Shale gas is abundant in the Paleozoic of the Yangtze Platform,and several high-yield shale gas fields have been built in the Upper Yangtze Platform,China.The Permian of the South Yellow Sea Basin(SYSB)in the Lower Ya...Shale gas is abundant in the Paleozoic of the Yangtze Platform,and several high-yield shale gas fields have been built in the Upper Yangtze Platform,China.The Permian of the South Yellow Sea Basin(SYSB)in the Lower Yangtze area is considered a potential target for shale gas exploration;however,the fundamental geological conditions of shale gas have not been studied.Based on the first whole-cored scientific drilling borehole(CSDP-2)in the SYSB,detailed tests involving petrology,organic geochemistry,and reservoir physical properties were conducted to evaluate the shale gas potential of the Lower Permian.The Lower Permian is dominated by organic-rich siliceous,clay,and clay-mixed shales.The average total organic carbon content is 5.99%,and the organic matter is mainly type Ⅱ_(1)−Ⅱ_(2),which has entered the high-over mature evolution stage.The pore types of organic-rich shales mainly include organic pores,dissolution pores,and intergranular pores,of which the meso-/macropores are well developed.The average porosity is 3.04%,and the total specific surface area and pore volume are 3.47 m^(2)/g and 7.21×10^(−3) cm^(3)/g,respectively.The average Langmuir volume obtained from the methane adsorption isotherms is 2.70 cm^(3)/g,and methane is mainly adsorbed in the meso-/macropores.The lower Permian shales are rich in methane as indicated by gas logging results,with an average content of 7.3%,which can reach up to 65.9%.A comparison of the study area with typical shale gas fields shows that the Lower Permian is brittle and shallowly buried and has a high potential for shale gas exploration and low-cost development.The depression areas of the SYSB are overlain by thick Mesozoic-Cenozoic sediments,show higher organic matter maturity,and may have greater shale gas potential.The shale gas exploration breakthrough of the study area is of great significance to ensure the energy supply of economically developed areas on the east China.展开更多
Objective This study aims to analyze the burden of lower respiratory infections in Chinese elderly people aged 70 and above.Methods This study utilized Global Burden of Disease(GBD)1990-2050 prediction data to analyze...Objective This study aims to analyze the burden of lower respiratory infections in Chinese elderly people aged 70 and above.Methods This study utilized Global Burden of Disease(GBD)1990-2050 prediction data to analyze changes in mortality rates and disability-adjusted life year(DALY)rates for lower respiratory infections in the elderly population(aged 70 and above)in China from 1990 to 2050.It also discusses future trends in the burden of lower respiratory infections(LRI)in China under different scenarios.Results According to GBD predictions,the burden of lower respiratory infections in the elderly aged 70 years and above in China is lower than the global average.The burden has been decreasing from 1990 to 2020,but is projected to increase from 2020 to 2050.Scenario-based predictions suggest that,under scenarios involving improvements in nutrition and vaccination,the burden of lower respiratory infections in the elderly in China is expected to be the lowest in 2050.Conclusion This study indicates that the burden of lower respiratory infections in elderly people aged 70 years and above in China remains a significant public health issue and may worsen.The government should consider strengthening the preventive measures and management strategies for respiratory infections in the elderly population.展开更多
BACKGROUND Most patients who were included in previous studies on achalasia had increased lower esophageal sphincter(LES)pressure.Peroral endoscopic myotomy(POEM)has been confirmed to be effective at relieving the cli...BACKGROUND Most patients who were included in previous studies on achalasia had increased lower esophageal sphincter(LES)pressure.Peroral endoscopic myotomy(POEM)has been confirmed to be effective at relieving the clinical symptoms of achalasia associated with increased LES pressure.AIM To identify the safety and efficacy of POEM for patients with normal LES integrated relaxation pressure(LES-IRP).METHODS The clinical data of patients who underwent POEM successfully in The First Medical Center of Chinese PLA General Hospital were retrospectively analyzed.A total of 481 patients who underwent preoperative high-resolution manometry(HRM)at our hospital were ultimately included in this research.According to the HRM results,the patients were divided into two groups:71 patients were included in the normal LES-IRP group(LES-IRP<15 mmHg)and 410 patients were included in the increased LES-IRP group(LES-IRP≥15 mmHg).Clinical characteristics,procedure-related parameters,adverse events,and outcomes were compared between the two groups to evaluate the safety and efficacy of POEM for patients with normal LES-IRP.RESULTS Among the 481 patients included in our study,209 were males and 272 were females,with a mean age of 44.2 years.All patients underwent POEM without severe adverse events.The median pre-treatment Eckardt scores of the normal LES-IRP and increased LES-IRP groups were 7.0 and 7.0(P=0.132),respectively,decreasing to 1.0 and 1.0 post-treatment(P=0.572).The clinical success rate of the normal LES-IRP group was 87.3%(62/71),and that of the increased LES-IRP group was 91.2%(374/410)(P=0.298).Reflux symptoms were measured by the GerdQ questionnaire,and the percentages of patients with GerdQ scores≥9 in the normal LES-IRP and increased LES-IRP groups were 8.5%and 10.7%,respectively(P=0.711).After matching,the rates of clinical success and the rates of GerdQ score≥9 were not significantly different between the two groups.CONCLUSION Our results suggest that POEM is safe and effective for achalasia and patients with normal LES-IRP.In addition,in patients with normal LES-IRP,compared with those with increased LES-IRP,POEM was not associated with a greater incidence of reflux symptoms.展开更多
Purpose: To evaluate open lower limb trauma management in children. Me-thod: We conducted a twelve-month cross-sectional prospective study. Results: Open trauma of lower limb had 7.9% of hospital frequency. Mean age w...Purpose: To evaluate open lower limb trauma management in children. Me-thod: We conducted a twelve-month cross-sectional prospective study. Results: Open trauma of lower limb had 7.9% of hospital frequency. Mean age was 8 years with a sex ratio of 2.45. In 68.4% of cases, trauma occurred in road traffic accidents. Average consultation time was 2.4 hours. Trauma mainly affected the leg in 39.5% of cases, and the thigh in 34.2%. Soft tissue wounds occurred in 52.6% of cases, and open fractures in 47.4%. Average response time was one hour. Wound trimming and suturing were performed in 76.3% of cases and combined with bone nailing in 15.8%. The outcome was favorable in 92.1% of cases. Average hospital stay was 4.37 days. Conclusion: Open trauma to the lower limb is a frequent and occurs mainly in road traffic accidents. Management was early, with a favorable outcome for most patients and a short hospital stay.展开更多
Introduction: Foreign bodies (FB) in the lower airways (LAs) constitute a potentially life-threatening emergency requiring immediate management. The objective of our study was to describe the patient pathway and manag...Introduction: Foreign bodies (FB) in the lower airways (LAs) constitute a potentially life-threatening emergency requiring immediate management. The objective of our study was to describe the patient pathway and management of foreign bodies in the lower airways. Methodology: This was a descriptive study with retrospective data collection conducted over a 6-year period (January 1, 2014, to December 31, 2019) in the ENT and Head and Neck Surgery Department of Donka National Hospital. Results: We observed a prevalence of 1.79%. The average age was 5.71 years, with a sex ratio of 1.2. However, 82.61% of the cases originated from rural areas. We noted that 78.83% of patients were referred after visiting 1 to 2 healthcare facilities (75.36%). The consultation delay was 3 days. Penetration syndrome was present in 98.56% of cases. The foreign body incidents occurred during play in 54.84% and during meals in 29.09% of cases. Radiographs were performed in 93.9% of cases. Endoscopy was used for both diagnostic and therapeutic purposes in all patients. The foreign bodies were located in the trachea (37.68%), larynx (26.08%), and bronchi (21.73%). Non-organic foreign bodies were predominant (52.17%). Postoperative outcomes were uncomplicated in 95.98% of cases, and the lethality rate was 2.85%. Conclusion: The pathway of patients with foreign bodies in the airways remains unpredictable in our context due to parental hesitations. Early management reduces morbidity and mortality rates.展开更多
Varicose veins of the lower limbs are a cosmopolitan condition, thought to be rare in Africa but widespread in Europe. The aim of this study is to analyze the indications and evaluate the results of surgical managemen...Varicose veins of the lower limbs are a cosmopolitan condition, thought to be rare in Africa but widespread in Europe. The aim of this study is to analyze the indications and evaluate the results of surgical management of varicose pathology of the IM in Dakar. We enrolled 280 patients, with a mean age of 36 and a sex ratio of 2. Factors favouring venous disease were dominated by prolonged orthostatism and multiparity. The average consultation time was 6 years. The reasons for consultation were functional manifestations, progressive complications and aesthetics. The venous trunks concerned were the great saphenous vein (GSV) in 58.9% of cases, the small saphenous vein (SSV) in 29% of cases, perforating veins and varicose veins were unsystematized in 28.5% of cases. Surgery was performed under spinal anaesthesia. Surgical procedures were dominated by stripping of the GSV, crossectomy of the SSV and staged ligations. One patient developed meningismus immediately after the operation. Average follow-up was 2 years. Mortality was null.展开更多
In Switzerland,the Opalinus Clay has been selected as a potential host rock for the deep geological disposal of radioactive waste due to its low hydraulic conductivity and favorable swelling properties.During the oper...In Switzerland,the Opalinus Clay has been selected as a potential host rock for the deep geological disposal of radioactive waste due to its low hydraulic conductivity and favorable swelling properties.During the operational phase of the repository,the host rock will be exposed to pH values as high as 13.5 due to concrete degradation,which will certainly affect its hydraulic properties.This study investigates the effect of pH increase on the water retention properties of Opalinus Clay.A series of samples from the lower sandy facies of the Mont Terri site in Switzerland,at initial dry state,were exposed to a hyperalkaline solution of pH=13.5 and to the synthetic water of pH=7.5 at different water contents.After equilibrium,the total suction was measured with a dew point potentiometer and microstructural analyses were conducted via mercury intrusion porosimetry(MIP)and nitrogen adsorption-desorption technique.It was found that the total suction decreased with hydration and pH increase.Since the two investigated solutions have the same osmotic suction,the decrease in total suction was attributed to the decrease in matric suction.Indeed,the total porosity increased with saturation and pH increase.This was confirmed by MIP data that evidenced an increase in the proportion of macropores,and by Barret eJoynereHalenda(BJH)data that showed mesopore generation.The specific surface area(SSA)also increased.The previous results were due to mineral hydration and,exclusively in the case of alkaline solution,to(1)the dissolution of quartz and calcite and(2)the acid-base reactions,which were concentrated at the edges of the clay particles,leading to an increase in negatively charged groups and thus to a face-to-face association of the clay particles(dispersion),causing an increase in the repulsive forces between the clay particles.In addition,the weakening of covalent bonds led to the primary dissolution of clay minerals,i.e.silicon and aluminum detachment.展开更多
BACKGROUND The prevalence of lower extremity arteriosclerosis obliterans(LEASO)in China is progressively increasing with the increment in age.Certain patients may be diagnosed with lower extremity arterial stenosis an...BACKGROUND The prevalence of lower extremity arteriosclerosis obliterans(LEASO)in China is progressively increasing with the increment in age.Certain patients may be diagnosed with lower extremity arterial stenosis and occlusion that resist complete curative efforts,which will invariably impose a substantial psychological strain on them.AIM To investigate the anxiety and depression conditions among patients with LEASO and analyze the associated risk factors.METHODS The Affiliated Hospital of Bengbu Medical University from January 2019 to December 2022.Their demographic and clinical data were obtained through the basic information questionnaire.The social support situation was assessed with the social support rating scale,and the hospital anxiety and depression scale were used to analyze their depression and anxiety levels.RESULTS The prevalence rate of anxiety was 44.0%among the 159 patients,with a total Self-Rating Anxiety Scale score of 49.01±9.65.The incidence of depression was 40.9%,and the total self-rating depression scale score reached 49.91±9.18.The overall social support score for all participants averaged 24.82±5.80.The correlation analysis between social support scores and anxiety and depression scores revealed that the total social support score,subjective social support,objective social support,as well as the degree of social support utilization,all exhibited a significant negative correlation with the anxiety and depression scores,which was statistically significant(P<0.05).The univariate analysis revealed statistically significant differences in the depression and anxiety states among patients with varying pain manifestations,disease stages,disease durations,and social support magnitudes(P<0.05).The multivariate analysis further demonstrated that patients presenting with intermittent claudication,rest pain,and pain,whose disease course was within half a year,and who had relatively low social support,were more predisposed to anxiety.Intriguingly,a monthly income of>6000 yuan was considered a protective factor in this context(P<0.05).Similarly,patients with intermittent claudication,rest pain,gangrene,and pain,and who had relatively low social support,were more liable to succumb to depressive moods(P<0.05).CONCLUSION Patients with LEASO typically receive relatively scant social support.Notably,those who concurrently present with symptoms,such as pain,claudication,and gangrene,are at a substantially increased risk of developing depression and anxiety disorders.A significant negative correlation is manifested between the social support level that patients receive and the severity of their anxiety and depression symptoms.Hence,the lower the social support score,the greater the propensity for patients to experience anxiety and depressive emotions.Therefore,during clinical practice,the crucial role that social support plays in safeguarding patients’physical and mental well-being as well as facilitating the effectiveness of disease treatment needs to be particularly emphasized.展开更多
BACKGROUND Lower abdominal pain presents as a common complaint with diverse etiologies ranging from benign conditions to surgical emergencies.Computed tomography(CT)imaging has become instrumental in accurate diagnosi...BACKGROUND Lower abdominal pain presents as a common complaint with diverse etiologies ranging from benign conditions to surgical emergencies.Computed tomography(CT)imaging has become instrumental in accurate diagnosis and management planning,though clinicians must carefully balance its benefits against radiation exposure concerns and resource allocation constraints.AIM To comprehensively evaluate the diagnostic accuracy,utility and clinical implications of CT in patients with acute lower abdominal pain,emphasizing rare anatomical variations,pregnancy-related issues,and practical limitations of other imaging modalities in emergency settings in Japan.METHODS This retrospective review included 230 patients who underwent CT scans for acute lower abdominal pain at Juntendo University Shizuoka Hospital throughout 2014.CT findings were systematically correlated with the final clinical diagnoses.Cases with diagnostic uncertain underwent independent reviewed by two experienced radiologists.The CT protocols included portal venous-phase imaging with selective arterial-phase acquisition when clinically indicated.RESULTS Idiopathic pain was the most common diagnosis(104 cases,45.2%),followed by appendicitis(46 cases,20.0%)and diverticulitis(27 cases,11.7%).Right lower quadrant pain predominantly revealed appendicitis(20.2%),whereas left lower quadrant pain frequently indicated diverticulitis(12.1%).Nonspecific pain cases have diverse etiologies.Rare conditions included situs inversus(one case)and intestinal malrotation(one case).Pregnancy-related diagnoses included acute appendicitis and uterine fibroid degeneration.CONCLUSION CT significantly aids in the diagnosis of lower abdominal pain,especially given limited access to ultrasonography and MRI during emergency hours in Japan.Awareness of the anatomical variations and pregnancy-related constraints is crucial.Diagnosis-specific protocols for CT based on pain location can optimize clinical management and resource utilization.展开更多
How the strong segmentation of cascade reservoir dams and the spatiotemporal changes of sediment retention volume affect the river morphology adjustment in the reservoir area is a scientific issue worthy of exploratio...How the strong segmentation of cascade reservoir dams and the spatiotemporal changes of sediment retention volume affect the river morphology adjustment in the reservoir area is a scientific issue worthy of exploration.This study aims to reveal the adjustment mechanism of the thalweg longitudinal profile of cascade reservoirs.This study focuses on the Xiangjiaba and Xiluodu reservoirs located in the lower reaches of the Jinsha River.Utilizing multi-period observational data of thalweg elevation in reservoir reaches both before and after dam construction,the research employs statistical,geomorphological,and sedimentological methodologies to analyze variation characteristics in the measured curves,trend curves,and theoretical fitting curves of the thalweg longitudinal profile.The investigation ultimately reveals two distinct adjustment patterns in the longitudinal profiles of these cascade reservoirs:the concave curve type and the convex curve type.The former is characterized by weak riverbed scouring and silting changed to rapid aggradation in the upstream section of the reservoir area after dam closure,then changed to slow aggradation in the whole reservoir area,which is the common feature of reservoirs that were built earlier and are relatively located in the downstream(such as the Xiangjiaba Reservoir).The latter is characterized by a straight line or concave curve type with weak riverbed scouring and silting before the dam closure changed to a convex curve type with strong siltation after dam closure,which is the characteristic of reservoirs that were built later and are relatively located in the upstream(such as the Xiluodu Reservoir).The adjustment of the cascade reservoir longitudinal profile is controlled by the spatiotemporal changes of the sediment deposition volume and sedimentation rate in the reservoir area,and the alternating changes of the hydrodynamic gradient and regulation mode affect the spatial heterogeneity of the sedimentation rate.The research results are helpful for understanding the adjustment mechanism of the cascade reservoir longitudinal profile in similar areas and have a guiding role in predicting the adjustment trend of the cascade reservoir longitudinal profile without observation data.展开更多
Understanding mixed infections in the female lower genital tract is a critical challenge in modern infection research.The interplay of multiple pathogens complicates disease progression,often resulting in treatment fa...Understanding mixed infections in the female lower genital tract is a critical challenge in modern infection research.The interplay of multiple pathogens complicates disease progression,often resulting in treatment failure,recurrent infections,and significant public health and economic burdens.These infections are further exacerbated by disrupted host immune responses,which hinder the recovery of the vaginal microecosystem.Additionally,microbial biofilms—a fundamental mode of pathogen coexistence—contribute to the persistence and drug resistance of these infections,complicating management strategies.This review examines the pathogenesis,diagnosis,and treatment of mixed infections in the female lower genital tract while exploring potential avenues for future research.These findings emphasize the need for greater focus on these infections and offer insights to enhance further research in this area.展开更多
BACKGROUND Gastric cancer(GC)poses a significant threat to public health.However,the clinicopathological features and tumor biological behaviors vary among the GC patients,leading to individual variations in lymph nod...BACKGROUND Gastric cancer(GC)poses a significant threat to public health.However,the clinicopathological features and tumor biological behaviors vary among the GC patients,leading to individual variations in lymph node metastasis.Consequently,the stratification of lymph node dissection according to the specific type,particularly upper GC,has emerged as a prominent area of research.AIM To investigate the distribution of metastatic lymph nodes in patients with upper and lower GC and to analyze the differences in related pathological elements and prognosis.METHODS Differential analysis between upper and lower GC patients with various clinicopathological factors was performed using the chi-square test and rank-sum regression models were used to analyze risk factors affecting patient prognosis.The Kaplan-Meier method was used to construct survival curves associated with prognostic risk factors for GC.RESULTS Significant differences were observed between the two GC populations regarding tumor diameter,histological grade,pT stage,pN stage,tumor-node-metastasis(pTNM)stage,vascular invasion,and adjuvant chemotherapy usage(all P<0.05).Lymph node metastasis rates were highest for Siewert type II patients in groups Nos.1,3,2 and 7;for Siewert type III patients in groups Nos.3,1,2 and 7;and for other/unclassified patients in groups Nos.1,3,7,2.In the lower GC samples,the sequences were Nos.3,6,7,4.Pathological type,pT stage,pTNM stage,and positive vascular invasion were independent risk factors for development of lymph node metastasis.Age,pathological type,pT stage,pN stage,pTNM stage,vascular invasion,and absence of adjuvant chemotherapy were identified as independent prognostic factors.CONCLUSION Upper GC showed a significantly higher malignancy grade and different lymph node metastasis pattern than lower GC.展开更多
Non-variceal upper gastrointestinal bleeding(GIB)remains a significant clinical challenge with a 30-day mortality of up to 11%.Peptic ulcers are the most common cause,followed by other conditions like Mallory-Weiss sy...Non-variceal upper gastrointestinal bleeding(GIB)remains a significant clinical challenge with a 30-day mortality of up to 11%.Peptic ulcers are the most common cause,followed by other conditions like Mallory-Weiss syndrome,Dieulafoy’s lesions,and gastric neoplasms.Treatment strategies include acid-suppressive therapy,endoscopic interventions,and surgical or radiological procedures.Endoscopic techniques such as over-the-scope clips,coagulation graspers,and endoscopic ultrasound-guided treatments have significantly improved outcomes,reducing rebleeding rates and the need for surgery.Injectable therapies,mechanical hemostasis via clips,and thermal modalities(e.g.,electrocoagulation,argon plasma coagulation)remain standard approaches for active bleeding.Newer hemostatic powders,such as TC-325,offer promising non-contact treatments,particularly in cases of refractory bleeding or malignancy.Doppler endoscopic probes aid in risk stratification by detecting residual arterial blood flow,improving the efficacy of endoscopic therapy and reducing rebleeding risks.For small bowel bleeding,endoscopic management with enteroscopy and thermal therapies remains key,though medical therapies are evolving.Lower GIB,which often involves conditions like diverticular disease and angioectasia,requires a comprehensive approach combining endoscopic,radiologic,and surgical interventions.Pharmacologic management focuses on balancing antithrombotic therapy with bleeding risks,with reversal agents playing a crucial role in life-threatening bleeding episodes.This review highlights advances in diagnostic tools and endoscopic therapies that have enhanced management outcomes for GIB across various etiologies.展开更多
Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three st...Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three stroke patients with hemiplegia admitted to our hospital from January 2022 to June 2024 were randomly divided into observation group(32 cases)and control group(31 cases)using the envelope method.The control group received task-oriented training,while the observation group received additional lower limb rehabilitation robot training.The motor function(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)and ankle joint function(Active Dorsiflexion Range of Motion,DF AROM)were compared between the two groups.Results:After treatment,the levels of FMA-LE and DF AROM in both groups increased significantly,and the improvement in each index in the observation group was better than that in the control group(P<0.05).Conclusion:The combination of task-oriented training and lower limb rehabilitation robot training can more effectively improve the overall motor function of the lower limbs and the active dorsiflexion ability of the ankle joint in stroke patients with hemiplegia.展开更多
To overcome the limitations of traditional exoskeletons in complex outdoor terrains,this study introduces a novel lower limb exoskeleton inspired by the snow leopard’s forelimb musculoskeletal structure.It features a...To overcome the limitations of traditional exoskeletons in complex outdoor terrains,this study introduces a novel lower limb exoskeleton inspired by the snow leopard’s forelimb musculoskeletal structure.It features a non-fully anthropomorphic design,attaching only at the thigh and ankle with a backward-knee configuration to mimic natural human knee movement.The design incorporates a single elastic element at the hip for gravity compensation and dual elastic elements at the knee for terrain adaptability,which adjust based on walking context.The design’s effectiveness was assessed by measuring metabolic cost reduction and motor output torque under various walking conditions.Results showed significant metabolic cost savings of 5.8–8.8%across different speeds and a 7.9%reduction during 9°incline walking on a flat indoor surface.Additionally,the spring element decreased hip motor output torque by 7–15.9%and knee torque by 8.1–14.2%.Outdoor tests confirmed the design’s robustness and effectiveness in reducing motor torque across terrains,highlighting its potential to advance multi-terrain adaptive exoskeleton research.展开更多
AIM:To evaluate the outcome and the degree of patient satisfaction with the reconstruction of full-thickness medial and central lower lid defects using a pendular flap of the remaining lateral part of the lower lid.ME...AIM:To evaluate the outcome and the degree of patient satisfaction with the reconstruction of full-thickness medial and central lower lid defects using a pendular flap of the remaining lateral part of the lower lid.METHODS:Totally 20 patients with full thickness medial or central lower lid defects that could not be repaired by direct closure with or without cantholysis.A sliding full-thickness composite flap was created from the lateral part of the remaining lid to cover the defect.The posterior lamella of the induced lateral defect was repaired by either a periosteal flap alone or in combination with a free tarsal graft.Postoperative cosmetic and functional outcomes were evaluated.RESULTS:The mean age of the patients was 46.3±18.1y(20-70y).The defects ranged from 30%-80%of the lid width and resulted from the excision of lid tumors in 11 patients(55%)and from trauma in 9(45%)patients.Postoperative complications included one case of lateral graft ectropion,2 cases of lid retraction and 3 cases of marginal graft necrosis.Most of the patients had an acceptable final cosmetic outcome.CONCLUSION:Reconstruction of moderate-sized defects in the medial/central lower lid via a sliding flap yielded acceptable cosmetic and functional outcomes with high patient satisfaction.Large defects≥50%of the horizontal length are at greater risk of complications.Reconstruction of medial defects by this technique was associated with a greater incidence of complications.展开更多
The Lower Cambrian shales in the Sichuan Basin are considered one of the most promising shale gas resources in China.However,large-scale commercial development has not been achieved due to the relatively low and signi...The Lower Cambrian shales in the Sichuan Basin are considered one of the most promising shale gas resources in China.However,large-scale commercial development has not been achieved due to the relatively low and significantly variable gas contents of the drilled shales.Excitingly,the first major breakthrough in deep and ultra-deep Lower Cambrian shale gas was made recently in the well Z201 in the southern Sichuan Basin,with a gas yield exceeding 73×10^(4)m^(3)/d.The success of well Z201 provides a favorable geological case to reveal the distinct enrichment mechanism of deep and ultra-deep Lower Cambrian shale gas.In this study,at drilling site of well Z201,fresh shale core samples with different gasin-place contents were collected,and their geochemical,pore development and water-bearing characteristics were analyzed systematically.The results showed that the Z201 organic-rich shales reached an overmature stage,with an average Raman maturity of 3.70%.The Z201 shales with high gas-in-place contents are mainly located in the Qiongzhusi 12section and the upper Qiongzhusi 11section,with an average gas-in-place content of 10.08 cm^(3)/g.Compared to the shales with low gas-in-place contents,the shales with high gas-in-place contents exhibit higher total organic carbon contents,greater porosities,and lower water saturations,providing more effective pore spaces for shale gas enrichment.The effective pore structures of the deep and ultra-deep Lower Cambrian shales are the primary factors affecting their gas-in-place contents.Similar to the shales with high gas-in-place contents of well Z201,the deep and ultra-deep Lower Cambrian shales in the Mianyang-Changning intracratonic sag,especially in the Ziyang area,generally developed in deep-water shelf facies with high total organic carbon contents and thick sedimentary thickness,providing favorable conditions for the development and preservation of effective pores.Therefore,they are the most promising targets for Lower Cambrian shale gas exploration.展开更多
This study focuses on tuffaceous clastic rocks of the Lower Cretaceous Qingshuihe Formation in the southern margin of Junggar Basin.It aims to explore the influence of sedimentation and parent rock on this kind of res...This study focuses on tuffaceous clastic rocks of the Lower Cretaceous Qingshuihe Formation in the southern margin of Junggar Basin.It aims to explore the influence of sedimentation and parent rock on this kind of reservoir development.The results show that the tuffaceous components formed by the denudation of ultramafic and mafic rocks can transform into chlorite coating or hematite,while those from intermediate rock denudation can be dissolved or transformed into illite.Sedimentary facies and lithofacies are essential in controlling the evolutionary result of tuffaceous components.Matrix-supported medium conglomerate and grain-supported medium-fine conglomerate that developed in the fan delta plain,with a closed original geochemical systems,have been in the oxidizing environment for a long time.The tuffaceous matrices mainly transforms into hematite or illite.These minerals occupy the primary pores and are difficult to dissolve by felsic fluids,which inhibits the development of high-quality reservoirs.The grain-supported sandy fine conglomerate developed in the fan delta front was in the underwater reductive environment with an open original geochemical system.The tuffaceous matrices not only can transform into chlorite coating to strengthen the particle's compaction resistance,but also can be fully dissolved,which promotes the formation of high-quality reservoirs.展开更多
The lower member of Dalazi Formation is an important oil reservoir in the Songjiang Basin.Based on the research on its field-measured geological profiles,lithological combination characteristics and grain size distrib...The lower member of Dalazi Formation is an important oil reservoir in the Songjiang Basin.Based on the research on its field-measured geological profiles,lithological combination characteristics and grain size distribution characteristics,combined with the analysis of the spatial distribution characteristics,sedimentary structural characteristics and hydrodynamic conditions of the sediments in this member,nine sedimentary microfacies of the fan delta plain subfacies,fan delta front subfacies and littoral-shallow lacustrine subfacies have been identified.The study reveals that lower member of Dalazi Formation in the research area follows a fan delta–shallow lacustrine depositional model in the steep slope zone of a rift lake basin.The sediments primarily originate from the Pre-Mesozoic strata in the steep southeastern and eastern margins.The basin center migrated from the early Xiaoshahe area to the Yangmucun–Shenglicun area,and the sedimentary system gradually transitioned from fan delta to littoral-shallow lacustrine facies.展开更多
BACKGROUND Serum retinol-binding protein(RBP)is the primary transport protein of circulating vitamin A.RBP has a crucial role in maintaining nutrient metabolism and physiologic homeostasis.Several studies have indicat...BACKGROUND Serum retinol-binding protein(RBP)is the primary transport protein of circulating vitamin A.RBP has a crucial role in maintaining nutrient metabolism and physiologic homeostasis.Several studies have indicated that serum RBP participates in the progression of diabetes and diabetes-related complications.However,the impact of serum RBP on lower limb atherosclerosis has not been determined in individuals with type 2 diabetes mellitus(T2DM).AIM To determine the association between serum RBP and lower limb atherosclerosis in individuals with T2DM.METHODS This retrospective study enrolled 4428 eligible T2DM patients and divided the patients into non-lower limb atherosclerosis(n=1913)and lower limb atherosclerosis groups(n=2515)based on lower limb arterial ultrasonography results.At hospital admission,baseline serum RBP levels were assessed,and all subjects were categorized into three groups(Q1-Q3)based on RBP tertiles.Logistic regression,restricted cubic spline regression,subgroup analysis,and machine learning were used to assess the association between RBP levels and lower limb atherosclerosis risk.RESULTS Among 4428 individuals with T2DM,2515(56.80%)had lower limb atherosclerosis.Logistic analysis showed that lower limb atherosclerosis risk increased by 1%for every 1 unit rise in serum RBP level(odds ratio=1.01,95%confidence interval:1.00-1.02,P=0.004).Patients in the highest tertile group(Q3)had a higher lower limb atherosclerosis risk compared to the lowest tertile group(Q1)(odds ratio=1.36,95%confidence interval:1.12-1.67,P=0.002).The lower limb atherosclerosis risk gradually increased with an increase in RBP tertile(P for trend=0.005).Restricted cubic spline analysis indicated a linear correlation between serum RBP levels and lower limb atherosclerosis risk(non-linear P<0.05).Machine learning demonstrated the significance and diagnostic value of serum RBP in predicting lower limb atherosclerosis risk.CONCLUSION Elevated serum RBP levels correlate with an increased lower limb atherosclerosis risk in individuals with T2DM.展开更多
基金supported by the Natural Science Foundation of Shandong Province(ZR2023MD112)financially supported by Laoshan Laboratory(LSKJ202203401).
文摘Shale gas is abundant in the Paleozoic of the Yangtze Platform,and several high-yield shale gas fields have been built in the Upper Yangtze Platform,China.The Permian of the South Yellow Sea Basin(SYSB)in the Lower Yangtze area is considered a potential target for shale gas exploration;however,the fundamental geological conditions of shale gas have not been studied.Based on the first whole-cored scientific drilling borehole(CSDP-2)in the SYSB,detailed tests involving petrology,organic geochemistry,and reservoir physical properties were conducted to evaluate the shale gas potential of the Lower Permian.The Lower Permian is dominated by organic-rich siliceous,clay,and clay-mixed shales.The average total organic carbon content is 5.99%,and the organic matter is mainly type Ⅱ_(1)−Ⅱ_(2),which has entered the high-over mature evolution stage.The pore types of organic-rich shales mainly include organic pores,dissolution pores,and intergranular pores,of which the meso-/macropores are well developed.The average porosity is 3.04%,and the total specific surface area and pore volume are 3.47 m^(2)/g and 7.21×10^(−3) cm^(3)/g,respectively.The average Langmuir volume obtained from the methane adsorption isotherms is 2.70 cm^(3)/g,and methane is mainly adsorbed in the meso-/macropores.The lower Permian shales are rich in methane as indicated by gas logging results,with an average content of 7.3%,which can reach up to 65.9%.A comparison of the study area with typical shale gas fields shows that the Lower Permian is brittle and shallowly buried and has a high potential for shale gas exploration and low-cost development.The depression areas of the SYSB are overlain by thick Mesozoic-Cenozoic sediments,show higher organic matter maturity,and may have greater shale gas potential.The shale gas exploration breakthrough of the study area is of great significance to ensure the energy supply of economically developed areas on the east China.
基金supported by the National High Level Hospital Clinical Research Funding(No.BJ-2023-066).
文摘Objective This study aims to analyze the burden of lower respiratory infections in Chinese elderly people aged 70 and above.Methods This study utilized Global Burden of Disease(GBD)1990-2050 prediction data to analyze changes in mortality rates and disability-adjusted life year(DALY)rates for lower respiratory infections in the elderly population(aged 70 and above)in China from 1990 to 2050.It also discusses future trends in the burden of lower respiratory infections(LRI)in China under different scenarios.Results According to GBD predictions,the burden of lower respiratory infections in the elderly aged 70 years and above in China is lower than the global average.The burden has been decreasing from 1990 to 2020,but is projected to increase from 2020 to 2050.Scenario-based predictions suggest that,under scenarios involving improvements in nutrition and vaccination,the burden of lower respiratory infections in the elderly in China is expected to be the lowest in 2050.Conclusion This study indicates that the burden of lower respiratory infections in elderly people aged 70 years and above in China remains a significant public health issue and may worsen.The government should consider strengthening the preventive measures and management strategies for respiratory infections in the elderly population.
文摘BACKGROUND Most patients who were included in previous studies on achalasia had increased lower esophageal sphincter(LES)pressure.Peroral endoscopic myotomy(POEM)has been confirmed to be effective at relieving the clinical symptoms of achalasia associated with increased LES pressure.AIM To identify the safety and efficacy of POEM for patients with normal LES integrated relaxation pressure(LES-IRP).METHODS The clinical data of patients who underwent POEM successfully in The First Medical Center of Chinese PLA General Hospital were retrospectively analyzed.A total of 481 patients who underwent preoperative high-resolution manometry(HRM)at our hospital were ultimately included in this research.According to the HRM results,the patients were divided into two groups:71 patients were included in the normal LES-IRP group(LES-IRP<15 mmHg)and 410 patients were included in the increased LES-IRP group(LES-IRP≥15 mmHg).Clinical characteristics,procedure-related parameters,adverse events,and outcomes were compared between the two groups to evaluate the safety and efficacy of POEM for patients with normal LES-IRP.RESULTS Among the 481 patients included in our study,209 were males and 272 were females,with a mean age of 44.2 years.All patients underwent POEM without severe adverse events.The median pre-treatment Eckardt scores of the normal LES-IRP and increased LES-IRP groups were 7.0 and 7.0(P=0.132),respectively,decreasing to 1.0 and 1.0 post-treatment(P=0.572).The clinical success rate of the normal LES-IRP group was 87.3%(62/71),and that of the increased LES-IRP group was 91.2%(374/410)(P=0.298).Reflux symptoms were measured by the GerdQ questionnaire,and the percentages of patients with GerdQ scores≥9 in the normal LES-IRP and increased LES-IRP groups were 8.5%and 10.7%,respectively(P=0.711).After matching,the rates of clinical success and the rates of GerdQ score≥9 were not significantly different between the two groups.CONCLUSION Our results suggest that POEM is safe and effective for achalasia and patients with normal LES-IRP.In addition,in patients with normal LES-IRP,compared with those with increased LES-IRP,POEM was not associated with a greater incidence of reflux symptoms.
文摘Purpose: To evaluate open lower limb trauma management in children. Me-thod: We conducted a twelve-month cross-sectional prospective study. Results: Open trauma of lower limb had 7.9% of hospital frequency. Mean age was 8 years with a sex ratio of 2.45. In 68.4% of cases, trauma occurred in road traffic accidents. Average consultation time was 2.4 hours. Trauma mainly affected the leg in 39.5% of cases, and the thigh in 34.2%. Soft tissue wounds occurred in 52.6% of cases, and open fractures in 47.4%. Average response time was one hour. Wound trimming and suturing were performed in 76.3% of cases and combined with bone nailing in 15.8%. The outcome was favorable in 92.1% of cases. Average hospital stay was 4.37 days. Conclusion: Open trauma to the lower limb is a frequent and occurs mainly in road traffic accidents. Management was early, with a favorable outcome for most patients and a short hospital stay.
文摘Introduction: Foreign bodies (FB) in the lower airways (LAs) constitute a potentially life-threatening emergency requiring immediate management. The objective of our study was to describe the patient pathway and management of foreign bodies in the lower airways. Methodology: This was a descriptive study with retrospective data collection conducted over a 6-year period (January 1, 2014, to December 31, 2019) in the ENT and Head and Neck Surgery Department of Donka National Hospital. Results: We observed a prevalence of 1.79%. The average age was 5.71 years, with a sex ratio of 1.2. However, 82.61% of the cases originated from rural areas. We noted that 78.83% of patients were referred after visiting 1 to 2 healthcare facilities (75.36%). The consultation delay was 3 days. Penetration syndrome was present in 98.56% of cases. The foreign body incidents occurred during play in 54.84% and during meals in 29.09% of cases. Radiographs were performed in 93.9% of cases. Endoscopy was used for both diagnostic and therapeutic purposes in all patients. The foreign bodies were located in the trachea (37.68%), larynx (26.08%), and bronchi (21.73%). Non-organic foreign bodies were predominant (52.17%). Postoperative outcomes were uncomplicated in 95.98% of cases, and the lethality rate was 2.85%. Conclusion: The pathway of patients with foreign bodies in the airways remains unpredictable in our context due to parental hesitations. Early management reduces morbidity and mortality rates.
文摘Varicose veins of the lower limbs are a cosmopolitan condition, thought to be rare in Africa but widespread in Europe. The aim of this study is to analyze the indications and evaluate the results of surgical management of varicose pathology of the IM in Dakar. We enrolled 280 patients, with a mean age of 36 and a sex ratio of 2. Factors favouring venous disease were dominated by prolonged orthostatism and multiparity. The average consultation time was 6 years. The reasons for consultation were functional manifestations, progressive complications and aesthetics. The venous trunks concerned were the great saphenous vein (GSV) in 58.9% of cases, the small saphenous vein (SSV) in 29% of cases, perforating veins and varicose veins were unsystematized in 28.5% of cases. Surgery was performed under spinal anaesthesia. Surgical procedures were dominated by stripping of the GSV, crossectomy of the SSV and staged ligations. One patient developed meningismus immediately after the operation. Average follow-up was 2 years. Mortality was null.
文摘In Switzerland,the Opalinus Clay has been selected as a potential host rock for the deep geological disposal of radioactive waste due to its low hydraulic conductivity and favorable swelling properties.During the operational phase of the repository,the host rock will be exposed to pH values as high as 13.5 due to concrete degradation,which will certainly affect its hydraulic properties.This study investigates the effect of pH increase on the water retention properties of Opalinus Clay.A series of samples from the lower sandy facies of the Mont Terri site in Switzerland,at initial dry state,were exposed to a hyperalkaline solution of pH=13.5 and to the synthetic water of pH=7.5 at different water contents.After equilibrium,the total suction was measured with a dew point potentiometer and microstructural analyses were conducted via mercury intrusion porosimetry(MIP)and nitrogen adsorption-desorption technique.It was found that the total suction decreased with hydration and pH increase.Since the two investigated solutions have the same osmotic suction,the decrease in total suction was attributed to the decrease in matric suction.Indeed,the total porosity increased with saturation and pH increase.This was confirmed by MIP data that evidenced an increase in the proportion of macropores,and by Barret eJoynereHalenda(BJH)data that showed mesopore generation.The specific surface area(SSA)also increased.The previous results were due to mineral hydration and,exclusively in the case of alkaline solution,to(1)the dissolution of quartz and calcite and(2)the acid-base reactions,which were concentrated at the edges of the clay particles,leading to an increase in negatively charged groups and thus to a face-to-face association of the clay particles(dispersion),causing an increase in the repulsive forces between the clay particles.In addition,the weakening of covalent bonds led to the primary dissolution of clay minerals,i.e.silicon and aluminum detachment.
基金Supported by the Key Project of Natural Science Research in Universities of Anhui Province,No.2023AH051985Key Project of Natural Science Research at Bengbu Medical University,No.2023byzd038Anhui Provincial Health Research Project,No.AHWJ2024BAc30042.
文摘BACKGROUND The prevalence of lower extremity arteriosclerosis obliterans(LEASO)in China is progressively increasing with the increment in age.Certain patients may be diagnosed with lower extremity arterial stenosis and occlusion that resist complete curative efforts,which will invariably impose a substantial psychological strain on them.AIM To investigate the anxiety and depression conditions among patients with LEASO and analyze the associated risk factors.METHODS The Affiliated Hospital of Bengbu Medical University from January 2019 to December 2022.Their demographic and clinical data were obtained through the basic information questionnaire.The social support situation was assessed with the social support rating scale,and the hospital anxiety and depression scale were used to analyze their depression and anxiety levels.RESULTS The prevalence rate of anxiety was 44.0%among the 159 patients,with a total Self-Rating Anxiety Scale score of 49.01±9.65.The incidence of depression was 40.9%,and the total self-rating depression scale score reached 49.91±9.18.The overall social support score for all participants averaged 24.82±5.80.The correlation analysis between social support scores and anxiety and depression scores revealed that the total social support score,subjective social support,objective social support,as well as the degree of social support utilization,all exhibited a significant negative correlation with the anxiety and depression scores,which was statistically significant(P<0.05).The univariate analysis revealed statistically significant differences in the depression and anxiety states among patients with varying pain manifestations,disease stages,disease durations,and social support magnitudes(P<0.05).The multivariate analysis further demonstrated that patients presenting with intermittent claudication,rest pain,and pain,whose disease course was within half a year,and who had relatively low social support,were more predisposed to anxiety.Intriguingly,a monthly income of>6000 yuan was considered a protective factor in this context(P<0.05).Similarly,patients with intermittent claudication,rest pain,gangrene,and pain,and who had relatively low social support,were more liable to succumb to depressive moods(P<0.05).CONCLUSION Patients with LEASO typically receive relatively scant social support.Notably,those who concurrently present with symptoms,such as pain,claudication,and gangrene,are at a substantially increased risk of developing depression and anxiety disorders.A significant negative correlation is manifested between the social support level that patients receive and the severity of their anxiety and depression symptoms.Hence,the lower the social support score,the greater the propensity for patients to experience anxiety and depressive emotions.Therefore,during clinical practice,the crucial role that social support plays in safeguarding patients’physical and mental well-being as well as facilitating the effectiveness of disease treatment needs to be particularly emphasized.
文摘BACKGROUND Lower abdominal pain presents as a common complaint with diverse etiologies ranging from benign conditions to surgical emergencies.Computed tomography(CT)imaging has become instrumental in accurate diagnosis and management planning,though clinicians must carefully balance its benefits against radiation exposure concerns and resource allocation constraints.AIM To comprehensively evaluate the diagnostic accuracy,utility and clinical implications of CT in patients with acute lower abdominal pain,emphasizing rare anatomical variations,pregnancy-related issues,and practical limitations of other imaging modalities in emergency settings in Japan.METHODS This retrospective review included 230 patients who underwent CT scans for acute lower abdominal pain at Juntendo University Shizuoka Hospital throughout 2014.CT findings were systematically correlated with the final clinical diagnoses.Cases with diagnostic uncertain underwent independent reviewed by two experienced radiologists.The CT protocols included portal venous-phase imaging with selective arterial-phase acquisition when clinically indicated.RESULTS Idiopathic pain was the most common diagnosis(104 cases,45.2%),followed by appendicitis(46 cases,20.0%)and diverticulitis(27 cases,11.7%).Right lower quadrant pain predominantly revealed appendicitis(20.2%),whereas left lower quadrant pain frequently indicated diverticulitis(12.1%).Nonspecific pain cases have diverse etiologies.Rare conditions included situs inversus(one case)and intestinal malrotation(one case).Pregnancy-related diagnoses included acute appendicitis and uterine fibroid degeneration.CONCLUSION CT significantly aids in the diagnosis of lower abdominal pain,especially given limited access to ultrasonography and MRI during emergency hours in Japan.Awareness of the anatomical variations and pregnancy-related constraints is crucial.Diagnosis-specific protocols for CT based on pain location can optimize clinical management and resource utilization.
基金National Key R&D Program of China,No.2022YFC3203903National Natural Science Foundation of China,No.42371010,No.41971004。
文摘How the strong segmentation of cascade reservoir dams and the spatiotemporal changes of sediment retention volume affect the river morphology adjustment in the reservoir area is a scientific issue worthy of exploration.This study aims to reveal the adjustment mechanism of the thalweg longitudinal profile of cascade reservoirs.This study focuses on the Xiangjiaba and Xiluodu reservoirs located in the lower reaches of the Jinsha River.Utilizing multi-period observational data of thalweg elevation in reservoir reaches both before and after dam construction,the research employs statistical,geomorphological,and sedimentological methodologies to analyze variation characteristics in the measured curves,trend curves,and theoretical fitting curves of the thalweg longitudinal profile.The investigation ultimately reveals two distinct adjustment patterns in the longitudinal profiles of these cascade reservoirs:the concave curve type and the convex curve type.The former is characterized by weak riverbed scouring and silting changed to rapid aggradation in the upstream section of the reservoir area after dam closure,then changed to slow aggradation in the whole reservoir area,which is the common feature of reservoirs that were built earlier and are relatively located in the downstream(such as the Xiangjiaba Reservoir).The latter is characterized by a straight line or concave curve type with weak riverbed scouring and silting before the dam closure changed to a convex curve type with strong siltation after dam closure,which is the characteristic of reservoirs that were built later and are relatively located in the upstream(such as the Xiluodu Reservoir).The adjustment of the cascade reservoir longitudinal profile is controlled by the spatiotemporal changes of the sediment deposition volume and sedimentation rate in the reservoir area,and the alternating changes of the hydrodynamic gradient and regulation mode affect the spatial heterogeneity of the sedimentation rate.The research results are helpful for understanding the adjustment mechanism of the cascade reservoir longitudinal profile in similar areas and have a guiding role in predicting the adjustment trend of the cascade reservoir longitudinal profile without observation data.
基金supported by a grant from the National Natural Science Foundation of China(No.81874483).
文摘Understanding mixed infections in the female lower genital tract is a critical challenge in modern infection research.The interplay of multiple pathogens complicates disease progression,often resulting in treatment failure,recurrent infections,and significant public health and economic burdens.These infections are further exacerbated by disrupted host immune responses,which hinder the recovery of the vaginal microecosystem.Additionally,microbial biofilms—a fundamental mode of pathogen coexistence—contribute to the persistence and drug resistance of these infections,complicating management strategies.This review examines the pathogenesis,diagnosis,and treatment of mixed infections in the female lower genital tract while exploring potential avenues for future research.These findings emphasize the need for greater focus on these infections and offer insights to enhance further research in this area.
文摘BACKGROUND Gastric cancer(GC)poses a significant threat to public health.However,the clinicopathological features and tumor biological behaviors vary among the GC patients,leading to individual variations in lymph node metastasis.Consequently,the stratification of lymph node dissection according to the specific type,particularly upper GC,has emerged as a prominent area of research.AIM To investigate the distribution of metastatic lymph nodes in patients with upper and lower GC and to analyze the differences in related pathological elements and prognosis.METHODS Differential analysis between upper and lower GC patients with various clinicopathological factors was performed using the chi-square test and rank-sum regression models were used to analyze risk factors affecting patient prognosis.The Kaplan-Meier method was used to construct survival curves associated with prognostic risk factors for GC.RESULTS Significant differences were observed between the two GC populations regarding tumor diameter,histological grade,pT stage,pN stage,tumor-node-metastasis(pTNM)stage,vascular invasion,and adjuvant chemotherapy usage(all P<0.05).Lymph node metastasis rates were highest for Siewert type II patients in groups Nos.1,3,2 and 7;for Siewert type III patients in groups Nos.3,1,2 and 7;and for other/unclassified patients in groups Nos.1,3,7,2.In the lower GC samples,the sequences were Nos.3,6,7,4.Pathological type,pT stage,pTNM stage,and positive vascular invasion were independent risk factors for development of lymph node metastasis.Age,pathological type,pT stage,pN stage,pTNM stage,vascular invasion,and absence of adjuvant chemotherapy were identified as independent prognostic factors.CONCLUSION Upper GC showed a significantly higher malignancy grade and different lymph node metastasis pattern than lower GC.
文摘Non-variceal upper gastrointestinal bleeding(GIB)remains a significant clinical challenge with a 30-day mortality of up to 11%.Peptic ulcers are the most common cause,followed by other conditions like Mallory-Weiss syndrome,Dieulafoy’s lesions,and gastric neoplasms.Treatment strategies include acid-suppressive therapy,endoscopic interventions,and surgical or radiological procedures.Endoscopic techniques such as over-the-scope clips,coagulation graspers,and endoscopic ultrasound-guided treatments have significantly improved outcomes,reducing rebleeding rates and the need for surgery.Injectable therapies,mechanical hemostasis via clips,and thermal modalities(e.g.,electrocoagulation,argon plasma coagulation)remain standard approaches for active bleeding.Newer hemostatic powders,such as TC-325,offer promising non-contact treatments,particularly in cases of refractory bleeding or malignancy.Doppler endoscopic probes aid in risk stratification by detecting residual arterial blood flow,improving the efficacy of endoscopic therapy and reducing rebleeding risks.For small bowel bleeding,endoscopic management with enteroscopy and thermal therapies remains key,though medical therapies are evolving.Lower GIB,which often involves conditions like diverticular disease and angioectasia,requires a comprehensive approach combining endoscopic,radiologic,and surgical interventions.Pharmacologic management focuses on balancing antithrombotic therapy with bleeding risks,with reversal agents playing a crucial role in life-threatening bleeding episodes.This review highlights advances in diagnostic tools and endoscopic therapies that have enhanced management outcomes for GIB across various etiologies.
文摘Objective:To evaluate the effect of task-oriented training combined with a lower limb rehabilitation robot on improving motor function and ankle joint function in stroke patients with hemiplegia.Methods:Sixty-three stroke patients with hemiplegia admitted to our hospital from January 2022 to June 2024 were randomly divided into observation group(32 cases)and control group(31 cases)using the envelope method.The control group received task-oriented training,while the observation group received additional lower limb rehabilitation robot training.The motor function(Fugl-Meyer Assessment of Lower Extremity,FMA-LE)and ankle joint function(Active Dorsiflexion Range of Motion,DF AROM)were compared between the two groups.Results:After treatment,the levels of FMA-LE and DF AROM in both groups increased significantly,and the improvement in each index in the observation group was better than that in the control group(P<0.05).Conclusion:The combination of task-oriented training and lower limb rehabilitation robot training can more effectively improve the overall motor function of the lower limbs and the active dorsiflexion ability of the ankle joint in stroke patients with hemiplegia.
基金sponsored by the Fundamental Research Funds for the Central Universities[N2329001].
文摘To overcome the limitations of traditional exoskeletons in complex outdoor terrains,this study introduces a novel lower limb exoskeleton inspired by the snow leopard’s forelimb musculoskeletal structure.It features a non-fully anthropomorphic design,attaching only at the thigh and ankle with a backward-knee configuration to mimic natural human knee movement.The design incorporates a single elastic element at the hip for gravity compensation and dual elastic elements at the knee for terrain adaptability,which adjust based on walking context.The design’s effectiveness was assessed by measuring metabolic cost reduction and motor output torque under various walking conditions.Results showed significant metabolic cost savings of 5.8–8.8%across different speeds and a 7.9%reduction during 9°incline walking on a flat indoor surface.Additionally,the spring element decreased hip motor output torque by 7–15.9%and knee torque by 8.1–14.2%.Outdoor tests confirmed the design’s robustness and effectiveness in reducing motor torque across terrains,highlighting its potential to advance multi-terrain adaptive exoskeleton research.
文摘AIM:To evaluate the outcome and the degree of patient satisfaction with the reconstruction of full-thickness medial and central lower lid defects using a pendular flap of the remaining lateral part of the lower lid.METHODS:Totally 20 patients with full thickness medial or central lower lid defects that could not be repaired by direct closure with or without cantholysis.A sliding full-thickness composite flap was created from the lateral part of the remaining lid to cover the defect.The posterior lamella of the induced lateral defect was repaired by either a periosteal flap alone or in combination with a free tarsal graft.Postoperative cosmetic and functional outcomes were evaluated.RESULTS:The mean age of the patients was 46.3±18.1y(20-70y).The defects ranged from 30%-80%of the lid width and resulted from the excision of lid tumors in 11 patients(55%)and from trauma in 9(45%)patients.Postoperative complications included one case of lateral graft ectropion,2 cases of lid retraction and 3 cases of marginal graft necrosis.Most of the patients had an acceptable final cosmetic outcome.CONCLUSION:Reconstruction of moderate-sized defects in the medial/central lower lid via a sliding flap yielded acceptable cosmetic and functional outcomes with high patient satisfaction.Large defects≥50%of the horizontal length are at greater risk of complications.Reconstruction of medial defects by this technique was associated with a greater incidence of complications.
基金supported by the National Natural Science Foundation of China(41925014).
文摘The Lower Cambrian shales in the Sichuan Basin are considered one of the most promising shale gas resources in China.However,large-scale commercial development has not been achieved due to the relatively low and significantly variable gas contents of the drilled shales.Excitingly,the first major breakthrough in deep and ultra-deep Lower Cambrian shale gas was made recently in the well Z201 in the southern Sichuan Basin,with a gas yield exceeding 73×10^(4)m^(3)/d.The success of well Z201 provides a favorable geological case to reveal the distinct enrichment mechanism of deep and ultra-deep Lower Cambrian shale gas.In this study,at drilling site of well Z201,fresh shale core samples with different gasin-place contents were collected,and their geochemical,pore development and water-bearing characteristics were analyzed systematically.The results showed that the Z201 organic-rich shales reached an overmature stage,with an average Raman maturity of 3.70%.The Z201 shales with high gas-in-place contents are mainly located in the Qiongzhusi 12section and the upper Qiongzhusi 11section,with an average gas-in-place content of 10.08 cm^(3)/g.Compared to the shales with low gas-in-place contents,the shales with high gas-in-place contents exhibit higher total organic carbon contents,greater porosities,and lower water saturations,providing more effective pore spaces for shale gas enrichment.The effective pore structures of the deep and ultra-deep Lower Cambrian shales are the primary factors affecting their gas-in-place contents.Similar to the shales with high gas-in-place contents of well Z201,the deep and ultra-deep Lower Cambrian shales in the Mianyang-Changning intracratonic sag,especially in the Ziyang area,generally developed in deep-water shelf facies with high total organic carbon contents and thick sedimentary thickness,providing favorable conditions for the development and preservation of effective pores.Therefore,they are the most promising targets for Lower Cambrian shale gas exploration.
基金supported by the National Natural Science Foundation of China(Grant Nos.42172109,41872113,42172108)China National Petroleum Corporation-China University of Petroleum(Beijing)Strategic Cooperation Science and Technology Project(Grant No.ZLZX2020-02)+1 种基金State's Key Project of Research and Development Plan(Grant No.2018YFA0702405)Science Foundation of China University of Petroleum(Beijing)(Grant Nos.2462020BJRC002,2462020YXZZ020)。
文摘This study focuses on tuffaceous clastic rocks of the Lower Cretaceous Qingshuihe Formation in the southern margin of Junggar Basin.It aims to explore the influence of sedimentation and parent rock on this kind of reservoir development.The results show that the tuffaceous components formed by the denudation of ultramafic and mafic rocks can transform into chlorite coating or hematite,while those from intermediate rock denudation can be dissolved or transformed into illite.Sedimentary facies and lithofacies are essential in controlling the evolutionary result of tuffaceous components.Matrix-supported medium conglomerate and grain-supported medium-fine conglomerate that developed in the fan delta plain,with a closed original geochemical systems,have been in the oxidizing environment for a long time.The tuffaceous matrices mainly transforms into hematite or illite.These minerals occupy the primary pores and are difficult to dissolve by felsic fluids,which inhibits the development of high-quality reservoirs.The grain-supported sandy fine conglomerate developed in the fan delta front was in the underwater reductive environment with an open original geochemical system.The tuffaceous matrices not only can transform into chlorite coating to strengthen the particle's compaction resistance,but also can be fully dissolved,which promotes the formation of high-quality reservoirs.
基金Supported by Jinchang City Level Science and Technology Plan Project(No.2023RC012).
文摘The lower member of Dalazi Formation is an important oil reservoir in the Songjiang Basin.Based on the research on its field-measured geological profiles,lithological combination characteristics and grain size distribution characteristics,combined with the analysis of the spatial distribution characteristics,sedimentary structural characteristics and hydrodynamic conditions of the sediments in this member,nine sedimentary microfacies of the fan delta plain subfacies,fan delta front subfacies and littoral-shallow lacustrine subfacies have been identified.The study reveals that lower member of Dalazi Formation in the research area follows a fan delta–shallow lacustrine depositional model in the steep slope zone of a rift lake basin.The sediments primarily originate from the Pre-Mesozoic strata in the steep southeastern and eastern margins.The basin center migrated from the early Xiaoshahe area to the Yangmucun–Shenglicun area,and the sedimentary system gradually transitioned from fan delta to littoral-shallow lacustrine facies.
基金The study was approved by the ethics committee of Southwest Hospital,the First Affiliated Hospital of Army Medical University of Chinese People's Liberation Army(No.KY2024007).
文摘BACKGROUND Serum retinol-binding protein(RBP)is the primary transport protein of circulating vitamin A.RBP has a crucial role in maintaining nutrient metabolism and physiologic homeostasis.Several studies have indicated that serum RBP participates in the progression of diabetes and diabetes-related complications.However,the impact of serum RBP on lower limb atherosclerosis has not been determined in individuals with type 2 diabetes mellitus(T2DM).AIM To determine the association between serum RBP and lower limb atherosclerosis in individuals with T2DM.METHODS This retrospective study enrolled 4428 eligible T2DM patients and divided the patients into non-lower limb atherosclerosis(n=1913)and lower limb atherosclerosis groups(n=2515)based on lower limb arterial ultrasonography results.At hospital admission,baseline serum RBP levels were assessed,and all subjects were categorized into three groups(Q1-Q3)based on RBP tertiles.Logistic regression,restricted cubic spline regression,subgroup analysis,and machine learning were used to assess the association between RBP levels and lower limb atherosclerosis risk.RESULTS Among 4428 individuals with T2DM,2515(56.80%)had lower limb atherosclerosis.Logistic analysis showed that lower limb atherosclerosis risk increased by 1%for every 1 unit rise in serum RBP level(odds ratio=1.01,95%confidence interval:1.00-1.02,P=0.004).Patients in the highest tertile group(Q3)had a higher lower limb atherosclerosis risk compared to the lowest tertile group(Q1)(odds ratio=1.36,95%confidence interval:1.12-1.67,P=0.002).The lower limb atherosclerosis risk gradually increased with an increase in RBP tertile(P for trend=0.005).Restricted cubic spline analysis indicated a linear correlation between serum RBP levels and lower limb atherosclerosis risk(non-linear P<0.05).Machine learning demonstrated the significance and diagnostic value of serum RBP in predicting lower limb atherosclerosis risk.CONCLUSION Elevated serum RBP levels correlate with an increased lower limb atherosclerosis risk in individuals with T2DM.
