and Scopus,and the identified pattern for assigning implicit reviews may be helpful to better labeling on websites,WoS and Scopus.Originality/value:This study investigated the assigning accuracy of document type of reviews and identified the some patterns of wrong assignments.
文摘There is a need to reduce the burden of child drop-off and pick-up for child-rearing generations, but most studies on the actual situation in Japan are based on survey results. In this study, we analyzed differences in child drop-off and pick-up by employment type and gender, utilizing the “Metropolitan Area Person Trip Survey,” which is a statistical data set. The study targeted households in which both spouses were between 30 and 49 years old, had children under the age of 6, and included the following three groups. 1) Dual-income Group 1 (both spouses employed/on contract/temporary);2) Dual-income Group 2 (husband employed/on contract/temporary, wife part-time);3) Full-time housewife group (husband employed, wife unemployed). The analysis revealed that a) wives are almost always responsible for dropping off and picking up their children;b) husbands drop off and pick up their children less frequently in dual-income households;and c) households with children raising within 10 to 30 km of Tokyo Station have longer commuting times and need to reduce the burden of dropping off and picking up their children.
文摘This paper contends that the public sign is a kind of text with such vocative functions as indicating,instructing,restricting,prohibiting,persuading,and publicizing,so it falls into the type of vocative texts.The paper suggests that conveying the vocative function of the public sign is the essential task of the translator,so as to achieve the intended effect of the public sign.
文摘The transmetallation reaction of 4 Schiff base type arylmercury compounds with metallic tin has been carried out in refluxing xylene.It was found that the reaction proceeds in the same manner as that of chloro[2-(phenylazo)phenyl]mercury(Ⅱ) to give dichlorobisaryltin(Ⅳ).The ~1H NMR spectra of the products provide evidence for the presence of N→Sn intramolecular coordination.The formation of dichlorobisaryltin(Ⅳ)as a unique product probably arises from the N→Sn intramolecular coordination which results in the increasing of the stability of the molecule.
基金Supported by National Science and Technology Support Program"Regional Development of Chinese Traditional Medicine Industry and Research of Characteristic Product"(2006BIA06A20)Personnel Services Business Action Plan of Ministry ofScience and Technology "Development of Series Products of Rare Edible Fungus"(2009GJD20012)~~
文摘[Objective] The mating genotype was studied and compared with esterase isozyme of Ganoderma lucidum populations between groups in order to clarify their differences in genetic relationship analysis. [Method] OWE-SOJ technique was applied to identify standard mating types and determinate mating genotype between groups of monokaryons isolates from 24 G. lucidum stains. Genetic relationships were analyzed by combined group mating genotype determination with esterase isozyme assay. [Result] All strains of G. lucidum could be divided into 7 large groups of the mating genotype. Four alleles of A factor, four alleles of B factor and one mixed alleles of A factor were found in this study. Distorted segregation ratio among monokaryon mycelia of G. lucidum had been observed in four kinds of mat- ing types to some extent. Twenty-eight different types of enzyme bands were determined in esterase isozyme test, Twenty-four strains of G. lucidum could be divided into 9 large groups through the cluster analysis when the genetic similarity coefficient was 0.73214. Comparing the results of mating genotype analysis and esterase isozyme analysis, it showed great similarity. [Conclusion] Mating genotype analysis could be used as an important supplementary method for strain identification and genetic diversity research.
基金supported by the National Natural Science Foundation of China(No.81370134).
文摘Objective Type A acute aortic dissection(TAAAD)is a dangerous and complicated condition with a high death rate before hospital treatment.Patients who are fortunate to receive prompt surgical treatment still face high in-hospital mortality.A series of post-operative complications further affects the prognosis.Post-operative pneumonia(POP)also leads to great morbidity and mortality.This study aimed to identify the prevalence as well as the risk factors for POP in TAAAD patients and offer references for clinical decisions to further improve the prognosis of patients who survived the surgical procedure.Methods The study enrolled 89 TAAAD patients who underwent surgical treatment in Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,Hubei province,China from December 2020 to July 2021 and analyzed the perioperative data and outcomes of these patients.Logistic regression analyses were used to identify the risk factors for POP.Results In the study,31.5%of patients developed POP.Patients with POP had higher proportions of severe oxygenation damage,pneumothorax,reintubation,tracheotomy,renal replacement therapy,arrhythmia,gastrointestinal bleeding,and longer duration of mechanical ventilation,fever,ICU stay,and length of stay(all with P<0.05).The in-hospital mortality was 2.3%.Smoking,preoperative white blood cells,and intraoperative transfusion were the independent risk factors for POP in TAAAD.Conclusion Patients who underwent TAAAD surgery suffered poorer outcomes when they developed POP.Furthermore,patients with risk factors should be treated with caution.
基金Jiangsu Provincial Medical Youth Talent Foundation,No.QXRC201621Outstanding Youth Project supported by Nanjing Medical Science and Technology Development Foundation,No.JQX17003and Social Development Program of Jiangsu Province,No.BE2019604.
文摘BACKGROUND A 63-year-old female was diagnosed with acute Stanford type A aortic dissection.The patient had pain in the chest and back for 1 wk.The computed tomography angiography(CTA)showed Stanford type A aortic dissection(Myla type III aortic arch).The intimal tear was located at the top of the aortic arch and retrograded to the ascending aorta.CASE SUMMARY Preoperatively,a three-dimensional(3D)-printed model of the aortic arch was made according to CTA data.Then,under the guidance of the 3D-printed aortic model,a pre-fenestrated stent-graft was customized,and the diameter of the stent-graft was reduced intraoperatively by surgeons.3D printing,triple prefenestration,and reduced diameter techniques were used during the surgery.The CTA examinations were performed at the 3rd mo and 1st year after the surgery;the results showed that the aortic dissection was repaired without endoleak,and all three branches of the aortic arch remained unobstructed.CONCLUSION Applying the triple pre-fenestration technique for aortic arch lesions was feasible and minimally invasive in our case.The technique provides a new avenue for thoracic endovascular aortic repair of Stanford type A aortic dissection.
基金supported by the regional geology and mineralization research program of Heilongjiang province (HLJKD201417)
文摘In this paper, we report new whole-rock geochemical and zircon U-Pb data for monzogranites in the NE Xing＇an block. These data constrained the petrogenesis of C type （high Sr/Y） adakitic rocks and showed the spatial extent of the influence of the Mongol-Okhostsk ocean tectonic regime and the collision between the Jiamusi Massif and Songliao Terrane. New zircon laser-ablation inductivity coupled plasma mass spectrometry （LA-ICP-MS） U-Pb data indicated that the monzogranites in the studied area were emplaced in the Early Jurassic （～ 180 Ma）. These rocks were characterized by unusally high SiO2 （≥67.49）, and Sr （461-759 ppm）, but strikingly low Y （4.63-8.06 ppm） and HREE （∑HREE = 3.83-6.49 ppm, Yb = 0.5-0.77 ppm） contents, with therefore high Sr/Y （67.2-119） and （La/Yb）N （29.7-41.5） ratios, showing the geochemical characteristics of C type adakitic granite. The data displayed negligible Eu anomalies （Eu/Eu^＊ =0.77-1.08）, LREE-enriched and pronounced negative Nb and Ta anomalies. The C-type adakites in the studied area were most likely derived from the partial melting of a thickened lower continental curst. The magma source is most likely dominated by amphibolites and garnet amphibolites. In combination with previously-reported data from igneous rocks from the Mesozoic in NE China, we conclude that the Xing＇ an block was influenced by the Mongol-Okhotsk subduction tectonic system, and experiences compressive settings from the amalgamation of the Jiamusi block in the east of the CAOB.
文摘Objective.To introduce the properties of Chinese type A botulinum toxin(CBTXA,made by Lanzhou Institute of Biological Products),and its long?term effect for focal dystonia and hemifacial spasm.Method.The purity and recovery of crude and crystalline toxin were tested.Long?term data from305patients with hemifacial spasm(HFS),blepharospasm(BS)and cervical dystonia(CD)were evalu-ated and subgroups of patients received CBTXA injections between1994and2000in at least six sepa-rate treatment sessions,with follow up for2～8years.The therapeutic results of the last session CBTXA injections were analyzed in comparison with the first session.Result.CBTXA purity was high[(2.55～2.60)×10 7 LD50/mgPr ,A260/A280≤0.55,high molecular substance accounted for99.2%of total proteins].Long term treatment with CBTXA in patients with focal dystonia and HFS was not associated with any decline in benefit,and efficacy may improve slightly with repeat treatments.CBTXA is an excellent long-term treatment of HFS,BS and CD.Conclusion.We conclude that Chinese type A botulinum toxin is of botulinum toxin therapy quality standard according to results obtained from the basic study and long?term clinical applications.The re?injection of CBTXA significantly improves the quality of life of most patients and is a safe,effective and comparatively economical treatment for patients with focal dystonia and HFS.
文摘We report a case of multiple duodenal, pancreatic, and gastric carcinoids. A 67-year old woman was admitted to our hospital for treatment of a duodenal carcinoid. Laboratory tests revealed that the patient was associated with macrocytic anemia and hypergastrinemia, and type A gastritis was shown by gastrofiberscopy. During surgery, another tumor was incidentally found in the head of the pancreas. The tumors in the duodenum and pancreas were completely excised by pancreatoduodenectomy and immunohistologically diagnosed as gastrin-and serotonin-producing carcinoids, respectively. Pathological examination revealed that in addition to the grossly found carcinoids, there were subclinical carcinoids, one of which was an endocrine cell micronest, located in the stomach and duodenum. The tumors in the duodenum, pancreas, and stomach showed different characteristics from one another morphologically and immunochemically. Although no definitive evidence has been obtained, some sort of genetic anomaly may have been involved in this case, and hypergastrinemia due to duodenal gastrinoma may induce multiple gastric carcinoids.
