BACKGROUND Esophageal cancer is a clinically common malignant tumor of the digestive sys-tem.In 2022,it ranked fifth among the leading causes of cancer-related deaths in China.Its predominant symptom is dysphagia,and ...BACKGROUND Esophageal cancer is a clinically common malignant tumor of the digestive sys-tem.In 2022,it ranked fifth among the leading causes of cancer-related deaths in China.Its predominant symptom is dysphagia,and approximately 30%–40%of patients are prone to developing postoperative recurrent stenosis,necessitating repeated esophageal dilation,which significantly affects patients’quality of life.The self-dilation technique,performed by patients,enables preventive esophageal dilation and aims to reduce the frequency of recurrent stenosis.CASE SUMMARY We report the case of a 61-year-old man who underwent repeated esophageal di-lations following endoscopic submucosal dissection.During his eighth hospital admission,a multidisciplinary management team was established to implement an evidence-based self-help balloon dilation technique,facilitate early identifi-cation of nursing concerns and complications,and provide transitional care fo-llowing discharge.The patient reported a high level of satisfaction during the hospital stay.During the 6-month follow-up after discharge,the patient’s quality of life improved,with a substantial reduction in dysphagia.The esophageal stric-ture was successfully dilated from 5 mm to 6 mm,the interval between readmi-ssions was prolonged,and the patient’s weight increased from 49 kg to 50 kg.CONCLUSION The establishment of a multidisciplinary case management team,combined with the implementation of a self-help balloon dilation technique,early identification and management of nursing issues and complications,and person-alized extended care,can significantly enhance patient satisfaction during hospitalization,improve quality of life,and extend the interval between readmissions.These strategies can provide valuable practical guidance for the clinical treatment and nursing of patients with recurrent esophageal stenosis.展开更多
AIM:To compare the efficacy of different administration regimens of compound tropicamide eyedrops(CTE)for pupil dilation for children with dark iris.METHODS:A prospective,comparative,randomized interventional study wa...AIM:To compare the efficacy of different administration regimens of compound tropicamide eyedrops(CTE)for pupil dilation for children with dark iris.METHODS:A prospective,comparative,randomized interventional study was conducted.Children in Group 1 received CTE 3 times with a 3min interval between each application.Children in Group 2 received CTE 4 times with a 5min interval between each application.We measured their pupil diameters at baseline(pre-drug instillation)and 30min and 60min post-drug instillation and assessed the pupillary light reflex at 60min post-drug instillation.RESULTS:In total,194 eyes of 101 children were enrolled.The changes of pupil diameter at 30min and 60min post-drug instillation were 1.2±0.6 mm and 2.3±1.0 mm in Group 1,and 2.3±0.9 mm and 3.7±1.0 mm in Group 2,respectively.Group 2 showed a larger change in pupil size than Group 1 at 30min(P<0.01)and 60min(P<0.01).The effect of pupil dilation in Group 2 was 1.25 times that in Group 1.The change in pupil size was positively associated with age.A higher proportion of children in Group 1 had smaller pupil diameter and reactive pupils at the final time point,with only 33 children(33.7%)had final pupil size≥6.5 mm,and only 9 children(9.2%)had non-reactive pupils.Children in Group 2 achieved larger pupil diameter and more nonreactive pupils at the final time point,with 84 children(87.5%)had final pupil size≥6.5 mm,and only 22 children(22.9%)had reactive pupils.CONCLUSION:Increasing the frequency of compound tropicamide and lengthening the interval between eye drop applications can produce stronger mydriatic effects.展开更多
Notch1 is a mechanosensitive endothelial receptor that responds to vascular wall shear stress.However,data on Notch1 activity in humans remains limited,particularly regarding its role in endothelial function.Objective...Notch1 is a mechanosensitive endothelial receptor that responds to vascular wall shear stress.However,data on Notch1 activity in humans remains limited,particularly regarding its role in endothelial function.Objectives:Accordingly,the purpose of this study was to determine whether Notch1 is associated with the flow-mediated dilatory(FMD)response and whether it is related to aerobic fitness.A secondary purpose was to determine whether Notch1 is related to concentrations of vascular endothelial growth factor(VEGF).Methods:Sixteen(8M/8F)young(20-30 yrs old)and healthy(BMI:25±4.2 kg/m^(2),blood pressure:117±11.63/69±11.25 mmHg)adults participated in the study.Aerobic fitness was determined by cycle VO_(2) peak.An FMDwas performed on the brachial artery,and blood samples were taken from an antecubital vein at rest(baseline)and 1min after cuff deflation(to align with peak vessel dilation).Concentrations of Notch1 extracellular domain(NECD)and VEGFwere determined from plasma using enzyme-linked immunosorbent assays.Results:In contrast to our hypothesis,concentrations of NECD and VEGF did not change throughout the FMDandwere unrelated to allometrically scaled FMD values(p all>0.05).Likewise,there was no relationship between changes inNECD and VEGF(p=0.331,r=0.127).However,the change in NECD across the FMD was moderately(r=0.515)and significantly(p=0.024)correlated with VO_(2) peak.Conclusions:These novel data indicate that in healthy young adults,Notch1 activity is linked to aerobic fitness but may not be acutely involved in the shear-mediated vasodilatory response.展开更多
BACKGROUND Intrahepatic and extrahepatic bile duct stones(BDSs)have a high rate of residual stones,a high risk of recurrence,and a high rate of reoperation.It is very important to take timely and effective surgical in...BACKGROUND Intrahepatic and extrahepatic bile duct stones(BDSs)have a high rate of residual stones,a high risk of recurrence,and a high rate of reoperation.It is very important to take timely and effective surgical intervention for patients.AIM To analyze the efficacy,postoperative rehabilitation,and quality of life(QoL)of patients with intra-and extrahepatic BDSs treated with endoscopic retrograde cholangiopancreatography(ERCP)+endoscopic papillary balloon dilation(EPBD)+laparoscopic hepatectomy(LH).METHODS This study selected 114 cases of intra-and extrahepatic BDSs from April 2021 to April 2024,consisting of 55 cases in the control group receiving laparoscopic common bile duct exploration and LH and 59 cases in the observation group treated with ERCP+EPBD+LH.Efficacy,surgical indicators[operation time(OT)and intraoperative blood loss(IBL)],postoperative rehabilitation(time for body temperature to return to normal,time for pain relief,and time for drainage to reduce jaundice),hospital stay,medical expenses,and QoL[Gastrointestinal Quality of Life Index(GIQLI)]were comparatively analyzed.Further,Logistic regression analysis was conducted to analyze factors influencing the QoL of patients with intra-and extrahepatic BDSs.RESULTS The data demonstrated a higher overall effective rate in the observation group compared to the control group(P=0.011),together with notably reduced OT,less IBL,shorter body temperature recovery time,pain relief time,time for drainage to reduce jaundice,and hospital stay(all P<0.05).The postoperative GIQLI of the observation group was more significantly increased compared to the control group(P<0.05).The two groups demonstrated no marked difference in medical expenses(P>0.05).CONCLUSION The above indicates that ERCP+EPBD+LH is effective in treating patients with intra-and extrahepatic BDSs,which is conducive to postoperative rehabilitation and QoL improvement,with promising prospects for clinical promotion.展开更多
Great potential of underground gas/energy storage in salt caverns seems to be a promising solution to support renewable energy.In the underground storage method,the operating cycle unfortunately may reach up to daily ...Great potential of underground gas/energy storage in salt caverns seems to be a promising solution to support renewable energy.In the underground storage method,the operating cycle unfortunately may reach up to daily or even hourly,which generates complicated pressures on the salt cavern.Furthermore,the mechanical behavior of rock salt may change and present distinct failure characteristics under different stress states,which affects the performance of salt cavern during the time period of full service.To reproduce a similar loading condition on the cavern surrounding rock mass,the cyclic triaxial loading/unloading tests are performed on the rock salt to explore the mechanical transition behavior and failure characteristics under different confinement.Experimental results show that the rock salt samples pre-sent a diffused shear failure band with significant bulges at certain locations in low confining pressure conditions(e.g.5 MPa,10 MPa and 15 MPa),which is closely related to crystal misorientation and grain boundary sliding.Under the elevated confinement(e.g.20 MPa,30 MPa and 40 MPa),the dilation band dominates the failure mechanism,where the large-size halite crystals are crushed to be smaller size and new pores are developing.The failure transition mechanism revealed in the paper provides additional insight into the mechanical performance of salt caverns influenced by complicated stress states.展开更多
BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP),with its clinical ad-vantages of less trauma and faster recovery,has become the primary treatment for choledocholithiasis.AIM To investigate the effects ...BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP),with its clinical ad-vantages of less trauma and faster recovery,has become the primary treatment for choledocholithiasis.AIM To investigate the effects of different ERCP procedures on the sphincter of Oddi.METHODS The clinical data of 91 patients who underwent ERCP at Yixing Hospital of Traditional Chinese Medicine between February 2018 and February 2021 were analyzed retrospectively.The patients were divided into endoscopic sphinc-terotomy(EST,n=24)and endoscopic papillary balloon dilation(EPBD,n=67)groups.The duration of operation,pancreatic development,pancreatic sphinc-terotomy,intubation difficulties,stone recurrence,and incidence of reflux cho-langitis and cholecystitis were statistically analyzed in patients with a history of choledocholithiasis,pancreatitis,and Oddi sphincter dysfunction in the EST and EPBD groups.RESULTS Differences in hypertension,diabetes,increased bilirubin,small diameter of the common bile duct,or ampullary diverticulum between the two groups were not significant.Statistically significant differences were observed between the two groups concerning sex and age(<60 years).Patients with a history of choledocholithiasis,pancreatitis,and Oddi sphincter dysfunction were higher in the EST group than in the EPBD group.The number of cases of pancreatic development,pancreatic duct sphincterotomy,and difficult intubation were higher in the EST group than in the EPBD group.The number of Oddi’s sphincter manometries,ERCP surgical outcomes,and guidewires entering the pancreatic duct several times in EST group were lower than those in the EPBD group.The numbers of stone recurrences,reflux cholangitis,and cholecystitis were higher in the EST group than in the EPBD group.CONCLUSION In summary,common bile duct stones,pancreatitis history,and multiple guided wire introductions into the pancreatic duct are independent risk factors for EST and EPBD.Based on this evidence,this study can provide actionable insights for clinicians and researchers.展开更多
Objective:To prospectively follow up a cohort of anterior urethral stricture disease patients managed with balloon dilation(BD)for 3 years to evaluate the long-term outcomes and to study factors that contribute to rec...Objective:To prospectively follow up a cohort of anterior urethral stricture disease patients managed with balloon dilation(BD)for 3 years to evaluate the long-term outcomes and to study factors that contribute to recurrence.Methods:This study included men who had urethral BD for significant anterior urethral stricture disease between January 2017 and March 2019.Data about the patient age,stricture characteristics,and recurrence date were recorded,along with information on postoperative indwelling catheter use and operative complications.Furthermore,information about the self-calibration procedure was collected and where available,free flow(FF)measurements during the follow-up period were recorded and analyzed.Success was defined as a lack of symptoms and acceptable FF rates(maximum flow rate>12 mL/s).Results:The final analysis was conducted on 187 patients.The mean follow-up period was 37 months.The long-term overall success rate at the end of our study was 66.8%.Our recurrence rate was 7.4%at 12 months,24.7%at 24 months,and reached 33.2%at the end of our study.The time to recurrence ranged from 91 days to 1635 days,with a mean of 670 days.The stricture-free survival was significantly shorter with lengthy peno-bulbar(p=0.031)and multiple strictures(p=0.015),and in the group of patients who were not committed to self-calibration protocol(p<0.011).However,post-procedural self-calibration was the most important factor that may have decreased the incidence of recurrence(odds ratioZ5.85).Adjuvant self-calibration after BD not only reduced the recurrence rate from 85.4%in the non-self-calibration group to 15.1%in the self-calibration one(p<0.001),but also improved the overall stricture-free survival and FF parameters.展开更多
We establish the Stinespring dilation theorem of the link product of quantum channels in two different ways,discuss the discrimination of quantum channels,and show that the distinguishability can be improved by self-l...We establish the Stinespring dilation theorem of the link product of quantum channels in two different ways,discuss the discrimination of quantum channels,and show that the distinguishability can be improved by self-linking each quantum channel n times as n grows.We also find that the maximum value of Uhlmann's theorem can be achieved for diagonal channels.展开更多
BACKGROUND The incidence of cholelithiasis has been on the rise in recent years,but the choice of procedure is controversial.AIM To investigate the efficacy of laparoscopic cholecystectomy(LC)combined with endoscopic ...BACKGROUND The incidence of cholelithiasis has been on the rise in recent years,but the choice of procedure is controversial.AIM To investigate the efficacy of laparoscopic cholecystectomy(LC)combined with endoscopic papillary balloon dilation(EPBD)in patients with gallbladder stones(GS)with common bile duct stones(CBDS).METHODS The clinical data of 102 patients with GS combined with CBDS were selected for retrospective analysis and divided into either an LC+EPBD group(n=50)or an LC+endoscopic sphincterotomy(EST)group(n=52)according to surgical methods.Surgery-related indexes,postoperative recovery,postoperative complications,and expression levels of inflammatory response indexes were compared between the two groups.RESULTS Total surgical time,stone free rate,rate of conversion to laparotomy,and successful stone extraction rate did not differ significantly between the LC+EPBD group and LC+EST group.Intraoperative hemorrhage,time to ambulation,and length of hospitalization in the LC+EPBD group were lower than those of the LC+EST group(P<0.05).The rate of total complications of the two groups was 9.80%and 17.65%,respectively,and the difference was not statistically significant.No serious complications occurred in either group.At 48 h postoperatively,the expression levels of interleukin-6,tumor necrosis factor-α,high-sensitivity Creactive protein,and procalcitonin were lower in the LC+EPBD group than in the LC+EST group(P<0.05).At 3 d postoperatively,the expression levels of aspartate transaminase,alanine transaminase,and total bilirubin were lower in the LC+EPBD group than in the LC+EST group(P<0.05).CONCLUSION LC combined with EPBD and LC combined with EST are both effective procedures for the treatment of GS with CBDS,in which LC combined with EPBD is beneficial to shorten the patient’s hospitalization time,reduce the magnitude of elevated inflammatory response indexes,and promote postoperative recovery.展开更多
BACKGROUND Incomplete congenital duodenal obstruction(ICDO)is caused by a congenitally perforated duodenal web(CPDW).Currently,only six cases of balloon dilatation of the PDW in newborns have been described.AIM To pre...BACKGROUND Incomplete congenital duodenal obstruction(ICDO)is caused by a congenitally perforated duodenal web(CPDW).Currently,only six cases of balloon dilatation of the PDW in newborns have been described.AIM To present our experience of balloon dilatation of a perforated duodenal memb-rane in newborns with ICDO.METHODS Five newborns who underwent balloon dilatation of the CPDW along a prein-stalled guidewire between 2021 and 2023 were included.Nineteen newborns diagnosed with ICDO who underwent laparotomy were included in the control group.RESULTS In all cases,good anatomical and clinical results were obtained.In three cases,a follow-up study was conducted after 1 year.The average time to start enteral feeding per os was significantly earlier in the study group(4.4 d)than in the laparotomic group(21.2 days;P<0.0001).The time spent by patients in the intensive care unit and hospital after balloon dilatation was also significantly shorter.We determined the selection criteria for possible and effective CPDW balloon dilatation in newborns as follows:(1)Presence of dynamic radiographic signs of the passage of a radiopaque substance beyond the zone of narrowing or radiographic signs of pneumatisation of the duodenum and small bowel distal to the web;(2)presence of endoscopic signs of CPDW;(3)successful cannulation with a guidewire performed parallel to the endoscope,with holes in the congenital duodenal web;and(4)successful positioning of the balloon performed along a freestanding guidewire on the web.CONCLUSION Strictly following selection criteria for newborns with ICDO caused by CPDW ensures that endoscopic balloon dilatation using a pre-installed guidewire is safe and effective and shows good 1-year follow-up results.展开更多
This paper presents a conceptual exploration that draws an intriguing parallelbetween a hypothetical travel scenario and the principles of special relativity. The scenario involves a traveler who reduces their speed b...This paper presents a conceptual exploration that draws an intriguing parallelbetween a hypothetical travel scenario and the principles of special relativity. The scenario involves a traveler who reduces their speed by an amount proportional to the distance traveled. Despite initially traveling at a high speed towards a given destination, the continual reduction in speed results in an asymptotic approach to the goal, analogous to the unattainable speed of light in relativity. Mathematically, the scenario is expressed through the Harmonic Series, demonstrating that the total travel time increases without bound, making the destination theoretically unreachable within a finite timeframe. This exploration mirrors the relativistic velocity addition and time dilation effects, providing a compelling analogy for understanding asymptotic limits. By highlighting the profound implications of diminishing returns and unattainable goals, this paper aims to stimulate further discussion and exploration of these fascinating parallels.展开更多
This paper is a further elaboration of the author’s Time Dilation Cosmology (TDC) holographic model that ties gravitation and celestial mechanics and kinematics directly to time dilation, resolving all the major conu...This paper is a further elaboration of the author’s Time Dilation Cosmology (TDC) holographic model that ties gravitation and celestial mechanics and kinematics directly to time dilation, resolving all the major conundrums in astrophysics, and ties astrophysics directly to quantum physics. It begins with a brief summary of the TDC model and contains the new derivation for the time dilation version of the formula for summing relativistic velocities, Einstein’s gravitational constant and the time dilation versions for the Lorentz factor and the Euclidean norm of the 3d velocity vector, the two of which can then be used in the Four-velocity formula. It is demonstrated how orbital curvature is manifested as the resultant of two time dilation-manifested velocities. It also explains why an interferometer cannot distinguish free fall from zero gravity and further elaborates on the author’s previous explanations of how spiral galaxies are formed, and contains mathematical proof that Black Holes are actually Magnetospheric Eternally Collapsing Objects (MECOs) that are massless spacetime vortices.展开更多
This is the fifth paper in a series on Time Dilation Cosmology, TDC. TDC is an eternal holographic model of the universe based on time dilation that ties astrophysics to quantum physics and resolves all the conundrums...This is the fifth paper in a series on Time Dilation Cosmology, TDC. TDC is an eternal holographic model of the universe based on time dilation that ties astrophysics to quantum physics and resolves all the conundrums in astrophysics and serves as a model for the unified field. In the author’s previous four TDC papers, it was demonstrated that all gravitationally induced velocities are compensation for the apparent difference in the rates of time, “dRt”, due to mass/energy densities, and, vice-versa, in all force-induced velocities the dRt is compensation for the velocity, so the uniform evolution of the continuum at c is maintained at the invariant 1 s/s rate of time of the universe as a whole. These compensations make it impossible for an event to lag behind or get ahead of the evolving continuum. When the author did the first velocity formula derivations in “General Relativity: Effects in Time as Causation” [1], the author felt the explanations for the appearance of the 2spatial and the 3temporal acceleration factors in the formulas were correct, but poorly explained and incomplete. This paper is a proof of the temporal and spatial acceleration factors used in the time dilation-based velocity formula derivations in the Time Dilation Cosmology model.展开更多
Two-dimensional endoscopic images are susceptible to interferences such as specular reflections and monotonous texture illumination,hindering accurate three-dimensional lesion reconstruction by surgical robots.This st...Two-dimensional endoscopic images are susceptible to interferences such as specular reflections and monotonous texture illumination,hindering accurate three-dimensional lesion reconstruction by surgical robots.This study proposes a novel end-to-end disparity estimation model to address these challenges.Our approach combines a Pseudo-Siamese neural network architecture with pyramid dilated convolutions,integrating multi-scale image information to enhance robustness against lighting interferences.This study introduces a Pseudo-Siamese structure-based disparity regression model that simplifies left-right image comparison,improving accuracy and efficiency.The model was evaluated using a dataset of stereo endoscopic videos captured by the Da Vinci surgical robot,comprising simulated silicone heart sequences and real heart video data.Experimental results demonstrate significant improvement in the network’s resistance to lighting interference without substantially increasing parameters.Moreover,the model exhibited faster convergence during training,contributing to overall performance enhancement.This study advances endoscopic image processing accuracy and has potential implications for surgical robot applications in complex environments.展开更多
The endothelium modulates vascular homeostasis owing to a variety of vasoconstrictors and vasodilators.Endothelial dysfunction(ED),characterized by impaired vasodilation,inflammation,and thrombosis,triggers future car...The endothelium modulates vascular homeostasis owing to a variety of vasoconstrictors and vasodilators.Endothelial dysfunction(ED),characterized by impaired vasodilation,inflammation,and thrombosis,triggers future cardiovascular(CV)diseases.Chronic kidney disease,a state of chronic inflammation caused by oxidative stress,metabolic abnormalities,infection,and uremic toxins damages the endothelium.ED is also associated with a decline in estimated glomerular filtration rate.After kidney transplantation,endothelial functions undergo immediate but partial restoration,promising graft longevity and enhanced CV health.However,the anticipated CV outcomes do not happen due to various transplant-related and unrelated risk factors for ED,culminating in poor CV health and graft survival.ED in kidney transplant recipients is an underrecognized and poorly studied entity.CV diseases are the leading cause of death among kidney transplant candidates with functioning grafts.ED contributes to the pathogenesis of many of the CV diseases.Various biomarkers and vasoreactivity tests are available to study endothelial functions.With an increasing number of transplants happening every year,and improved graft rejection rates due to the availability of effective immunosuppressants,the focus has now shifted to endothelial protection for the prevention,early recognition,and treatment of CV diseases.展开更多
A primary hallmark of pathological cardiac hypertrophy is excess protein synthesis due to enhanced translational activity.However,regulatory mechanisms at the translational level under cardiac stress remain poorly und...A primary hallmark of pathological cardiac hypertrophy is excess protein synthesis due to enhanced translational activity.However,regulatory mechanisms at the translational level under cardiac stress remain poorly understood.Here we examined the translational regulations in a mouse cardiac hypertrophy model induced by transaortic constriction(TAC)and explored the conservative networks versus the translatome pattern in human dilated cardiomyopathy(DCM).The results showed that the heart weight to body weight ratio was significantly elevated,and the ejection fraction and fractional shortening significantly decreased 8 weeks after TAC.Puromycin incorporation assay showed that TAC significantly increased protein synthesis rate in the left ventricle.RNAseq revealed 1,632 differentially expressed genes showing functional enrichment in pathways including extracellular matrix remodeling,metabolic processes,and signaling cascades associated with pathological cardiomyocyte growth.When combined with ribosome profiling analysis,we revealed that translation efficiency(TE)of 1,495 genes was enhanced,while the TE of 933 genes was inhibited following TAC.In DCM patients,1,354 genes were upregulated versus 1,213 genes were downregulated at the translation level.Although the majority of the genes were not shared between mouse and human,we identified 93 genes,including Nos3,Kcnj8,Adcy4,Itpr1,Fasn,Scd1,etc.,with highly conserved translational regulations.These genes were remarkably associated with myocardial function,signal transduction,and energy metabolism,particularly related to cGMP-PKG signaling and fatty acid metabolism.Motif analysis revealed enriched regulatory elements in the 5′untranslated regions(5′UTRs)of transcripts with differential TE,which exhibited strong cross-species sequence conservation.Our study revealed novel regulatory mechanisms at the translational level in cardiac hypertrophy and identified conserved translation-sensitive targets with potential applications to treat cardiac hypertrophy and heart failure in the clinic.展开更多
BACKGROUND In pediatric and adolescent athletes,there is a lack of understanding about the impact of factors such as race on the structural or cardiovascular adaptations in response to exercise which may unnecessarily...BACKGROUND In pediatric and adolescent athletes,there is a lack of understanding about the impact of factors such as race on the structural or cardiovascular adaptations in response to exercise which may unnecessarily disqualify athletes from the competitive sport.We hypothesized that race has an impact on cardiac adaptions in non-adult athletes.AIM To explore the racial disparity in electrocardiographic(ECG)and echocardiographic(ECHO)parameters in healthy adolescent athletes.METHODS A comprehensive electronic systematic literature search using MEDLINE database was performed from inception to September 20,2024.Inclusion criteria included randomized or observational cohort studies that recruited adolescent competitive athletes in any sport discipline and compared between the Black and White races with an age range of 12-18 years.RESULTS Of 723 records that were identified by the literature search,seven studies(n=5036)were included.The mean age was 13.0-18.0 years old with male predominance.Black athletes had significantly longer PR interval[mean difference(MD)=17.49 millisecond,95% CI:11.70-23.29]and shorter QRS complex duration(MD=-7.35 millisecond,95% CI:-9.17 to-5.53)and corrected QT interval(MD=-4.95 millisecond,95% CI:-7.69 to-2.22)than the White athletes.Black athletes were approximately four times more likely to have first-degree atrioventricular(AV)block,inverted T wave,ST-segment elevation,and left atrium(LA)enlargement than their White counterparts.In terms of ECHO parameters,Black athletes had significantly greater septal wall thickness(MD=0.85 mm,95% CI:0.62-1.07),posterior wall thickness(MD=1.07 mm,95% CI:0.36-1.78),relative wall thickness(MD=0.03,95%CI:0.001-0.06),maximal wall thickness(MD=1.05 mm,95%CI:0.28-1.83),and LA diameter(MD=1.64 mm,95%CI:0.16-3.12).CONCLUSION Race has an impact on the ECG and ECHO parameters that reflect cardiac adaptations in adolescent athletes.Black athletes tend to have an increased prevalence of distinct ECG changes such as first-degree AV block and T-wave inversions compared with their White counterparts.Despite having thicker septal and posterior walls,the overall prevalence of left ventricular hypertrophy did not differ between the races.展开更多
Dear Editor,Varicocele(VC)is a vascular condition characterized by abnormal tortuosity and dilation of the pampiniform plexus veins within the spermatic cord.VC is commonly observed in young adults,predominantly on th...Dear Editor,Varicocele(VC)is a vascular condition characterized by abnormal tortuosity and dilation of the pampiniform plexus veins within the spermatic cord.VC is commonly observed in young adults,predominantly on the left side;it is a frequent cause of male infertility and can lead to testicular hypofunction,pain,and discomfort.Microsurgical varicocelectomy is the gold standard for treating infertility caused by VC.VC repair is strongly recommended for couple infertility,oligoasthenoteratozoospermia(OAT),Grade 2 or 3 clinical VC,partner age<37 years,patient age<40 years,or testicular hypotrophy in children and adolescents.展开更多
Pediatric dilated cardiomyopathy(DCM)isa leading cause of heart failure in children,presenting.significant therapeutic challenges due to the limited efficacy of pharmacological treatments,thescarcity of donor hearts f...Pediatric dilated cardiomyopathy(DCM)isa leading cause of heart failure in children,presenting.significant therapeutic challenges due to the limited efficacy of pharmacological treatments,thescarcity of donor hearts for transplantation,and the high costs associated with ventricular assistdevices.Also,the economic burden of DCM medical management is a critical topic for world wide.In this context,the development of a safe,effective,and economically viable surgical intervention isof paramount importance.A recent study published in CongenitalHeart Disease,titled"CardiacRehabilitation by Pulmonary Artery Banding after Induced Dilated Candiomyopathy:A Pilot Studyon a Rodent Model",represents a significant advancement in this field.This study evaluated thefeasibility and therapeutic potential of pulmonary artery banding(PAB)in a drug-induced DMrodent model,providing critical preclinical evidence to support its clinical translation[1].展开更多
The Mentawai Forearc Sliver(MFS)is characterized by oblique deformation formed as slip partitioned between normal and parallel trench plate convergence.The surge of great earthquakes from 2004 to2012 along the adjacen...The Mentawai Forearc Sliver(MFS)is characterized by oblique deformation formed as slip partitioned between normal and parallel trench plate convergence.The surge of great earthquakes from 2004 to2012 along the adjacent Sunda trench left a large unbroken segment known as the Mentawai Seismic Gap.Here,we adopted continuous Global Navigation Satellite System(GNSS)observation data to identify the present regional crustal deformation using geodetic strain rates.The principal strain rate,dilatation rate,and maximum shear strain rate are about 0.13 microstrain/yr,0.2 microstrain/yr,and 0.1 microstrain/yr,respectively,with the range of its uncertainties between 0.01 and 0.04 microstrain/yr.The dilatation and maximum shear strain rates reveal the spatial coverage of strike-slip duplex and backthrust tectonics along the Mentawai Forearc Sliver.展开更多
文摘BACKGROUND Esophageal cancer is a clinically common malignant tumor of the digestive sys-tem.In 2022,it ranked fifth among the leading causes of cancer-related deaths in China.Its predominant symptom is dysphagia,and approximately 30%–40%of patients are prone to developing postoperative recurrent stenosis,necessitating repeated esophageal dilation,which significantly affects patients’quality of life.The self-dilation technique,performed by patients,enables preventive esophageal dilation and aims to reduce the frequency of recurrent stenosis.CASE SUMMARY We report the case of a 61-year-old man who underwent repeated esophageal di-lations following endoscopic submucosal dissection.During his eighth hospital admission,a multidisciplinary management team was established to implement an evidence-based self-help balloon dilation technique,facilitate early identifi-cation of nursing concerns and complications,and provide transitional care fo-llowing discharge.The patient reported a high level of satisfaction during the hospital stay.During the 6-month follow-up after discharge,the patient’s quality of life improved,with a substantial reduction in dysphagia.The esophageal stric-ture was successfully dilated from 5 mm to 6 mm,the interval between readmi-ssions was prolonged,and the patient’s weight increased from 49 kg to 50 kg.CONCLUSION The establishment of a multidisciplinary case management team,combined with the implementation of a self-help balloon dilation technique,early identification and management of nursing issues and complications,and person-alized extended care,can significantly enhance patient satisfaction during hospitalization,improve quality of life,and extend the interval between readmissions.These strategies can provide valuable practical guidance for the clinical treatment and nursing of patients with recurrent esophageal stenosis.
基金Supported by the National Natural Science Foundation of China(No.82371093,No.72342015)R&D Program of Beijing Municipal Education Commission(No.KZ202110025039).
文摘AIM:To compare the efficacy of different administration regimens of compound tropicamide eyedrops(CTE)for pupil dilation for children with dark iris.METHODS:A prospective,comparative,randomized interventional study was conducted.Children in Group 1 received CTE 3 times with a 3min interval between each application.Children in Group 2 received CTE 4 times with a 5min interval between each application.We measured their pupil diameters at baseline(pre-drug instillation)and 30min and 60min post-drug instillation and assessed the pupillary light reflex at 60min post-drug instillation.RESULTS:In total,194 eyes of 101 children were enrolled.The changes of pupil diameter at 30min and 60min post-drug instillation were 1.2±0.6 mm and 2.3±1.0 mm in Group 1,and 2.3±0.9 mm and 3.7±1.0 mm in Group 2,respectively.Group 2 showed a larger change in pupil size than Group 1 at 30min(P<0.01)and 60min(P<0.01).The effect of pupil dilation in Group 2 was 1.25 times that in Group 1.The change in pupil size was positively associated with age.A higher proportion of children in Group 1 had smaller pupil diameter and reactive pupils at the final time point,with only 33 children(33.7%)had final pupil size≥6.5 mm,and only 9 children(9.2%)had non-reactive pupils.Children in Group 2 achieved larger pupil diameter and more nonreactive pupils at the final time point,with 84 children(87.5%)had final pupil size≥6.5 mm,and only 22 children(22.9%)had reactive pupils.CONCLUSION:Increasing the frequency of compound tropicamide and lengthening the interval between eye drop applications can produce stronger mydriatic effects.
基金supported by the Natural Sciences and Engineering Research Council of Canada(NSERC)Discovery Grant,held by Dr.Bain(RGPIN-2020-05760).
文摘Notch1 is a mechanosensitive endothelial receptor that responds to vascular wall shear stress.However,data on Notch1 activity in humans remains limited,particularly regarding its role in endothelial function.Objectives:Accordingly,the purpose of this study was to determine whether Notch1 is associated with the flow-mediated dilatory(FMD)response and whether it is related to aerobic fitness.A secondary purpose was to determine whether Notch1 is related to concentrations of vascular endothelial growth factor(VEGF).Methods:Sixteen(8M/8F)young(20-30 yrs old)and healthy(BMI:25±4.2 kg/m^(2),blood pressure:117±11.63/69±11.25 mmHg)adults participated in the study.Aerobic fitness was determined by cycle VO_(2) peak.An FMDwas performed on the brachial artery,and blood samples were taken from an antecubital vein at rest(baseline)and 1min after cuff deflation(to align with peak vessel dilation).Concentrations of Notch1 extracellular domain(NECD)and VEGFwere determined from plasma using enzyme-linked immunosorbent assays.Results:In contrast to our hypothesis,concentrations of NECD and VEGF did not change throughout the FMDandwere unrelated to allometrically scaled FMD values(p all>0.05).Likewise,there was no relationship between changes inNECD and VEGF(p=0.331,r=0.127).However,the change in NECD across the FMD was moderately(r=0.515)and significantly(p=0.024)correlated with VO_(2) peak.Conclusions:These novel data indicate that in healthy young adults,Notch1 activity is linked to aerobic fitness but may not be acutely involved in the shear-mediated vasodilatory response.
文摘BACKGROUND Intrahepatic and extrahepatic bile duct stones(BDSs)have a high rate of residual stones,a high risk of recurrence,and a high rate of reoperation.It is very important to take timely and effective surgical intervention for patients.AIM To analyze the efficacy,postoperative rehabilitation,and quality of life(QoL)of patients with intra-and extrahepatic BDSs treated with endoscopic retrograde cholangiopancreatography(ERCP)+endoscopic papillary balloon dilation(EPBD)+laparoscopic hepatectomy(LH).METHODS This study selected 114 cases of intra-and extrahepatic BDSs from April 2021 to April 2024,consisting of 55 cases in the control group receiving laparoscopic common bile duct exploration and LH and 59 cases in the observation group treated with ERCP+EPBD+LH.Efficacy,surgical indicators[operation time(OT)and intraoperative blood loss(IBL)],postoperative rehabilitation(time for body temperature to return to normal,time for pain relief,and time for drainage to reduce jaundice),hospital stay,medical expenses,and QoL[Gastrointestinal Quality of Life Index(GIQLI)]were comparatively analyzed.Further,Logistic regression analysis was conducted to analyze factors influencing the QoL of patients with intra-and extrahepatic BDSs.RESULTS The data demonstrated a higher overall effective rate in the observation group compared to the control group(P=0.011),together with notably reduced OT,less IBL,shorter body temperature recovery time,pain relief time,time for drainage to reduce jaundice,and hospital stay(all P<0.05).The postoperative GIQLI of the observation group was more significantly increased compared to the control group(P<0.05).The two groups demonstrated no marked difference in medical expenses(P>0.05).CONCLUSION The above indicates that ERCP+EPBD+LH is effective in treating patients with intra-and extrahepatic BDSs,which is conducive to postoperative rehabilitation and QoL improvement,with promising prospects for clinical promotion.
基金This research was financially supported by the Science and Technology Department of Sichuan Province Project,China(Grant Nos.2022YFSY0007,2021YFH0010)the National Scientific Science Foundation of China(Grant No.U20A20266).
文摘Great potential of underground gas/energy storage in salt caverns seems to be a promising solution to support renewable energy.In the underground storage method,the operating cycle unfortunately may reach up to daily or even hourly,which generates complicated pressures on the salt cavern.Furthermore,the mechanical behavior of rock salt may change and present distinct failure characteristics under different stress states,which affects the performance of salt cavern during the time period of full service.To reproduce a similar loading condition on the cavern surrounding rock mass,the cyclic triaxial loading/unloading tests are performed on the rock salt to explore the mechanical transition behavior and failure characteristics under different confinement.Experimental results show that the rock salt samples pre-sent a diffused shear failure band with significant bulges at certain locations in low confining pressure conditions(e.g.5 MPa,10 MPa and 15 MPa),which is closely related to crystal misorientation and grain boundary sliding.Under the elevated confinement(e.g.20 MPa,30 MPa and 40 MPa),the dilation band dominates the failure mechanism,where the large-size halite crystals are crushed to be smaller size and new pores are developing.The failure transition mechanism revealed in the paper provides additional insight into the mechanical performance of salt caverns influenced by complicated stress states.
文摘BACKGROUND Endoscopic retrograde cholangiopancreatography(ERCP),with its clinical ad-vantages of less trauma and faster recovery,has become the primary treatment for choledocholithiasis.AIM To investigate the effects of different ERCP procedures on the sphincter of Oddi.METHODS The clinical data of 91 patients who underwent ERCP at Yixing Hospital of Traditional Chinese Medicine between February 2018 and February 2021 were analyzed retrospectively.The patients were divided into endoscopic sphinc-terotomy(EST,n=24)and endoscopic papillary balloon dilation(EPBD,n=67)groups.The duration of operation,pancreatic development,pancreatic sphinc-terotomy,intubation difficulties,stone recurrence,and incidence of reflux cho-langitis and cholecystitis were statistically analyzed in patients with a history of choledocholithiasis,pancreatitis,and Oddi sphincter dysfunction in the EST and EPBD groups.RESULTS Differences in hypertension,diabetes,increased bilirubin,small diameter of the common bile duct,or ampullary diverticulum between the two groups were not significant.Statistically significant differences were observed between the two groups concerning sex and age(<60 years).Patients with a history of choledocholithiasis,pancreatitis,and Oddi sphincter dysfunction were higher in the EST group than in the EPBD group.The number of cases of pancreatic development,pancreatic duct sphincterotomy,and difficult intubation were higher in the EST group than in the EPBD group.The number of Oddi’s sphincter manometries,ERCP surgical outcomes,and guidewires entering the pancreatic duct several times in EST group were lower than those in the EPBD group.The numbers of stone recurrences,reflux cholangitis,and cholecystitis were higher in the EST group than in the EPBD group.CONCLUSION In summary,common bile duct stones,pancreatitis history,and multiple guided wire introductions into the pancreatic duct are independent risk factors for EST and EPBD.Based on this evidence,this study can provide actionable insights for clinicians and researchers.
文摘Objective:To prospectively follow up a cohort of anterior urethral stricture disease patients managed with balloon dilation(BD)for 3 years to evaluate the long-term outcomes and to study factors that contribute to recurrence.Methods:This study included men who had urethral BD for significant anterior urethral stricture disease between January 2017 and March 2019.Data about the patient age,stricture characteristics,and recurrence date were recorded,along with information on postoperative indwelling catheter use and operative complications.Furthermore,information about the self-calibration procedure was collected and where available,free flow(FF)measurements during the follow-up period were recorded and analyzed.Success was defined as a lack of symptoms and acceptable FF rates(maximum flow rate>12 mL/s).Results:The final analysis was conducted on 187 patients.The mean follow-up period was 37 months.The long-term overall success rate at the end of our study was 66.8%.Our recurrence rate was 7.4%at 12 months,24.7%at 24 months,and reached 33.2%at the end of our study.The time to recurrence ranged from 91 days to 1635 days,with a mean of 670 days.The stricture-free survival was significantly shorter with lengthy peno-bulbar(p=0.031)and multiple strictures(p=0.015),and in the group of patients who were not committed to self-calibration protocol(p<0.011).However,post-procedural self-calibration was the most important factor that may have decreased the incidence of recurrence(odds ratioZ5.85).Adjuvant self-calibration after BD not only reduced the recurrence rate from 85.4%in the non-self-calibration group to 15.1%in the self-calibration one(p<0.001),but also improved the overall stricture-free survival and FF parameters.
基金Project supported by the National Natural Science Foundation of China(Grant Nos.61877054,12031004,and 12271474).
文摘We establish the Stinespring dilation theorem of the link product of quantum channels in two different ways,discuss the discrimination of quantum channels,and show that the distinguishability can be improved by self-linking each quantum channel n times as n grows.We also find that the maximum value of Uhlmann's theorem can be achieved for diagonal channels.
基金Supported by Qiqihar Science and Technology Plan Joint Guidance Project,No.LHYD-2021058.
文摘BACKGROUND The incidence of cholelithiasis has been on the rise in recent years,but the choice of procedure is controversial.AIM To investigate the efficacy of laparoscopic cholecystectomy(LC)combined with endoscopic papillary balloon dilation(EPBD)in patients with gallbladder stones(GS)with common bile duct stones(CBDS).METHODS The clinical data of 102 patients with GS combined with CBDS were selected for retrospective analysis and divided into either an LC+EPBD group(n=50)or an LC+endoscopic sphincterotomy(EST)group(n=52)according to surgical methods.Surgery-related indexes,postoperative recovery,postoperative complications,and expression levels of inflammatory response indexes were compared between the two groups.RESULTS Total surgical time,stone free rate,rate of conversion to laparotomy,and successful stone extraction rate did not differ significantly between the LC+EPBD group and LC+EST group.Intraoperative hemorrhage,time to ambulation,and length of hospitalization in the LC+EPBD group were lower than those of the LC+EST group(P<0.05).The rate of total complications of the two groups was 9.80%and 17.65%,respectively,and the difference was not statistically significant.No serious complications occurred in either group.At 48 h postoperatively,the expression levels of interleukin-6,tumor necrosis factor-α,high-sensitivity Creactive protein,and procalcitonin were lower in the LC+EPBD group than in the LC+EST group(P<0.05).At 3 d postoperatively,the expression levels of aspartate transaminase,alanine transaminase,and total bilirubin were lower in the LC+EPBD group than in the LC+EST group(P<0.05).CONCLUSION LC combined with EPBD and LC combined with EST are both effective procedures for the treatment of GS with CBDS,in which LC combined with EPBD is beneficial to shorten the patient’s hospitalization time,reduce the magnitude of elevated inflammatory response indexes,and promote postoperative recovery.
基金The study was reviewed and approved by the Research Ethics Committee of Republican Scientific and Practical Center of Pediatric Surgery Minsk,Republic of Belarus(Protocol 9 of August 24,2023).
文摘BACKGROUND Incomplete congenital duodenal obstruction(ICDO)is caused by a congenitally perforated duodenal web(CPDW).Currently,only six cases of balloon dilatation of the PDW in newborns have been described.AIM To present our experience of balloon dilatation of a perforated duodenal memb-rane in newborns with ICDO.METHODS Five newborns who underwent balloon dilatation of the CPDW along a prein-stalled guidewire between 2021 and 2023 were included.Nineteen newborns diagnosed with ICDO who underwent laparotomy were included in the control group.RESULTS In all cases,good anatomical and clinical results were obtained.In three cases,a follow-up study was conducted after 1 year.The average time to start enteral feeding per os was significantly earlier in the study group(4.4 d)than in the laparotomic group(21.2 days;P<0.0001).The time spent by patients in the intensive care unit and hospital after balloon dilatation was also significantly shorter.We determined the selection criteria for possible and effective CPDW balloon dilatation in newborns as follows:(1)Presence of dynamic radiographic signs of the passage of a radiopaque substance beyond the zone of narrowing or radiographic signs of pneumatisation of the duodenum and small bowel distal to the web;(2)presence of endoscopic signs of CPDW;(3)successful cannulation with a guidewire performed parallel to the endoscope,with holes in the congenital duodenal web;and(4)successful positioning of the balloon performed along a freestanding guidewire on the web.CONCLUSION Strictly following selection criteria for newborns with ICDO caused by CPDW ensures that endoscopic balloon dilatation using a pre-installed guidewire is safe and effective and shows good 1-year follow-up results.
文摘This paper presents a conceptual exploration that draws an intriguing parallelbetween a hypothetical travel scenario and the principles of special relativity. The scenario involves a traveler who reduces their speed by an amount proportional to the distance traveled. Despite initially traveling at a high speed towards a given destination, the continual reduction in speed results in an asymptotic approach to the goal, analogous to the unattainable speed of light in relativity. Mathematically, the scenario is expressed through the Harmonic Series, demonstrating that the total travel time increases without bound, making the destination theoretically unreachable within a finite timeframe. This exploration mirrors the relativistic velocity addition and time dilation effects, providing a compelling analogy for understanding asymptotic limits. By highlighting the profound implications of diminishing returns and unattainable goals, this paper aims to stimulate further discussion and exploration of these fascinating parallels.
文摘This paper is a further elaboration of the author’s Time Dilation Cosmology (TDC) holographic model that ties gravitation and celestial mechanics and kinematics directly to time dilation, resolving all the major conundrums in astrophysics, and ties astrophysics directly to quantum physics. It begins with a brief summary of the TDC model and contains the new derivation for the time dilation version of the formula for summing relativistic velocities, Einstein’s gravitational constant and the time dilation versions for the Lorentz factor and the Euclidean norm of the 3d velocity vector, the two of which can then be used in the Four-velocity formula. It is demonstrated how orbital curvature is manifested as the resultant of two time dilation-manifested velocities. It also explains why an interferometer cannot distinguish free fall from zero gravity and further elaborates on the author’s previous explanations of how spiral galaxies are formed, and contains mathematical proof that Black Holes are actually Magnetospheric Eternally Collapsing Objects (MECOs) that are massless spacetime vortices.
文摘This is the fifth paper in a series on Time Dilation Cosmology, TDC. TDC is an eternal holographic model of the universe based on time dilation that ties astrophysics to quantum physics and resolves all the conundrums in astrophysics and serves as a model for the unified field. In the author’s previous four TDC papers, it was demonstrated that all gravitationally induced velocities are compensation for the apparent difference in the rates of time, “dRt”, due to mass/energy densities, and, vice-versa, in all force-induced velocities the dRt is compensation for the velocity, so the uniform evolution of the continuum at c is maintained at the invariant 1 s/s rate of time of the universe as a whole. These compensations make it impossible for an event to lag behind or get ahead of the evolving continuum. When the author did the first velocity formula derivations in “General Relativity: Effects in Time as Causation” [1], the author felt the explanations for the appearance of the 2spatial and the 3temporal acceleration factors in the formulas were correct, but poorly explained and incomplete. This paper is a proof of the temporal and spatial acceleration factors used in the time dilation-based velocity formula derivations in the Time Dilation Cosmology model.
基金Supported by Sichuan Science and Technology Program(2023YFSY0026,2023YFH0004)Supported by the Institute of Information&Communications Technology Planning&Evaluation(IITP)grant funded by the Korean government(MSIT)(No.RS-2022-00155885,Artificial Intelligence Convergence Innovation Human Resources Development(Hanyang University ERICA)).
文摘Two-dimensional endoscopic images are susceptible to interferences such as specular reflections and monotonous texture illumination,hindering accurate three-dimensional lesion reconstruction by surgical robots.This study proposes a novel end-to-end disparity estimation model to address these challenges.Our approach combines a Pseudo-Siamese neural network architecture with pyramid dilated convolutions,integrating multi-scale image information to enhance robustness against lighting interferences.This study introduces a Pseudo-Siamese structure-based disparity regression model that simplifies left-right image comparison,improving accuracy and efficiency.The model was evaluated using a dataset of stereo endoscopic videos captured by the Da Vinci surgical robot,comprising simulated silicone heart sequences and real heart video data.Experimental results demonstrate significant improvement in the network’s resistance to lighting interference without substantially increasing parameters.Moreover,the model exhibited faster convergence during training,contributing to overall performance enhancement.This study advances endoscopic image processing accuracy and has potential implications for surgical robot applications in complex environments.
文摘The endothelium modulates vascular homeostasis owing to a variety of vasoconstrictors and vasodilators.Endothelial dysfunction(ED),characterized by impaired vasodilation,inflammation,and thrombosis,triggers future cardiovascular(CV)diseases.Chronic kidney disease,a state of chronic inflammation caused by oxidative stress,metabolic abnormalities,infection,and uremic toxins damages the endothelium.ED is also associated with a decline in estimated glomerular filtration rate.After kidney transplantation,endothelial functions undergo immediate but partial restoration,promising graft longevity and enhanced CV health.However,the anticipated CV outcomes do not happen due to various transplant-related and unrelated risk factors for ED,culminating in poor CV health and graft survival.ED in kidney transplant recipients is an underrecognized and poorly studied entity.CV diseases are the leading cause of death among kidney transplant candidates with functioning grafts.ED contributes to the pathogenesis of many of the CV diseases.Various biomarkers and vasoreactivity tests are available to study endothelial functions.With an increasing number of transplants happening every year,and improved graft rejection rates due to the availability of effective immunosuppressants,the focus has now shifted to endothelial protection for the prevention,early recognition,and treatment of CV diseases.
基金supported by grants from National Natural Science Foundation of China(No.82370392)Shenzhen Medical Research Fund(No.B2302026)+4 种基金Science,Technology and Innovation Commission of Shenzhen Municipality(No.RCJC20210706091947009)National Key R&D Program of China(No.2022YFA1104500)CAMS Innovation Fund for Medical Sciences(No.2023-I2M-1-003 and 2022-I2M-2-001)Non-profit Central Research Institute Fund of Chinese Academy of Medical Sciences(No.2019PT320026)National High Level Hospital Clinical Research Funding(No.2022-GSP-GG-7)。
文摘A primary hallmark of pathological cardiac hypertrophy is excess protein synthesis due to enhanced translational activity.However,regulatory mechanisms at the translational level under cardiac stress remain poorly understood.Here we examined the translational regulations in a mouse cardiac hypertrophy model induced by transaortic constriction(TAC)and explored the conservative networks versus the translatome pattern in human dilated cardiomyopathy(DCM).The results showed that the heart weight to body weight ratio was significantly elevated,and the ejection fraction and fractional shortening significantly decreased 8 weeks after TAC.Puromycin incorporation assay showed that TAC significantly increased protein synthesis rate in the left ventricle.RNAseq revealed 1,632 differentially expressed genes showing functional enrichment in pathways including extracellular matrix remodeling,metabolic processes,and signaling cascades associated with pathological cardiomyocyte growth.When combined with ribosome profiling analysis,we revealed that translation efficiency(TE)of 1,495 genes was enhanced,while the TE of 933 genes was inhibited following TAC.In DCM patients,1,354 genes were upregulated versus 1,213 genes were downregulated at the translation level.Although the majority of the genes were not shared between mouse and human,we identified 93 genes,including Nos3,Kcnj8,Adcy4,Itpr1,Fasn,Scd1,etc.,with highly conserved translational regulations.These genes were remarkably associated with myocardial function,signal transduction,and energy metabolism,particularly related to cGMP-PKG signaling and fatty acid metabolism.Motif analysis revealed enriched regulatory elements in the 5′untranslated regions(5′UTRs)of transcripts with differential TE,which exhibited strong cross-species sequence conservation.Our study revealed novel regulatory mechanisms at the translational level in cardiac hypertrophy and identified conserved translation-sensitive targets with potential applications to treat cardiac hypertrophy and heart failure in the clinic.
文摘BACKGROUND In pediatric and adolescent athletes,there is a lack of understanding about the impact of factors such as race on the structural or cardiovascular adaptations in response to exercise which may unnecessarily disqualify athletes from the competitive sport.We hypothesized that race has an impact on cardiac adaptions in non-adult athletes.AIM To explore the racial disparity in electrocardiographic(ECG)and echocardiographic(ECHO)parameters in healthy adolescent athletes.METHODS A comprehensive electronic systematic literature search using MEDLINE database was performed from inception to September 20,2024.Inclusion criteria included randomized or observational cohort studies that recruited adolescent competitive athletes in any sport discipline and compared between the Black and White races with an age range of 12-18 years.RESULTS Of 723 records that were identified by the literature search,seven studies(n=5036)were included.The mean age was 13.0-18.0 years old with male predominance.Black athletes had significantly longer PR interval[mean difference(MD)=17.49 millisecond,95% CI:11.70-23.29]and shorter QRS complex duration(MD=-7.35 millisecond,95% CI:-9.17 to-5.53)and corrected QT interval(MD=-4.95 millisecond,95% CI:-7.69 to-2.22)than the White athletes.Black athletes were approximately four times more likely to have first-degree atrioventricular(AV)block,inverted T wave,ST-segment elevation,and left atrium(LA)enlargement than their White counterparts.In terms of ECHO parameters,Black athletes had significantly greater septal wall thickness(MD=0.85 mm,95% CI:0.62-1.07),posterior wall thickness(MD=1.07 mm,95% CI:0.36-1.78),relative wall thickness(MD=0.03,95%CI:0.001-0.06),maximal wall thickness(MD=1.05 mm,95%CI:0.28-1.83),and LA diameter(MD=1.64 mm,95%CI:0.16-3.12).CONCLUSION Race has an impact on the ECG and ECHO parameters that reflect cardiac adaptations in adolescent athletes.Black athletes tend to have an increased prevalence of distinct ECG changes such as first-degree AV block and T-wave inversions compared with their White counterparts.Despite having thicker septal and posterior walls,the overall prevalence of left ventricular hypertrophy did not differ between the races.
文摘Dear Editor,Varicocele(VC)is a vascular condition characterized by abnormal tortuosity and dilation of the pampiniform plexus veins within the spermatic cord.VC is commonly observed in young adults,predominantly on the left side;it is a frequent cause of male infertility and can lead to testicular hypofunction,pain,and discomfort.Microsurgical varicocelectomy is the gold standard for treating infertility caused by VC.VC repair is strongly recommended for couple infertility,oligoasthenoteratozoospermia(OAT),Grade 2 or 3 clinical VC,partner age<37 years,patient age<40 years,or testicular hypotrophy in children and adolescents.
文摘Pediatric dilated cardiomyopathy(DCM)isa leading cause of heart failure in children,presenting.significant therapeutic challenges due to the limited efficacy of pharmacological treatments,thescarcity of donor hearts for transplantation,and the high costs associated with ventricular assistdevices.Also,the economic burden of DCM medical management is a critical topic for world wide.In this context,the development of a safe,effective,and economically viable surgical intervention isof paramount importance.A recent study published in CongenitalHeart Disease,titled"CardiacRehabilitation by Pulmonary Artery Banding after Induced Dilated Candiomyopathy:A Pilot Studyon a Rodent Model",represents a significant advancement in this field.This study evaluated thefeasibility and therapeutic potential of pulmonary artery banding(PAB)in a drug-induced DMrodent model,providing critical preclinical evidence to support its clinical translation[1].
基金supported by Universitas Gadjah Mada through the 2022 Indonesian Collaborative Research Program.
文摘The Mentawai Forearc Sliver(MFS)is characterized by oblique deformation formed as slip partitioned between normal and parallel trench plate convergence.The surge of great earthquakes from 2004 to2012 along the adjacent Sunda trench left a large unbroken segment known as the Mentawai Seismic Gap.Here,we adopted continuous Global Navigation Satellite System(GNSS)observation data to identify the present regional crustal deformation using geodetic strain rates.The principal strain rate,dilatation rate,and maximum shear strain rate are about 0.13 microstrain/yr,0.2 microstrain/yr,and 0.1 microstrain/yr,respectively,with the range of its uncertainties between 0.01 and 0.04 microstrain/yr.The dilatation and maximum shear strain rates reveal the spatial coverage of strike-slip duplex and backthrust tectonics along the Mentawai Forearc Sliver.
