Patients with complete spinal cord injury retain the potential for volitional muscle activity in muscles located below the spinal injury level.However,because of prolonged inactivity,initial attempts to activate these...Patients with complete spinal cord injury retain the potential for volitional muscle activity in muscles located below the spinal injury level.However,because of prolonged inactivity,initial attempts to activate these muscles may not effectively engage any of the remaining neurons in the descending pathway.A previous study unexpectedly found that a brief clinical round of passive activity significantly increased volitional muscle activation,as measured by surface electromyography.In this study,we further explored the effect of passive activity on surface electromyographic signals during volitional control tasks among individuals with complete spinal cord injury.Eleven patients with chronic complete thoracic spinal cord injury were recruited.Surface electromyography data from eight major leg muscles were acquired and compared before and after the passive activity protocol.The results indicated that the passive activity led to an increased number of activated volitional muscles and an increased frequency of activation.Although the cumulative root mean square of surface electromyography amplitude for volitional control of movement showed a slight increase after passive activity,the difference was not statistically significant.These findings suggest that brief passive activity may enhance the ability to initiate volitional muscle activity during surface electromyography tasks and underscore the potential of passive activity for improving residual motor control among patients with motor complete spinal cord injury.展开更多
BACKGROUND Recently,several endoscopic techniques have been used to improve the R0 resection rate of rectal neuroendocrine neoplasms(R-NENs).However,none of these methods can achieve 100%complete resection(CR),particu...BACKGROUND Recently,several endoscopic techniques have been used to improve the R0 resection rate of rectal neuroendocrine neoplasms(R-NENs).However,none of these methods can achieve 100%complete resection(CR),particularly in the vertical direction.Endoscopic full-thickness resection(EFTR)has proven to be an effective method for the treatment of submucosal tumors but is seldom utilized in the eradication of R-NENs.AIM To review cases of R-NENs removed using EFTR and to evaluate the safety and efficacy of this technique.METHODS This retrospective cohort study enrolled 160 patients with pathologically confirmed R-NENs,including 132 who underwent endoscopic submucosal dissection(ESD)and 28 who underwent EFTR.Lesions were categorized as<1 cm,1-2 cm,and>2 cm in size.CR rate,en bloc resection rate,operation time,and complications were evaluated.Subgroup analyses and follow-up were also performed.RESULTS EFTR achieved 100%CR rates for lesions<1 cm and 1-2 cm,compared with 67.0%and 50.0%,respectively,in the ESD group.En bloc resection and successful removal of the R-NENs were achieved in all patients.Meanwhile,EFTR showed performance comparable to ESD in terms of operation time,hospitalization cost,and postoperative adverse events,except for a one-day longer hospital stay.We also analyzed the invasion depth of R-NENs based on full-thickness specimens.The data showed that 80%of lesions(<1 cm)and 85.7%of lesions(1-2 cm)had invaded the SM3 level or deeper at the time of resection.For ESD specimens,46.6%(<1 cm)and 89.3%(1-2 cm)of lesions had infiltrated more than 2000μm beneath the muscularis mucosae.CONCLUSION EFTR has shown superior performance in the resection of small R-NENs compared with that of ESD.展开更多
The undrained mechanical behavior of unsaturated completely weathered granite(CWG)is highly susceptible to alterations in the hydraulic environment,particularly under uniaxial loading conditions,due to the unique natu...The undrained mechanical behavior of unsaturated completely weathered granite(CWG)is highly susceptible to alterations in the hydraulic environment,particularly under uniaxial loading conditions,due to the unique nature of this soil type.In this study,a series of unconfined compression tests were carried out on unsaturated CWG soil in an underground engineering site,and the effects of varying the environmental variables on the main undrained mechanical properties were analyzed.Based on the experimental results,a novel constitutive model was then established using the damage mechanics theory and the undetermined coefficient method.The results demonstrate that the curves of remolded CWG specimens with different moisture contents and dry densities exhibited diverse characteristics,including brittleness,significant softening,and ductility.As a typical indicator,the unconfined compression strength of soil specimens initially increased with an increase in moisture content and then decreased.Meanwhile,an optimal moisture content of approximately 10.5%could be observed,while a critical moisture content value of 13.0%was identified,beyond which the strength of the specimen decreases sharply.Moreover,the deformation and fracture of CWG specimens were predominantly caused by shear failure,and the ultimate failure modes were primarily influenced by moisture content rather than dry density.Furthermore,by comparing several similar models and the experimental data,the proposed model could accurately replicate the undrained mechanical characteristics of unsaturated CWG soil,and quantitatively describe the key mechanical indexes.These findings offer a valuable reference point for understanding the underlying mechanisms,anticipating potential risks,and implementing effective control measures in similar underground engineering projects.展开更多
BACKGROUND Gallbladder cancer(GBC)is the most common and aggressive subtype of biliary tract cancer(BTC)and has a poor prognosis.A newly developed regimen of gemcitabine,cisplatin,and durvalumab shows promise for the ...BACKGROUND Gallbladder cancer(GBC)is the most common and aggressive subtype of biliary tract cancer(BTC)and has a poor prognosis.A newly developed regimen of gemcitabine,cisplatin,and durvalumab shows promise for the treatment of advanced BTC.However,the efficacy of this treatment for GBC remains unclear.CASE SUMMARY In this report,we present a case in which the triple-drug regimen exhibited marked effectiveness in treating locally advanced GBC,thus leading to a long-term survival benefit.A 68-year-old man was diagnosed with locally advanced GBC,which rendered him ineligible for curative surgery.Following three cycles of therapy,a partial response was observed.After one year of combined therapy,a clinical complete response was successfully achieved.Subsequent maintenance therapy with durvalumab monotherapy resulted in a disease-free survival of 9 months for the patient.The patient experienced tolerable toxicities of reversible grade 2 nausea and fatigue.Tolerable adverse events were observed in the patient throughout the entirety of the treatment.CONCLUSION The combination of gemcitabine and cisplatin chemotherapy with durvalumab was proven to be an effective treatment approach for advanced GBC,with manageable adverse events.Further research is warranted to substantiate the effectiveness of the combined regimen in the context of GBC.展开更多
The complete convergence for weighted sums of sequences of independent,identically distributed random variables under sublinear expectation space is studied.By moment inequality and truncation methods,we establish the...The complete convergence for weighted sums of sequences of independent,identically distributed random variables under sublinear expectation space is studied.By moment inequality and truncation methods,we establish the equivalent conditions of complete convergence for weighted sums of sequences of independent,identically distributed random variables under sublinear expectation space.The results complement the corresponding results in probability space to those for sequences of independent,identically distributed random variables under sublinear expectation space.展开更多
In this paper,by utilizing the Marcinkiewicz-Zygmund inequality and Rosenthal-type inequality of negatively superadditive dependent(NSD)random arrays and truncated method,we investigate the complete f-moment convergen...In this paper,by utilizing the Marcinkiewicz-Zygmund inequality and Rosenthal-type inequality of negatively superadditive dependent(NSD)random arrays and truncated method,we investigate the complete f-moment convergence of NSD random variables.We establish and improve a general result on the complete f-moment convergence for Sung’s type randomly weighted sums of NSD random variables under some general assumptions.As an application,we show the complete consistency for the randomly weighted estimator in a nonparametric regression model based on NSD errors.展开更多
In this paper,we introduce the real pairwise completely positive(RPCP)matrices with one of them is necessarily positive semidefinite while the other one is necessarily entrywise nonnegative,which has a real pairwise c...In this paper,we introduce the real pairwise completely positive(RPCP)matrices with one of them is necessarily positive semidefinite while the other one is necessarily entrywise nonnegative,which has a real pairwise completely positive(RPCP)decomposition.We study the properties of RPCP matrices and give some necessary and sufficient conditions for a matrix pair to be RPCP.First,we give an equivalent decomposition for the RPCP matrices,which is different from the RPCP-decomposition and show that the matrix pair(X,X)is RPCP if and only if X is completely positive.Besides,we also prove that the RPCP matrices checking problem is equivalent to the separable completion problem.A semidefinite algorithm is also proposed for detecting whether or not a matrix pair is RPCP.The asymptotic and finite convergence of the algorithm are also discussed.If it is RPCP,we can further give a RPCP-decomposition for it;if it is not,we can obtain a certificate for this.展开更多
BACKGROUND Cirrhotic patients with super-giant hepatocellular carcinoma(HCC)and portal vein invasion generally have a poor prognosis.This paper presents a patient with super-giant HCC and portal vein invasion,who unde...BACKGROUND Cirrhotic patients with super-giant hepatocellular carcinoma(HCC)and portal vein invasion generally have a poor prognosis.This paper presents a patient with super-giant HCC and portal vein invasion,who underwent hepatectomy followed by a combination of sorafenib and camrelizumab,resulting in complete remission(CR)for 5 years.CASE SUMMARY A 40-year-old male with compensated hepatitis B-related cirrhosis was diagnosed with HCC,Barcelona Clinic Liver Cancer stage C.Enhanced computed tomography imaging revealed a 152 mm×171 mm tumor in the right liver,invading the portal vein and hepatic vein.Liver function was normal.The patient successfully underwent hepatectomy on July 18,2019.However,by December 2019,HCC recurrence with lung metastases and portal vein invasion were detected.He started treatment with sorafenib(200 mg twice daily)and camrelizumab(200 mg every 3 weeks).By May 12,2020,the patient was confirmed to have CR.Camrelizumab was adjusted to 200 mg every 12 weeks from June 16,2021,with the last infusion on March 29,2024.Although no further tumor recurrence was observed,he experienced two episodes of gastrointestinal bleeding due to esophagogastric varices,which were managed with endoscopic therapy.To date,the patient has remained in CR for 5 years.CONCLUSION The combination of hepatectomy with sorafenib and camrelizumab can achieve durable CR in patients with supergiant HCC and portal vein invasion.Further research is necessary to address these challenges and improve patient outcomes.展开更多
BACKGROUND Gallbladder cancer is a highly malignant and aggressive tumor,often diagnosed at an advanced stage.The prognosis for advanced gallbladder cancer remains poor,with limited options for effective treatment.CAS...BACKGROUND Gallbladder cancer is a highly malignant and aggressive tumor,often diagnosed at an advanced stage.The prognosis for advanced gallbladder cancer remains poor,with limited options for effective treatment.CASE SUMMARY A 65-year-old male patient presented with a soft tissue mass in the gallbladder.Following laparoscopic exploration,he underwent radical surgery for gallbladder cancer,with the tumor staged as pT2N1M0(stage III).Post-surgery,the patient received four cycles of adjuvant chemotherapy.However,one month later,over 60 metastatic lesions were detected in the liver,lungs,and lymph nodes.In response to the widespread metastasis,he underwent six cycles of combination therapy consisting of sintilimab,albumin-bound paclitaxel,and cisplatin.After two cycles,a partial response was achieved.Maintenance therapy was initiated with a combination of sintilimab and albumin-bound paclitaxel for four cycles.Monotherapy with sintilimab was continued thereafter until October 2023.Complete remission was confirmed in September 2021.The patient sustained this complete response for more than three years,including an eleven-month period without disease progression following the discontinuation of sintilimab.Genetic analysis revealed a tumor mutational burden of 15.4 mutations/megabase,which indicates a potentially favorable response to immunotherapy.CONCLUSION This case demonstrates the potential of combining immunotherapy(sintilimab)with chemotherapy to achieve durable remission in metastatic gallbladder cancer,even in a patient with extensive metastasis.In addition,it indicated the importance of tumor mutational burden as a predictive biomarker of immunotherapy.展开更多
1.Introduction Hepatocellular carcinoma(HCC)is the most common primary malignancy of the liver.HCC is the sixth most frequently diagnosed cancer and the third leading cause of cancer-relatedmortality worldwide.[1]Part...1.Introduction Hepatocellular carcinoma(HCC)is the most common primary malignancy of the liver.HCC is the sixth most frequently diagnosed cancer and the third leading cause of cancer-relatedmortality worldwide.[1]Partial hepatectomy is recommended for patients with early stage HCC.[2]A large proportion of patients with HCC inChina are diagnosed in the intermediate to advanced HCC stages,rendering them ineligible for hepatectomy due to aspects such as liver dysfunction,insufficient residual liver volume,or surgical technique.展开更多
Transition metal-based nanomaterials have emerged as promising electrocatalysts for oxygen evolution reaction(OER).Considerable research efforts have shown that self-reconstruction occurs on these nanomaterials under ...Transition metal-based nanomaterials have emerged as promising electrocatalysts for oxygen evolution reaction(OER).Considerable research efforts have shown that self-reconstruction occurs on these nanomaterials under operating conditions of OER process.However,most of them undergo incomplete reconstruction with limited thickness of reconstruction layer,leading to low component utilization and arduous exploration of real catalytic mechanism.Herein,we identify the dynamic behaviors in complete reconstruction of Co-based complexes during OER.The hollow phytic acid(PA)cross-linked CoFe-based complex nanoboxes with porous nanowalls are designed because of their good electrolyte penetration and mass transport ability,in favor of the fast and complete reconstruction.A series of experiment characterizations demonstrate that the reconstruction process includes the fast substitution of PA by OH-to form Co(Fe)(OH)xand subsequent potential-driven oxidation to Co(Fe)OOH.The obtained CoFeOOH delivers a low overpotential of 290 mV at a current density of 10 mA cm^(-2)and a long-term stability.The experiment results together with theory calculations reveal that the Fe incorporation can result in the electron rearrangement of reconstructed CoFeOOH and optimization of their electronic structure,accounting for the enhanced OER activity.The work provides new insights into complete reconstruction of metal-based complexes during OER and offers guidelines for rational design of high-performance electrocatalysts.展开更多
Palladium-based catalysts have long been considered the benchmark for methane combustion;however,the authentic phase of catalytic active sites remains a subject of ongoing debate.Additionally,challenges like water-poi...Palladium-based catalysts have long been considered the benchmark for methane combustion;however,the authentic phase of catalytic active sites remains a subject of ongoing debate.Additionally,challenges like water-poisoning and long-term stability need to be addressed to advance catalyst performance.Herein,we investigate Pd on Co_(3)O_(4) nanorods as a highly effective catalyst for catalytic oxidation of methane,demonstrating long-term stability and water tolerance during a 100-h continuous operation at 350℃.Comprehensive characterizations reveal the presence of an active Pd-oxygen vacancy(Ov)-cobalt interface in Pd/Co_(3)O_(4),which effectively adsorbs molecular O_(2).The absorbed oxygen species on this interface are activated and directly participate in methane combustion.Moreover,near-ambient pressure X-ray photoelectron spectroscopy demonstrates that Pd nanoparticles undergo a rapid phase transition and predominantly remain in the metallic state during the reaction.This behavior is attributed to the electronic metal-support interaction between Pd and Co_(3)O_(4).Furthermore,in situ Fourier transformed infrared spectrum reveals that under reaction conditions,HCO3*species are formed initially and subsequently transformed into formate species,indicating that the formate pathway is the dominant mechanism for CH_(4) oxidation.展开更多
Accurate description of noncova-lent interactions in large systems is challenging due to the require-ment of high-level electron corre-lation methods.The generalized energy-based fragmentation(GEBF)approach,in conjunc...Accurate description of noncova-lent interactions in large systems is challenging due to the require-ment of high-level electron corre-lation methods.The generalized energy-based fragmentation(GEBF)approach,in conjunc-tion with the domain-based local pair natural orbital(DLPNO)method,has been applied to assess the average binding energies(ABEs)of large benzene clus-ters,specifically(C6H6)13,at the coupled cluster singles and doubles with perturbative triples correction[CCSD(T)]level and the complete basis set(CBS)limit.Utilizing GEBF-DLPNO-CCSD(T)/CBS ABEs as benchmarks,various DFT functionals were evaluated.It was found that several functionals with empirical dispersion correction,including M06-2X-D3,B3LYP-D3(BJ),and PBE-D3(BJ),provide accurate descriptions of the ABEs for(C6H6)13 clusters.Additionally,the M06-2X-D3 functional was used to calculate the ABEs and relative stabili-ties of(C6H6)n clusters for n=11,12,13,14,and 15 revealing that the(C6H6)13 cluster ex-hibits the highest relative stability.These findings align with experimental evidence suggest-ing that n=13 is one of the magic numbers for benzene clusters(C6H6)n,with n≤30.展开更多
BACKGROUND Descending duodenal adenocarcinoma(DDA)is a rare malignancy of the digestive system,typically characterized by microsatellite instability-high(MSIH).Pembrolizumab is a monoclonal antibody that has been appr...BACKGROUND Descending duodenal adenocarcinoma(DDA)is a rare malignancy of the digestive system,typically characterized by microsatellite instability-high(MSIH).Pembrolizumab is a monoclonal antibody that has been approved for the treatment of MSI-H solid tumors in China.CASE SUMMARY We present the case of a 55-year-old female patient diagnosed with DDA.Biopsy findings indicated MSI-H status with high expression of programmed cell deathligand 1(PD-L1).The patient was unable to undergo immediate surgery due to multiple metastatic lymph nodes in the retroperitoneum.After one cycle of the SOX(S-1+oxaliplatin)chemotherapy regimen,the patient’s performance status significantly declined,and she experienced active gastrointestinal bleeding.Following active communication with the patient's family,pembrolizumab treatment was initiated.After two cycles of treatment,the disease was assessed as a partial response.A positron emission tomography/computed tomography scan performed after two years of treatment indicated a clinical complete response(CCR).The patient maintained this CCR for four years.She has now discontinued pembrolizumab for over one year,and no disease recurrence has been observed during re-examination.CONCLUSION Patients with MSI-H DDA exhibiting high PD-L1 expression who are treated with pembrolizumab can achieve sustained CCR.展开更多
Residual atrioventricular valve regurgitation after correction of complete atrioventricular septal defect(cAVSD)is still not ideal.As a modification of the double-patch method,our technique comprises a suture-bite-wid...Residual atrioventricular valve regurgitation after correction of complete atrioventricular septal defect(cAVSD)is still not ideal.As a modification of the double-patch method,our technique comprises a suture-bite-wide strip of a third patch that is incorporated to the upper margin of the left side of the ventricular septal defect(VSD)patch.This third patch counteracts not only the valvular tissue loss caused by the suture bites but also the rightward displacement of the VSD patch in a bulged fashion that occurs with increased left ventricular pressure after weaning from cardiopulmonary bypass.This unfavorable outcome was addressed with the current technique through augmentation of the left-sided bridging leaflets serving to prevent the separation of them from their corresponding mural leaflets.The concept was applied in two cases with Down syndrome aged 5 months and 6 months,respectively,as a rescue procedure in the same session just after a failed cAVSD repair.Since the immediate-and short-term outcomes of the atrioventricular valves in regard to regurgitation are satisfying,we believe that the technique proposed herein holds promise for the future in terms of tackling residual atrioventricular valve regurgitation.展开更多
Assume that{a_(i),−∞<i<∞}is an absolutely summable sequence of real numbers.We establish the complete q-order moment convergence for the partial sums of moving average processes{X_(n)=Σ_(i=−∞)^(∞)a_(i)Y_(i+...Assume that{a_(i),−∞<i<∞}is an absolutely summable sequence of real numbers.We establish the complete q-order moment convergence for the partial sums of moving average processes{X_(n)=Σ_(i=−∞)^(∞)a_(i)Y_(i+n),n≥1}under some proper conditions,where{Yi,-∞<i<∞}is a doubly infinite sequence of negatively dependent random variables under sub-linear expectations.These results extend and complement the relevant results in probability space.展开更多
In the article,we provide a sharp lower bound for the weighted Lehmer mean of the complete p-elliptic integrals of the first and second kinds,which is the extension of the previous results for complete p-elliptic inte...In the article,we provide a sharp lower bound for the weighted Lehmer mean of the complete p-elliptic integrals of the first and second kinds,which is the extension of the previous results for complete p-elliptic integrals.展开更多
In the era of big data,data-driven technologies are increasingly leveraged by industry to facilitate autonomous learning and intelligent decision-making.However,the challenge of“small samples in big data”emerges whe...In the era of big data,data-driven technologies are increasingly leveraged by industry to facilitate autonomous learning and intelligent decision-making.However,the challenge of“small samples in big data”emerges when datasets lack the comprehensive information necessary for addressing complex scenarios,which hampers adaptability.Thus,enhancing data completeness is essential.Knowledge-guided virtual sample generation transforms domain knowledge into extensive virtual datasets,thereby reducing dependence on limited real samples and enabling zero-sample fault diagnosis.This study used building air conditioning systems as a case study.We innovatively used the large language model(LLM)to acquire domain knowledge for sample generation,significantly lowering knowledge acquisition costs and establishing a generalized framework for knowledge acquisition in engineering applications.This acquired knowledge guided the design of diffusion boundaries in mega-trend diffusion(MTD),while the Monte Carlo method was used to sample within the diffusion function to create information-rich virtual samples.Additionally,a noise-adding technique was introduced to enhance the information entropy of these samples,thereby improving the robustness of neural networks trained with them.Experimental results showed that training the diagnostic model exclusively with virtual samples achieved an accuracy of 72.80%,significantly surpassing traditional small-sample supervised learning in terms of generalization.This underscores the quality and completeness of the generated virtual samples.展开更多
Spinal cord injury is a condition in which the parenchyma of the spinal cord is damaged by trauma or various diseases.While rapid progress has been made in regenerative medicine for spinal cord injury that was previou...Spinal cord injury is a condition in which the parenchyma of the spinal cord is damaged by trauma or various diseases.While rapid progress has been made in regenerative medicine for spinal cord injury that was previously untreatable,most research in this field has focused on the early phase of incomplete injury.However,the majority of patients have chronic severe injuries;therefore,treatments for these situations are of fundamental importance.The reason why the treatment of complete spinal cord injury has not been studied is that,unlike in the early stage of incomplete spinal cord injury,there are various inhibitors of neural regeneration.Thus,we assumed that it is difficult to address all conditions with a single treatment in chronic complete spinal cord injury and that a combination of several treatments is essential to target severe pathologies.First,we established a combination therapy of cell transplantation and drug-releasing scaffolds,which contributes to functional recovery after chronic complete transection spinal cord injury,but we found that functional recovery was limited and still needs further investigation.Here,for the further development of the treatment of chronic complete spinal cord injury,we review the necessary approaches to the different pathologies based on our findings and the many studies that have been accumulated to date and discuss,with reference to the literature,which combination of treatments is most effective in achieving functional recovery.展开更多
In this article,we study Kahler metrics on a certain line bundle over some compact Kahler manifolds to find complete Kahler metrics with positive holomorphic sectional(or bisectional)curvatures.Thus,we apply a strateg...In this article,we study Kahler metrics on a certain line bundle over some compact Kahler manifolds to find complete Kahler metrics with positive holomorphic sectional(or bisectional)curvatures.Thus,we apply a strategy to a famous Yau conjecture with a co-homogeneity one geometry.展开更多
基金supported by the Fundamental Research Funds for Central Public Welfare Research Institute,No.2020CZ-5(to WS and GS)the National Natural Science Foundation of China,No.31970970(to JSR)Fundamental Research Funds for the Central Universities,No.YWF-23-YG-QB-010(to JSR)。
文摘Patients with complete spinal cord injury retain the potential for volitional muscle activity in muscles located below the spinal injury level.However,because of prolonged inactivity,initial attempts to activate these muscles may not effectively engage any of the remaining neurons in the descending pathway.A previous study unexpectedly found that a brief clinical round of passive activity significantly increased volitional muscle activation,as measured by surface electromyography.In this study,we further explored the effect of passive activity on surface electromyographic signals during volitional control tasks among individuals with complete spinal cord injury.Eleven patients with chronic complete thoracic spinal cord injury were recruited.Surface electromyography data from eight major leg muscles were acquired and compared before and after the passive activity protocol.The results indicated that the passive activity led to an increased number of activated volitional muscles and an increased frequency of activation.Although the cumulative root mean square of surface electromyography amplitude for volitional control of movement showed a slight increase after passive activity,the difference was not statistically significant.These findings suggest that brief passive activity may enhance the ability to initiate volitional muscle activity during surface electromyography tasks and underscore the potential of passive activity for improving residual motor control among patients with motor complete spinal cord injury.
基金Supported by National Natural Science Foundation of China,No.82004298Jiangsu Graduate Research and Practice Innovation Program,China,No.KYCX23_2090.
文摘BACKGROUND Recently,several endoscopic techniques have been used to improve the R0 resection rate of rectal neuroendocrine neoplasms(R-NENs).However,none of these methods can achieve 100%complete resection(CR),particularly in the vertical direction.Endoscopic full-thickness resection(EFTR)has proven to be an effective method for the treatment of submucosal tumors but is seldom utilized in the eradication of R-NENs.AIM To review cases of R-NENs removed using EFTR and to evaluate the safety and efficacy of this technique.METHODS This retrospective cohort study enrolled 160 patients with pathologically confirmed R-NENs,including 132 who underwent endoscopic submucosal dissection(ESD)and 28 who underwent EFTR.Lesions were categorized as<1 cm,1-2 cm,and>2 cm in size.CR rate,en bloc resection rate,operation time,and complications were evaluated.Subgroup analyses and follow-up were also performed.RESULTS EFTR achieved 100%CR rates for lesions<1 cm and 1-2 cm,compared with 67.0%and 50.0%,respectively,in the ESD group.En bloc resection and successful removal of the R-NENs were achieved in all patients.Meanwhile,EFTR showed performance comparable to ESD in terms of operation time,hospitalization cost,and postoperative adverse events,except for a one-day longer hospital stay.We also analyzed the invasion depth of R-NENs based on full-thickness specimens.The data showed that 80%of lesions(<1 cm)and 85.7%of lesions(1-2 cm)had invaded the SM3 level or deeper at the time of resection.For ESD specimens,46.6%(<1 cm)and 89.3%(1-2 cm)of lesions had infiltrated more than 2000μm beneath the muscularis mucosae.CONCLUSION EFTR has shown superior performance in the resection of small R-NENs compared with that of ESD.
基金Project(42202318)supported by the National Natural Science Foundation of ChinaProject(252300421199)supported by the Natural Science Foundation of Henan Province,ChinaProject(2024JJ6219)supported by the Hunan Provincial Natural Science Foundation of China。
文摘The undrained mechanical behavior of unsaturated completely weathered granite(CWG)is highly susceptible to alterations in the hydraulic environment,particularly under uniaxial loading conditions,due to the unique nature of this soil type.In this study,a series of unconfined compression tests were carried out on unsaturated CWG soil in an underground engineering site,and the effects of varying the environmental variables on the main undrained mechanical properties were analyzed.Based on the experimental results,a novel constitutive model was then established using the damage mechanics theory and the undetermined coefficient method.The results demonstrate that the curves of remolded CWG specimens with different moisture contents and dry densities exhibited diverse characteristics,including brittleness,significant softening,and ductility.As a typical indicator,the unconfined compression strength of soil specimens initially increased with an increase in moisture content and then decreased.Meanwhile,an optimal moisture content of approximately 10.5%could be observed,while a critical moisture content value of 13.0%was identified,beyond which the strength of the specimen decreases sharply.Moreover,the deformation and fracture of CWG specimens were predominantly caused by shear failure,and the ultimate failure modes were primarily influenced by moisture content rather than dry density.Furthermore,by comparing several similar models and the experimental data,the proposed model could accurately replicate the undrained mechanical characteristics of unsaturated CWG soil,and quantitatively describe the key mechanical indexes.These findings offer a valuable reference point for understanding the underlying mechanisms,anticipating potential risks,and implementing effective control measures in similar underground engineering projects.
基金Supported by General Project of Natural Science Foundation of Chongqing,China,No.cstc2021jcyj-msxmX0604Chongqing Doctoral"Through Train"Research Program,China,No.CSTB2022BSXM-JCX0045.
文摘BACKGROUND Gallbladder cancer(GBC)is the most common and aggressive subtype of biliary tract cancer(BTC)and has a poor prognosis.A newly developed regimen of gemcitabine,cisplatin,and durvalumab shows promise for the treatment of advanced BTC.However,the efficacy of this treatment for GBC remains unclear.CASE SUMMARY In this report,we present a case in which the triple-drug regimen exhibited marked effectiveness in treating locally advanced GBC,thus leading to a long-term survival benefit.A 68-year-old man was diagnosed with locally advanced GBC,which rendered him ineligible for curative surgery.Following three cycles of therapy,a partial response was observed.After one year of combined therapy,a clinical complete response was successfully achieved.Subsequent maintenance therapy with durvalumab monotherapy resulted in a disease-free survival of 9 months for the patient.The patient experienced tolerable toxicities of reversible grade 2 nausea and fatigue.Tolerable adverse events were observed in the patient throughout the entirety of the treatment.CONCLUSION The combination of gemcitabine and cisplatin chemotherapy with durvalumab was proven to be an effective treatment approach for advanced GBC,with manageable adverse events.Further research is warranted to substantiate the effectiveness of the combined regimen in the context of GBC.
基金supported by Doctoral Scientific Research Starting Foundation of Jingdezhen Ceramic University(Grant No.102/01003002031)Re-accompanying Funding Project of Academic Achievements of Jingdezhen Ceramic University(Grant Nos.215/20506277,215/20506341)。
文摘The complete convergence for weighted sums of sequences of independent,identically distributed random variables under sublinear expectation space is studied.By moment inequality and truncation methods,we establish the equivalent conditions of complete convergence for weighted sums of sequences of independent,identically distributed random variables under sublinear expectation space.The results complement the corresponding results in probability space to those for sequences of independent,identically distributed random variables under sublinear expectation space.
基金supported by the National Social Science Fundation(Grant No.21BTJ040)the Project of Outstanding Young People in University of Anhui Province(Grant Nos.2023AH020037,SLXY2024A001).
文摘In this paper,by utilizing the Marcinkiewicz-Zygmund inequality and Rosenthal-type inequality of negatively superadditive dependent(NSD)random arrays and truncated method,we investigate the complete f-moment convergence of NSD random variables.We establish and improve a general result on the complete f-moment convergence for Sung’s type randomly weighted sums of NSD random variables under some general assumptions.As an application,we show the complete consistency for the randomly weighted estimator in a nonparametric regression model based on NSD errors.
文摘In this paper,we introduce the real pairwise completely positive(RPCP)matrices with one of them is necessarily positive semidefinite while the other one is necessarily entrywise nonnegative,which has a real pairwise completely positive(RPCP)decomposition.We study the properties of RPCP matrices and give some necessary and sufficient conditions for a matrix pair to be RPCP.First,we give an equivalent decomposition for the RPCP matrices,which is different from the RPCP-decomposition and show that the matrix pair(X,X)is RPCP if and only if X is completely positive.Besides,we also prove that the RPCP matrices checking problem is equivalent to the separable completion problem.A semidefinite algorithm is also proposed for detecting whether or not a matrix pair is RPCP.The asymptotic and finite convergence of the algorithm are also discussed.If it is RPCP,we can further give a RPCP-decomposition for it;if it is not,we can obtain a certificate for this.
文摘BACKGROUND Cirrhotic patients with super-giant hepatocellular carcinoma(HCC)and portal vein invasion generally have a poor prognosis.This paper presents a patient with super-giant HCC and portal vein invasion,who underwent hepatectomy followed by a combination of sorafenib and camrelizumab,resulting in complete remission(CR)for 5 years.CASE SUMMARY A 40-year-old male with compensated hepatitis B-related cirrhosis was diagnosed with HCC,Barcelona Clinic Liver Cancer stage C.Enhanced computed tomography imaging revealed a 152 mm×171 mm tumor in the right liver,invading the portal vein and hepatic vein.Liver function was normal.The patient successfully underwent hepatectomy on July 18,2019.However,by December 2019,HCC recurrence with lung metastases and portal vein invasion were detected.He started treatment with sorafenib(200 mg twice daily)and camrelizumab(200 mg every 3 weeks).By May 12,2020,the patient was confirmed to have CR.Camrelizumab was adjusted to 200 mg every 12 weeks from June 16,2021,with the last infusion on March 29,2024.Although no further tumor recurrence was observed,he experienced two episodes of gastrointestinal bleeding due to esophagogastric varices,which were managed with endoscopic therapy.To date,the patient has remained in CR for 5 years.CONCLUSION The combination of hepatectomy with sorafenib and camrelizumab can achieve durable CR in patients with supergiant HCC and portal vein invasion.Further research is necessary to address these challenges and improve patient outcomes.
文摘BACKGROUND Gallbladder cancer is a highly malignant and aggressive tumor,often diagnosed at an advanced stage.The prognosis for advanced gallbladder cancer remains poor,with limited options for effective treatment.CASE SUMMARY A 65-year-old male patient presented with a soft tissue mass in the gallbladder.Following laparoscopic exploration,he underwent radical surgery for gallbladder cancer,with the tumor staged as pT2N1M0(stage III).Post-surgery,the patient received four cycles of adjuvant chemotherapy.However,one month later,over 60 metastatic lesions were detected in the liver,lungs,and lymph nodes.In response to the widespread metastasis,he underwent six cycles of combination therapy consisting of sintilimab,albumin-bound paclitaxel,and cisplatin.After two cycles,a partial response was achieved.Maintenance therapy was initiated with a combination of sintilimab and albumin-bound paclitaxel for four cycles.Monotherapy with sintilimab was continued thereafter until October 2023.Complete remission was confirmed in September 2021.The patient sustained this complete response for more than three years,including an eleven-month period without disease progression following the discontinuation of sintilimab.Genetic analysis revealed a tumor mutational burden of 15.4 mutations/megabase,which indicates a potentially favorable response to immunotherapy.CONCLUSION This case demonstrates the potential of combining immunotherapy(sintilimab)with chemotherapy to achieve durable remission in metastatic gallbladder cancer,even in a patient with extensive metastasis.In addition,it indicated the importance of tumor mutational burden as a predictive biomarker of immunotherapy.
文摘1.Introduction Hepatocellular carcinoma(HCC)is the most common primary malignancy of the liver.HCC is the sixth most frequently diagnosed cancer and the third leading cause of cancer-relatedmortality worldwide.[1]Partial hepatectomy is recommended for patients with early stage HCC.[2]A large proportion of patients with HCC inChina are diagnosed in the intermediate to advanced HCC stages,rendering them ineligible for hepatectomy due to aspects such as liver dysfunction,insufficient residual liver volume,or surgical technique.
基金National Natural Science Foundation of China(22478310,U21A20286 and 22206054)。
文摘Transition metal-based nanomaterials have emerged as promising electrocatalysts for oxygen evolution reaction(OER).Considerable research efforts have shown that self-reconstruction occurs on these nanomaterials under operating conditions of OER process.However,most of them undergo incomplete reconstruction with limited thickness of reconstruction layer,leading to low component utilization and arduous exploration of real catalytic mechanism.Herein,we identify the dynamic behaviors in complete reconstruction of Co-based complexes during OER.The hollow phytic acid(PA)cross-linked CoFe-based complex nanoboxes with porous nanowalls are designed because of their good electrolyte penetration and mass transport ability,in favor of the fast and complete reconstruction.A series of experiment characterizations demonstrate that the reconstruction process includes the fast substitution of PA by OH-to form Co(Fe)(OH)xand subsequent potential-driven oxidation to Co(Fe)OOH.The obtained CoFeOOH delivers a low overpotential of 290 mV at a current density of 10 mA cm^(-2)and a long-term stability.The experiment results together with theory calculations reveal that the Fe incorporation can result in the electron rearrangement of reconstructed CoFeOOH and optimization of their electronic structure,accounting for the enhanced OER activity.The work provides new insights into complete reconstruction of metal-based complexes during OER and offers guidelines for rational design of high-performance electrocatalysts.
文摘Palladium-based catalysts have long been considered the benchmark for methane combustion;however,the authentic phase of catalytic active sites remains a subject of ongoing debate.Additionally,challenges like water-poisoning and long-term stability need to be addressed to advance catalyst performance.Herein,we investigate Pd on Co_(3)O_(4) nanorods as a highly effective catalyst for catalytic oxidation of methane,demonstrating long-term stability and water tolerance during a 100-h continuous operation at 350℃.Comprehensive characterizations reveal the presence of an active Pd-oxygen vacancy(Ov)-cobalt interface in Pd/Co_(3)O_(4),which effectively adsorbs molecular O_(2).The absorbed oxygen species on this interface are activated and directly participate in methane combustion.Moreover,near-ambient pressure X-ray photoelectron spectroscopy demonstrates that Pd nanoparticles undergo a rapid phase transition and predominantly remain in the metallic state during the reaction.This behavior is attributed to the electronic metal-support interaction between Pd and Co_(3)O_(4).Furthermore,in situ Fourier transformed infrared spectrum reveals that under reaction conditions,HCO3*species are formed initially and subsequently transformed into formate species,indicating that the formate pathway is the dominant mechanism for CH_(4) oxidation.
基金supported by the National Key R&D Program of China(No.2023YFB3712504)the National Natural Science Foundation of China(Nos.22273038,22073043,and 22033004)。
文摘Accurate description of noncova-lent interactions in large systems is challenging due to the require-ment of high-level electron corre-lation methods.The generalized energy-based fragmentation(GEBF)approach,in conjunc-tion with the domain-based local pair natural orbital(DLPNO)method,has been applied to assess the average binding energies(ABEs)of large benzene clus-ters,specifically(C6H6)13,at the coupled cluster singles and doubles with perturbative triples correction[CCSD(T)]level and the complete basis set(CBS)limit.Utilizing GEBF-DLPNO-CCSD(T)/CBS ABEs as benchmarks,various DFT functionals were evaluated.It was found that several functionals with empirical dispersion correction,including M06-2X-D3,B3LYP-D3(BJ),and PBE-D3(BJ),provide accurate descriptions of the ABEs for(C6H6)13 clusters.Additionally,the M06-2X-D3 functional was used to calculate the ABEs and relative stabili-ties of(C6H6)n clusters for n=11,12,13,14,and 15 revealing that the(C6H6)13 cluster ex-hibits the highest relative stability.These findings align with experimental evidence suggest-ing that n=13 is one of the magic numbers for benzene clusters(C6H6)n,with n≤30.
基金Supported by Medical Science Research Project of Hebei Province in 2023,Key Laboratory of Research on Molecular Mechanism of Gastrointestinal Tumors in Qinhuangdao,No.20231891.
文摘BACKGROUND Descending duodenal adenocarcinoma(DDA)is a rare malignancy of the digestive system,typically characterized by microsatellite instability-high(MSIH).Pembrolizumab is a monoclonal antibody that has been approved for the treatment of MSI-H solid tumors in China.CASE SUMMARY We present the case of a 55-year-old female patient diagnosed with DDA.Biopsy findings indicated MSI-H status with high expression of programmed cell deathligand 1(PD-L1).The patient was unable to undergo immediate surgery due to multiple metastatic lymph nodes in the retroperitoneum.After one cycle of the SOX(S-1+oxaliplatin)chemotherapy regimen,the patient’s performance status significantly declined,and she experienced active gastrointestinal bleeding.Following active communication with the patient's family,pembrolizumab treatment was initiated.After two cycles of treatment,the disease was assessed as a partial response.A positron emission tomography/computed tomography scan performed after two years of treatment indicated a clinical complete response(CCR).The patient maintained this CCR for four years.She has now discontinued pembrolizumab for over one year,and no disease recurrence has been observed during re-examination.CONCLUSION Patients with MSI-H DDA exhibiting high PD-L1 expression who are treated with pembrolizumab can achieve sustained CCR.
文摘Residual atrioventricular valve regurgitation after correction of complete atrioventricular septal defect(cAVSD)is still not ideal.As a modification of the double-patch method,our technique comprises a suture-bite-wide strip of a third patch that is incorporated to the upper margin of the left side of the ventricular septal defect(VSD)patch.This third patch counteracts not only the valvular tissue loss caused by the suture bites but also the rightward displacement of the VSD patch in a bulged fashion that occurs with increased left ventricular pressure after weaning from cardiopulmonary bypass.This unfavorable outcome was addressed with the current technique through augmentation of the left-sided bridging leaflets serving to prevent the separation of them from their corresponding mural leaflets.The concept was applied in two cases with Down syndrome aged 5 months and 6 months,respectively,as a rescue procedure in the same session just after a failed cAVSD repair.Since the immediate-and short-term outcomes of the atrioventricular valves in regard to regurgitation are satisfying,we believe that the technique proposed herein holds promise for the future in terms of tackling residual atrioventricular valve regurgitation.
基金Supported by the Academic Achievement Re-cultivation Projects of Jingdezhen Ceramic University(Grant Nos.215/20506341215/20506277)the Doctoral Scientific Research Starting Foundation of Jingdezhen Ceramic University(Grant No.102/01003002031)。
文摘Assume that{a_(i),−∞<i<∞}is an absolutely summable sequence of real numbers.We establish the complete q-order moment convergence for the partial sums of moving average processes{X_(n)=Σ_(i=−∞)^(∞)a_(i)Y_(i+n),n≥1}under some proper conditions,where{Yi,-∞<i<∞}is a doubly infinite sequence of negatively dependent random variables under sub-linear expectations.These results extend and complement the relevant results in probability space.
基金Supported by the National Natural Science Foundation of China(11971142)the Natural Science Foundation of Zhejiang Province(LY19A010012)the key Scientific Research Projects of Hunan Provincial Department of Education in 2021(21A0526)。
文摘In the article,we provide a sharp lower bound for the weighted Lehmer mean of the complete p-elliptic integrals of the first and second kinds,which is the extension of the previous results for complete p-elliptic integrals.
基金supported by the National Natural Science Foundation of China(No.62306281)the Natural Science Foundation of Zhejiang Province(Nos.LQ23E060006 and LTGG24E050005)the Key Research Plan of Jiaxing City(No.2024BZ20016).
文摘In the era of big data,data-driven technologies are increasingly leveraged by industry to facilitate autonomous learning and intelligent decision-making.However,the challenge of“small samples in big data”emerges when datasets lack the comprehensive information necessary for addressing complex scenarios,which hampers adaptability.Thus,enhancing data completeness is essential.Knowledge-guided virtual sample generation transforms domain knowledge into extensive virtual datasets,thereby reducing dependence on limited real samples and enabling zero-sample fault diagnosis.This study used building air conditioning systems as a case study.We innovatively used the large language model(LLM)to acquire domain knowledge for sample generation,significantly lowering knowledge acquisition costs and establishing a generalized framework for knowledge acquisition in engineering applications.This acquired knowledge guided the design of diffusion boundaries in mega-trend diffusion(MTD),while the Monte Carlo method was used to sample within the diffusion function to create information-rich virtual samples.Additionally,a noise-adding technique was introduced to enhance the information entropy of these samples,thereby improving the robustness of neural networks trained with them.Experimental results showed that training the diagnostic model exclusively with virtual samples achieved an accuracy of 72.80%,significantly surpassing traditional small-sample supervised learning in terms of generalization.This underscores the quality and completeness of the generated virtual samples.
文摘Spinal cord injury is a condition in which the parenchyma of the spinal cord is damaged by trauma or various diseases.While rapid progress has been made in regenerative medicine for spinal cord injury that was previously untreatable,most research in this field has focused on the early phase of incomplete injury.However,the majority of patients have chronic severe injuries;therefore,treatments for these situations are of fundamental importance.The reason why the treatment of complete spinal cord injury has not been studied is that,unlike in the early stage of incomplete spinal cord injury,there are various inhibitors of neural regeneration.Thus,we assumed that it is difficult to address all conditions with a single treatment in chronic complete spinal cord injury and that a combination of several treatments is essential to target severe pathologies.First,we established a combination therapy of cell transplantation and drug-releasing scaffolds,which contributes to functional recovery after chronic complete transection spinal cord injury,but we found that functional recovery was limited and still needs further investigation.Here,for the further development of the treatment of chronic complete spinal cord injury,we review the necessary approaches to the different pathologies based on our findings and the many studies that have been accumulated to date and discuss,with reference to the literature,which combination of treatments is most effective in achieving functional recovery.
文摘In this article,we study Kahler metrics on a certain line bundle over some compact Kahler manifolds to find complete Kahler metrics with positive holomorphic sectional(or bisectional)curvatures.Thus,we apply a strategy to a famous Yau conjecture with a co-homogeneity one geometry.
