BACKGROUND The therapeutic role of neurodynamic mobilization in improving lower limb function in patients with mild post-traumatic knee osteoarthritis remains poorly understood.AIM To further elucidate the role of neu...BACKGROUND The therapeutic role of neurodynamic mobilization in improving lower limb function in patients with mild post-traumatic knee osteoarthritis remains poorly understood.AIM To further elucidate the role of neurodynamic mobilization in facilitating knee joint functional recovery.METHODS Thirty-two patients with post-traumatic knee osteoarthritis treated at Chonghua Hospital of Traditional Chinese Medicine(Guilin)from March 2024 to August 2025 were randomly assigned to a control group(n=16)or an intervention group(n=16).Both groups received eight weeks of conventional treatment;and the intervention group additionally underwent neurodynamic mobilization.Outcomes including pain assessed by the visual analogue scale,active range of motion,Lysholm score,stork stand test,single hop test,and Y-balance test were assessed before and after the intervention.RESULTS There were no significant differences between the two groups in baseline characteristics,including gender,age,body mass index,or surgical side(P>0.05).Two-way repeated-measures analysis of variance demonstrated significant time×group interaction effects for the visual analogue scale score(F=13.364,P<0.05),Lysholm knee score(F=20.385,P<0.05),stork stand test(F=103.756,P<0.05),and Y-balance test score(F=8.089,P<0.05).CONCLUSION Neurodynamic mobilization effectively reduces pain,improves knee function,and enhances lower limb balance in patients with mild post-traumatic knee osteoarthritis.展开更多
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
Background Frailty is a major determinant of outcomes in patients with coronary artery disease(CAD)undergoing lower limb amputation.This study evaluates the impact of frailty on in-hospital outcomes in these patients....Background Frailty is a major determinant of outcomes in patients with coronary artery disease(CAD)undergoing lower limb amputation.This study evaluates the impact of frailty on in-hospital outcomes in these patients.Methods We performed a retrospective analysis of the National Inpatient Sample(2016–2021)to identify adult patients with CAD who underwent lower limb amputation.Frailty was defined using the Johns Hopkins Adjusted Clinical Groups(ACG)frailty indicator.Multivariable logistic regression was used to assess the independent association of frailty with in-hospital outcomes,and propensity score matching(PSM)was performed to further account for confounding factors.Results After PSM,9,990 patients were included in each cohort.Frail patients experienced higher rates of in-hospital mortality(3.9%vs.1.5%,P<0.001),acute limb ischemia(3.8%vs.3.1%,P=0.015),fasciotomy(2.1%vs.1.4%,P<0.001),stump infection(7.9%vs.6.6%,P<0.001),cardiogenic shock(0.9%vs.0.7%,P=0.032),sudden cardiac arrest(2.7%vs.2.1%,P=0.004),mechanical circulatory support(0.3%vs.0.2%,P=0.028),major adverse cardiac and cerebrovascular events(7.7%vs.5.4%,P<0.001),and sepsis(18.3%vs.13.8%,P<0.001).In multivariable logistic regression analysis,frailty remained an independent predictor of inhospital mortality and major complications.Conclusion Frailty is independently associated with increased in-hospital mortality and adverse events among CAD patients undergoing lower limb amputation.Incorporating frailty assessment into preoperative evaluation may improve risk stratification and guide clinical decision-making in this high-risk population.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
Here we report a left cheek plate of Psarolepis,a postparietal shield of Youngolepis,a skull of Diabolepis,and a scale of Styloichthys from the Lianhuashan and Nahkaoling formations(Lochkovian,Lower Devonian)of Nannin...Here we report a left cheek plate of Psarolepis,a postparietal shield of Youngolepis,a skull of Diabolepis,and a scale of Styloichthys from the Lianhuashan and Nahkaoling formations(Lochkovian,Lower Devonian)of Nanning,Guangxi.This marks the first report of Diabolepis and Styloichthys beside Qujing,Yunnan,and the latest occurrence of Psarolepis to date.The fossil community displays significant similarities to the Xujiachong Assemblage,and provides new data for the Lower Devonian stratigraphic correlation between southwestern China and northern Vietnam.Given the latest dating constraint based on the conodont evidence,we regard that the Xujiachong Assemblage has a much longer range than previously supposed,extending from the latest Lochkovian to the end of Pragian.We propose that the transition of the Nahkaoling and Lianhuashan formations in Nanning might correspond to the Guijiatun Formation in Qujing.The relatively large size of fish individuals from Guangxi is probably attributed to the increase in the oxygen content of the ocean.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
Early Cambrian organic-rich shales in the Yangtze Plate are key shale gas exploration targets in China,but their sedimentary environments are not well understood.This lack of knowledge complicates the evaluation of th...Early Cambrian organic-rich shales in the Yangtze Plate are key shale gas exploration targets in China,but their sedimentary environments are not well understood.This lack of knowledge complicates the evaluation of these targets and associated risks.Assessing shale depositional environments is also challenging due to the fine-grained nature of the sediments and subtle compositional variations.Herein,marine black shales of the Lower Cambrian Shiyantou(SYT)Formation(Fm)and Yu'anshan(YAS)Fm are investigated through a series of experiment,including thin sections,scanning electron microscopy,and major and trace elements analysis.Results show that five lithofacies can be identified in the SYT and YAS shales:(1)calcareous mudstone;(2)wavy-laminated sand,silt,and clay bearing mudstone;(3)laminated and massive mudstone;(4)planar-laminated pyritic mudstone,and(5)thin bedded sand and siltstone.Average content of major elements SiO_(2),Al_(2)O_(3),MgO,Fe_(2)O_(3),K_(2)O,CaO,Na_(2)O,TiO_(2),P_(2)O_(5),and MnO of SYT Fm are 57.03%,12.74%,4.20%,3.97%,3.93%,3.35%,1.09%,0.68%,0.28%,and 0.05%,respectively.Average content of major elements SiO_(2),Al_(2)O_(3),MgO,Fe_(2)O_(3),K_(2)O,CaO,Na_(2)O,TiO_(2),P_(2)O_(5),and MnO of Yu'anshan Fm are 54.93%,14.52%,5.26%,6.00%,3.77%,3.88%,0.15%,0.63%,0.19%,and 0.10%,respectively.Samples from SYT Fm are enriched in Li,V,Cr,Co,Zr,Cs,and U relative to Upper Continental Crust(UCC)and most of shale samples from YAS Fm are enriched in Li,V,Co,and U relative to UCC.The marine black shales are deposited in dynamic anoxic to oxic environment in upper Yangtze Plate,which indicated the seabed had already oxidized in the Cambrian Stages 2 and 3.The Chemical Index of Alteration(CIA)values ranged 51.84–79.46 indicate a warm and humid climate in the 2 stages.These findings are consistent with the region's paleogeography and previous studies.They hold significance for sedimentologists,paleontologists,and other researchers involved in petroleum geology.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
Understanding the relationships between human activities and hydrological processes is critical for sustainable water resources management, especially under the threat of increasing climate extremes. China's Lower...Understanding the relationships between human activities and hydrological processes is critical for sustainable water resources management, especially under the threat of increasing climate extremes. China's Lower Yellow River(LYR) region is one of the world's most water-scarce and human-impacted areas, yet comprehensive information on its water resources is lacking. This study adopted a water resources system(WRS) analytical framework to investigate the water crisis facing the region. The findings reveal that over the last decade, the system's resilience has been undermined by the combined impacts of climate aridification and intensified human interference. Specifically, a delicate balance between natural groundwater depletion and irrigation replenishment has been disrupted by a series of drought events since 2012. Increased groundwater extraction during droughts, coupled with an imbalanced allocation of surface water resources, has led to a persistent decline in water storage that has continued even after the droughts have ended. To mitigate future climate risks in the LYR,we recommend implementing more adaptive strategies, such as flexible water regulation policies and combined surface-groundwater management. Lessons from the LYR have important implications for other regions facing water resource challenges.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
A feasible criterion was established to determine the lower size limit of raw coal(d_(pRm))for efficient beneficiation in the air-fluidized bed with magnetite particles.The feasibility of using small magnetite particl...A feasible criterion was established to determine the lower size limit of raw coal(d_(pRm))for efficient beneficiation in the air-fluidized bed with magnetite particles.The feasibility of using small magnetite particles to accommodate the fine raw coal was demonstrated from the experimental perspective.The minimum size for the magnetite particles to be fluidized smoothly was clarified as 47.1μm,which corresponded to the border between Geldart-B and-A groups.Since the gangue and coal components in the raw coal were crushed into the same size,d_(pRm)depended on the greater one between d_(pGm)(minimum size required for the gangue particles to sink towards the bottom)and d_(pCm)(minimum size required for the coal particles to float towards the top).dpcm was determined as 259μm by supposing that provided the gangue particles accumulated in the lower half bed,they could be potentially extracted from the bottom.On the other hand,it was observed that the coal particles could always accumulate in the upper half bed.Under such circumstances,dpcm was revealed as 9.8μm since finer coal particles would be blown out by air before the 47.1μm sized magnetite particles became fluidized.Eventually,dpRm was clarified as 259μm,agreeing with the common view that raw coal coarser than 6 mm could be effectively beneficiated in the air-fluidized bed with magnetite particles.Additionally,the difficulty in beneficiating the fine raw coal was revealed to arise more from the remixing of sorted gangue particles than that of separated coal particles.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
Lower Paleozoic black shales are important source rocks worldwide.The Upper Ordovician-Lower Silurian Renheqiao Formation of the Baoshan Block is a low-maturity equivalent of the Wufeng-Longmaxi(WF-LMX)Shale of the Si...Lower Paleozoic black shales are important source rocks worldwide.The Upper Ordovician-Lower Silurian Renheqiao Formation of the Baoshan Block is a low-maturity equivalent of the Wufeng-Longmaxi(WF-LMX)Shale of the Sichuan Basin.However,organic matter(OM)characteristics in these low-maturity Lower Paleozoic shales are not well understood.In this study,50 Renheqiao Formation shale samples collected from seven outcrop sections and one drill core were investigated with organic petrology,organic geochemistry,R_(o)ck-Eval pyrolysis,N_(2) and CO_(2) adsorption,and scanning electron microscope(SEM)analyses to study the OM content,type,thermal maturity,and the development of OM-hosted pores in these Lower Paleozoic shales.The total organic carbon(TOC)content of the Renheqiao Formation shales varies,with the maximum content of 10.07 wt%.R_(o)ck-Eval pyrolysis results show that present OM in the Renheqiao Formation shales is Type IV kerogen,a result of advanced thermal maturation.Graptolite reflectance(GR_(o))ranges from 1.26%to 1.85%,and equivalent vitrinite reflectance(EqR_(o))converted from GR_(o) ranges from 1.08%to 1.51%,indicating that the studied Renheqiao Formation shales are dominantly within the late-mature stage.EqR_(o) based on R_(o)ck-Eval T_(max) shows large variations,which indicates that R_(o)ck-Eval T_(max) is not a reliable thermal maturity indicator for the Lower Paleozoic Renheqiao Formation shales.Caution should be applied when assessing the thermal maturity of high-maturity black shales based on T_(max) when the S2 values are too low.Organic petrographic observations show that OM in these shales is dominated by solid bitumen(>70 vol%of total OM),with minor contributions by graptolites and chitinozoans.The specific surface area and pore volume of shales are controlled by TOC content.Organic pores are hosted by solid bitumen and were not observed in graptolites when examined under the SEM.Although the Renheqiao Formation has a lower thermal maturity than the over-mature WF-LMX Shale,it is mature enough that primary oil-prone macerals have been thermally transformed and could not be identified under the microscope.展开更多
基金Supported by the Central Guided Local Science and Technology Development Fund Project for Science and Technology Innovation Base Construction,No.Guike ZY24212046National Natural Science Foundation of China,No.U22A2092+3 种基金Guangxi Education Science“the 14th Five-Year Plan”2024 Special Project“Research on Steam Education Practice in Rehabilitation Engineering”,No.2024ZJY304the Research Basic Ability Enhancement Program for Young and Middle-aged Teachers of Guangxi,No.2025KY2255the Innovation Project of GUET Graduate Education,No.2025YCXB010Natural Science Research Project of Guilin Life and Health Career Technical College,No.2025GKKY04.
文摘BACKGROUND The therapeutic role of neurodynamic mobilization in improving lower limb function in patients with mild post-traumatic knee osteoarthritis remains poorly understood.AIM To further elucidate the role of neurodynamic mobilization in facilitating knee joint functional recovery.METHODS Thirty-two patients with post-traumatic knee osteoarthritis treated at Chonghua Hospital of Traditional Chinese Medicine(Guilin)from March 2024 to August 2025 were randomly assigned to a control group(n=16)or an intervention group(n=16).Both groups received eight weeks of conventional treatment;and the intervention group additionally underwent neurodynamic mobilization.Outcomes including pain assessed by the visual analogue scale,active range of motion,Lysholm score,stork stand test,single hop test,and Y-balance test were assessed before and after the intervention.RESULTS There were no significant differences between the two groups in baseline characteristics,including gender,age,body mass index,or surgical side(P>0.05).Two-way repeated-measures analysis of variance demonstrated significant time×group interaction effects for the visual analogue scale score(F=13.364,P<0.05),Lysholm knee score(F=20.385,P<0.05),stork stand test(F=103.756,P<0.05),and Y-balance test score(F=8.089,P<0.05).CONCLUSION Neurodynamic mobilization effectively reduces pain,improves knee function,and enhances lower limb balance in patients with mild post-traumatic knee osteoarthritis.
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.
文摘Background Frailty is a major determinant of outcomes in patients with coronary artery disease(CAD)undergoing lower limb amputation.This study evaluates the impact of frailty on in-hospital outcomes in these patients.Methods We performed a retrospective analysis of the National Inpatient Sample(2016–2021)to identify adult patients with CAD who underwent lower limb amputation.Frailty was defined using the Johns Hopkins Adjusted Clinical Groups(ACG)frailty indicator.Multivariable logistic regression was used to assess the independent association of frailty with in-hospital outcomes,and propensity score matching(PSM)was performed to further account for confounding factors.Results After PSM,9,990 patients were included in each cohort.Frail patients experienced higher rates of in-hospital mortality(3.9%vs.1.5%,P<0.001),acute limb ischemia(3.8%vs.3.1%,P=0.015),fasciotomy(2.1%vs.1.4%,P<0.001),stump infection(7.9%vs.6.6%,P<0.001),cardiogenic shock(0.9%vs.0.7%,P=0.032),sudden cardiac arrest(2.7%vs.2.1%,P=0.004),mechanical circulatory support(0.3%vs.0.2%,P=0.028),major adverse cardiac and cerebrovascular events(7.7%vs.5.4%,P<0.001),and sepsis(18.3%vs.13.8%,P<0.001).In multivariable logistic regression analysis,frailty remained an independent predictor of inhospital mortality and major complications.Conclusion Frailty is independently associated with increased in-hospital mortality and adverse events among CAD patients undergoing lower limb amputation.Incorporating frailty assessment into preoperative evaluation may improve risk stratification and guide clinical decision-making in this high-risk population.
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Here we report a left cheek plate of Psarolepis,a postparietal shield of Youngolepis,a skull of Diabolepis,and a scale of Styloichthys from the Lianhuashan and Nahkaoling formations(Lochkovian,Lower Devonian)of Nanning,Guangxi.This marks the first report of Diabolepis and Styloichthys beside Qujing,Yunnan,and the latest occurrence of Psarolepis to date.The fossil community displays significant similarities to the Xujiachong Assemblage,and provides new data for the Lower Devonian stratigraphic correlation between southwestern China and northern Vietnam.Given the latest dating constraint based on the conodont evidence,we regard that the Xujiachong Assemblage has a much longer range than previously supposed,extending from the latest Lochkovian to the end of Pragian.We propose that the transition of the Nahkaoling and Lianhuashan formations in Nanning might correspond to the Guijiatun Formation in Qujing.The relatively large size of fish individuals from Guangxi is probably attributed to the increase in the oxygen content of the ocean.
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 National Natural Science Foundation of China(Nos.42130206,41302076)the Ministry of Science and Technology of the People’s Republic of China(MOST)Special Fund+1 种基金the State Key Laboratory of Continental Dynamics,Northwest University(No.201210128)the Major Scientific and Technological Projects of Changqing Oilfield(No.ZDZX-2021-03)。
文摘Early Cambrian organic-rich shales in the Yangtze Plate are key shale gas exploration targets in China,but their sedimentary environments are not well understood.This lack of knowledge complicates the evaluation of these targets and associated risks.Assessing shale depositional environments is also challenging due to the fine-grained nature of the sediments and subtle compositional variations.Herein,marine black shales of the Lower Cambrian Shiyantou(SYT)Formation(Fm)and Yu'anshan(YAS)Fm are investigated through a series of experiment,including thin sections,scanning electron microscopy,and major and trace elements analysis.Results show that five lithofacies can be identified in the SYT and YAS shales:(1)calcareous mudstone;(2)wavy-laminated sand,silt,and clay bearing mudstone;(3)laminated and massive mudstone;(4)planar-laminated pyritic mudstone,and(5)thin bedded sand and siltstone.Average content of major elements SiO_(2),Al_(2)O_(3),MgO,Fe_(2)O_(3),K_(2)O,CaO,Na_(2)O,TiO_(2),P_(2)O_(5),and MnO of SYT Fm are 57.03%,12.74%,4.20%,3.97%,3.93%,3.35%,1.09%,0.68%,0.28%,and 0.05%,respectively.Average content of major elements SiO_(2),Al_(2)O_(3),MgO,Fe_(2)O_(3),K_(2)O,CaO,Na_(2)O,TiO_(2),P_(2)O_(5),and MnO of Yu'anshan Fm are 54.93%,14.52%,5.26%,6.00%,3.77%,3.88%,0.15%,0.63%,0.19%,and 0.10%,respectively.Samples from SYT Fm are enriched in Li,V,Cr,Co,Zr,Cs,and U relative to Upper Continental Crust(UCC)and most of shale samples from YAS Fm are enriched in Li,V,Co,and U relative to UCC.The marine black shales are deposited in dynamic anoxic to oxic environment in upper Yangtze Plate,which indicated the seabed had already oxidized in the Cambrian Stages 2 and 3.The Chemical Index of Alteration(CIA)values ranged 51.84–79.46 indicate a warm and humid climate in the 2 stages.These findings are consistent with the region's paleogeography and previous studies.They hold significance for sedimentologists,paleontologists,and other researchers involved in petroleum geology.
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.
基金supported by the National Natural Science Foundation of China (Grant No. 42041007)。
文摘Understanding the relationships between human activities and hydrological processes is critical for sustainable water resources management, especially under the threat of increasing climate extremes. China's Lower Yellow River(LYR) region is one of the world's most water-scarce and human-impacted areas, yet comprehensive information on its water resources is lacking. This study adopted a water resources system(WRS) analytical framework to investigate the water crisis facing the region. The findings reveal that over the last decade, the system's resilience has been undermined by the combined impacts of climate aridification and intensified human interference. Specifically, a delicate balance between natural groundwater depletion and irrigation replenishment has been disrupted by a series of drought events since 2012. Increased groundwater extraction during droughts, coupled with an imbalanced allocation of surface water resources, has led to a persistent decline in water storage that has continued even after the droughts have ended. To mitigate future climate risks in the LYR,we recommend implementing more adaptive strategies, such as flexible water regulation policies and combined surface-groundwater management. Lessons from the LYR have important implications for other regions facing water resource challenges.
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.
基金supported by Shandong Provincial Natural Science Foundation(ZR2023MB038)Youth Innovation Team Program of Shandong Higher Education Institution(2022KJ156)。
文摘A feasible criterion was established to determine the lower size limit of raw coal(d_(pRm))for efficient beneficiation in the air-fluidized bed with magnetite particles.The feasibility of using small magnetite particles to accommodate the fine raw coal was demonstrated from the experimental perspective.The minimum size for the magnetite particles to be fluidized smoothly was clarified as 47.1μm,which corresponded to the border between Geldart-B and-A groups.Since the gangue and coal components in the raw coal were crushed into the same size,d_(pRm)depended on the greater one between d_(pGm)(minimum size required for the gangue particles to sink towards the bottom)and d_(pCm)(minimum size required for the coal particles to float towards the top).dpcm was determined as 259μm by supposing that provided the gangue particles accumulated in the lower half bed,they could be potentially extracted from the bottom.On the other hand,it was observed that the coal particles could always accumulate in the upper half bed.Under such circumstances,dpcm was revealed as 9.8μm since finer coal particles would be blown out by air before the 47.1μm sized magnetite particles became fluidized.Eventually,dpRm was clarified as 259μm,agreeing with the common view that raw coal coarser than 6 mm could be effectively beneficiated in the air-fluidized bed with magnetite particles.Additionally,the difficulty in beneficiating the fine raw coal was revealed to arise more from the remixing of sorted gangue particles than that of separated coal particles.
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.
基金supported by the project of“Shale Gas Resources Investigation and Evaluation in the Baoshan Block”from Sinopec Exploration Company and the National Natural Science Foundation of China(41925014 and 42172192)。
文摘Lower Paleozoic black shales are important source rocks worldwide.The Upper Ordovician-Lower Silurian Renheqiao Formation of the Baoshan Block is a low-maturity equivalent of the Wufeng-Longmaxi(WF-LMX)Shale of the Sichuan Basin.However,organic matter(OM)characteristics in these low-maturity Lower Paleozoic shales are not well understood.In this study,50 Renheqiao Formation shale samples collected from seven outcrop sections and one drill core were investigated with organic petrology,organic geochemistry,R_(o)ck-Eval pyrolysis,N_(2) and CO_(2) adsorption,and scanning electron microscope(SEM)analyses to study the OM content,type,thermal maturity,and the development of OM-hosted pores in these Lower Paleozoic shales.The total organic carbon(TOC)content of the Renheqiao Formation shales varies,with the maximum content of 10.07 wt%.R_(o)ck-Eval pyrolysis results show that present OM in the Renheqiao Formation shales is Type IV kerogen,a result of advanced thermal maturation.Graptolite reflectance(GR_(o))ranges from 1.26%to 1.85%,and equivalent vitrinite reflectance(EqR_(o))converted from GR_(o) ranges from 1.08%to 1.51%,indicating that the studied Renheqiao Formation shales are dominantly within the late-mature stage.EqR_(o) based on R_(o)ck-Eval T_(max) shows large variations,which indicates that R_(o)ck-Eval T_(max) is not a reliable thermal maturity indicator for the Lower Paleozoic Renheqiao Formation shales.Caution should be applied when assessing the thermal maturity of high-maturity black shales based on T_(max) when the S2 values are too low.Organic petrographic observations show that OM in these shales is dominated by solid bitumen(>70 vol%of total OM),with minor contributions by graptolites and chitinozoans.The specific surface area and pore volume of shales are controlled by TOC content.Organic pores are hosted by solid bitumen and were not observed in graptolites when examined under the SEM.Although the Renheqiao Formation has a lower thermal maturity than the over-mature WF-LMX Shale,it is mature enough that primary oil-prone macerals have been thermally transformed and could not be identified under the microscope.
