OBJECTIVE:To evaluate the 10-year therapeutic efficacy of Traditional Chinese Medicine(TCM)using the Strengthening Spleen and Draining Dampness therapy in the management of idiopathic membranous nephropathy(IMN).METHO...OBJECTIVE:To evaluate the 10-year therapeutic efficacy of Traditional Chinese Medicine(TCM)using the Strengthening Spleen and Draining Dampness therapy in the management of idiopathic membranous nephropathy(IMN).METHODS:A single-center,retrospective analysis was conducted on patients diagnosed with IMN who met predefined inclusion and exclusion criteria.Data were collected from the Department of Nephrology at Longhua Hospital,affiliated with Shanghai University of Traditional Chinese Medicine,between January 2007 and December 2011.Clinical parameters including 24-h urinary protein,serum albumin,serum creatinine,and estimated glomerular filtration rate(e GFR,EPI)were assessed at baseline and at 1,3,5,and 10 years of follow-up.The efficacy of the Strengthening Spleen and Draining Dampness therapy was analyzed using repeated measures analysis of variance(ANOVA).Kaplan-Meier survival curves and multivariate proportional hazards model(Cox regression models)were employed to identify factors associated with treatment outcomes.RESULTS:A total of 265 patients were included,with a median follow-up duration of 96 months(36,122).TCM treatment significantly reduced 24-h urinary protein levels(P<0.001),and increased serum albumin levels(P<0.001),while serum creatinine remained stable(P=0.187).Remission rates at 1,3,5,and 10 years were 52.81%,69.71%,68.39%,and 72.36%,respectively,and the rates of avoiding composite outcome events at the same intervals were 98.27%,94.29%,94.19%,and 93.50%.In the subgroup receiving TCM only,remission rates were 56.67%,84.44%,76.32%,and 82.86%.For patients treated initially with Western Medicine followed by TCM,the rates were 52.83%,65.85%,67.47%and 67.75%.In the cohort of patients who received TCM as their first-line therapy,remission rates were 49.23%,62.50%,61.76%,and 69.23%.Multivariate Cox regression analysis revealed that the duration of TCM treatment[hazard ratio(HR)=0.826,95%confidence interval(CI)(0.779,0.876),P<0.001],presence of hypertension[HR=1.912,95%CI(1.181,3.094),P=0.008],baseline serum albumin level[HR=0.930,95%CI(0.894,0.969),P<0.001],and the rate of serum albumin increase within the first year of treatment[HR=0.930,95%CI(0.909,0.957),P<0.001]were significantly associated with clinical outcomes.CONCLUSION:The Strengthening Spleen and Draining Dampness therapy demonstrated robust short-and longterm efficacy in treating IMN,with high rates of remission and renal survival over 10 years.Key factors influencing clinical remission included the duration of TCM treatment,baseline serum albumin levels,the presence of hypertension,and the rate of increase in serum albumin within the first year.These findings suggest that this TCM approach provides a viable long-term treatment option for IMN.展开更多
A pancreatic paraganglioma is a rare neoplasm that is difficult to distinguish from a pancreatic neuroendocrine tumour. Here we present a case of pancreatic paraganglioma that was surgically resected following preoper...A pancreatic paraganglioma is a rare neoplasm that is difficult to distinguish from a pancreatic neuroendocrine tumour. Here we present a case of pancreatic paraganglioma that was surgically resected following preoperative diagnosis of a pancreatic neuroendocrine tumour. Careful evaluation of the endoscopic ultrasonography findings revealed abundant draining ves-sels,which could have led to a correct preoperative diagnosis of pancreatic paraganglioma.展开更多
Slag carry-over during the draining of molten steel from a teeming ladle is numerically studied here. Two-phase isothermal transient 3D Computational Fluid Dynamics simulations were employed to simulate the draining p...Slag carry-over during the draining of molten steel from a teeming ladle is numerically studied here. Two-phase isothermal transient 3D Computational Fluid Dynamics simulations were employed to simulate the draining process. Two nozzle diameters, two nozzle positions and three slag heights were considered. From mass balances, the slag carry-over in terms of mass flow rate was obtained for each of the above variables. Besides, the draining times of the teeming ladle were estimated from theoretical considerations and CDF simulations, and compared.展开更多
To select the location of sewage outlet in the sewage disposal program of Shanghai is a rather comprehensive problem which covers many fields and has great influences. The sewage outlet at Zuyuan, about 10 km away fro...To select the location of sewage outlet in the sewage disposal program of Shanghai is a rather comprehensive problem which covers many fields and has great influences. The sewage outlet at Zuyuan, about 10 km away from Wusongkou, is situated on the south bank of the South Channel in the Yangtze Estuary. In order to determine the water depth which can guaranteed the safe draining of sewage at the outlet, a statistical method is adopted in this paper for the determination of the guarantee rate of safe draining at Zuyuan sewage outlet by means of the characteristics of fluvial process and previous topographic data, and the guaranteed water depth for safe draining is then determined.展开更多
BACKGROUND Postoperative abdominal infections are an important and heterogeneous health challenge.Many samll abdominal abscesses are resolved with antibiotics,but larger or symptomatic abscesses may require procedural...BACKGROUND Postoperative abdominal infections are an important and heterogeneous health challenge.Many samll abdominal abscesses are resolved with antibiotics,but larger or symptomatic abscesses may require procedural management.CASE SUMMARY A 65-year-old male patient who suffered operation for the left hepatocellular carcinoma eight months ago,came to our hospital with recurrent abdominal pain,vomit,and fever for one month.Abdominal computed tomography showed that a big low-density dumbbell-shaped mass among the liver and intestine.Colonoscopy showed a submucosal mass with a fistula at colon of liver region.Gastroscopy showed a big rupture on the submucosal mass at the descending duodenum and a fistula at the duodenal bulb.Under colonoscopy,the brown liquid and pus were drained from the mass with“special stent device”.Under gastroscopy,we closed the rupture of the mass with a loop and six clips for purse stitching at the descending duodenum,and the same method as colonoscopy was used to drain the brown liquid and pus from the mass.The symptom of abdominal pain,vomit and fever were relieved after the treatment.CONCLUSION The special stent device could be effectively for draining the abdominal abscess respectively from colon and duodenum.展开更多
Underground coal mining activities in the Quangninh coal basin (in the North ofVietnam) have been carried out at a depth of-130 m to-150 m,and in the near future thismining depth will become-300 m and-500 m.Together w...Underground coal mining activities in the Quangninh coal basin (in the North ofVietnam) have been carried out at a depth of-130 m to-150 m,and in the near future thismining depth will become-300 m and-500 m.Together with the increasing coal output,the quantity of methane and other mine gases emitted from coal beds during mining activitieswill grow bigger and bigger.According to the forecast of the coal mining industry,ifmines go deeper downward,all underground coal mines in the Quangninh basin will beclassified into the mine group with the dangerous level of methane bearings.Mine gascontrol and management operations with conventional ventilation are less effective andentail high expenses.One of the main solutions is to carry out short,medium and longboreholes for controlling and recovering methane and other mine gases from coal bedsbefore mining activities.Efficiency of drilling activities for methane gas recovery from coalseams with horizontal bore holes at underground coal mines depends on many factors includingthe mine gas draining borehole layout at the roadways,gas content in the coalbeds,technologies for mine gas draining boring activities,and so on.Methane gas existsin the coal beds under the adhesive state with stable physical and chemical bonds.In orderto recover these gases,it is necessary to carry out boreholes and create artificial joints(collecting pits) in coal beds with the impulse method (hydraulic separation method).展开更多
Chronic heart failure(CHF)is a public health problem that seriously affects the quality of life of patients with poor prognosis.Western medicine has been mature in the treatment of CHF,but it still has some limitation...Chronic heart failure(CHF)is a public health problem that seriously affects the quality of life of patients with poor prognosis.Western medicine has been mature in the treatment of CHF,but it still has some limitations and adverse reactions in improving the clinical symptoms of CHF.TCM has a long history of understanding of CHF,and in recent years,TCM has summarized and developed the experience of predecessors in the treatment of CHF,In particular,diuretic therapy,combined with Warming Yang,tonifying Qi,promoting blood circulation and removing blood stasis,has achieved good curative effect in treating CHF.When combined with basic treatment of Western medicine,it can reduce the adverse reactions of Western medicine.This review is to summarize.展开更多
During the dissection of a 72-year old male cadaver,the hemiazygos vein(HAV)coursing the left side that drains into the persistent left superior vena cava was observed.The HAV was formed at the junction of the 9th to ...During the dissection of a 72-year old male cadaver,the hemiazygos vein(HAV)coursing the left side that drains into the persistent left superior vena cava was observed.The HAV was formed at the junction of the 9th to 11th right posterior intercostal veins,right subcostal vein,5th to 11th left posterior intercostal veins,and left subcostal vein;then ascended posteriorly to the thoracic aorta.After collecting the accessory hemiazygos vein,it crossed over the aorta and the pedicle of the left lung via the hemiazygos arch,then converged with a communicative branch(vein of Marshall)that emerged from the left brachiocephalic vein to form the persistent left superior vena cava and entered the pericardium.展开更多
The maturation of dendritic cells(DCs)and infiltration effector T cells in tumor-draining lymph node(tdLN)and tumor tissue are crucial for immunotherapy.Despite constructive progresses have been made with anti-program...The maturation of dendritic cells(DCs)and infiltration effector T cells in tumor-draining lymph node(tdLN)and tumor tissue are crucial for immunotherapy.Despite constructive progresses have been made with anti-programmed death-1(anti-PD1)checkpoint blockade for immunotherapy,the efficacy of PD1/PD-L1 therapy deserves to be improved.Here,we constructed a novel transfersomes based nanovaccine complexed microneedles to enhance anti-PD1 immunotherapy via transdermal immunization for skin tumor therapy.Transfersomes were functionalized with DCs targeting moietyαCD40,co-encapsulated with antigens and adjuvant poly I:C.Moreover,transdermal administration promoted accumulation in tumor-draining lymph nodes(tdLN),which could facilitate cellular uptake,activate DCs maturation and enhance Th1 immune responses.Using a mouse melanoma model,combined therapy of such nanovaccine complexed microneedles with pembrolizumab(αPD1)was able to enhance cytotoxic T lymphocytes activation,promote infiltration and reduce regulatory T cells frequency in tdLN and tumor tissues,which achieved reversion of the immunosuppressive microenvironment into immune activation.This study highlighted the potential of transfersomes based nanovaccines complexed microneedles as an attractive platform for tumor immunotherapy.展开更多
A dimple appears on a free surface while rotating a cylinder tank filled with liquid. The dimple starts to concentrically deeper to a drain port at the bottom center of the tank. Over time, the dimple penetrates the d...A dimple appears on a free surface while rotating a cylinder tank filled with liquid. The dimple starts to concentrically deeper to a drain port at the bottom center of the tank. Over time, the dimple penetrates the drain port, a free surface forms a long and slender string shape in the tank, and a so-called vortexing （air core） phenomenon occurs. The generation of a vortex core depends on the size of the tank and drain port, and on the properties of the liquid in the tank. In this study, the liquid level and the time at which the vortex core is initially generated are numerically investigated using different values of tank diameter, drain port diameter, and ini- tial tank rotational speeds. Instead of a full three-dimensional analysis, a two-dimensional axisymmetric simulation is conducted. The momentum conservation equation in the circumferential direction is additionally solved in the two-dimensional mesh system. Several non-dimensional variables are created： the ratio of the air core generation distance and tank diameter, the diameter ratio of the tank and drain port, the rotational Reynolds number, the rotational Froude number, and the rotational Weber number. Finally, the non-dimensional air core generation distance is correlated with the other non-dimensional parameters.展开更多
Fibre-based wearables for embroidery,chemosensing,and biofluid’s unidirectional draining with goodflexibility,tunability,and designability drive technological advance.However,synthetic polymerfibres are non-degradabl...Fibre-based wearables for embroidery,chemosensing,and biofluid’s unidirectional draining with goodflexibility,tunability,and designability drive technological advance.However,synthetic polymerfibres are non-degradable,threatening the environment and human health.Herein,we have developed versatile microfibre-based wearables by combining many advantages in one platform of biodegradable polylactic acid(PLA)and melt electrowriting strategy.Diverse potential applications of PLA wearables are achieved byflexibly designing their printingfiles,components and structures.Three-dimensional printingfiles are generated from two-dimensional images to fabricate‘embroidery-like’patterns.PLA/aggregation-induced emissionfluorogens(AIE)chemosensors exhibit colorimetric andfluorescent colour changes upon exposure to amine vapours.Janus PLA-cotton textiles with a hydropho-bic/hydrophilic structure could facilitate unidirectional draining of sweats which is favourable for the management of temperature and humidity on the surface of skin.The proposed platform can not only broaden the design possibilities in 3D/4D printing but also offer wide potential applications for functional wearables.展开更多
A numerical algorithm is developed for the approximation of the solution to certain boundary value problems involving the third-order ordinary differential equation associated with draining and coating flows. The auth...A numerical algorithm is developed for the approximation of the solution to certain boundary value problems involving the third-order ordinary differential equation associated with draining and coating flows. The authors show that the approximate so- lutions obtained by the numerical algorithm developed by using uonpolynomial quintic spline functions ave better than those produced by other spline and domain decomposition methods. The algorithm is tested on two problems associated with draining and coating flows to demonstrate the practical usefulness of the approach.展开更多
A mathematical analysis of a singular boundary value problem which arisesin the model for flows draining down a dry vertical wall is given. Questionsabout existence and qualitative properties of solutions are discusse...A mathematical analysis of a singular boundary value problem which arisesin the model for flows draining down a dry vertical wall is given. Questionsabout existence and qualitative properties of solutions are discussed. An explicitsolution is found.展开更多
Mao’s vision of'borrowing'South China’s water for the North BY DAVID DAWSONcomes to fruition六十多年前,毛泽东在视察黄河时提出的'南水北调'构想在今天已经实现When your capital city of over 20 million li...Mao’s vision of'borrowing'South China’s water for the North BY DAVID DAWSONcomes to fruition六十多年前,毛泽东在视察黄河时提出的'南水北调'构想在今天已经实现When your capital city of over 20 million lies in a parched,semi-arid region,water problems are inevitable.Mao Zedong noted the problem back in the 1950s when he reportedly said,'Water in the south is abundant,water in the north scarce.If possible,it would be fine to borrow a little.''Borrow a little'has to be among the biggest understatements of the century.The realization of this vision is now known as the South to North Water Diversion Project(SNWDP,南水北调)and展开更多
A new study by Huang et al.in Cell identified the presence of tumorspecific memory CD8^(+)T cells in tumor-draining lymph nodes(TdLNs)and confirmed the critical role of this population in PD-1/PD-L1 immune checkpoint ...A new study by Huang et al.in Cell identified the presence of tumorspecific memory CD8^(+)T cells in tumor-draining lymph nodes(TdLNs)and confirmed the critical role of this population in PD-1/PD-L1 immune checkpoint therapy for cancer.I The work enriched our understanding of tumor-specific CD8^(+)T cell subsets and further refined the spatiotemporal mechanism of the antitumor effects of PD-1/PD-L1 immune checkpoint blockade(ICB).展开更多
The functional exhaustion of CD8^(+)T cells represents a fundamental hallmark of chronic viral infection and cancer and,in both scenarios,is driven by prolonged exposure to persistent cognate antigens in the context o...The functional exhaustion of CD8^(+)T cells represents a fundamental hallmark of chronic viral infection and cancer and,in both scenarios,is driven by prolonged exposure to persistent cognate antigens in the context of an immunoinhibitory microenvironment.Exhausted CD8^(+)T cells upregulate the expression of a wide diversity of coinhibitory immunoreceptors(also referred to as immune checkpoint receptors),such as PD-1,Tim-3,LAG-3,and TIGIT.Concomitantly,exhausted CD8^(+)T cells lose their potential to differentiate into functional memory cells and are characterized by hierarchical loss of effector function,leading to compromised tumor control and viral eradication[1,2].展开更多
Dear Editor,We introduce a novel surgical instrument designed to overcome the challenges in draining fluid from the suprachoroidal space in patients with choroidal detachment.In the evolving landscape of ophthalmic su...Dear Editor,We introduce a novel surgical instrument designed to overcome the challenges in draining fluid from the suprachoroidal space in patients with choroidal detachment.In the evolving landscape of ophthalmic surgeries,procedures that were once considered complex,such as those for choroidal detachment,are becoming increasingly common.Drainage of subchoroidal fluid was derived from 1985[1]with indirect visualization during scleral buckle surgery[2-4].展开更多
BACKGROUND Historically intraoperative drains were employed after pancreatic surgery but over the last decade,there has been debate over the routine usage of drains.AIM To assess the necessity of intra-abdominal drain...BACKGROUND Historically intraoperative drains were employed after pancreatic surgery but over the last decade,there has been debate over the routine usage of drains.AIM To assess the necessity of intra-abdominal drain placement,identify the most effective drain type,and determine the optimal timing for drain removal.METHODS A systematic review of electronic databases,including PubMed,MEDLINE,PubMed Central,and Google Scholar,was conducted using Medical Subject Headings and keywords until December 2023.From an initial pool of 1910 articles,48 were included after exclusion and screening.The primary outcomes analyzed were clinically relevant postoperative pancreatic fistula(CR-POPF),delayed gastric emptying(DGE),overall morbidity,and mortality.Subgroup analyses were performed for pancreaticoduodenectomy and distal pancreatectomy.RESULTS Routine use of drains is associated with a statistically significant increase in the risk of CR-POPF and DGE.Conversely,patients who did not have drains placed experienced a significant reduction in morbidity,readmission rates,and reoperations.No significant differences were observed between active and passive drain types.Early drain removal(<3 days)yielded favorable outcomes compared to delayed removal.CONCLUSION Analysis of randomized controlled trials and cohort studies did not demonstrate an advantage of routine drain placement following pancreatic resection,potentially contributing to increased morbidity and mortality.The decision to use drains should be left to the discretion of the operating surgeon.However,early drain removal can substantially reduce morbidity.展开更多
BACKGROUND Esophagojejunal anastomotic leakage(EJAL)is a severe complication following gastrectomy for gastric cancer,typically treated with drainage and nutritional support.We report a case of intraluminal drain migr...BACKGROUND Esophagojejunal anastomotic leakage(EJAL)is a severe complication following gastrectomy for gastric cancer,typically treated with drainage and nutritional support.We report a case of intraluminal drain migration near the esophagojejunal anastomosis(EJA),resulting in persistent drainage and mimicking EJAL after total gastrectomy.CASE SUMMARY A 64-year-old male underwent open total gastrectomy with Roux-en-Y reconstruction for gastric adenocarcinoma,with two silicone drains placed near the EJA.On postoperative day(POD)4,the patient developed signs of peritonitis and sepsis,necessitating surgical re-exploration abscess drainage,peritoneal lavage,and drain repositioning.A contrast swallow study on POD 18 revealed rapid filling of the abdominal drain without extraluminal contrast collection.Persistent drainage prompted an upper gastrointestinal endoscopy on POD 59,which revealed approximately 5 cm of the drain within the esophagus,with the perforation site located 2 cm distal to the intact EJA.The drain was repositioned under endoscopic guidance.A repeat contrast radiograph on POD 67 demonstrated no evidence of extraluminal contrast extravasation or filling of the abdominal drain.The patient was subsequently discharged without further incident.CONCLUSION Intraluminal drain migration is a rare complication following gastric surgery but should be considered when persistent drainage occurs.展开更多
基金Supported by the National Key Research and Development Project,Clinical Study on the Treatment of Refractory Membranous Nephropathy with the Treatment of Strengthening Spleen and Draining Dampness in Method using Single Group Target Value Method(No.2019YFC1709403)Systematic Study on the Diagnosis and Treatment Rules of Membranous Nephropathy in Traditional Chinese Medicine(No.2023YFC35033501,No.2023YFC35033503)。
文摘OBJECTIVE:To evaluate the 10-year therapeutic efficacy of Traditional Chinese Medicine(TCM)using the Strengthening Spleen and Draining Dampness therapy in the management of idiopathic membranous nephropathy(IMN).METHODS:A single-center,retrospective analysis was conducted on patients diagnosed with IMN who met predefined inclusion and exclusion criteria.Data were collected from the Department of Nephrology at Longhua Hospital,affiliated with Shanghai University of Traditional Chinese Medicine,between January 2007 and December 2011.Clinical parameters including 24-h urinary protein,serum albumin,serum creatinine,and estimated glomerular filtration rate(e GFR,EPI)were assessed at baseline and at 1,3,5,and 10 years of follow-up.The efficacy of the Strengthening Spleen and Draining Dampness therapy was analyzed using repeated measures analysis of variance(ANOVA).Kaplan-Meier survival curves and multivariate proportional hazards model(Cox regression models)were employed to identify factors associated with treatment outcomes.RESULTS:A total of 265 patients were included,with a median follow-up duration of 96 months(36,122).TCM treatment significantly reduced 24-h urinary protein levels(P<0.001),and increased serum albumin levels(P<0.001),while serum creatinine remained stable(P=0.187).Remission rates at 1,3,5,and 10 years were 52.81%,69.71%,68.39%,and 72.36%,respectively,and the rates of avoiding composite outcome events at the same intervals were 98.27%,94.29%,94.19%,and 93.50%.In the subgroup receiving TCM only,remission rates were 56.67%,84.44%,76.32%,and 82.86%.For patients treated initially with Western Medicine followed by TCM,the rates were 52.83%,65.85%,67.47%and 67.75%.In the cohort of patients who received TCM as their first-line therapy,remission rates were 49.23%,62.50%,61.76%,and 69.23%.Multivariate Cox regression analysis revealed that the duration of TCM treatment[hazard ratio(HR)=0.826,95%confidence interval(CI)(0.779,0.876),P<0.001],presence of hypertension[HR=1.912,95%CI(1.181,3.094),P=0.008],baseline serum albumin level[HR=0.930,95%CI(0.894,0.969),P<0.001],and the rate of serum albumin increase within the first year of treatment[HR=0.930,95%CI(0.909,0.957),P<0.001]were significantly associated with clinical outcomes.CONCLUSION:The Strengthening Spleen and Draining Dampness therapy demonstrated robust short-and longterm efficacy in treating IMN,with high rates of remission and renal survival over 10 years.Key factors influencing clinical remission included the duration of TCM treatment,baseline serum albumin levels,the presence of hypertension,and the rate of increase in serum albumin within the first year.These findings suggest that this TCM approach provides a viable long-term treatment option for IMN.
文摘A pancreatic paraganglioma is a rare neoplasm that is difficult to distinguish from a pancreatic neuroendocrine tumour. Here we present a case of pancreatic paraganglioma that was surgically resected following preoperative diagnosis of a pancreatic neuroendocrine tumour. Careful evaluation of the endoscopic ultrasonography findings revealed abundant draining ves-sels,which could have led to a correct preoperative diagnosis of pancreatic paraganglioma.
文摘Slag carry-over during the draining of molten steel from a teeming ladle is numerically studied here. Two-phase isothermal transient 3D Computational Fluid Dynamics simulations were employed to simulate the draining process. Two nozzle diameters, two nozzle positions and three slag heights were considered. From mass balances, the slag carry-over in terms of mass flow rate was obtained for each of the above variables. Besides, the draining times of the teeming ladle were estimated from theoretical considerations and CDF simulations, and compared.
文摘To select the location of sewage outlet in the sewage disposal program of Shanghai is a rather comprehensive problem which covers many fields and has great influences. The sewage outlet at Zuyuan, about 10 km away from Wusongkou, is situated on the south bank of the South Channel in the Yangtze Estuary. In order to determine the water depth which can guaranteed the safe draining of sewage at the outlet, a statistical method is adopted in this paper for the determination of the guarantee rate of safe draining at Zuyuan sewage outlet by means of the characteristics of fluvial process and previous topographic data, and the guaranteed water depth for safe draining is then determined.
文摘BACKGROUND Postoperative abdominal infections are an important and heterogeneous health challenge.Many samll abdominal abscesses are resolved with antibiotics,but larger or symptomatic abscesses may require procedural management.CASE SUMMARY A 65-year-old male patient who suffered operation for the left hepatocellular carcinoma eight months ago,came to our hospital with recurrent abdominal pain,vomit,and fever for one month.Abdominal computed tomography showed that a big low-density dumbbell-shaped mass among the liver and intestine.Colonoscopy showed a submucosal mass with a fistula at colon of liver region.Gastroscopy showed a big rupture on the submucosal mass at the descending duodenum and a fistula at the duodenal bulb.Under colonoscopy,the brown liquid and pus were drained from the mass with“special stent device”.Under gastroscopy,we closed the rupture of the mass with a loop and six clips for purse stitching at the descending duodenum,and the same method as colonoscopy was used to drain the brown liquid and pus from the mass.The symptom of abdominal pain,vomit and fever were relieved after the treatment.CONCLUSION The special stent device could be effectively for draining the abdominal abscess respectively from colon and duodenum.
文摘Underground coal mining activities in the Quangninh coal basin (in the North ofVietnam) have been carried out at a depth of-130 m to-150 m,and in the near future thismining depth will become-300 m and-500 m.Together with the increasing coal output,the quantity of methane and other mine gases emitted from coal beds during mining activitieswill grow bigger and bigger.According to the forecast of the coal mining industry,ifmines go deeper downward,all underground coal mines in the Quangninh basin will beclassified into the mine group with the dangerous level of methane bearings.Mine gascontrol and management operations with conventional ventilation are less effective andentail high expenses.One of the main solutions is to carry out short,medium and longboreholes for controlling and recovering methane and other mine gases from coal bedsbefore mining activities.Efficiency of drilling activities for methane gas recovery from coalseams with horizontal bore holes at underground coal mines depends on many factors includingthe mine gas draining borehole layout at the roadways,gas content in the coalbeds,technologies for mine gas draining boring activities,and so on.Methane gas existsin the coal beds under the adhesive state with stable physical and chemical bonds.In orderto recover these gases,it is necessary to carry out boreholes and create artificial joints(collecting pits) in coal beds with the impulse method (hydraulic separation method).
基金National Natural Science Foundation of China(No.81673891,81560760)Project of Health Department of Guangxi Zhuang Autonomous Region(No.GZZJ16-03)+1 种基金Project of Health and Family Planning Commission of Guangxi Zhuang Autonomous Region(No.S201532)Second Batch of Special Scientific Research Projects for the Construction of the National TCM Clinical Research Base(No.JDZX2015146)。
文摘Chronic heart failure(CHF)is a public health problem that seriously affects the quality of life of patients with poor prognosis.Western medicine has been mature in the treatment of CHF,but it still has some limitations and adverse reactions in improving the clinical symptoms of CHF.TCM has a long history of understanding of CHF,and in recent years,TCM has summarized and developed the experience of predecessors in the treatment of CHF,In particular,diuretic therapy,combined with Warming Yang,tonifying Qi,promoting blood circulation and removing blood stasis,has achieved good curative effect in treating CHF.When combined with basic treatment of Western medicine,it can reduce the adverse reactions of Western medicine.This review is to summarize.
文摘During the dissection of a 72-year old male cadaver,the hemiazygos vein(HAV)coursing the left side that drains into the persistent left superior vena cava was observed.The HAV was formed at the junction of the 9th to 11th right posterior intercostal veins,right subcostal vein,5th to 11th left posterior intercostal veins,and left subcostal vein;then ascended posteriorly to the thoracic aorta.After collecting the accessory hemiazygos vein,it crossed over the aorta and the pedicle of the left lung via the hemiazygos arch,then converged with a communicative branch(vein of Marshall)that emerged from the left brachiocephalic vein to form the persistent left superior vena cava and entered the pericardium.
基金work was supported by the National Natural Science Foundation of China(No.31670972)the Taishan Scholar Program,China.
文摘The maturation of dendritic cells(DCs)and infiltration effector T cells in tumor-draining lymph node(tdLN)and tumor tissue are crucial for immunotherapy.Despite constructive progresses have been made with anti-programmed death-1(anti-PD1)checkpoint blockade for immunotherapy,the efficacy of PD1/PD-L1 therapy deserves to be improved.Here,we constructed a novel transfersomes based nanovaccine complexed microneedles to enhance anti-PD1 immunotherapy via transdermal immunization for skin tumor therapy.Transfersomes were functionalized with DCs targeting moietyαCD40,co-encapsulated with antigens and adjuvant poly I:C.Moreover,transdermal administration promoted accumulation in tumor-draining lymph nodes(tdLN),which could facilitate cellular uptake,activate DCs maturation and enhance Th1 immune responses.Using a mouse melanoma model,combined therapy of such nanovaccine complexed microneedles with pembrolizumab(αPD1)was able to enhance cytotoxic T lymphocytes activation,promote infiltration and reduce regulatory T cells frequency in tdLN and tumor tissues,which achieved reversion of the immunosuppressive microenvironment into immune activation.This study highlighted the potential of transfersomes based nanovaccines complexed microneedles as an attractive platform for tumor immunotherapy.
基金supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education,Science and Technology(Grant No.2010-0024619)
文摘A dimple appears on a free surface while rotating a cylinder tank filled with liquid. The dimple starts to concentrically deeper to a drain port at the bottom center of the tank. Over time, the dimple penetrates the drain port, a free surface forms a long and slender string shape in the tank, and a so-called vortexing （air core） phenomenon occurs. The generation of a vortex core depends on the size of the tank and drain port, and on the properties of the liquid in the tank. In this study, the liquid level and the time at which the vortex core is initially generated are numerically investigated using different values of tank diameter, drain port diameter, and ini- tial tank rotational speeds. Instead of a full three-dimensional analysis, a two-dimensional axisymmetric simulation is conducted. The momentum conservation equation in the circumferential direction is additionally solved in the two-dimensional mesh system. Several non-dimensional variables are created： the ratio of the air core generation distance and tank diameter, the diameter ratio of the tank and drain port, the rotational Reynolds number, the rotational Froude number, and the rotational Weber number. Finally, the non-dimensional air core generation distance is correlated with the other non-dimensional parameters.
基金Shenzhen-Hong Kong Science and Technology Innovation Cooperation Zone Shenzhen Park Project,Grant/Award Number:HZQB-KCZYB-2020030Hong Kong RGC Theme-based Research Scheme,Grant/Award Number:AoE/M-402/20Shenzhen Science and Technology Program,Grant/Award Number:JCYJ20220818101204010。
文摘Fibre-based wearables for embroidery,chemosensing,and biofluid’s unidirectional draining with goodflexibility,tunability,and designability drive technological advance.However,synthetic polymerfibres are non-degradable,threatening the environment and human health.Herein,we have developed versatile microfibre-based wearables by combining many advantages in one platform of biodegradable polylactic acid(PLA)and melt electrowriting strategy.Diverse potential applications of PLA wearables are achieved byflexibly designing their printingfiles,components and structures.Three-dimensional printingfiles are generated from two-dimensional images to fabricate‘embroidery-like’patterns.PLA/aggregation-induced emissionfluorogens(AIE)chemosensors exhibit colorimetric andfluorescent colour changes upon exposure to amine vapours.Janus PLA-cotton textiles with a hydropho-bic/hydrophilic structure could facilitate unidirectional draining of sweats which is favourable for the management of temperature and humidity on the surface of skin.The proposed platform can not only broaden the design possibilities in 3D/4D printing but also offer wide potential applications for functional wearables.
文摘A numerical algorithm is developed for the approximation of the solution to certain boundary value problems involving the third-order ordinary differential equation associated with draining and coating flows. The authors show that the approximate so- lutions obtained by the numerical algorithm developed by using uonpolynomial quintic spline functions ave better than those produced by other spline and domain decomposition methods. The algorithm is tested on two problems associated with draining and coating flows to demonstrate the practical usefulness of the approach.
文摘A mathematical analysis of a singular boundary value problem which arisesin the model for flows draining down a dry vertical wall is given. Questionsabout existence and qualitative properties of solutions are discussed. An explicitsolution is found.
文摘Mao’s vision of'borrowing'South China’s water for the North BY DAVID DAWSONcomes to fruition六十多年前,毛泽东在视察黄河时提出的'南水北调'构想在今天已经实现When your capital city of over 20 million lies in a parched,semi-arid region,water problems are inevitable.Mao Zedong noted the problem back in the 1950s when he reportedly said,'Water in the south is abundant,water in the north scarce.If possible,it would be fine to borrow a little.''Borrow a little'has to be among the biggest understatements of the century.The realization of this vision is now known as the South to North Water Diversion Project(SNWDP,南水北调)and
基金the CAMS Innovation Fund for Medical Sciences(2021-12M-1-050).
文摘A new study by Huang et al.in Cell identified the presence of tumorspecific memory CD8^(+)T cells in tumor-draining lymph nodes(TdLNs)and confirmed the critical role of this population in PD-1/PD-L1 immune checkpoint therapy for cancer.I The work enriched our understanding of tumor-specific CD8^(+)T cell subsets and further refined the spatiotemporal mechanism of the antitumor effects of PD-1/PD-L1 immune checkpoint blockade(ICB).
基金the National Key Research and Development Program of China(no.2021YFC-2300602 to LY)the Key Program of the National Natural Science Foundation of China(no.32030041 to LY)+2 种基金the National Science Foundation for Outstanding Young Scholars of China(no.82122028 to LX)the National Natural Science Foundation of China(no.82173094 to LX,no.31900643 to QH)the Chongqing Postdoctoral Science Foundation Project(no.cstc2021jcyj-bshX0232 to QL).
文摘The functional exhaustion of CD8^(+)T cells represents a fundamental hallmark of chronic viral infection and cancer and,in both scenarios,is driven by prolonged exposure to persistent cognate antigens in the context of an immunoinhibitory microenvironment.Exhausted CD8^(+)T cells upregulate the expression of a wide diversity of coinhibitory immunoreceptors(also referred to as immune checkpoint receptors),such as PD-1,Tim-3,LAG-3,and TIGIT.Concomitantly,exhausted CD8^(+)T cells lose their potential to differentiate into functional memory cells and are characterized by hierarchical loss of effector function,leading to compromised tumor control and viral eradication[1,2].
基金Supported by Science and Technology Foundation of Tianjin Eye Hospital(No.YKPY2207)Tianjin Key Medical Discipline(Specialty)Construction Project(No.TJYXZDXK-016A).
文摘Dear Editor,We introduce a novel surgical instrument designed to overcome the challenges in draining fluid from the suprachoroidal space in patients with choroidal detachment.In the evolving landscape of ophthalmic surgeries,procedures that were once considered complex,such as those for choroidal detachment,are becoming increasingly common.Drainage of subchoroidal fluid was derived from 1985[1]with indirect visualization during scleral buckle surgery[2-4].
文摘BACKGROUND Historically intraoperative drains were employed after pancreatic surgery but over the last decade,there has been debate over the routine usage of drains.AIM To assess the necessity of intra-abdominal drain placement,identify the most effective drain type,and determine the optimal timing for drain removal.METHODS A systematic review of electronic databases,including PubMed,MEDLINE,PubMed Central,and Google Scholar,was conducted using Medical Subject Headings and keywords until December 2023.From an initial pool of 1910 articles,48 were included after exclusion and screening.The primary outcomes analyzed were clinically relevant postoperative pancreatic fistula(CR-POPF),delayed gastric emptying(DGE),overall morbidity,and mortality.Subgroup analyses were performed for pancreaticoduodenectomy and distal pancreatectomy.RESULTS Routine use of drains is associated with a statistically significant increase in the risk of CR-POPF and DGE.Conversely,patients who did not have drains placed experienced a significant reduction in morbidity,readmission rates,and reoperations.No significant differences were observed between active and passive drain types.Early drain removal(<3 days)yielded favorable outcomes compared to delayed removal.CONCLUSION Analysis of randomized controlled trials and cohort studies did not demonstrate an advantage of routine drain placement following pancreatic resection,potentially contributing to increased morbidity and mortality.The decision to use drains should be left to the discretion of the operating surgeon.However,early drain removal can substantially reduce morbidity.
文摘BACKGROUND Esophagojejunal anastomotic leakage(EJAL)is a severe complication following gastrectomy for gastric cancer,typically treated with drainage and nutritional support.We report a case of intraluminal drain migration near the esophagojejunal anastomosis(EJA),resulting in persistent drainage and mimicking EJAL after total gastrectomy.CASE SUMMARY A 64-year-old male underwent open total gastrectomy with Roux-en-Y reconstruction for gastric adenocarcinoma,with two silicone drains placed near the EJA.On postoperative day(POD)4,the patient developed signs of peritonitis and sepsis,necessitating surgical re-exploration abscess drainage,peritoneal lavage,and drain repositioning.A contrast swallow study on POD 18 revealed rapid filling of the abdominal drain without extraluminal contrast collection.Persistent drainage prompted an upper gastrointestinal endoscopy on POD 59,which revealed approximately 5 cm of the drain within the esophagus,with the perforation site located 2 cm distal to the intact EJA.The drain was repositioned under endoscopic guidance.A repeat contrast radiograph on POD 67 demonstrated no evidence of extraluminal contrast extravasation or filling of the abdominal drain.The patient was subsequently discharged without further incident.CONCLUSION Intraluminal drain migration is a rare complication following gastric surgery but should be considered when persistent drainage occurs.
