Objective:To study the efficacy of biofeedback combined with occupational therapy in stroke patients,including upper arm function,hand function,and self-care ability.Methods:A total of 60 stroke patients who met the i...Objective:To study the efficacy of biofeedback combined with occupational therapy in stroke patients,including upper arm function,hand function,and self-care ability.Methods:A total of 60 stroke patients who met the inclusion and exclusion criteria of this study were divided into a treatment group and a control group,with 30 cases in each group,using a random number table method.The total course of treatment was 4 weeks,with 5 treatments per week.Both groups received routine rehabilitation treatment,while the treatment group was supplemented with biofeedback therapy on the basis of routine rehabilitation.Before treatment and after 4 weeks of treatment,the Hemiplegic Hand Function Assessment Scale,Carroll Upper Extremity Function Assessment Scale,Wolf Motor Function Test(WMFT),and Brunnstrom Scale were used to evaluate patients’hand function,Activities of Daily Living(ADL)ability,and motor function,respectively.Adverse events during treatment were observed.Results:After treatment,the Brunnstrom stages,Carroll upper extremity function scores,and Wolf upper extremity function scores of patients in both groups were significantly improved(p<0.001),and the improvement effect in the treatment group was more significant(p<0.001).Conclusion:Stroke patients receiving basic rehabilitation treatment combined with occupational therapy and biofeedback therapy can better improve their upper arm and hand functions.Meanwhile,the combination of biofeedback therapy and occupational therapy is superior to occupational therapy alone,enhancing the self-care ability of stroke patients.展开更多
1 Introduction Recently,the increasing demand for advanced telecommunication systems has spurred extensive research into bandpass filters(BPFs),with particular emphasis on miniaturization,reduction of insertion loss(I...1 Introduction Recently,the increasing demand for advanced telecommunication systems has spurred extensive research into bandpass filters(BPFs),with particular emphasis on miniaturization,reduction of insertion loss(IL),and enhancement of upper stopband rejection(Huang et al.,2021;Snyder et al.,2021;Lin et al.,2023;Zeng et al.,2023).展开更多
Objective:To investigate the impact of targeted nursing interventions based on frailty prediction models on peri-hospitalization clinical outcomes in middle-aged and elderly patients with upper gastrointestinal bleedi...Objective:To investigate the impact of targeted nursing interventions based on frailty prediction models on peri-hospitalization clinical outcomes in middle-aged and elderly patients with upper gastrointestinal bleeding(UGIB).Methods:A prospective cohort study was conducted,and 126 middle-aged and elderly patients with UGIB admitted from August 2024 to August 2025 were selected as the study subjects.The patients were divided into the intervention group(63 cases)and the control group(63 cases)based on whether they received nursing intervention based on frailty prediction models.The control group received routine care,while the intervention group,on the basis of routine care,used the FRAIL scale combined with laboratory indicators(albumin,hemoglobin,etc.)to establish a predictive model to evaluate patients within 24 hours of admission,and implemented multi-dimensional targeted nursing intervention for pre-frailty or frailty patients screened out.The incidence of frailty,rebleeding rate,average length of stay,hospitalization cost,and nursing satisfaction during hospitalization were compared between the two groups.Results:The incidence of frailty during hospitalization in the intervention group was 11.1%(7 cases/63 cases),significantly lower than 31.7%(20 cases/63 cases)in the control group,and the difference was statistically significant(p<0.05).The rebleeding rate of 4.8%vs 12.7%,the average length of stay of(7.2±1.5)days vs(9.1±2.2)days,and the average hospitalization cost of(23,000±6,000)yuan vs(28,000±7,000)yuan in the intervention group were all lower than those in the control group(all p<0.05).The nursing satisfaction score of the intervention group(93.5±4.2)points was higher than that of the control group(86.3±5.8)points(p<0.05).Conclusion:The frailty prediction model applied to the peri-hospitalization care of middle-aged and elderly patients with UGIB can effectively identify frailty risk.Through early targeted intervention,the incidence of frailty and rebleeding rate can be reduced,the length of hospital stay can be shortened,medical expenses can be reduced,and nursing satisfaction can be improved,which has clinical promotion value.展开更多
Nail changes following upper extremity transplantation(UET)cannot be overlooked as they possess diagnostic and prognostic relevance in allotransplantation of upper limbs.This comprehensive review explores nail and nai...Nail changes following upper extremity transplantation(UET)cannot be overlooked as they possess diagnostic and prognostic relevance in allotransplantation of upper limbs.This comprehensive review explores nail and nail bed related changes encountered in UET recipients in the literature.The differential diagnosis of nail abnormalities in UET includes a wide range of systemic,local and iatrogenic conditions other than immune responses to the allograft.It requires interdisciplinary evaluation by primary transplant surgeons,pathologists,dermatologists and immunologists.The possible underlying mechanisms of nail pathology in UET and the management are discussed.It also underscores the importance of onychodystrophy and need for timely intervention and to improve outcomes in UET recipients.展开更多
Objective:To evaluate the clinical efficacy of blood-letting cupping combined with manual lymphatic drainage in treating breast cancer-related lymphedema(BCRL)and explore its mechanism of action from both traditional ...Objective:To evaluate the clinical efficacy of blood-letting cupping combined with manual lymphatic drainage in treating breast cancer-related lymphedema(BCRL)and explore its mechanism of action from both traditional Chinese medicine and modern medical perspectives,providing a scientific basis and novel therapeutic approaches for clinical management of BCRL.Methods:Patients with BCRL admitted to the outpatient and inpatient departments of Hebei University Affiliated Hospital were enrolled.A prospective randomized controlled trial design was adopted,with eligible patients randomly assigned to a treatment group and a control group.The control group received manual lymphatic drainage alone,while the treatment group received manual lymphtic drainage combined with blood-letting cupping therapy.Posttreatment comparisons evaluated upper limb circumference reduction,edema severity grading,and upper limb functional scores.Vital signs and adverse reactions during treatment were recorded for both groups.Statistical software analyzed the data.Results:The treatment group demonstrated significantly greater reduction in upper limb circumference,improvement in edema severity,and higher upper limb function scores compared to the control group(P<0.05).Vital signs remained stable throughout treatment in both groups.No severe adverse reactions occurred in the treatment group;only isolated cases of mild skin itching were reported,which resolved after symptomatic management.Conclusion:The combination of bloodletting cupping and manual lymphatic drainage demonstrates reliable efficacy in treating BCRL,effectively alleviating edema symptoms and improving upper limb function with high safety.Its mechanism may relate to traditional Chinese medicine principles of“unblocking meridians,promoting blood circulation,and resolving stasis”and modern medical concepts of“enhancing local blood circulation,facilitating lymphatic drainage,and reducing inflammatory responses”.展开更多
Temperature-dependent resistivity,upper critical field H_(c2)and its anisotropy in overdoped superconducting Ba_(1-x)K_x Fe_2As_2(x=0.6-1)single crystals have been measured in steady magnetic fields up to 44 T and low...Temperature-dependent resistivity,upper critical field H_(c2)and its anisotropy in overdoped superconducting Ba_(1-x)K_x Fe_2As_2(x=0.6-1)single crystals have been measured in steady magnetic fields up to 44 T and low temperatures down to 0.4 K.Analysis using both the quadratic term and power-law fitting demonstrates that the in-plane resistivityρ_(ab)(T)progressively approaches the Fermi-liquid T~2behavior with increasing K doping and reaches a saturation plateau at x≈0.8.The temperature dependence of both H_(c2)^(ab)and H^(c)_(c2)follows the Werthamer-Helfand-Hohenberg model,incorporating orbital and spin paramagnetic effects.For x≤0.8,the orbital effect dominates for H ab,while the Pauli paramagnetic effect prevails for H c.For x>0.8,the Pauli paramagnetic effect becomes dominant in both crystallographic directions.The anisotropy of H_(c2)(0)exhibits a discontinuity in its dependence on K doping concentration with a significant enhancement at x=0.8 and a maximum at x=0.9.These experimental results indicate that the electron correlation effect is enhanced in the heavily overdoped Ba_(1-x)K_(x)Fe_(2)As_(2)system where the underlying symmetries are broken due to the Fermi surface reconstruction before x=0.9.展开更多
By analyzing the deep seismic sounding profiles across the Longmen Shan,this paper focuses on the study of the relationship between the upper crust structure of the Longmen Shan area and the Wenchuan earthquake.The Lo...By analyzing the deep seismic sounding profiles across the Longmen Shan,this paper focuses on the study of the relationship between the upper crust structure of the Longmen Shan area and the Wenchuan earthquake.The Longmen Shan thrust belt marks not only the topographical change,but also the lateral velocity variation between the eastern Tibetan Plateau and the Sichuan Basin.A low-velocity layer has consistently been found in the crust beneath the eastern edge of the Tibetan Plateau,and ends beneath the western Sichuan Basin.The low-velocity layer at a depth of-20 km beneath the eastern edge of the Tibetan Plateau has been considered as the deep condition for favoring energy accumulation that formed the great Wenchuan earthquake.展开更多
A recently developed backward extrusion method entitled “modified backward extrusion” was presented using an upper bound analysis. For this purpose deformation area was divided into four distinct zones and a kinemat...A recently developed backward extrusion method entitled “modified backward extrusion” was presented using an upper bound analysis. For this purpose deformation area was divided into four distinct zones and a kinematically admissible velocity field for each of them was suggested. Total dissipated power was calculated for the deformation zones and the extrusion power wascomputed. The correlations of important geometrical parameters with extrusion force and dissipated powers were shown. Finding the initial billet size, a challenging area in the modified backward extrusion method, was discussed and the optimum billet radius was obtained, considering the minimum relative extrusion pressure. Finite element analyses were conducted and the results werecompared with the upper bound analysis. Finally, experiments were executed on commercially pure aluminium and a good agreement between upper bound and finite element analyses with experimental values was observed.展开更多
1 IntroductionIn this paper we study the existence of pullback attractors for multivalued nonautonomous and multivalued random semiflow. In [1] and [2], the authors have proved the existence of pullback attractors of ...1 IntroductionIn this paper we study the existence of pullback attractors for multivalued nonautonomous and multivalued random semiflow. In [1] and [2], the authors have proved the existence of pullback attractors of multivalued nonautonomous semiflow （random semiflow） under the assumption of the existence of compact absorbing set. In [3], the authors have proved the existence of pullback attractors of multivalued nonautonomous semiflow and random semiflow under the assumptions of uniformly pullback asymptotically upper semicompact and closed graph. In [4], the authors consider the existence of pullback attractor of singlevalued nonautonomous semiflow and random semiflow under the assumption of pullback asymptotic compactness. Instead of these assumptions, we consider multivalued nonautonomous semiflow and multivalued random semiflow with weak pullback asymptotic upper semi-compactness and prove the existence of pullback attractors.展开更多
OBJECTIVE:To investigate the effects of acupuncture combined with upper limb rehabilitation robot on neural remodeling and functional recovery in post-stroke patients.METHODS:There were 50 stroke patients were randoml...OBJECTIVE:To investigate the effects of acupuncture combined with upper limb rehabilitation robot on neural remodeling and functional recovery in post-stroke patients.METHODS:There were 50 stroke patients were randomly divided into an experimental group(acupuncture combined with upper limb rehabilitation robot assisted training)and a control group(upper limb rehabilitation robot assisted training).Various assessments were conducted to compare the effects of the two treatments on neural remodeling and functional recovery.Functional near-infrared spectroscopy technology was used to assess the effects of different treatments on neural plasticity and their impact on upper limb function and activities of daily living.RESULTS:The experimental group showed significantly higher concentrations of oxygenated hemoglobin and total hemoglobin in specific brain regions compared to the control group(P<0.05).Additionally,the experimental group had significantly lower concentrations of deoxygenated hemoglobin(P<0.05).After treatment,both groups showed improvements in various measures,but the experimental group had significantly greater improvements(P<0.05).CONCLUSION:Acupuncture combined with upper limb rehabilitation robot can effectively improve upper limb function and neural remodeling in stroke patients.This study supports the integration of Traditional Chinese and Western Medicine in improving limb dysfunction poststroke.展开更多
Background China is seeing a growing demand for rehabilitation treatments for post-stroke upper limb spastic paresis(PSSP-UL).Although acupuncture is known to be effective for PSSP-UL,there is room to enhance its effi...Background China is seeing a growing demand for rehabilitation treatments for post-stroke upper limb spastic paresis(PSSP-UL).Although acupuncture is known to be effective for PSSP-UL,there is room to enhance its efficacy.Objective This study explored a semi-personalized acupuncture approach for PSSP-UL that used three-dimensional kinematic analysis(3DKA)results to select additional acupoints,and investigated the feasibility,efficacy and safety of this approach.Design,setting,participants and interventions This single-blind,single-center,randomized,controlled trial involved 74 participants who experienced a first-ever ischemic or hemorrhagic stroke with spastic upper limb paresis.The participants were then randomly assigned to the intervention group or the control group in a 1:1 ratio.Both groups received conventional treatments and acupuncture treatment 5 days a week for 4 weeks.The main acupoints in both groups were the same,while participants in the intervention group received additional acupoints selected on the basis of 3DKA results.Follow-up assessments were conducted for 8 weeks after the treatment.Main outcome measures The primary outcome was the Fugl-Meyer Assessment for Upper Extremity(FMA-UE)response rate(≥6-point change)at week 4.Secondary outcomes included changes in motor function(FMA-UE),Brunnstrom recovery stage(BRS),manual muscle test(MMT),spasticity(Modified Ashworth Scale,MAS),and activities of daily life(Modified Barthel Index,MBI)at week 4 and week 12.Results Sixty-four participants completed the trial and underwent analyses.Compared with control group,the intervention group exhibited a significantly higher FMA-UE response rate at week 4(χ^(2)=5.479,P=0.019)and greater improvements in FMA-UE at both week 4 and week 12(both P<0.001).The intervention group also showed bigger improvements from baseline in the MMT grades for shoulder adduction and elbow flexion at weeks 4 and 12 as well as thumb adduction at week 4(P=0.007,P=0.049,P=0.019,P=0.008,P=0.029,respectively).The intervention group showed a better change in the MBI at both week 4 and week 12(P=0.004 and P=0.010,respectively).Although the intervention group had a higher BRS for the hand at week 12(P=0.041),no intergroup differences were observed at week 4(all P>0.05).The two groups showed no differences in MAS grades as well as in BRS for the arm at weeks 4 and 12(all P>0.05).Conclusion Semi-personalized acupuncture prescription based on 3DKA results significantly improved motor function,muscle strength,and activities of daily living in patients with PSSP-UL.展开更多
The Tan-Lu Fault Zone is a large NNE-trending fault zone that has a substantial effect on the development of eastern China and its earthquake disaster prevention efforts. Aiming at the azimuthally anisotropic structur...The Tan-Lu Fault Zone is a large NNE-trending fault zone that has a substantial effect on the development of eastern China and its earthquake disaster prevention efforts. Aiming at the azimuthally anisotropic structure in the upper crust and seismogenic tectonics in the Hefei segment of this fault, we collected phase velocity dispersion data of fundamental mode Rayleigh waves from ambient noise cross-correlation functions of ~400 temporal seismographs in an area of approximately 80 × 70 km along the fault zone. The period band of the dispersion data was ~0.5–10 s. We inverted for the upper crustal three-dimensional(3-D) shear velocity model with azimuthal anisotropy from the surface to 10 km depth by using a 3-D direct azimuthal anisotropy inversion method. The inversion result shows the spatial distribution characteristics of the tectonic units in the upper crust. Additionally, the deformation of the Tan-Lu Fault Zone and its conjugated fault systems could be inferred from the anisotropy model. In particular, the faults that have remained active from the early and middle Pleistocene control the anisotropic characteristics of the upper crustal structure in this area. The direction of fast axes near the fault zone area in the upper crust is consistent with the strike of the faults, whereas for the region far away from the fault zone, the direction of fast axes is consistent with the direction of the regional principal stress caused by plate movement. Combined with the azimuthal anisotropy models in the deep crust and uppermost mantle from the surface wave and Pn wave, the different anisotropic patterns caused by the Tan-Lu Fault Zone and its conjugated fault system nearby are shown in the upper and lower crust. Furthermore,by using the double-difference method, we relocated the Lujiang earthquake series, which contained 32 earthquakes with a depth shallower than 10 km. Both the Vs model and earthquake relocation results indicate that earthquakes mostly occurred in the vicinity of structural boundaries with fractured media, with high-level development of cracks and small-scale faults jammed between more rigid areas.展开更多
Taking the second member of the Xujiahe Formation of the Upper Triassic in the Xinchang structural belt as an example,based on data such as logging,production,seismic interpretation and test,a systematic analysis was ...Taking the second member of the Xujiahe Formation of the Upper Triassic in the Xinchang structural belt as an example,based on data such as logging,production,seismic interpretation and test,a systematic analysis was conducted on the structural characteristics and evolution,reservoir diagenesis and densification processes,and types and stages of faults/fractures,and revealing the multi-stage and multi-factor dynamic coupled enrichment mechanisms of tight gas reservoirs.(1)In the early Yanshan period,the paleo-structural traps were formed with low-medium maturity hydrocarbons accumulating in structural highs driven by buoyancy since reservoirs were not fully densified in this stage,demonstrating paleo-structure control on traps and early hydrocarbon accumulation.(2)In the middle-late Yanshan period,the source rocks became mature to generate and expel a large quantity of hydrocarbons.Grain size and type of sandstone controlled the time of reservoir densification,which restricted the scale of hydrocarbon charging,allowing for only a small-scale migration through sand bodies near the fault/fracture or less-densified matrix reservoirs.(3)During the Himalayan period,the source rocks reached overmaturity,and the residual oil cracking gas was efficiently transported along the late-stage faults/fractures.Wells with high production capacity were mainly located in Type I and II fault/fracture zones comprising the late-stage north-south trending fourth-order faults and the late-stage fractures.The productivity of the wells was controlled by the transformation of the late-stage faults/fractures.(4)The Xinchang structural belt underwent three stages of tectonic evolution,two stages of reservoir formation,and three stages of fault/fractures development.Hydrocarbons mainly accumulated in the paleo-structure highs.After reservoir densification and late fault/fracture adjustment,a complex gas-water distribution pattern was formed.Thus,it is summarized as the model of“near-source and low-abundance hydrocarbon charging in the early stage,and differential enrichment of natural gas under the joint control of fault-fold-fracture complex,high-quality reservoirs and structural highs in the late stage”.Faults/fractures with well-coupled fault-fold-fracture-pore are favorable exploration targets with high exploration effectiveness.展开更多
Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives ...Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives and may lead them to be confined to bed.However,the effect of upper and lower motor neuron impairment and other risk factors on bilateral limb involvement is unclear.To address this issue,we retrospectively collected data from 586 amyotrophic lateral sclerosis patients with limb onset diagnosed at Peking University Third Hospital between January 2020 and May 2022.A univariate analysis revealed no significant differences in the time intervals of spread in different directions between individuals with upper motor neuron-dominant amyotrophic lateral sclerosis and those with classic amyotrophic lateral sclerosis.We used causal directed acyclic graphs for risk factor determination and Cox proportional hazards models to investigate the association between the duration of bilateral limb involvement and clinical baseline characteristics in amyotrophic lateral sclerosis patients.Multiple factor analyses revealed that higher upper motor neuron scores(hazard ratio[HR]=1.05,95%confidence interval[CI]=1.01–1.09,P=0.018),onset in the left limb(HR=0.72,95%CI=0.58–0.89,P=0.002),and a horizontal pattern of progression(HR=0.46,95%CI=0.37–0.58,P<0.001)were risk factors for a shorter interval until bilateral limb involvement.The results demonstrated that a greater degree of upper motor neuron involvement might cause contralateral limb involvement to progress more quickly in limb-onset amyotrophic lateral sclerosis patients.These findings may improve the management of amyotrophic lateral sclerosis patients with limb onset and the prediction of patient prognosis.展开更多
The Upper Cretaceous of Tantou Basin in western Henan has yielded many vertebrate fossils,which are featured by several non-avian dinosaurs.Meanwhile,studies on their eggs were yet inadequate though many eggshells hav...The Upper Cretaceous of Tantou Basin in western Henan has yielded many vertebrate fossils,which are featured by several non-avian dinosaurs.Meanwhile,studies on their eggs were yet inadequate though many eggshells have been reported.The newly discovered material 41HⅤ0199 was excavated from the Upper Cretaceous Qiupa Formation in 2021.The block preserves eight complete eggs arranged in two partial rings that form a partial clutch,and there are some scattered eggshells preserved closely with the block,showing a concave-up to concave-down ratio of 54.5:45.5,which indicates that the scattered eggshells come from the clutch and the clutch had been partially broken before it was buried.Based on morphological and microstructural characteristics,the eggs and eggshells can be assigned to Macroolithus yaotunensis(Elongatoolithidae),an oospecies known to be related to oviraptorids,which leads Yulong mini to be its probable producer.Besides,some eggshells show microstructural signs indicating egg retention,which marks the second example of egg retention in the oofamily Elongatoolithidae.展开更多
[Objective]Implementation of the Ten-Year Fishing Ban policy may alter fish diversity and niche characteristics of dominant species in spawning grounds within the National Nature Reserve for Rare and Endemic Fish in t...[Objective]Implementation of the Ten-Year Fishing Ban policy may alter fish diversity and niche characteristics of dominant species in spawning grounds within the National Nature Reserve for Rare and Endemic Fish in the Upper Yangtze River.This study initiated continuous monitoring of natural spawning habitats from February 2022 to assess these ecological changes.[Methods]Environmental DNA(eDNA)metabarcoding was employed to analyze fish species composition,biodiversity patterns,and niche parameters of dominant species.Water sampling followed the CEN/TS 19461 standard across five monitoring transects(ZT1-ZT5).[Results]The eDNA analysis detected 45 species of fish belonging to 38 genera,13 families,and 3 orders were detected through environmental DNA(eDNA)in this survey,including 10 species endemic to the upper reaches of the Yangtze River,such as Procypris rabaudi and Myxocyprinus asiaticus.The fish community was mainly composed of bottom-dwelling,settling ovum-producing,omnivorous fish.The variation ranges of the Chao1 index,ACE index,Shannon index,and Simpson index are 736~996,719~965,1.58~3.23,and 0.83~0.99,respectively,indicating that fish species in spawning sites are abundant and community distribution uniformity is high.All indexes are highest at ZT1 monitoring points.Cluster analysis showed that,at a certain similarity level,fish community types in spawning sites could be basically divided into two groups:ZT1,ZT3,and ZT5 clustered together,and ZT2 and ZT4 clustered together,indicating similar fish community habitats.There are 9 dominant fish species in typical deep pool habitats in the reserve,with niche widths(Bi)ranging from 1.13 to 3.87.The dominant fish species are broad and medium niche fish,such as Cyprinus carpio and Hemiculter tchangi,with the niche overlap index(Oik)of some dominant fish species reaching more than 0.95.This indicates fierce competition for resources among the fish in this spawning ground.[Conclusion]The Zhutuo spawning ground demonstrates high species richness with homogeneous community structure and intense resource competition.This study establishes an eDNA-based monitoring framework that enhances conventional survey method,providing critical baseline data for adaptive management under the fishing moratorium regime.展开更多
Objective:This article reviews the latest updates and outcomes of kidney-sparing surgery(KSS)in patients with upper tract urothelial carcinoma(UTUC).Methods:A comprehensive literature search was performed using the Pu...Objective:This article reviews the latest updates and outcomes of kidney-sparing surgery(KSS)in patients with upper tract urothelial carcinoma(UTUC).Methods:A comprehensive literature search was performed using the PubMed and Embase databases to identify related English-language studies published within the last 10 years.Key search words included“upper urinary tract tumour/cancer/carcinoma”,“kidney-sparing surgery or approach”,“endoscopic treatment for upper tract tumour/cancer/carcinoma”,“topical instillation in the upper urinary tract”,and“urinary marker for urothelial carcinoma”.References within the identified literature were explored and evaluated for relevance.Results:KSS is recommended for both low-risk and selected high-risk UTUC with imperative indications such as solitary kidney.Studies have shown comparable oncological outcomes after KSS including endoscopic ablation,segmental ureterectomy,and topical instillation of novel agents when compared to radical nephroureterectomy in well-selected cases.The development of novel diagnostic tools and risk-stratifying models allows optimal case selection for KSS without compromising oncological outcomes.Conclusion:Kidney-sparing approach for UTUC is an evolving and promising area in urologic oncology,driven by advances in technology,better diagnostic tools,and novel therapeutic agents.Our article provides a comprehensive review of the latest advancements and clinical recommendations.While current evidence is mainly based on retrospective studies,prospective trials are required to address important but unanswered clinical questions in this field.展开更多
The Upper Cretaceous successions of Wadi Umm-Khayshar,southern Galala Plateau,North Eastern Desert,Egypt,are composed of highly diversified faunas and subdivided from base to top into the Galala(Middle-Late Cenomanian...The Upper Cretaceous successions of Wadi Umm-Khayshar,southern Galala Plateau,North Eastern Desert,Egypt,are composed of highly diversified faunas and subdivided from base to top into the Galala(Middle-Late Cenomanian),Maghra El Hadida(Latest Cenomanian-Late Turonian),Matulla(Coniacian-Santonian),and Sudr(Campanian-Maastrichtian)formations.Five ammonite biozones are recorded in the studied section:Neolobites vibrayeanus,Vascoceras cauvini(late Cenomanian),Vascoceras proprium,Choffaticeras segne,and Coilopoceras requienianum(Turonian)zones.The paleoenvironments of the Upper Cretaceous succession are interpreted based on detailed study and microfacies analysis that reflect a deposition in a homoclinal ramp platform ranging from intertidal to deep subtidal.The paleoecology of the Cenomanian-Turonian succession in the studied section is explained based on a detailed study of macrofaunal associations and sedimentary facies.Quantitative analysis(Q-mode cluster analysis,using the Raup-Crick Paired group method)of 1029 macrobenthic specimens,including 45 species of mollusks and echinoids yielded five macrofaunal associations(A-E)that are described and interpreted as remnants of communities.The nektonic elements are represented by 235 cephalopod specimens of 20 species;heatmap cluster analyses show the distribution of these specimens during the Upper Cenomanian-Turonian stages.Environmental parameters(substrate consistency,rate of sedimentation,water energy,surface-water productivity,and oxygen availability)controlled the distribution of the studied macrofauna.The five associations are divided into two major groups:low-stress associations(A,B,C,and D),and a highstress association(E).The low stress associations are recorded from two different habitats:(1)a high-energy,firm substrate habitat,dominated by epifaunal bivalves,large epifaunal gastropods and a regular echinoid;(2)a low-energy,soft substrate habitat dominated by infaunal bivalves and echinoids.The high stress association is dominated by only two species and recorded from a high-energy shoal environment during a regression phase.A detailed study of macrobenthos and cephalopods provides a good paleoecological understanding of Cenomanian-Turonian succession in the Wadi Umm-Khayshar section.展开更多
BACKGROUND Acute nonvariceal upper gastrointestinal bleeding(NVUGIB)is a life-threatening emergency.Endoscopic hemostasis and vascular interventional therapy are two major minimally invasive treatment strategies.Altho...BACKGROUND Acute nonvariceal upper gastrointestinal bleeding(NVUGIB)is a life-threatening emergency.Endoscopic hemostasis and vascular interventional therapy are two major minimally invasive treatment strategies.Although these modalities are widely used,their comparative efficacy and safety across different patient populations and anatomical sites remain controversial.AIM To evaluate the clinical outcomes and safety of endoscopic hemostasis combined with vascular interventional therapy for NVUGIB.METHODS A systematic search was done on PubMed,EMBASE,Cochrane Library,and Web of Science(from database establishment to April 2025).Randomized controlled trial(RCT)quality was assessed via Cochrane RoB 2.0,and observational studies via the Critical Appraisal Skills Program.RevMan 5.4 was used for quantitative analysis;fixed/random-effects models were chosen through I^(2)-assessed heterogeneity.Publication bias was checked using funnel plots and sensitivity analysis via model switching.RESULTS Twenty-one studies(3 RCTs,12 single-group studies,and 6 retrospective cohort studies)with good quality were included.For single-group data,combined therapy had risk differences of 0.70(clinical success),0.24(mortality),and 0.22(rebleeding;all P<0.00001,I^(2)=0).Moreover,the≥60-year rebleeding risk difference was 0.43.Reintervention was found to differ by approach(Z=3.03,P=0.002,inter-subgroup I^(2)=99%).In the RCT and cohort studies,combined vs standard therapy had similar initial hemostasis(Z=0.04,P=0.97)and mortality(Z=1.56,P=0.12)but lower rebleeding(Z=3.26/P=0.001;Z=2.95/P=0.03).Symmetrical funnel plots and robust sensitivity analysis showed no publication bias.CONCLUSION Combined endoscopic hemostasis and vascular interventional therapy for acute NVUGIB can significantly reduce rebleeding,without differences in mortality.Age and vascular interventional methods may influence the therapeutic efficacy.展开更多
Upper gastrointestinal bleeding (UGIB) refers to the bleeding caused by the digestive tract above the flexor ligament, including esophageal, gastric, duodenal, pancreatic and biliary diseases, and lesions after gastro...Upper gastrointestinal bleeding (UGIB) refers to the bleeding caused by the digestive tract above the flexor ligament, including esophageal, gastric, duodenal, pancreatic and biliary diseases, and lesions after gastrojejunostomy. UGIB is one of the common diseases in the clinical work of gastroenterology. There are many causes that can lead to upper gastrointestinal bleeding, which are mainly divided into two categories: one is non-variceal upper gastrointestinal bleeding (NVUGIB), and the other is variceal upper gastrointestinal bleeding (VUGIB). This article reviews various causes of UGIB and the latest progress in treatment, aiming to improve the efficiency of diagnosis and treatment in future clinical work, and reduce the risk of rebleeding and mortality.展开更多
文摘Objective:To study the efficacy of biofeedback combined with occupational therapy in stroke patients,including upper arm function,hand function,and self-care ability.Methods:A total of 60 stroke patients who met the inclusion and exclusion criteria of this study were divided into a treatment group and a control group,with 30 cases in each group,using a random number table method.The total course of treatment was 4 weeks,with 5 treatments per week.Both groups received routine rehabilitation treatment,while the treatment group was supplemented with biofeedback therapy on the basis of routine rehabilitation.Before treatment and after 4 weeks of treatment,the Hemiplegic Hand Function Assessment Scale,Carroll Upper Extremity Function Assessment Scale,Wolf Motor Function Test(WMFT),and Brunnstrom Scale were used to evaluate patients’hand function,Activities of Daily Living(ADL)ability,and motor function,respectively.Adverse events during treatment were observed.Results:After treatment,the Brunnstrom stages,Carroll upper extremity function scores,and Wolf upper extremity function scores of patients in both groups were significantly improved(p<0.001),and the improvement effect in the treatment group was more significant(p<0.001).Conclusion:Stroke patients receiving basic rehabilitation treatment combined with occupational therapy and biofeedback therapy can better improve their upper arm and hand functions.Meanwhile,the combination of biofeedback therapy and occupational therapy is superior to occupational therapy alone,enhancing the self-care ability of stroke patients.
基金supported by the National Natural Science Foundation of China(No.62371263)the Postgraduate Research&Practice Innovation Program of Jiangsu Province(No.SJCK25_1995).
文摘1 Introduction Recently,the increasing demand for advanced telecommunication systems has spurred extensive research into bandpass filters(BPFs),with particular emphasis on miniaturization,reduction of insertion loss(IL),and enhancement of upper stopband rejection(Huang et al.,2021;Snyder et al.,2021;Lin et al.,2023;Zeng et al.,2023).
基金Construction and Application of Frailty Trajectory Prediction Model for Middle-aged and Elderly Patients with Upper Gastrointestinal Bleeding,Project Source:Sichuan Vocational College of Nursing(Project No.:2024ZRY25)。
文摘Objective:To investigate the impact of targeted nursing interventions based on frailty prediction models on peri-hospitalization clinical outcomes in middle-aged and elderly patients with upper gastrointestinal bleeding(UGIB).Methods:A prospective cohort study was conducted,and 126 middle-aged and elderly patients with UGIB admitted from August 2024 to August 2025 were selected as the study subjects.The patients were divided into the intervention group(63 cases)and the control group(63 cases)based on whether they received nursing intervention based on frailty prediction models.The control group received routine care,while the intervention group,on the basis of routine care,used the FRAIL scale combined with laboratory indicators(albumin,hemoglobin,etc.)to establish a predictive model to evaluate patients within 24 hours of admission,and implemented multi-dimensional targeted nursing intervention for pre-frailty or frailty patients screened out.The incidence of frailty,rebleeding rate,average length of stay,hospitalization cost,and nursing satisfaction during hospitalization were compared between the two groups.Results:The incidence of frailty during hospitalization in the intervention group was 11.1%(7 cases/63 cases),significantly lower than 31.7%(20 cases/63 cases)in the control group,and the difference was statistically significant(p<0.05).The rebleeding rate of 4.8%vs 12.7%,the average length of stay of(7.2±1.5)days vs(9.1±2.2)days,and the average hospitalization cost of(23,000±6,000)yuan vs(28,000±7,000)yuan in the intervention group were all lower than those in the control group(all p<0.05).The nursing satisfaction score of the intervention group(93.5±4.2)points was higher than that of the control group(86.3±5.8)points(p<0.05).Conclusion:The frailty prediction model applied to the peri-hospitalization care of middle-aged and elderly patients with UGIB can effectively identify frailty risk.Through early targeted intervention,the incidence of frailty and rebleeding rate can be reduced,the length of hospital stay can be shortened,medical expenses can be reduced,and nursing satisfaction can be improved,which has clinical promotion value.
文摘Nail changes following upper extremity transplantation(UET)cannot be overlooked as they possess diagnostic and prognostic relevance in allotransplantation of upper limbs.This comprehensive review explores nail and nail bed related changes encountered in UET recipients in the literature.The differential diagnosis of nail abnormalities in UET includes a wide range of systemic,local and iatrogenic conditions other than immune responses to the allograft.It requires interdisciplinary evaluation by primary transplant surgeons,pathologists,dermatologists and immunologists.The possible underlying mechanisms of nail pathology in UET and the management are discussed.It also underscores the importance of onychodystrophy and need for timely intervention and to improve outcomes in UET recipients.
文摘Objective:To evaluate the clinical efficacy of blood-letting cupping combined with manual lymphatic drainage in treating breast cancer-related lymphedema(BCRL)and explore its mechanism of action from both traditional Chinese medicine and modern medical perspectives,providing a scientific basis and novel therapeutic approaches for clinical management of BCRL.Methods:Patients with BCRL admitted to the outpatient and inpatient departments of Hebei University Affiliated Hospital were enrolled.A prospective randomized controlled trial design was adopted,with eligible patients randomly assigned to a treatment group and a control group.The control group received manual lymphatic drainage alone,while the treatment group received manual lymphtic drainage combined with blood-letting cupping therapy.Posttreatment comparisons evaluated upper limb circumference reduction,edema severity grading,and upper limb functional scores.Vital signs and adverse reactions during treatment were recorded for both groups.Statistical software analyzed the data.Results:The treatment group demonstrated significantly greater reduction in upper limb circumference,improvement in edema severity,and higher upper limb function scores compared to the control group(P<0.05).Vital signs remained stable throughout treatment in both groups.No severe adverse reactions occurred in the treatment group;only isolated cases of mild skin itching were reported,which resolved after symptomatic management.Conclusion:The combination of bloodletting cupping and manual lymphatic drainage demonstrates reliable efficacy in treating BCRL,effectively alleviating edema symptoms and improving upper limb function with high safety.Its mechanism may relate to traditional Chinese medicine principles of“unblocking meridians,promoting blood circulation,and resolving stasis”and modern medical concepts of“enhancing local blood circulation,facilitating lymphatic drainage,and reducing inflammatory responses”.
基金supported by the National Key Research and Development Program of China(Grant Nos.2024YFA1611100,2023YFA1406100,and 2018YFA0704201)the Systematic Fundamental Research Program Leveraging Major Scientific and Technological Infrastructure,Chinese Academy of Sciences(Grant No.JZHKYPT-2021-08)+1 种基金the National Natural Science Foundation of China(Grant Nos.11704385,11874359,and 12274444)the Strategic Priority Research Program(B)of the Chinese Academy of Sciences(Grant No.XDB25000000)。
文摘Temperature-dependent resistivity,upper critical field H_(c2)and its anisotropy in overdoped superconducting Ba_(1-x)K_x Fe_2As_2(x=0.6-1)single crystals have been measured in steady magnetic fields up to 44 T and low temperatures down to 0.4 K.Analysis using both the quadratic term and power-law fitting demonstrates that the in-plane resistivityρ_(ab)(T)progressively approaches the Fermi-liquid T~2behavior with increasing K doping and reaches a saturation plateau at x≈0.8.The temperature dependence of both H_(c2)^(ab)and H^(c)_(c2)follows the Werthamer-Helfand-Hohenberg model,incorporating orbital and spin paramagnetic effects.For x≤0.8,the orbital effect dominates for H ab,while the Pauli paramagnetic effect prevails for H c.For x>0.8,the Pauli paramagnetic effect becomes dominant in both crystallographic directions.The anisotropy of H_(c2)(0)exhibits a discontinuity in its dependence on K doping concentration with a significant enhancement at x=0.8 and a maximum at x=0.9.These experimental results indicate that the electron correlation effect is enhanced in the heavily overdoped Ba_(1-x)K_(x)Fe_(2)As_(2)system where the underlying symmetries are broken due to the Fermi surface reconstruction before x=0.9.
基金financed by International Sciences and Technology cooperation(2006DFA21340)the special funds for Sciences and technology research of public welfare trades(200811021)+2 种基金the key innovation project for sciences and technology of ministry of land and resources(1212010711813)the Basic outlay of scientific research work from Ministry of Science and Technology of the People's Republic of China(J0803)the National Natural Science Foundation of China(40830316 and 40874045)and SINOPPROBE-02
文摘By analyzing the deep seismic sounding profiles across the Longmen Shan,this paper focuses on the study of the relationship between the upper crust structure of the Longmen Shan area and the Wenchuan earthquake.The Longmen Shan thrust belt marks not only the topographical change,but also the lateral velocity variation between the eastern Tibetan Plateau and the Sichuan Basin.A low-velocity layer has consistently been found in the crust beneath the eastern edge of the Tibetan Plateau,and ends beneath the western Sichuan Basin.The low-velocity layer at a depth of-20 km beneath the eastern edge of the Tibetan Plateau has been considered as the deep condition for favoring energy accumulation that formed the great Wenchuan earthquake.
文摘A recently developed backward extrusion method entitled “modified backward extrusion” was presented using an upper bound analysis. For this purpose deformation area was divided into four distinct zones and a kinematically admissible velocity field for each of them was suggested. Total dissipated power was calculated for the deformation zones and the extrusion power wascomputed. The correlations of important geometrical parameters with extrusion force and dissipated powers were shown. Finding the initial billet size, a challenging area in the modified backward extrusion method, was discussed and the optimum billet radius was obtained, considering the minimum relative extrusion pressure. Finite element analyses were conducted and the results werecompared with the upper bound analysis. Finally, experiments were executed on commercially pure aluminium and a good agreement between upper bound and finite element analyses with experimental values was observed.
文摘1 IntroductionIn this paper we study the existence of pullback attractors for multivalued nonautonomous and multivalued random semiflow. In [1] and [2], the authors have proved the existence of pullback attractors of multivalued nonautonomous semiflow （random semiflow） under the assumption of the existence of compact absorbing set. In [3], the authors have proved the existence of pullback attractors of multivalued nonautonomous semiflow and random semiflow under the assumptions of uniformly pullback asymptotically upper semicompact and closed graph. In [4], the authors consider the existence of pullback attractor of singlevalued nonautonomous semiflow and random semiflow under the assumption of pullback asymptotic compactness. Instead of these assumptions, we consider multivalued nonautonomous semiflow and multivalued random semiflow with weak pullback asymptotic upper semi-compactness and prove the existence of pullback attractors.
基金Supported by Zhejiang Province Traditional Chinese Medicine Science and Technology Project(2024ZL769):Effect of Xingshen Kaiqiao Acupuncture Method combined with Upper Limb Robot-assisted Training on Upper Limb Function and Neuroplasticity Mechanism of Hemiplegia after Stroke based on Functional Near-Infrared Spectroscopy Technology。
文摘OBJECTIVE:To investigate the effects of acupuncture combined with upper limb rehabilitation robot on neural remodeling and functional recovery in post-stroke patients.METHODS:There were 50 stroke patients were randomly divided into an experimental group(acupuncture combined with upper limb rehabilitation robot assisted training)and a control group(upper limb rehabilitation robot assisted training).Various assessments were conducted to compare the effects of the two treatments on neural remodeling and functional recovery.Functional near-infrared spectroscopy technology was used to assess the effects of different treatments on neural plasticity and their impact on upper limb function and activities of daily living.RESULTS:The experimental group showed significantly higher concentrations of oxygenated hemoglobin and total hemoglobin in specific brain regions compared to the control group(P<0.05).Additionally,the experimental group had significantly lower concentrations of deoxygenated hemoglobin(P<0.05).After treatment,both groups showed improvements in various measures,but the experimental group had significantly greater improvements(P<0.05).CONCLUSION:Acupuncture combined with upper limb rehabilitation robot can effectively improve upper limb function and neural remodeling in stroke patients.This study supports the integration of Traditional Chinese and Western Medicine in improving limb dysfunction poststroke.
基金funded by Science Foundation for Youth supported by Shanghai Municipal Health Commission(No.20204Y0313)Sailing Program with the support of Science and Technology Commission of Shanghai Municipality(No.21YF1443800).
文摘Background China is seeing a growing demand for rehabilitation treatments for post-stroke upper limb spastic paresis(PSSP-UL).Although acupuncture is known to be effective for PSSP-UL,there is room to enhance its efficacy.Objective This study explored a semi-personalized acupuncture approach for PSSP-UL that used three-dimensional kinematic analysis(3DKA)results to select additional acupoints,and investigated the feasibility,efficacy and safety of this approach.Design,setting,participants and interventions This single-blind,single-center,randomized,controlled trial involved 74 participants who experienced a first-ever ischemic or hemorrhagic stroke with spastic upper limb paresis.The participants were then randomly assigned to the intervention group or the control group in a 1:1 ratio.Both groups received conventional treatments and acupuncture treatment 5 days a week for 4 weeks.The main acupoints in both groups were the same,while participants in the intervention group received additional acupoints selected on the basis of 3DKA results.Follow-up assessments were conducted for 8 weeks after the treatment.Main outcome measures The primary outcome was the Fugl-Meyer Assessment for Upper Extremity(FMA-UE)response rate(≥6-point change)at week 4.Secondary outcomes included changes in motor function(FMA-UE),Brunnstrom recovery stage(BRS),manual muscle test(MMT),spasticity(Modified Ashworth Scale,MAS),and activities of daily life(Modified Barthel Index,MBI)at week 4 and week 12.Results Sixty-four participants completed the trial and underwent analyses.Compared with control group,the intervention group exhibited a significantly higher FMA-UE response rate at week 4(χ^(2)=5.479,P=0.019)and greater improvements in FMA-UE at both week 4 and week 12(both P<0.001).The intervention group also showed bigger improvements from baseline in the MMT grades for shoulder adduction and elbow flexion at weeks 4 and 12 as well as thumb adduction at week 4(P=0.007,P=0.049,P=0.019,P=0.008,P=0.029,respectively).The intervention group showed a better change in the MBI at both week 4 and week 12(P=0.004 and P=0.010,respectively).Although the intervention group had a higher BRS for the hand at week 12(P=0.041),no intergroup differences were observed at week 4(all P>0.05).The two groups showed no differences in MAS grades as well as in BRS for the arm at weeks 4 and 12(all P>0.05).Conclusion Semi-personalized acupuncture prescription based on 3DKA results significantly improved motor function,muscle strength,and activities of daily living in patients with PSSP-UL.
基金financially supported by the National Key Research and Development Program of China (2022YFC3005600)the Foundation of the Anhui Educational Commission (2023AH051198)+1 种基金the National Natural Science Foundation of China (42125401 and 42104063)the Joint Open Fund of Mengcheng National Geophysical Observatory (MENGO-202201)。
文摘The Tan-Lu Fault Zone is a large NNE-trending fault zone that has a substantial effect on the development of eastern China and its earthquake disaster prevention efforts. Aiming at the azimuthally anisotropic structure in the upper crust and seismogenic tectonics in the Hefei segment of this fault, we collected phase velocity dispersion data of fundamental mode Rayleigh waves from ambient noise cross-correlation functions of ~400 temporal seismographs in an area of approximately 80 × 70 km along the fault zone. The period band of the dispersion data was ~0.5–10 s. We inverted for the upper crustal three-dimensional(3-D) shear velocity model with azimuthal anisotropy from the surface to 10 km depth by using a 3-D direct azimuthal anisotropy inversion method. The inversion result shows the spatial distribution characteristics of the tectonic units in the upper crust. Additionally, the deformation of the Tan-Lu Fault Zone and its conjugated fault systems could be inferred from the anisotropy model. In particular, the faults that have remained active from the early and middle Pleistocene control the anisotropic characteristics of the upper crustal structure in this area. The direction of fast axes near the fault zone area in the upper crust is consistent with the strike of the faults, whereas for the region far away from the fault zone, the direction of fast axes is consistent with the direction of the regional principal stress caused by plate movement. Combined with the azimuthal anisotropy models in the deep crust and uppermost mantle from the surface wave and Pn wave, the different anisotropic patterns caused by the Tan-Lu Fault Zone and its conjugated fault system nearby are shown in the upper and lower crust. Furthermore,by using the double-difference method, we relocated the Lujiang earthquake series, which contained 32 earthquakes with a depth shallower than 10 km. Both the Vs model and earthquake relocation results indicate that earthquakes mostly occurred in the vicinity of structural boundaries with fractured media, with high-level development of cracks and small-scale faults jammed between more rigid areas.
基金Supported by the National Natural Science Foundation of China(42302141).
文摘Taking the second member of the Xujiahe Formation of the Upper Triassic in the Xinchang structural belt as an example,based on data such as logging,production,seismic interpretation and test,a systematic analysis was conducted on the structural characteristics and evolution,reservoir diagenesis and densification processes,and types and stages of faults/fractures,and revealing the multi-stage and multi-factor dynamic coupled enrichment mechanisms of tight gas reservoirs.(1)In the early Yanshan period,the paleo-structural traps were formed with low-medium maturity hydrocarbons accumulating in structural highs driven by buoyancy since reservoirs were not fully densified in this stage,demonstrating paleo-structure control on traps and early hydrocarbon accumulation.(2)In the middle-late Yanshan period,the source rocks became mature to generate and expel a large quantity of hydrocarbons.Grain size and type of sandstone controlled the time of reservoir densification,which restricted the scale of hydrocarbon charging,allowing for only a small-scale migration through sand bodies near the fault/fracture or less-densified matrix reservoirs.(3)During the Himalayan period,the source rocks reached overmaturity,and the residual oil cracking gas was efficiently transported along the late-stage faults/fractures.Wells with high production capacity were mainly located in Type I and II fault/fracture zones comprising the late-stage north-south trending fourth-order faults and the late-stage fractures.The productivity of the wells was controlled by the transformation of the late-stage faults/fractures.(4)The Xinchang structural belt underwent three stages of tectonic evolution,two stages of reservoir formation,and three stages of fault/fractures development.Hydrocarbons mainly accumulated in the paleo-structure highs.After reservoir densification and late fault/fracture adjustment,a complex gas-water distribution pattern was formed.Thus,it is summarized as the model of“near-source and low-abundance hydrocarbon charging in the early stage,and differential enrichment of natural gas under the joint control of fault-fold-fracture complex,high-quality reservoirs and structural highs in the late stage”.Faults/fractures with well-coupled fault-fold-fracture-pore are favorable exploration targets with high exploration effectiveness.
基金supported by the National Natural Science Foundation of China,Nos.82071426,81873784Clinical Cohort Construction Program of Peking University Third Hospital,No.BYSYDL2019002(all to DF)。
文摘Amyotrophic lateral sclerosis is a rare neurodegenerative disease characterized by the involvement of both upper and lower motor neurons.Early bilateral limb involvement significantly affects patients'daily lives and may lead them to be confined to bed.However,the effect of upper and lower motor neuron impairment and other risk factors on bilateral limb involvement is unclear.To address this issue,we retrospectively collected data from 586 amyotrophic lateral sclerosis patients with limb onset diagnosed at Peking University Third Hospital between January 2020 and May 2022.A univariate analysis revealed no significant differences in the time intervals of spread in different directions between individuals with upper motor neuron-dominant amyotrophic lateral sclerosis and those with classic amyotrophic lateral sclerosis.We used causal directed acyclic graphs for risk factor determination and Cox proportional hazards models to investigate the association between the duration of bilateral limb involvement and clinical baseline characteristics in amyotrophic lateral sclerosis patients.Multiple factor analyses revealed that higher upper motor neuron scores(hazard ratio[HR]=1.05,95%confidence interval[CI]=1.01–1.09,P=0.018),onset in the left limb(HR=0.72,95%CI=0.58–0.89,P=0.002),and a horizontal pattern of progression(HR=0.46,95%CI=0.37–0.58,P<0.001)were risk factors for a shorter interval until bilateral limb involvement.The results demonstrated that a greater degree of upper motor neuron involvement might cause contralateral limb involvement to progress more quickly in limb-onset amyotrophic lateral sclerosis patients.These findings may improve the management of amyotrophic lateral sclerosis patients with limb onset and the prediction of patient prognosis.
文摘The Upper Cretaceous of Tantou Basin in western Henan has yielded many vertebrate fossils,which are featured by several non-avian dinosaurs.Meanwhile,studies on their eggs were yet inadequate though many eggshells have been reported.The newly discovered material 41HⅤ0199 was excavated from the Upper Cretaceous Qiupa Formation in 2021.The block preserves eight complete eggs arranged in two partial rings that form a partial clutch,and there are some scattered eggshells preserved closely with the block,showing a concave-up to concave-down ratio of 54.5:45.5,which indicates that the scattered eggshells come from the clutch and the clutch had been partially broken before it was buried.Based on morphological and microstructural characteristics,the eggs and eggshells can be assigned to Macroolithus yaotunensis(Elongatoolithidae),an oospecies known to be related to oviraptorids,which leads Yulong mini to be its probable producer.Besides,some eggshells show microstructural signs indicating egg retention,which marks the second example of egg retention in the oofamily Elongatoolithidae.
文摘[Objective]Implementation of the Ten-Year Fishing Ban policy may alter fish diversity and niche characteristics of dominant species in spawning grounds within the National Nature Reserve for Rare and Endemic Fish in the Upper Yangtze River.This study initiated continuous monitoring of natural spawning habitats from February 2022 to assess these ecological changes.[Methods]Environmental DNA(eDNA)metabarcoding was employed to analyze fish species composition,biodiversity patterns,and niche parameters of dominant species.Water sampling followed the CEN/TS 19461 standard across five monitoring transects(ZT1-ZT5).[Results]The eDNA analysis detected 45 species of fish belonging to 38 genera,13 families,and 3 orders were detected through environmental DNA(eDNA)in this survey,including 10 species endemic to the upper reaches of the Yangtze River,such as Procypris rabaudi and Myxocyprinus asiaticus.The fish community was mainly composed of bottom-dwelling,settling ovum-producing,omnivorous fish.The variation ranges of the Chao1 index,ACE index,Shannon index,and Simpson index are 736~996,719~965,1.58~3.23,and 0.83~0.99,respectively,indicating that fish species in spawning sites are abundant and community distribution uniformity is high.All indexes are highest at ZT1 monitoring points.Cluster analysis showed that,at a certain similarity level,fish community types in spawning sites could be basically divided into two groups:ZT1,ZT3,and ZT5 clustered together,and ZT2 and ZT4 clustered together,indicating similar fish community habitats.There are 9 dominant fish species in typical deep pool habitats in the reserve,with niche widths(Bi)ranging from 1.13 to 3.87.The dominant fish species are broad and medium niche fish,such as Cyprinus carpio and Hemiculter tchangi,with the niche overlap index(Oik)of some dominant fish species reaching more than 0.95.This indicates fierce competition for resources among the fish in this spawning ground.[Conclusion]The Zhutuo spawning ground demonstrates high species richness with homogeneous community structure and intense resource competition.This study establishes an eDNA-based monitoring framework that enhances conventional survey method,providing critical baseline data for adaptive management under the fishing moratorium regime.
文摘Objective:This article reviews the latest updates and outcomes of kidney-sparing surgery(KSS)in patients with upper tract urothelial carcinoma(UTUC).Methods:A comprehensive literature search was performed using the PubMed and Embase databases to identify related English-language studies published within the last 10 years.Key search words included“upper urinary tract tumour/cancer/carcinoma”,“kidney-sparing surgery or approach”,“endoscopic treatment for upper tract tumour/cancer/carcinoma”,“topical instillation in the upper urinary tract”,and“urinary marker for urothelial carcinoma”.References within the identified literature were explored and evaluated for relevance.Results:KSS is recommended for both low-risk and selected high-risk UTUC with imperative indications such as solitary kidney.Studies have shown comparable oncological outcomes after KSS including endoscopic ablation,segmental ureterectomy,and topical instillation of novel agents when compared to radical nephroureterectomy in well-selected cases.The development of novel diagnostic tools and risk-stratifying models allows optimal case selection for KSS without compromising oncological outcomes.Conclusion:Kidney-sparing approach for UTUC is an evolving and promising area in urologic oncology,driven by advances in technology,better diagnostic tools,and novel therapeutic agents.Our article provides a comprehensive review of the latest advancements and clinical recommendations.While current evidence is mainly based on retrospective studies,prospective trials are required to address important but unanswered clinical questions in this field.
文摘The Upper Cretaceous successions of Wadi Umm-Khayshar,southern Galala Plateau,North Eastern Desert,Egypt,are composed of highly diversified faunas and subdivided from base to top into the Galala(Middle-Late Cenomanian),Maghra El Hadida(Latest Cenomanian-Late Turonian),Matulla(Coniacian-Santonian),and Sudr(Campanian-Maastrichtian)formations.Five ammonite biozones are recorded in the studied section:Neolobites vibrayeanus,Vascoceras cauvini(late Cenomanian),Vascoceras proprium,Choffaticeras segne,and Coilopoceras requienianum(Turonian)zones.The paleoenvironments of the Upper Cretaceous succession are interpreted based on detailed study and microfacies analysis that reflect a deposition in a homoclinal ramp platform ranging from intertidal to deep subtidal.The paleoecology of the Cenomanian-Turonian succession in the studied section is explained based on a detailed study of macrofaunal associations and sedimentary facies.Quantitative analysis(Q-mode cluster analysis,using the Raup-Crick Paired group method)of 1029 macrobenthic specimens,including 45 species of mollusks and echinoids yielded five macrofaunal associations(A-E)that are described and interpreted as remnants of communities.The nektonic elements are represented by 235 cephalopod specimens of 20 species;heatmap cluster analyses show the distribution of these specimens during the Upper Cenomanian-Turonian stages.Environmental parameters(substrate consistency,rate of sedimentation,water energy,surface-water productivity,and oxygen availability)controlled the distribution of the studied macrofauna.The five associations are divided into two major groups:low-stress associations(A,B,C,and D),and a highstress association(E).The low stress associations are recorded from two different habitats:(1)a high-energy,firm substrate habitat,dominated by epifaunal bivalves,large epifaunal gastropods and a regular echinoid;(2)a low-energy,soft substrate habitat dominated by infaunal bivalves and echinoids.The high stress association is dominated by only two species and recorded from a high-energy shoal environment during a regression phase.A detailed study of macrobenthos and cephalopods provides a good paleoecological understanding of Cenomanian-Turonian succession in the Wadi Umm-Khayshar section.
文摘BACKGROUND Acute nonvariceal upper gastrointestinal bleeding(NVUGIB)is a life-threatening emergency.Endoscopic hemostasis and vascular interventional therapy are two major minimally invasive treatment strategies.Although these modalities are widely used,their comparative efficacy and safety across different patient populations and anatomical sites remain controversial.AIM To evaluate the clinical outcomes and safety of endoscopic hemostasis combined with vascular interventional therapy for NVUGIB.METHODS A systematic search was done on PubMed,EMBASE,Cochrane Library,and Web of Science(from database establishment to April 2025).Randomized controlled trial(RCT)quality was assessed via Cochrane RoB 2.0,and observational studies via the Critical Appraisal Skills Program.RevMan 5.4 was used for quantitative analysis;fixed/random-effects models were chosen through I^(2)-assessed heterogeneity.Publication bias was checked using funnel plots and sensitivity analysis via model switching.RESULTS Twenty-one studies(3 RCTs,12 single-group studies,and 6 retrospective cohort studies)with good quality were included.For single-group data,combined therapy had risk differences of 0.70(clinical success),0.24(mortality),and 0.22(rebleeding;all P<0.00001,I^(2)=0).Moreover,the≥60-year rebleeding risk difference was 0.43.Reintervention was found to differ by approach(Z=3.03,P=0.002,inter-subgroup I^(2)=99%).In the RCT and cohort studies,combined vs standard therapy had similar initial hemostasis(Z=0.04,P=0.97)and mortality(Z=1.56,P=0.12)but lower rebleeding(Z=3.26/P=0.001;Z=2.95/P=0.03).Symmetrical funnel plots and robust sensitivity analysis showed no publication bias.CONCLUSION Combined endoscopic hemostasis and vascular interventional therapy for acute NVUGIB can significantly reduce rebleeding,without differences in mortality.Age and vascular interventional methods may influence the therapeutic efficacy.
文摘Upper gastrointestinal bleeding (UGIB) refers to the bleeding caused by the digestive tract above the flexor ligament, including esophageal, gastric, duodenal, pancreatic and biliary diseases, and lesions after gastrojejunostomy. UGIB is one of the common diseases in the clinical work of gastroenterology. There are many causes that can lead to upper gastrointestinal bleeding, which are mainly divided into two categories: one is non-variceal upper gastrointestinal bleeding (NVUGIB), and the other is variceal upper gastrointestinal bleeding (VUGIB). This article reviews various causes of UGIB and the latest progress in treatment, aiming to improve the efficiency of diagnosis and treatment in future clinical work, and reduce the risk of rebleeding and mortality.
